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The patient versus friend debate

Image: Facebook

Jack Black is about to eat a piece of pumpkin pie.

Ima M. Osquito just had the most amazing vacation with the most amazing friends.

Sound familiar? These would be examples of entries that pop up on the news feed of the “century’s-most-invasive-way-to-keep-in-touch-with-people” a.k.a. Facebook. Sure, I have found some people I knew from grade school, the old co-worker, and that favorite middle school teacher that I would not be “friends” with had this social network not come to fruition.

But how about news feed updates such as these:

My little buddy had a rough night last night. Fever, vomiting, no appetite- looks like we will be taking another trip to Children’s.

The dreaded transplant discussion has come up again. We are all so scared.

So excited to have my family home all together for dinner after such a long hospitalization.

Happy first birthday to our little angel, you are such a trouper, who would have thought we would ever see today! In lieu of gifts for today’s party, please donate to CCHD Awareness.

Ah, and perspective smacks you in the face. For those immersed in the medical scene due to ailing family members, in some instances social networking sites serve as an outlet for people reaching out for support, keeping those family members who may not be in contact on a daily basis in the loop on life events, and even as an means to support a specific cause. However people choose to utilize Facebook, there is no denying that the site has grown by endemic proportions in recent years. I am a wholehearted Facebook supporter, active user, and verified stalker (I joke). But in all seriousness, a burning question that exists in the Facebook realm still stumps me. Is it appropriate to be Facebook friends with patients and their family members?

As a Children’s employee, we are discouraged from having personal relationships with patients outside of the facility. But amidst the nature of our floor where these families become, in a way, a part of our own families due to frequent admissions and extended stays, that expected emotional detachment becomes more difficult. A life motto that I will forever stick to is that once you become stoic, apathetic, or even disinterested, it is time to move on to something that will once again reignite that caregiver spark that all nurses should have. In light of this, some attachment is acceptable, even expected. It is only natural to want to keep in touch with families post hospital discharge to see how they are doing in their “normal” lives. But is it appropriate to have access to the fine details of their personal lives that are shared on Facebook, and vice versa? Let’s weigh the benefits and possible implications involved in said topic.


For families that may have frequent admissions, keeping in touch via social networking may allow the medical staff to have a more extensive history of events from months leading up to admission, more than could be detailed from a quick H&P.

Nurses can enjoy that part of the job that I enjoy most, on a daily basis- seeing children that you cared for doing well in their home environment. Nothing beats a patient coming back for a visit and through Facebook, you can virtually experience that visit with each login.

Due to the rapid wild-fire spread of information through Facebook, staff can stay informed of benefits, fundraisers, and functions that may assist a family in need or even benefit the hospital. It is a great resource for diffusing information to a larger population.

In reality, these “friends” are people that enter our lives, impact them, and in most cases make us better person. Isn’t that what the collection of friends on the ol’ book is about anyway?


When parents start seeking medical advice through their social networking site because, “I’m friends with my son’s nurse so I can just ask her this question instead of calling the pediatrician.” Big no-no and huge liability.

Professional vs personal boundaries are completely crossed and ultimately destroyed when parents have full access to your profile. As a single mid-20 something who is still having fun doing single mid-20 something activities during my personal time, I would prefer that my families not peruse pictures of the great cabin weekend that was had over Memorial Day.

It is easy enough to get attached to a patient when they are in the hospital, let alone seeing pictures of them growing up in their home environment. It is the unavoidably ugly truth that some of these patients will not make it to their next birthday, and the emotional bond made stronger through Facebook will make losing the patient that much harder on the nurse.

In the event that a benefit or fundraiser is held for a patient, the nurse of that child may feel obligated to support the cause. Attending one benefit? Great. Donating to the cause of the twenty patients that are your friends on Facebook? Burden.

Although I will not reveal my direct opinion on the matter, I do believe there are valid arguments on both sides. As an alternative to Facebook, there are websites such as and Caringbridge that make communicating outside the hospital very feasible. Parents can update information about their child’s condition as they please. The perk of these sites is that basically there are filters to what information is given and received- so my wild Memorial Day weekend pictures can be kept to myself. On a lighter note, I suppose in light of recent trends there soon will be a “Babybook” version of Facebook coming to a computer near you. Perhaps at that point the baby can make the final decision on whether their nurse is friend worthy :)

Happy Facebooking!

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Nicole Lehr

Nicole Lehr is a pediatric nurse. She can be described in three adjectives: content, thankful and fortunate. All credit for the aforementioned description can be given to the love she has for her profession as an RN. She graduated from University of Florida with her Bachelor’s in Nursing and moved to Atlanta to work at the Cardiac Stepdown Unit at Children’s — her dream job.

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2 Responses to The patient versus friend debate

  1. Megan

    I can see how this is a potential problem and liability. However, my son is turning 2 this weekend and I just recently friended one of his NICU nurses who cared for him for 3 weeks after he was born. My son was born with an extremely rare syndrome and this nurse played a pivotal role in helping us through the very tough and emotional days. I just had to tell her how amazing her care was and I how couldn’t of gotten through those days without her!!!

  2. Nicole Lehr Scrubs Blogger

    @ Megan- And this is the exactly the type of example that would bring any nurse on Facebook to tears having received a message like that from you, detailing your experience and your appreciation. I think it’s fabulous that you were able to find her, and I’m sure she will be ecstatic to see pictures from your son’s 2nd birthday party :)