It has been clear for some time just how much potential social media sites, blogs and online forums have for supporting conversation and sharing opinions, but the dilemma of whether to remain anonymous when participating is still one that faces many people who would otherwise get involved without hesitation.
The fear of raising concerns has been well justified in recent times, reinforced by many stories of nurses who spoke up and faced repercussions rather than protection. The Freedom to Speak Up review attempts to normalise the process of raising concerns, and recommends that “staff should be encouraged to raise concerns informally”. The online world remains a controversial place for raising concerns, especially as specific identifying information cannot be communicated via public online channels.
Remaining anonymous or using a pseudonym when participating online offers a perceived safety net for some who are fearful of potential repercussions. In a recent #NurChat discussion, the two most feared consequences of using a real name in online discussions were stated as bullying and “trolling”. Being misunderstood and not having the chance to elaborate on a comment were also highlighted as possible pitfalls, but those can often be avoided by thoughtful consideration before posting.
In real life, when discussing an issue with a colleague or peer, the aim is to be as objective as possible and come to a well-reasoned conclusion, even if it’s respectful disagreement. By removing the name of the individual, the validity of the comments are diminished.
The removal of abusive or threatening comments from the online world does not yet have the profile it should in the media, but we are increasingly seeing action against people who perpetrate this type of behaviour. A quick online search shows many examples of convictions and even jail terms for the worst offenders. While using a real name online can, in extreme circumstances, result in such action, the impact of not using a real name is felt in the authenticity of the discussion. Knowing how to handle any type of negativity that’s directed unconstructively can empower individuals to be less fearful of using their real name online, but the tools and tactics available are not widely publicised enough.
There should be no difference in the nature and potential validity of professional discussions, no matter whether they take place in the physical or virtual world. The discussion of best practice, the debate of current issues and the sharing of individual experiences should be as valid online as they are offline, but this can only be fully realised when there is truly no difference between an individual’s online and offline behaviour.
Taking the professional approach to participating in an online discussion can bring benefits both for the individual and the wider healthcare community. Sharing knowledge and experience through these open channels has seen debates on the findings of Sir Robert Francis QC, revalidation of the Nursing and Midwifery Council’s code of conduct and end-of-life care attract participants from across the healthcare sector - both student and qualified - to share their expertise, express their opinions and learn from each other.
As a platform for discussion, social media has a significant role in the future of the healthcare debate. The absence of any organisational hierarchy gives individuals the chance to connect and communicate with leaders who may otherwise not be accessible, and vice versa. Social media channels for NHS Change Day in 2014 achieved 500,000+ pledges - a staggering example of their potential.
Donna Mullikin is lead nurse for #NurChat and Newcross Healthcare Solutions