Social Media and Nursing: What Not to Post

Social media has connected us in ways we wouldn’t have thought possible only a short time ago. It’s a part of everyone’s lives, and we all know the companies Facebook, Instagram, Twitter, and Snapchat. With Facebook buying Instagram, the biggest social media platforms have started to bleed into each other, making it even easier to share one post to multiple platforms with just a tap. Facebook alone has over two billion active users as of October 2018. 

For most people, that doesn’t present much of a problem. Millions of users take advantage of the prevalence and ease of sharing on social media, and some even rely on social media use for income. But for people in the medical profession, social media comes with a strict set of warnings. 

Because of the amount of information nurses need to do their jobs well, they have access to sensitive patient information and are required to treat that information with respect. There’s a level of trust that we place in the nurses caring for us. A seemingly innocent photo posted to Instagram could have serious legal repercussions for not only the one who posted it but also the hospital in which they work or the nursing program they’re enrolled in. 

Here, we’ll go over what you should and shouldn’t post to social media, what exactly constitutes patient privacy and confidential information, and the consequences for the wrong post on social media. 

What Not to Post: Social Media Best Practices for Nurses

The American Nurses Association (ANA) has provided six best practices for posting on social media. The goal of these best practices is to help nurses avoid a potentially disastrous misstep and make sure they’re respecting the privacy of patients, coworkers, and the hospitals where they work. 

  1. Do not transmit or place online individually identifiable patient information. This obviously includes things like names, addresses, or medical histories, but also encompasses any information that could even potentially be used to identify patients, like the circumstances of an injury or their room number.
  2. Observe ethically prescribed professional patient-nurse boundaries. A nurse should act online just as they would in person with patients and not post disparaging information about them or anything that would violate their privacy.
  3. Understand that patients, coworkers, organizations like nursing boards, and potential employers can see what you post. These day’s we’re all more aware that, if it’s on the internet, it lives forever. If a patient knows enough about you to find your Facebook page, you’re applying to work at a new hospital, or you’re connected with your coworkers via social media, all of them can see what you post unless you adjust your privacy settings. Which brings us to the next point.
  4. Take advantage of privacy settings to screen personal accounts and separate them from your more professional life online. In recent years, social networks have done more to allow users to control who can see what they post. On Facebook, for example, you can make posts visible only to those in your friend network. None of the methods offered are completely foolproof, and caution should still be strongly exercised. This can act as an extra layer between your personal life and your professional one, but keep in mind that others in your network who are granted access can screenshot or share what you post. Because of this loophole, sensitive information can still get out.
  5. Bring sensitive content posted by others to the attention of the proper authorities. Even if you’ve never posted something that violates patient privacy, you should be ready to address it if a colleague does. The ANA has recommended talking to the person who made the post first. If that doesn’t work, and especially if the information in the offending post threatens a patient’s health, welfare, or basic right to privacy, the next step would be to report the post to a supervisor. If the problem persists, it may be time to report the matter to external authorities, like the local nursing board. It is of the utmost importance that you have the evidence to back up your claim should you have to take the process further than a colleague.
  6. Participate when policies are being made. Take an active role when policies around patient privacy and social media are being constructed. Make sure your voice gets heard, and you know the ins and outs of the rules being established so you aren’t taken by surprise.

Breaching a patient’s trust doesn’t just reflect poorly on you, it can reflect poorly on the entire profession. Social media lets us post so quickly and often that we can lose the capacity to consider a post carefully before it’s made. Whenever posting something on your personal pages or a professional social network, take a few extra seconds to consider whether what you’re about to post could jeopardize a patient’s privacy or cause a conflict with your colleague. 

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The Consequences

If a post made on social media is found to be in violation of the Health Insurance Portability and Accountability Act (HIPAA), the consequences can be severe and far-reaching. Monetary fines can be as high as $50,000, and nurses can be terminated from their positions or lose their licenses. In their overview of social media best practices, the ANA related the story of a nursing student’s seemingly innocent mistake, and how it got both her and her program in trouble: 

“Emily, a 20-year-old nursing student, wasn’t aware of the potential repercussions that could occur when she took a photo of Tommy, a 3-year-old leukemia patient in a pediatric unit, on her personal cell phone. When Tommy’s mom went to the cafeteria, Emily asked him if she could take his picture . . . She posted Tommy’s photo on her Facebook page with this caption: ‘This is my 3-year-old leukemia patient who is bravely receiving chemotherapy! He is the reason I am so proud to be a nurse!’ In the photo, Room 324 of the pediatric unit was visible.” 

Emily ended up being expelled from her nursing program after a nurse from the hospital found and reported the photo. That program was also barred from future students of theirs using that hospital’s pediatric unit to train. While the photo was taken with the underage patient’s permission and had a positive message, she did not receive consent for the photo from the patient’s parent, and the photo had private information (the patient’s face and room number) displayed on a public social network. 

What Is Okay to Post?

Everything we’ve said above may make it seem like nurses can’t post anything at all to social media, but that isn’t necessarily true. Nurse and author Brittney Wilson has recommended sharing information about yourself, the nursing profession as a whole, and your interest while making sure to keep topics of discussion away from patients and coworkers. If you wouldn’t say it in front of your boss, you probably shouldn’t post it online. 

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