When first thinking about how to manage our professional boundaries on Twitter, and other social media spaces, some of my first thoughts are "what are those professional boundaries?" and "who defines them?" Whilst the NMC Code and Social Media guidance help us to ensure that our behavior in online spaces remains professional I think that there are still some grey areas; How do we act with "patients" on Twitter? How do we keep personal from bleeding into professional? How do we balance being professional whilst expressing political views? How do we keep ourselves safe within this space? I am entirely unsure of the answers here and part of me thinks that it is different for each individual.  For example: I find it very difficult to express political views on Twitter; talking politics can often be construed confrontational and I find that 140 characters is a meager character limit in which to explain complex thought processes - however I know many nurses who express political viewpoints very well indeed in the Twittersphere ... are they crossing professional boundaries? I don't think so.  So we each operate very differently which perhaps leads me to reflect that boundaries are often a set of  self imposed values and that professional boundaries are different to, yet interwoven with, to professionalism. 

This WeNurses discussion was one that really started to make me think and reflect about how am I online and how I manage my professional digital identity and most importantly how I stay safe on Twitter.   The discussion started with exploring the term "Professional Boundaries" and there were some very diverse views:

A very interesting question was then posed by @MrsGracePoole who tweeted:

This is surely where our boundaries start to blur? Being approached by people in a social media space for health advice, what do we do ? Is it unprofessional to respond ? Is it unprofessional not to? I am pretty sure there are arguments both for and against responding here.  So by putting ourselves center stage on a social media platform and identifying ourselves as nurses does this mean we are never off duty and that the professional / personal boundaries is forever blurred ? There were also some interesting tweets around blurring of boundaries:

Perhaps the most important part of this conversation, regardless of opinion around professionalism, boundaries and social media was how nurses protect themselves in this space, how they stay safe both personally and professionally; participants had some great suggestions as to how nurses can protect themselves:

Ultimately I think that being professional within social media spaces is a skill and as with all skills it can take time to develop.  Staying within the NMC Code and adhering to the NMC Social Networking guidelines is a vital place to start from, however finding a way that works for you and keeps you safe online is equally important.  I believe that boundaries are being blurred - when stepping into social media spaces as nurses, often we are sat in the comfort of our own home ... never before have we invited members of the public, patients, diverse political opinion (and so much more) into our personal home spaces .. yet this is, metaphorically speaking, what we are doing on Twitter - we are opening ourselves up to the world. So my final thought on this is perhaps to encourage others to remember that social media is a choice, we can choose to participate or not ...taken time to reflect on events that make you feel uncomfortable and remember you have the choice whether to post or not.  If you are unsure perhaps discuss the situation with a friend or colleague, organise your thoughts and feelings as you would in clinical practice.  Most importantly the "off" button, though much underused, is a wonderful social media invention so don't forget about it.