Today’s correspondent says:

I have noticed an increasing trend on some social media channels (particularly a Facebook paramedic group) an increasing incidence of Paramedics requesting assistance or contacts for specific crews. Examples include “I’ve got an uncle/friend/relative in ED and we’re not getting any information. Can someone contact me, so you can let us know what’s going on?” Another is “I’m trying to contact the crew who attended xyz job the other day in abc location. They did a great job and we / family / neighbours just want to thank them / gather some more information about what happened on-scene.”

These are just examples, but I’m wondering whether they breach the Social Media guidelines as set by AHPRA and/or the Code of Conduct?

The website of the Paramedicine Board has a page on Social media: How to meet your obligations under the National Law (November 2019). There they say:

Inappropriate use of social media can result in harm to patients and the profession, particularly given the changing nature of privacy and the capacity for material to be posted by others. Harm may include breaches of confidentiality, defamation of colleagues or employers, violation of practitioner–patient boundaries or an unintended exposure of personal information to the public, employers, consumers and others. Information stays on social media indefinitely. Information published on social media is often impossible to remove or change and can be circulated widely, easily and rapidly. Therefore, it’s important that you are very careful about what you like or post online-regardless of where in the world the site is based or the language used.

It’s hard to see how the questions identified by my correspondent lead to harm unless they identify too much material about the incident or the patient.  For example, a paramedic who said ‘my mother’s friend was treated at xyz nursing home for abc condition and I heard the doctor failed to do 123.  Can the paramedic crew who treated her contact me?’ Paramedic practitioners ‘must display a standard of professional behaviour that warrants the trust and respect of the community’ [Code of Conduct Principal 8] and divulging what a paramedic knows, or should know, is confidential information may be in breach of that obligation because the mother’s friend should be able to expect a registered health professional to respect their privacy, even if they did not ever treat the patient.

The real issue is not asking for that sort of information but answering it.  The Paramedicine Board gives the following example of an inappropriate use of social media:

A mother posts an update about her daughter’s admission to hospital, following a car accident. The mother tags her friend, a health practitioner, who happened to be on the ward the night the daughter was admitted. The tag is complimentary about the care received at the hospital. The nurse responds publicly to the comment, thinking it was a private message and inadvertently provides information about the daughter’s recovery and the status of the other passengers in the car.

Parents of the other passengers make a formal complaint about the privacy breach.

A paramedic has to be careful about giving information about ‘an uncle/friend/relative in ED’ or ‘giving more information about what happened on-scene’ but that is true whether they are giving that information privately or on the social media platform where the question was asked.  Regardless of where the answer is given, to provide details of a patient’s care to someone other than the patient or other treating practitioner would be a breach of confidence (Code of Conduct [3.3]).  The person may ‘not [be] getting any information’ because the information is confidential, and they are not entitled to that information.  The paramedic could not determine, via social media, whether the person asking was the patient’s legal guardian, person responsible or otherwise legally entitled to the information. A person who is entitled to information would have to contact the institution where the person is being treated or would need to apply to the service for access to the patient care record.

Equally a paramedic who answered a question with – “yes that crew was Paramedic A and Paramedic B – here are their phone numbers and email addresses” may be in breach of their professional responsibilities including an obligation to ‘behave professionally and courteously toward colleagues and other practitioners at all times, including when using social media’ (Code of Conduct [5.1]).

Trying to identify the treating crew to thank them for their work or to ask for information is not a breach of the social policy rules or the Code of Conduct.  Answering those questions, whether on social media or not, may be. 

This blog is made possible with generous financial support from the Australasian College of Paramedicine, the Australian Paramedics Association (NSW), Natural Hazards Research Australia, NSW Rural Fire Service Association and the NSW SES Volunteers Association. I am responsible for the content in this post including any errors or omissions. Any opinions expressed are mine, and do not necessarily reflect the opinion or understanding of the donors.