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Association may expel nurse over social media posts

Carolyn StromREGINA – As a result of criticisms on Facebook she made about the nursing care her hospitalized grandfather received, a Saskatchewan registered nurse is facing expulsion from the Saskatchewan Registered Nurses’ Association.

Carolyn Strom (pictured), a registered nurse in the Prince Albert Parkland Health Region, was charged by the association with professional misconduct, the Regina Leader-Post reported. She pleaded not guilty in a two-day hearing in Regina.

Strom said she is passionate about healthcare and often initiates social media discussions on the subject. She also said she never intended to hurt anyone’s feelings when she wrote a Facebook post on Feb. 25, 2015, addressing the care her grandfather received at a Macklin, Sask. long-term care facility.

“I use Facebook to generate discussion,” said Strom. “I like to learn, and that’s why I ask questions, too.”

Her post linked to a Vancouver Province article about palliative and end-of-life care, and referenced her grandfather’s end-of-life care at St. Joseph’s Health Facility, where he’d died a month before.

She wrote that not all staff seemed “up to speed” on end-of-life care and cautioned families with loved ones at St. Joseph’s to “keep an eye on things and report anything you do not like.”

The SRNA investigation committee called six witnesses – all RNs – four of whom still work at St. Joseph’s and believe the post tarnished their reputations and that of the facility.

Strom testified in the SRNA’s first disciplinary hearing related to social media.

Strom said her family had concerns, which they reported to staff, regarding her grandfather’s care – specifically a “feeding situation,” referenced only in passing during the hearing.

Strom’s grandparents, who were both residents of St. Joseph’s, cannot be named due to a publication ban.

The SRNA alleges Strom’s Facebook post violated her grandparents’ confidentiality as per the Health Information Protection Act; that she failed to employ proper channels in complaining about St. Joseph’s staff; she negatively impacted St. Joseph’s reputation; she failed to obtain all of the facts; and she used her RN status for personal purposes.

Strom said the post was never meant as an attack on the staff and it does not name any individual staff member.

“I do feel badly that it was interpreted in this way. That was never my intent,” she said. Strom said she frequently uses Facebook and Twitter to discuss healthcare.

In the last year, her tweets include personal messages (about Nurses’ Week and Saskatchewan Change Day – the Health Quality Council’s initiative to engage healthcare workers in improving their industry), newspaper articles and opinions relating to long-term care, and concern for the “culture of fear” in speaking out.

“I do feel that people are afraid to speak out,” said Strom, who began her nursing career in 2004.

She said she’d hoped her Facebook post would encourage family members of long-term care residents to speak up when they see something is wrong.

She said she meant to encourage healthcare workers to put themselves in the families’ shoes: “You are on the other side of that care,” Strom said. She said RNs have a duty to advocate for better care.

Strom maintains she did not breach patient confidentiality because her grandfather was not her patient.

“He was not my client,” Strom said. “He was my family member … I don’t believe that what I said on Facebook breached confidentiality on his behalf.”

SRNA lawyer Roger Lepage pointed out she disclosed her grandfather’s name, place of residence and the fact he was in palliative care – a violation of the Canadian Nurses’ Association code of ethics and HIPA, Lepage said.

“It was also public information,” said Strom – his name had been in the newspaper multiple times and people in the community knew him. “What I revealed was not confidential.”

Lepage asked if Strom had her grandfather’s permission in disclosing his information. “He had died, so I didn’t have a chance to ask him,” she answered and began crying.

Strom said multiple times that she wrote the post not as a nurse, but as a granddaughter. As a result, Strom’s lawyer Marcus Davies asserted, the code of ethics should not apply.

If Strom is found guilty, the ultimate penalty would be her expulsion from the SRNA, which would forbid her from working as a registered nurse in Saskatchewan. Closing arguments are scheduled for March 3.

According to a report by CBC News, Davies said Strom had agreed to a sentence which included writing five different essays for the SRNA on social media and ethics, but when presented with a statement of facts by the association, Strom refused to sign the document.

Davies said when Strom countered with a statement of facts that she believed to be true, the SRNA refused it, taking the matter to a public disciplinary hearing.

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3 Comment responses

  1. Avatar
    February 18, 2016

    Professional misconduct?
    Shame on the SRNA
    Just another example of how the patient confidentially law is subverted to protect institutions instead of patients.
    Every organization can be improved and St. Joseph’s should be thanking Strom instead of leading the charge to have her made an example of for speaking out.

    Reply

  2. Avatar
    February 18, 2016

    Agreed. Whether as professionals or concerned loved ones, we have all witnessed questionable levels of care in primary, acute, rehab, long term and end-of-life care. I applaud Ms. Strom for taking the stand she did, and think the SRNA she consider offering her a position around best practice and it’s implementation, not taking a nurse willing to stand up for the vulnerable out of the profession.

    Reply

  3. Avatar
    February 19, 2016

    Wow. SRNA just soiled the bed in the relationship with their constituents. The ultimate outcome of the case, as described here, will just serve to cement the public’s perception of the nursing and medical profession as a closed caste, and build mistrust in the same way as police are often perceived (e.g. protect your own, public’s interests be damned).

    Sure, a hearing was warranted — but it should have been treated as a mutual learning opportunity — not a show of force.

    Reply

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