Well this was my first time hosting a WeChat and it was so interesting to hear everyone’s views and the discussions. Here are the general themes/summary that emerged from the #WeLDNurses chat;

Most agreed that the internet can be both an opportunity (a blessing/godsend/a fabulous tool) and a threat (a curse/lots of risks) for anybody, depending on how it was used. Because of its wide reach, the internet had the potential to cause serious repercussions for any individual if not managed properly. The opportunities the internet could bring to everyone included; better social inclusion through greater networking opportunities, enabling people to form friendships in aspace that felt safe (even establishing close ‘virtual’ friendships), which offered that person someone to ‘turn to’ and receive ‘great support’ from. The internet could be used by those limited by their offline environment and increase interaction in offline spaces, e.g. finding Pokemons. Learning (including forming Facebook groups) and sharing information with colleagues and peers was cited as a way to gain advice and support from one another. It also made people feel more connected with others who may not be at a close distance to them, helped to ‘spark’ ideas and bring communities together. The internet could also be a powerful way to build up your reputation and allow people, whofind face-to-face contact ‘awkward’, to find information or communicate withothers more easily.

The problems associated with spending too much time on the internet included; disruption to sleep patterns/insomnia, not being able to switch off and dreaming about games that they had been playing, negative effects on posture, obesity/weight gain due to inactivity, eye strain,‘disassociation with reality’, withdrawing from social engagement, ‘altered perceptions’, not being able to escape an online world where bullying may be happening and addiction. Some of these the community members or those they hadworked with had experienced. There was a worry about the online world becoming an alternative to human interaction.

People spoke about how they encouraged people with LD, they worked with, to look up bus timetables, use social media to connect or stay in touch with friends they didn’t see regularly or to use apps to monitor health, and Fitbits to encourage reaching competitive goals in physical fitness. One community member saw a news post about an app that helped someone with disabilities to make new friends; http://www.ctvnews.ca/mobile/sci-tech/teen-develops-app-to-help-brother-with-disabilities-make-new-friends-1.3337657

As we are all in the digital era, many thought that internet activities, such as gaming, should be available for all, and that we needed to ensure that we were all educated about online safety, benefits and risks, from pre-school to adulthood. As more information becomes available online we need to ensure that people with LD are not left behind or excluded. Day hubs/‘clinics’ were highlighted as a potential creative and enjoyable way to support internet education.

Many felt that everyone has the right to take a risk, if they are prepared to accept responsibility and are aware of the consequences. It was acknowledged that some people with LD may be less aware of or not have the ability to weigh up online risks, benefits, and consequences or may have different perceptions. Education and support were seen as important to encouraging this group’s safe internet use, but questions were raised over how we can do this for someone else without ‘overstepping boundaries’ and how we can empower people with LD to assess these risks themselves, rather than the professional.

Education, online decision making and weighing up risks, was a key area to support people with LD, but there was some debate over how much (and if it was internet focused enough) young people received in SEN schools. In some people’s experience, this was either not happening or they were dubious about how internet safety was actually explored in these settings. Online education was not only seen as important for young people with learning disabilities, (‘digital natives’), but also for adults with learning disabilities too (‘digital immigrants’), and a lack of online education was highlighted in adult forensic practice. One community member had developed a psychoeducational intervention to support skilldevelopment for people with LD who were offenders in the area of risk awareness in this area, which was published in 2013; available at; http://www.emeraldinsight.com/doi/abs/10.1108/JIDOB-04-2013-0008 (Batey and Comer). He felt it was a shame that this could not be translated into a free resource. Others had heard of people with LD getting into‘mischief’ or financial difficulties online and were let off with a ‘bless & head tilt’.

Community members felt that they had an online role in educating others, and moderating and reporting what they saw online as negative, as well as an offline role in helping those they worked with recognise what is acceptable online, encouraging them to report bullying and signpost safe websites for them to use. Some members felt it was important not to get too caught up in the negatives and to remember that people with LD should be encouraged to have a wide range of experiences, both online and offline. Buddying, by more experiences social media users, for new starters, who would benefit from their advice, could be beneficial for both LD professionals and people with LD. People had experienced parents not understanding the benefits of social media and being concerned for a child with LD using the internet. There was agreement that there should be a collaborative/shared approach, targeted at individual’s need, which included parents/families/carers, so everyone could learn from each other.

Most people generally felt safe online, often due to the education they had received on this and how their account settings were set up. However, some had experienced, or knew of others that had been, trolling/ed and experienced racism online. With the support of their friends, they had been able to get though this experience, or had felt that it was better to hear this online than offline.  Cyberbullying was highlighted as something that appeared to be increasing and some members had responded to racist comments by muting or blocking, and reporting them. It was suggested that people with LD were often punished if they had been victims of cyberbullying or trolling, by having their internet access restricted or taken away. Supporting people with LD to stop interacting with bullies, maintain genuine friendships and recognise hate crime was suggested. It was highlighted that there was good guidance and work on this area, but it wasn’t well distributed or there was reluctance to do so. Good advice and work, highlighted in this area, was from SaferNet, Glenn Batey and Theresa Comer (link above) and Darren Chadwick http://onlinelibrary.wiley.com/doi/10.1111/bld.12170/abstract

Some people preferred to keep one type of social media for their personal life and one for professional life, whilst others were comfortable merging their social and professional lives across many social media platforms. Some had experienced ‘patients’ trying to add them as friends and it was highlighted that it was important to be careful and know who to connect with and who not to connect with. This was an area in nurse training that was ‘drilled into’ students, so that boundaries are maintained between patients and professionals.

As a result of this WeLDNurses chat, many community members stated that they would go and find out more about how social media was being used, and the support available, in their work area, and what role the LD nurses take in this. Others thought about widening access to the internet to people they worked with, minimising risks like cyberbullying, and supported internet education, through ‘clinics’, ‘drop ins’, etc.. It was realised that those taking part in this chat were people who already knew about the opportunities the internet brings to both themselves and to those they work with. Perhaps we need to spread the word to those who only see the internet as a risk to people with LD and are not aware of the opportunities?

I personally found it interesting the boundaries we, and the NMC, set between the patient and professional, when it comes to social media. I wonder what will happen in the future when we may be regularly communicating with ‘patients’, for example facilitating online support and self-management groups when needed, as using technology is one of the government and NHS aims,and the idea of GP appointment online is not that far away! Facebook has already created a social media platform for our professional life, allowing usto separate this from our personal life, but it seems that through this chat, many gain so much support and friendship from other professional peers and colleagues, that separating this may be difficult. I also found something one member raised interesting; how do we support people with LD to access the internet safely without ‘overstepping boundaries’? Thus who is deciding what is risky and what is not? Is a professional’s perception of risk different to a person with LD? How do we manage our role in this area without ‘overstepping[those] boundaries’ and deciding for someone with LD, rather than with them?

Thanks to @Gillian_HH for her comprehensive analysis of the transcript of last night's chat.

@dmarsden49