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'Anonymity online is ‘safe’ but can hinder a discussion’s validity'


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


Readers' comments (8)

  • michael stone

    '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.'

    I don't understand why the validity of an 'analysis' should be diminished by its author being anonymous: unless readers wish to inappropriately judge the quality of an analysis by the reputation of its author, as opposed to [correctly] judging 'the validity of an analysis by its own internal qualities'.

    By coincidence, I mentioned that most posts on NT are anonymous during a discussion [about something else, but some confusing inserts from FaceBook introduced 'labels'] at:

    Jan Burns commented:

    mmm Mike I wonder so many people enter posts using the name Anonymous is it fear? is it cowardice? is it safety? who knows only the people who use the name.

    It moved on with me:

    Hi Jan,

    Judging from the posts on Nursing Times about nurses who has raised a concern and then been 'bullied and harassed' by their colleagues or 'the NHS organisation they work for', I would say that fear of 'criticising my boss' is a major factor. Although some people have probably also experienced 'general online bullying' as well.

    I don't like 'cowardice' - you shouldn't NEED to be brave to raise a legitimate concern, in my opinion, so if the process 'requires bravery' something is badly wrong !

    Then Jan:

    No Mike you shouldn't need to be brave to raise a legitimate concern but it is my experience that unfortunately a great deal of bravery is needed for some. One of our Dignity do's is that people should feel free to complain without fear of retribution - how many people say don't say anything!!! Yes maybe the term cowardice is not likeable I will think about that.
    I would still maintain that the culture and leadership of an organisation needs to be healthy and positive to facilitate people being able to work in a non blameworthy environment - learning organisation.

    So some themes this NT article has pointed at.

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  • Any action will generate a consequence.If something is questioned then the questioner must be prepared for the consequence,whatever that may be.Its something any professional person should be capable of,if not they should have a job that wont put them under any pressure.

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  • people wish to be anonomous, freedom of speech is not allowed

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  • People should not be labelled cowards as life is more complicated than categorising. There are many reasons for not speaking up.

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  • Most people won't speak up because they are intimidated by the bullying culture that dominates middle management in the NHS. And we all know which profession dominates middle management. We don't look after each other. Some tend to defecate on others in order to climb the greasy pole. There are so many of us, but we are so easily divided and are led by sycophants into being put down and kept in check. No wonder people preserve their anonymity.

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  • as a matter of professionalism some may not wish to have their name, user name or account associated with them on any site, yet the may still wish to comment and are offered this option. it is not there for no reason! peoples' personal choices must be respected whatever their reasons which they are under no obligation to disclose to other readers. Furthermore,, it is the content of the comments that is important and also has the potential to lead to further discussion - not made so easy by this site - cf the Disqus model.
    somebody try explaining that to critics such as Michael stone who needs to show more respect for other commentators and show a little maturity.

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  • michael stone

    Anonymous | 4-Apr-2015 11:38 am

    I am not a critic of 'it is the content which is important' and I'm certainly not a critic of '[leading to] further discussion'.

    Not for the first time, I am being traduced anonymously on NT !

    But at least I'm used to that, by now !

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  • I feel very strongly that it is the CONTENT of any comment that should be reviewed seriously - the ID is totally irrelevant, though mention of relevant experience may be important.

    Like it or not, we all tend to be more supportive of people with whom we share commonality. The viewing of a person can in other circumstances, say courts or selection of those to receive medical treatment, lead to the favouring of some people judged on their appearance and their perceived similarities to ourselves.

    Those who are very clever and successful at being deceitful normally have carefully refined their presentation and are very plausible.

    As one who had false allegations made against me, with the potential for a rigged criminal conviction to occur, I cannot recommend the use of one's own name. Only when the bully cultures rife in some areas have been effectively dealt with (not just talked about) can we sensibly identify ourselves.

    To achieve this, everything possible to support the call for NHS Senior Managers to undergo regulation and checks in the same way that doctors and nurses do, needs to be done.

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