Exploring Boundaries Online and Off


On Wednesday I was the facilitator of an online chat for the #hcsmca community. HCSMCA stands for Health Care Social Media Canada and the Twitter chats happen online, so you can participate from anywhere. It’s a diverse group made up of people working in health care- patient advocates, volunteers, doctors, nurses, researchers, health administrators, health communicators, med and nursing students, dieticians-  you name it. Every week there’s a discussion of two topics.   

If you don’t have an account on Twitter, or you haven’t been on one of the chats, you can view transcripts of them to get a feel for it. (Warning for those not familiar with Twitter- the hashtags and lingo may seem confusing. I felt that way when I started too. It’s worth keeping at it.)

One of the topics we discussed this week was setting boundaries around personal and professional social media use. With so many people connecting through home computers, smart phones, tablets and the like, it’s possible to be engaged 24 hours a day, 7 days a week. But people don’t run 24/7. We discussed the pressures of expectations people feel to be available at any time. This could be work-related or community related. It made me think of the early days of HIV work.  

There was an incredible speed to HIV work in the early days before successful HIV treatments were available. Needs were big and urgent, all the time. Understandable- people were dying. Volunteers and staff were run ragged trying to keep up. The expectation was that you gave it your all, and all the time. Volunteers and staff alike felt incredible pressure to be everything for everyone.

Of course it wasn’t possible. People burnt out, and then felt guilty. People in the HIV community realized things needed to change. Even before the life-saving meds came along, organizations made program changes. AIDS Vancouver, for example, had a one-to-one Buddy program that matched a volunteer with a person living with HIV. As the HIV+ person’s health declined, it often ended up that the volunteers were providing personal care needs as well.  Demands became so great that the buddy support people were burnt out and isolated to boot. AIDS Vancouver moved to a Care Team approach, which had several volunteers supporting one person. Being part of a team built in the chance to share the work and the worry. At PWN we rescheduled drop-in hours and home visits in part to balance out the needs of women who were out of town with local members.

While providing support and services to people with HIV is different from managing your online presence, the commonality of boundaries popped into my mind. Social media channels like Twitter and Facebook are exciting ways to enrich services and ultimately improve support for people with HIV. But it’s a slippery slope- how much is enough?

I’m left with the awareness that we need to think about what we are doing to stay healthy in how we engage online. What kinds of boundaries or limits do we have in place to balance personal and community/ work? I’m thinking.  


 Photo: MorgueFile


  • Thanks for this post of weaving your experience moderating #hcsmca and the work in HIV. #hcsmca is a Think Tank, people gathering around a virtual water cooler, amassing an incredible collection of knowledge. It is always good to see how people bring their queries and ideas to #hcsmca and, equally important, how they transfer the new knowledge and innovation back to their lives and workplaces.

    I’d like to re-iterate Janet’s open invitation. All are welcome to take part in our weekly chats on Twitter on Wednesdays at 10am PT. On the last week of the month we shift to an evening hour – 6pm PT. I look forward to tw-meeting you.