Keeping it personal: Professional boundaries on Facebook
Thank you to the College of Registered Nurses of British Columbia for permission to adapt their case study.
The post immediately catches Kiera's eye. A new mom is describing her four-month-old's persistent barking cough and is asking a mom and baby Facebook group for advice.
This post is different from the usual chat about deals on used strollers and baby food recipes. As a new mom herself, Kiera enjoys the support the group provides, but as a nurse, this post raises a red flag.
Kiera knows a persistent, barking cough could be a symptom of something serious. When others begin responding with home remedies — and no one suggests taking the baby to a health-care professional — her concern grows. Kiera has neither seen the baby nor spoken directly to the mom and isn't sure how serious this might be. Should she give advice or say nothing?
As a public health nurse, Kiera feels she should comment but is uncertain about her professional boundaries in the situation. She wants to keep her personal and professional lives separate. She joined the group as a new mom and her profile doesn’t mention that she’s a nurse. However, she lives and works in the same small community as many of the group members.
What are the risks?
- The mom may not have the information she needs to make an informed decision about the care of her baby.
- Some of the suggested home remedies are potentially dangerous.
- Saying nothing may put the baby at risk.
- Giving nursing advice may create a nurse-client relationship (and a duty to provide care).
- If Kiera is known as a nurse, her status within the group may change from "new mom" to "nurse".
What do the standards say?
Kiera consults Professional Boundaries for Registered Nurses: Guidelines for the Nurse-Client Relationship for guidance. She’s reminded that keeping her professional and personal relationships separate in her small community requires caution and professional judgement. She wants to make sure she isn't perceived as beginning a professional relationship with this mom and her baby by offering nursing advice, but also recognizes that the baby’s safety and well-being are a priority.
What does she do?
Kiera considers her options carefully. After calling a trusted colleague and discussing the situation, she private messages the mom on Facebook. "You seem concerned about your baby’s cough. Trust your instincts; if it worries you, it should be taken seriously. Have you thought about talking with your physician or calling 811(AB Health Link) and speaking with a registered nurse? Both have expertise in this area and can give you safe advice."
Armed with these resources, Kiera feels this new mom can get the information she needs to make an informed decision about her baby’s care. Kiera's also confident she hasn't blurred the boundary between a personal and professional relationship.
Disclaimer: Our case studies are fictional educational resources. While we strive to make the scenarios as realistic as possible, any resemblance to actual people or events is coincidental.