Stop and think before you post. 

Takeaways:

· Social media is a powerful double-edged sword capable of providing access to education and also leading to negative consequences when misused.

· Old rules of communication etiquette apply to social media.

· Nurses should educate themselves about proper social media use and act responsibly.

· Mindful social media use is crucial to ensure personal and patient privacy, safety, and security.

Social media example: A nurse posts on social media about how fulfilled she feels after successfully performing cardiopulmonary resuscitation (CPR) on a person in the local grocery store.  

Potential pitfalls: The nurse left out the person’s name and the name of the grocery store, but her friends all know where she shops and one or more may know the person on whom she performed CPR. They might be able piece together the story, which will create a breach of privacy. Maybe the person didn’t want others to know about the cardiac event at the grocery store. 

 For many of us, social media, such as Twitter, Snapchat, Instagram, Pinterest, LinkedIn, and Facebook, defines how, when, and where we communicate. We share our thoughts and ideas in blogs, wikis, podcasts, and videos, and we can enter chat rooms and have heart-to-heart talks about our lives—personal and professional. These platforms are powerful and far-reaching, creating ramifications that challenge our privacy and regulatory laws and can either enhance our profession or cause harm both to the profession and to individual nurses’ careers. 

Privacy and HIPAA 

Social media and electronic communication have created a need to review, revisit, and rewrite guidelines to maintain and protect patient privacy—and our own. Many organizations are reframing how, when, and where staff and patients can use social media platforms, with the goal of maintaining privacy and confidentiality for everyone. Security and privacy settings and data encryption are used to maintain electronic health record integrity, but our personal electronic devices may be vulnerable to security breaches. In many cases, privacy settings aren’t as private as we think.  

The Health Insurance Portability and Accountability Act (HIPAA) was enacted to protect patient and client privacy, but the ease with which we share information, even when we change a patient’s personal data, may leave enough information that a person’s identity can be uncovered. And remember, HIPAA protects the public, not the organization or the provider.  

You know the rules

Much has been written about the “do’s and don’ts” of social media communication, but communication really hasn’t changed since the inception of the spoken word. We listen and respond. The venue and speed of communication may be different, but the etiquette remains the same. The old rules still apply. (See 8 rules of communication etiquette.)

A good rule of thumb is to stop, think, wait, and revisit what you want to say or post, and look to your board of nursing and employer for guidance when posting to a social media site about professional behavior. Think about who you want to reach, how the information will be viewed, whether the platform is appropriate, and how you’ll evaluate your post’s effectiveness. Personal posts are just as important as professional posts and should reflect behaviors that don’t embarrass the profession. You never want to be accused of breaking patient confidentiality laws or cyberbullying your peers or employer. And remember that breaking confidences and breaching patient confidentiality can lead to financial consequences, licensure discipline, and potential lawsuits and criminal prosecution.  

Set the standard 

Social media has much to offer—networking opportunities; forums to discuss current professional issues, trends, and evidence-based practices; and platforms for health promotion and patient education dissemination. Mindful social media practices create a positive nursing presence. But it’s a double-edged sword that also can destroy trust and careers if not wielded responsibly. Educate yourself and volunteer to serve on committees that write policies about nursing practice and electronic communication, patient privacy, and confidentiality. We need to set the standard for others who use these platforms and frame the guidelines. 

Mary E. Fortier is an associate professor in the department of nursing at the New Jersey City University in Jersey City. 

Selected references

Balestra ML. Social media missteps could put your nursing license at risk. Am Nurs Today. 2018;13(3):20-21,63. myamericannurse.com/social-media-nursing-license-risk/  

Brous E. How to avoid the pitfalls of social media. Am Nurs Today. 2013;8(5). myamericannurse.com/how-to-avoid-the-pitfalls-of-social-media  

The history of social media: A timeline. 2018. phrasee.co/the-history-of-social-media-a-timeline  

National Council of State Boards of Nursing. A Nurse’s Guide to the Use of Social Media. 2018. https://ncsbn.org/NCSBN_SocialMedia.pdf 

Roberts SJ. Lateral violence in nursing: A review of the past three decades. Nurs Sci Q. 2015;28(1):36-41.  

Spector N, Kappel DM. Guidelines for using electronic and social media: The regulatory perspective. Online J Issues Nurs. 2012;17(3):1.