Social Media and Nurses: Promising or Perilous?

Laura A. Stokowski, RN, MS


November 17, 2011

In This Article

New Territory, New Rules

We are charting new territory with social media, and new rules are needed to guide us. Recently, 2 national nursing organizations -- the NCSBN and the American Nurses Association (ANA) -- issued guidelines to help nurses use social media effectively, reap its benefits, and avoid its perils. Nurses who use social media are advised to read and heed the recommendations in these 2 documents.

NCSBN Nurse's Guide to Social Media

In August 2011, the NCSBN released White Paper: A Nurse's Guide to the Use of Social Media. This document delineates the possible consequences for inappropriate use of social and electronic media and dispells common myths and misunderstandings related to the use of social media by nurses. Among these are the following mistaken beliefs:


  • Communications or posts are private and accessible only by the intended recipient;

  • Deleted content is no longer accessible;

  • Patient privacy is upheld if information is communicated only to the intended recipient; and

  • It is acceptable to discuss patients as long as no names are used.

The NCSBN white paper offers a list of 12 recommendations to avoid inadvertently disclosing confidential or private information about patients, and to minimize the risks of social media in general. These recommendations cover the use of patient information or likenesses, professional boundaries with patients in the online environment, making disparaging remarks about employers or coworkers, and being aware of employers' policies on the use of electronic devices in the workplace and making work-related online postings. Nurses are obligated to report any identified breaches of confidentiality or privacy that they may encounter. The whitepaper also provides 7 different scenarios to illustrate improper use of social media by nurses, along with the consequences of these actions.

ANA: Principles for Social Networking

In September 2011, the American Nurses Association released Principles for Social Networking and the Nurse: Guidance for the Registered Nurse. The ANA principles were informed by professional foundational documents including the Code of Ethics for Nurses and standards of practice, and include the following:[2]

  • Nurses must not transmit or place online individually identifiable patient information;

  • Nurses must observe ethically prescribed professional patient -- nurse boundaries;

  • Nurses should understand that patients, colleagues, institutions, and employers may view postings;

  • Nurses should take advantage of privacy settings and seek to separate personal and professional information online;

  • Nurses should bring content that could harm a patient’s privacy, rights, or welfare to the attention of appropriate authorities; and

  • Nurses should participate in developing institutional policies governing online conduct.

The ANA guidelines also offer tips to nurses to help avoid problems in online arenas, beginning with the key principle that the standards of professionalism are the same online as in any other circumstance. Nurses should not share or post information or photos gained through the nurse-patient relationshipe. Because online contact with patients can blur the separation between nurse and patient, nurses must be careful to maintain professional boundaries with electronic media. Nurses should not make disparaging comments about patients, employers, or coworkers, even if they are not identified, nor take photos or videos of patients, even with a cell phone. Merely removing the name or the face is not sufficient to protect identity.[2]

The ANA has made available a Social Networking Principles Toolkit that contains a poster of their "Six Tips for Using Social Media," a tip card for nurses using social media, and a fact sheet titled "Navigating the World of Social Media."

Use Social Media Wisely

Nurses shouldn't shy away from using social media. In fact, social media are likely to play an increasing role in healthcare, and may soon become integral to the practice of nursing.[1] If nurses and students keep the principles of patient confidentiality and privacy, respect for employers and colleagues, and patient-professional boundaries uppermost in mind[1] they will be able to participate in the social media revolution without fear that they will harm themselves or others.


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