Do’s and Don’ts of Social Media Use for Nursing Professionals

Nurses use social media every day. For personal and professional purposes, nurses access social media platforms, blogs, video websites and forums to network, share information, find peer support, and enhance their nursing knowledge and skills. Social media is often considered an essential tool for nursing professionals, but its benefits come with potential risks.

Little education on using professional social media is offered to nurses. The ability to instantly post or share information without adequate guidance on professional or legal liability poses a unique and constantly evolving challenge for the nursing community.

What is social media?

Social media are interactive technologies that facilitate the creation and sharing of information, ideas, interests and other forms of expression through virtual communities and networks.

Well-known social media platforms include Facebook, Instagram, TikTok, SnapChat and Reddit, messenger services such as WhatsApp and WeChat, media sharing platforms such as YouTube and Pinterest, and commercial sites such as Etsy and Zillow. Social media platforms also include content formats such as blogs and podcasts. Social media is all over the internet, and nurses may use it whether they realize it or not.

What are the benefits of using social media?

For nurses, there are many benefits to using social media:

• Education – Social media allows for learning without boundaries, suspending time and space for educational content. Nurses can access content to support a variety of learning styles with an asynchronous approach that can support them anytime, anywhere. Content is also available in real time, offering an opportunity for learners to access just-in-time education and data.
• Peer Support – Users can benefit from interacting with others online, gaining feelings of belonging and peer support. Social media can foster safe spaces to ask for support and share stories and advice.
• Disaster Response – When disasters occur, social media is often the first place communities share stories and information. During the COVID-19 pandemic, nurses used social media to communicate, educate themselves, and advocate for training and care delivery needs.
• Networking – It can be easy to build professional contacts when time and location aren’t barriers. Nurses can connect with other healthcare professionals, attract potential employers, and leverage an expansive network for professional development and career advancement.

Risks of Using Social Media

Despite the potential benefits, there are risks for nursing professionals when they use social media:

• HIPAA Violations – Sharing protected health information (PHI) and general patient care information. Here are a few examples of social media HIPAA violations:
  • Sharing photographs or any other form of PHI without written consent from a patient
  • Posting what seem like innocent comments or pictures, such as a workplace lunch in the workspace that happens to have visible patient info on a screen in the background
• Violating Employer’s Professional Conduct Policies – Inadvertent violations of professional conduct policies may include:
  • Sharing a company name or logo without permission
  • Posting content created at work while on shift
  • Spreading healthcare misinformation
• Loss of Job or License – Social media posts have led to nurses being fired or even losing their licenses; here are a few examples:
  • Emory Hospital nurses no longer employed after viral TikTok mocked expectant mothers (Atlanta, 2022)
  • Florida nurse fired after posting photos of baby born with birth defect on social media (Miami, 2021)

  • “Nurse Firing Highlights Hazards of Social Media in Hospitals” (New York City, 2014)
• Lawsuits – Nurses can be sued because of their social media posts.

Privacy: A Legal and Ethical Obligation

Maintaining patient privacy is both an ethical and a legal obligation for nurses. According to the “American Nurses Association Position Statement on Privacy and Confidentiality,” protecting privacy and confidentiality is essential to maintain the trusting relationship between healthcare providers and patients – and integral to professional practice. Further, the Health Insurance Portability and Accountability Act (HIPAA) makes it a legal requirement for nurses to keep all PHI confidential. This requirement is crucial for nurses to understand when they use social media.

Best Practices for Nurses Using Social Media

With such a complex social media landscape to navigate, how can nurses keep their social media use professional and compliant with policies and laws?

Here are strategies to help nursing professionals be safe and successful on social media:

• Assess social media account privacy settings
  • It is essential to know the privacy settings on each platform used. Reassessing those settings occasionally is also essential, as companies may change their policies.
• Know your employer’s social media or professional conduct policies
  • Most healthcare organizations now have social media and professional conduct policies (sometimes known as a “code of conduct”). Employees are held accountable to know their organizations’ policies, and many clauses extend to online activities.
• Be cautious about posting during work hours
  • Know your organization’s social media policy, and check to see if it is allowed to post on social media during work hours. Posting while on shift is another frequent violation of professional conduct policies and can put you in legal liability if an adverse event occurs at the same time you have timestamped activity online.
• Avoid sharing any kind of confidential patient information in any posted content
  • Sometimes, nurses accidentally share PHI. It can be as simple as discussing patient care cases online or not blurring patient information on a computer screen in the background of a posted photo. Employers, regulatory organizations and the legal system can and will hold individuals accountable for those posts, whether accidental or not. Nurses cannot share or post information or images about a patient or information gained in the nurse-patient relationship with anyone else unless there is a patient care-related need to disclose it or a legal obligation.
• Report any violations of patient privacy
  • Even if the content was posted by another healthcare worker, it is imperative that nurses report patient privacy violations per their facility policy and procedure.
• Do not take photos or videos at work
  • It has become increasingly common, but do not do it. This activity typically goes against organizations’ professional conduct policies and often leads to accidental sharing of PHI. If the workplace does allow photos, ensure there are no PHI, patients, visitors or other potentially problematic content in the images.
• Always blur or cover your badge in photos
  • This procedure is important for many reasons, including personal safety, professional conduct and organizational security. Badges can have security or private information that can be extracted from a photo.
• Only share credible information
  • ANA’s “Social Media Principles” notes that disseminating credible and reliable information protects the health and well-being of the public.
• Engage in content in a respectful and professional tone
  • It is best not to post about anyone’s drug or alcohol use. Refrain from speaking poorly of the nursing profession. Do not make insulting or disparaging comments about patients, visitors or colleagues. Avoid making negative comments about an employer. Do not post for or speak on behalf of an employer unless authorized to do so, and then follow all organization policies.
• Be careful if connecting with patients or their loved ones online
  • Relationship lines can get blurred on social media. It is essential to maintain professional boundaries when interacting with patients or their loved ones online. As emphasized by a University at Buffalo School of Nursing blog, exercise extreme caution in every interaction, as even identifying yourself as an online connection’s nurse could breach patient confidentiality.
• Consider the risk of fraud or identity theft
  • When sharing information about themselves online, nurses must consider their own risk of identity theft. Often, data points are collected from social networking sites to commit fraud or identity theft.
• Avoid sharing logos, including your employer’s logo, unless you have written permission
  • Company names and logos are usually trademarked and require written permission before sharing them. Consider if this policy applies to social media content before posting.
• Always identify content that includes compensated endorsements, ads or affiliate links
  • Nurses are participating in online commerce more and more, often as social media influencers. If you’re working as a nurse for an organization while participating in compensated social media content, it is important to identify those relationships and content in every post to avoid potential conflicts of interest at work or other legal issues.

The internet is like a permanent record

Once content is posted online, it is really difficult to get it removed. Consider the internet to be a huge permanent record. Content shared on social media gets put in a permanent record whether it is deleted or not. Somewhere, social media companies have everything backed up in digital storage, which is almost always discoverable in a court of law.

Keep the following in mind when accessing content or posting commentary on social media: Would this look good in court?

Proceed with caution

Nurses can and should use social media for professional purposes if they want to. Benefits exist for healthcare professionals who use social media platforms. However, always proceed cautiously and consider the potential consequences of content shared or engaged in. The internet never forgets.

Resources

• “American Nurses Association Position Statement on Privacy and Confidentiality”
• American Nurses Association: “Social Media Principles”
• Association of Pediatric Hematology/Oncology Nurses: “Position Paper on the Nurse’s Use of Social Media”
• Healthy Nurse, Healthy Nation Blog: “Social Media Do’s and Don’ts for Nurses”
• International Council of Nurses: Position Statement on Nurses and Social Media
• International Nurse Regulator Collaborative: “Social Media Use: Common Expectations for Nurses”
• National Council of State Boards of Nursing: “A Nurse’s Guide to the Use of Social Media”
• The HIPAA Journal: “HIPAA and Social Media Guidelines”