10 Things: Social Media Use for Forensic Clinicians

{Note: this post doesn’t discuss the use of social media for professional purposes, only personal ones. We’ll address the professional use of social media, such as crowd-sourcing clinical information, at a later date.}

A favorite topic of conversation here at FHO continues to be the use of social media by forensic clinicians. In my travels I have seen my fair share of what I would consider to be questionable or even inappropriate comments on social media, and during testimony workshops, I definitely field a number of questions related to this issue. I have created a short course on personal use of social media (which I may publish in the future), but in the meantime, I’ve created a 10 Things list to help provide some guidance:

1. Don’t feel like you have to give up social media use just because you do this work, but understand its potential impact on your career (and other aspects of your life). Our lives on social media may only portray a fragment of our thoughts or feelings on any given subject, but social media, and how people read into your social media feeds, isn’t about nuance. Jon Ronson, who wrote a book on public shaming and social media’s role, said: “The way we are defined on social media…has become more important than who we actually are as people because everybody you date is going to Google you. Every time you apply for a job people are going to Google you. So these false definitions, these scant parts of your life, these tiny moments, the most extreme thing you did, as opposed to the 25 billion ordinary things that you did, have now become more important ways of defining you than who you actually are.”

2. Boards of Nursing have an interest in our social media use. A 2012 article reviewed the nature of related Board complaints. Note that some of these are a bit ambiguous, meaning that things like “boundary violations” are open to interpretation:

  • Breach of privacy or confidentiality against patients
  • Failure to report others’ violations of privacy against patients
  • Lateral violence against colleagues
  • Communication against employers
  • Boundary violation
  • Employer/faculty use of social media against employees/students

If allegations of misuse of social media are found to be true, the nurse may face disciplinary action by the BON, including a reprimand or sanction, assessment of a monetary fine, or temporary or permanent loss of licensure. (See also: White Paper for definitions and guidance). Civil and criminal penalties are also possible. Check to see what your own State Board has to say on the topic, if anything (e.g.).

3. Physicians are not exempt from reprimands and Board complaints for social media use, and specific guidance exists.

4.  Regardless, many professional organizations view social media use as being more than just compatible with our role as healthcare providers: “Social networking can be a positive tool that fosters professional connections, enriches a nurse’s knowledge base, and promotes timely communication with patients and family members.” (ANA, 2012). Clinicians should feel free to embrace social media, but programs should have policies that help define expectations. If your parent organization has one, great–make sure you review it, adopt it (if it gets the job done), and distribute to every member of the team (including your Medical Director). Program managers–if there’s no policy in place, it’s incumbent upon you to create one. Every forensic clinical program should have a social media policy, regularly reviewed and updated. Examples of policies that can be adapted or used as a template can be found here, here, here, and here. (And there are many others–if you have a good one that you’d be willing to share, I’d love to see it.)

5. There is no such thing as privacy online. I promise you. No matter how stringent your privacy settings are on your accounts, it only takes one person with access forwarding something you’ve posted to others to expose your private online activities. Don’t lull yourself into thinking you can keep online information contained. You can’t.

6. There is also no such thing as delete. Information is cached online, even when you think you’ve gotten rid of it. For example, many years ago, I made the switch from my old URL to the current one, and migrated everything to a new platform. I “deleted” the old one. And yet, I still can pull up pages from the previous site. Many things may not stand the test of time, but tweets and Instagram posts will.

7. In our line of work, you can’t truly de-identify a patient enough for social media, so just don’t try it. Keep all patient information out of your social media feeds. Seems obvious, but it happens, even if it’s an innocuous Instagram photo at work that happens to have a board with patient names in the background. There’s a difference between what a patient chooses to share vs what a healthcare organization chooses to share with the patient’s consent vs a nurse or physician’s ability to share. These 3 things are not equal.

8. Disparaging a co-worker or your employer online is also problematic, even if they are never identified. It speaks to a lack of professionalism, which is never a good look on anyone. Don’t be that guy. My general rule of thumb is if you wouldn’t be comfortable saying it to someone’s face, don’t post it. Need to vent–do it one on one with a person you trust.

9. People have asked me how I use social media accounts when getting ready for trial. The answer is, I don’t, generally, at least not with anyone that has reached out to connect with me personally on any number of social media platforms, whose information would otherwise be inaccessible to me. To do so feels a bit exploitative, and I don’t like the way that feels, so I avoid doing it. But that’s me. Others may have a very different perspective on it, so be prepared for that possibility (and consider how you might answer questions about what’s in your social media feed that may imply things like bias or unprofessional behavior). Btw, I don’t have the same qualms about information that is publicly available (meaning no friend or contact request is needed to access the information). For those of you who have considered it, specifically friending someone on social media for the purpose of using it in court is ethically shady (our attorney colleagues have called it straight up unethical). I don’t know of any healthcare standards that have said this kind of behavior is verboten, but I think we all know it’s a lousy practice.

10.) This topic is a good one for a staff meeting or a component of a professional development day. If you’re looking for some resources apart from the ones already mentioned here, let me suggest a few:

Social Networking Principles Toolkit (ANA)

A Nurse’s Guide to the Use of Social Media (NCSBN)

Ethics in Practice for Registered Nurses (Canadian Nurses Association)

Professional Guidelines for Social Media Use (AMA Journal of Ethics)


{What else should be included that I haven’t touched on here? Feel free to add your two cents in the comments below.}


Sexual Assault Nurse Examiner Expert Witness Training

Generally, I don’t post live events here, but seeing as this is one of my very favorite courses to teach…

Once again we are putting on the Sexual Assault Nurse Examiner Expert Witness course at the National Advocacy Center in Columbia, SC. It will be held July 12-14, and is open to both SANEs and prosecutors. Priority will go to those working in Indian country; regardless, if you are at all interested in this topic, I encourage you to apply. The conversation at the course is always fantastic, and it’s experiential  (which means you’ll be testifying, in a courtroom with a prosecutor, defense counsel, and a judge). Nominations for the course are due May 5th. This is a free training, and if you’ve never been to the NAC, I can’t say enough about what a stellar location it is.

Feel free to email me if you have questions…


Since Last We Spoke, 4-24-17

Happy Monday, all (or as we like to refer to it in my house, Happy 1st Full Week at Home Since Mid-February). The trial I had in the great north went away, so here I am, in my pajamas, eating breakfast not from a sad hotel buffet. It’s glorious. It’s going to be an odds and ends kind of week here–still so much writing to get done, and sadly, a million other things to distract me. Like the interwebs–let’s see what’s caught my eye since last we spoke:

I did not make it to the science march, did you?

Related (I heart Neil deGrasse Tyson)

Great op-ed

Why are men terrible at apologizing?

Guns in abusive relationships–a problem even when they’re not fired

(Full-text of the aforementioned study)

FGM, here in the US


Shuffling offenders from one gig to the next (have you been tracking this story?)

Disheartening, but not surprising (like so much of our world)

Strides we’ve made in the military are facing some significant threats from the top

Funny and not (also like so much of our world)

Cannot ignore the impact of history on health

Finally, a little levity


A Note About Sending Questions or Requests

I love receiving questions and requests from FHO readers via my Contact page, and I am more than happy to answer. However, if you want me to respond, it has to include more than just a subject (e.g. “sexual assault injury” or “child abuse statistics”). I won’t respond to requests like that (one, it’s an enormous topic area, and two, it helps to know the specifics of what you need and how it’ll be used so I can tailor appropriately).

Additionally, as I think most people know, FHO is my hobby, not my job. So if you send me a request that has multiple parts, and much of it can be found on this site, I will most likely refer you back here first, and then if you can’t find what you’re looking for, assist from there. Again, this is for the sake of expediency. As you might guess, I receive a lot of requests and questions every week, so I need to be as efficient as possible in answering. This isn’t me complaining (FHO readers have always been shy in posting comments, so most of what I hear from you all is via email), but it is about making sure I am both responsive to FHO readers while also managing my hectic schedule.

Finally, if you want me to contact you for some reason, you will need to be pretty specific. Generally speaking, I don’t respond to blind requests for calls and emails.

Thanks and have a lovely weekend {I plan on it–I’ll be home in DC puttering in my garden 🙂 }


School-Based Health Services for Adolescent Dating and Sexual Violence

Futures Without Violence is hosting a webinar next week on school-based health services, adolescent health and anticipatory guidance for dating and sexual violence and harassment. The session will be April 27th at 6:30pm ET (yes, it’s a late one). From the announcement:

Teens experiencing relationship abuse are more likely to report unhealthy diet behaviors, engage in substance abuse, and report having suicidal thoughts. Given these sobering facts, adolescent relationship abuse is a major health concern facing teens today, and health care providers have a unique role to play in preventing it. Not only can they provide valuable prevention messages to help their patients build healthy relationships, but medical professionals are also uniquely positioned to help those exposed to abuse access the resources they need.

Clinical settings that serve adolescents in particular, such as confidential teen clinics and school health centers, are strategic sites for adolescent health promotion, prevention, and intervention. Unfortunately, the standard-of-care within adolescent health settings does not currently include specified protocols to assess for or intervene to reduce dating and sexual violence and harassment. This webinar will provide participants with strategies and tools to provide universal education on safe, consensual and healthy relationships, as well as models for trauma-informed responses to disclosure of DSV.

(My one wish for Futures Without Violence is that they would publicize their events a little sooner, but alas, here we are, another intriguing topic with not much notice.)

Articles of Note Uncategorized

Articles of Note, April 2017 Edition

Time once again for Articles of Note, our monthly romp through the newly published, peer-reviewed journals. This month, lots of good stuff related to sexual assault, including some interesting new research around genital injury. Definitely one of the better months, IMHO. As always, I am posting the Word doc with active links, and the printable PDF (perfect for handing to hospital librarians if they still exist in your institution). Note the always present caveat–please attribute appropriately if you choose to use the information in your own work.



Vicarious Trauma Toolkit

OVC has just published a vicarious trauma toolkit, and there’s a lot here that may be useful to you in both your work as forensic healthcare providers and in other aspects of your clinical life. I have only just started to work my way through it, and there are some things that appear to be absent (healthcare providers other than EMS don’t get specific focus, and that’s unfortunate), but there are definitely tools that are valuable, as well (see, for instance, the organizational readiness guide or their compendium of resources). Worth your time.


Since Last We Spoke, 4-17-17

These last 6 weeks make me feel like I have been neglectful, so it’s great to be back among my FHO readers. London was a blast, albeit a fast one, and I definitely feel recharged and ready to return to my previously scheduled life. Which is good, because I hit the ground running. Many of you are in Orlando this week at EVAWI, but alas, I cannot join you there; I’ll be in Philly with many of my favorite lawyers, teaching for the Army. In any event, time off affords one the ability to peruse the interwebs at length, so here’s what’s caught my eye since last we spoke:

Cleveland, my heart breaks

Love seeing our colleagues’ good work in the news

The One-Sided Gun War of the Sexes

Marine Corps needs to address their misogyny problem

Good for DC

Giving new meaning to moble clinics

Also, Nevada

This totally resonated with me (for obvious reasons)

Calculated misery

Finally, one of the best things we did in London was catch the West End production of Kinky Boots (and were lucky enough to have the Olivier-winning actor who plays Lola still in the cast). If you have the opportunity to see it, I highly recommend. We all *loved* it. This was one of the best numbers by far:

Sexual Assault

State by State Syphilis Rates

[First things first: I am taking some much-needed vacation next week after a very long March. FHO will be dark while I’m off. I promise to pick back up Monday, April 17th with a new Articles of Note, among other things.]

April isn’t only #SAAM, it’s also Child Abuse Prevention Month and Sexually Transmitted Disease Awareness Month. In that vein, a new MMWR article on state-specific primary and secondary syphilis rates that’s worth your attention. Always critical to be familiar with incidence and prevalence of STDs in our communities. BTW–contrary to the title of the article, the statistics reviewed are not exclusive to men who have sex with men, as you’ll see once you scroll down.

Sexual Assault

Building an Effective SANE Program

Apologies for missing the 1st half of the week, but I had my hands full with our Leadership Training and Lobby Day, which was a fantastic couple of days. And now, seeing as April is Sexual Assault Awareness Month, a totally appropriate posting for the 1st one I’m managing this #SAAM2017. And featuring my friends, no less. OVCTTAC is sponsoring a Q&A with Susan Chasson and Jennifer Pierce-Weeks on building an effective SANE program. The session will be held April 19th at 2pm ET.  From the registration:

Providing comprehensive health care to survivors of sexual assault is critical to minimizing the long-term consequences of this traumatic experience. That is where a Sexual Assault Nurse Examiner (SANE) can help. This session will focus on how to start or improve a SANE program in your community with OVC’s SANE Program Development and Operation Guide. Now available online at