A nurse continuously cyber bullied for more than five years by anonymous blog posts, some of which falsely accused her of being a sex worker, is just one example of the abuse those in the profession now have to face, a researcher says.
Massey University PhD student Natalia D'Souza studied the experiences of nurses and found that no longer was it just traditional face-to-face bullying they had to deal with but that cyber bullying was becoming an increasing problem.
Of the eight bullied nurses D'Souza interviewed, seven of them had experienced both forms during their careers.
While other research showed many nurses experienced bullying from other staff, she was concerned to find many had been attacked by students they had taught, patients or the family of patients.
Another nurse, who worked in a mental health service, faced continuous abuse from a patient's mother through voicemails and phone calls, even after the case was transferred to another worker, she said.
"She used her son to gain access. She would call to ask for help for her son, but then start abusing the nurse, so the nurse was hesitant to block the calls in case it was a genuine emergency," D'Souza said.
A major concern among nurses was that cyber bullying meant people outside their organisation could bully them constantly - even when they were not at work.
The public nature of some cyber bullying also left nurses fearing their reputations could be tarnished, she said.
"Emails are distressing but it's more distressing when more people viewed it and it affected their reputation," D'Souza said. "When it was potentially impacting their career, that was the worst."
The nurse accused of being a sex worker also had her contact details posted online and had false complaints about her made to the Nursing Council.
D'Souza said the incidents caused the woman a lot of anxiety, not just because of the potential damage to her reputation, but because she had not told her children about it and was worried they might come across it online.
"So the traditional bullying impacts of anxiety and depression apply, but there is an almost unique anxiety associated with the public nature of cyber bullying, along with the constant accessibility outside of work hours."
The researcher was concerned there seemed to be little done to deal with cyber bullying in many companies. A lot of organisations had social media policies for staff but did not have policies to protect staff from external abuse.
She said there needed to be more awareness of the issue and recommended explicitly including cyber bullying in workplace bullying and harassment policies to show staff it was taken seriously.
New Zealand Nurses Organisation professional nursing adviser Suzanne Rolls agreed cyber bullying was an emerging problem.
It seemed some people were using social media to have an "unfiltered" say rather than using formal complaint channels, she said.
"There is a huge issue around access to health care. Money is tight for a lot of people or people are dealing with complex issues and have many reasons for doing what they do," she said.
"We can understand that but would like to work with them rather than having that stuff out there [on social media]."
Rolls said cyber bullying was harmful to both the physical and emotional wellbeing of nurses.
"The essence of being a nurse comes from a willingness to care for people and provide relief from suffering and when that is criticised, people feel that quite deeply."
She said health providers needed to take action to engage with the complainant to understand why they were doing it and try to come to a resolution.
Netsafe chief executive Martin Cocker said the organisation now received 50 to 60 complaints a week under the Harmful Digital Communications Act.
People who performed frontline roles, such as nurses, were more exposed to cyber bullying and online criticism because of the job they did, he said.
If people were unhappy with the care or service received, it was often easiest to take it out on frontline staff like nurses.
Cocker said employers could only support their staff in the event they were targeted and refer them to Netsafe for support and help.
Netsafe would work to come to a resolution between the two parties and could have posts removed or blocked if need be. If it was not able to deal with the issue, the matter would be referred to the courts.