How to Handle Cyberbullying in the Nursing Unit

October is National Bullying Prevention Awareness Month, highlighting the dangers of bullying in all settings.

The following was adapted from an excerpt of Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young and Each Other by Kathleen Bartholomew, RN, MN, which explores the dangers of cyberbullying in the nursing unit.

Facebook boasts more than 1.86 billion monthly users worldwide, with more than 40% of Americans logging in every single day. In 2007, Twitter reported 5,000 tweets a day; and in only six years, tweets jumped to more than 400 million. Ten years later, in 2017, we tweet 6,000 tweets per second. Without a doubt, we have entered the digital world—one which has gotten more than a few nurses into trouble:

• Fifteen nurses received letters of warning from their State Board of Nursing after they were reported by their nurse executive for “liking” a derogatory comment that one nurse posted about a husband who was uncaring and unsupportive during childbirth. They did not heed the first warning.
• A nursing student was dismissed from the program after taking a picture of herself holding an unidentified placenta and proudly commenting how thrilled she was to assist at her first birth.
• A group of nurses who were friends started a conversation on Facebook which included several disparaging comments about a nurse they didn’t like, as well as remarks on the safety of the organization’s staffing levels.

We talk to each other on online chat rooms in casual conversations that feel so real we forget that no discussion in this virtual world is ever private. Every one of the nurses in the above situations had no idea that they were violating professional ethical guidelines by breaching confidence.

While it is generally accepted that we cannot speak about our patients, even anonymously, many nurses do not realize that it is also not professional to speak about a coworker. According to the National Council for the State Board of Nursing policy on Social Media, any online comments posted about a coworker may constitute lateral violence; even if the post is from home during non-work hours. Communication modes for cyberbullying include: instant messaging, email, text messaging, bash boards, social networking sites, chat rooms, blogs, and even Internet gaming.

Nurses often fail to realize that deleting a comment does not erase it. Talking about coworkers is unprofessional and contrary to the standards of honesty and good morals (moral turpitude). Depending on the laws of a jurisdiction, a Board of Nursing may investigate reports of inappropriate disclosures on social media by a nurse on the grounds of:

• Unprofessional conduct
• Unethical conduct
• Moral turpitude
• Mismanagement of patient records
• Revealing a privileged communication
• Breach of confidentiality

Guidelines for nurses victimized by cyberbullying

Save all evidence. Copy messages or use the “print screen” function. Use the “save” button on instant messages.

First offense. Ask to speak to the person in private and bring a copy of the evidence. Use the D-E-S-C communication model.

• Describe: “I was on Facebook yesterday and my friend sent me this post because it was about me.”
• Explain the impact: “I was really surprised because I had no idea that you didn’t like working with me, or that that was the reason you switched weekends.”
• State what you need: “No one is perfect. Next time could you come to me privately and let me know if you are having any issues so that we can work together to resolve them?”
• Conclusion: “I am willing to learn how we can be more mutually supportive of each other for the sake of our relationship, our team, and our patients.”

Document the conversation and the outcome.

Second serious offense: Report to manager (if not serious, try a mediated conversation).

Third serious offense: Report to the chief nursing officer.

Manager guidelines

Verbalize that no bullying or hostility of any kind will be tolerated, including online.

Set the expectation that all staff are responsible for monitoring their virtual world. Don’t assume the parental or vigilante friend role.

Educate staff on standards and policies, and provide examples.

• National Council of State Board of Nursing Guidelines
• Hospital/organizational policy (including use of hospital computers, cell phones, etc.)
• Review common myths. Use case studies from NCSBN YouTube.

Be supportive of online targets and take derogatory online comments seriously.

Source: Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young and Each Other