Online RN to MSN
Clinical Systems Leadership

Nurses Should Be Cautious When Using Social Media

This past summer, Katie Duke, a nurse who was a subject of the television show “New York Med,” was fired from her job after posting a photo of a trauma room to social media. After treating a patient who had been hit by a subway train, Duke shared the photo along with the caption “#Man vs 6 train.” Although she claimed that the photo was reposted from the social media page of a doctor, who received no punishment, the nurse was fired from her job, reportedly due to insensitivity.

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While this example demonstrates a rare and extreme scenario, it does highlight the problems that any nurse might run into when using social media. To the outside observer, Duke’s comments may well have seemed to be making light of a serious situation, but she saw it differently.

“If you hung around the nurse’s station and heard the way we talk about injuries, life and death, you might get the wrong impression but it’s just a coping mechanism,” Duke told ABC News.

Clear confidentiality violations
Whether Duke’s post was appropriate may be a matter of personal opinion, but it illustrates some of the potential issues nurses should be cognizant of when using social media. Given the medical profession’s emphasis on patient privacy and confidentiality, posting any photos from within the hospital or any information about a patient has the potential to get a nurse in serious trouble.

In 2011, the National Council of State Boards of Nursing reported that a student had been expelled from nursing school and the entire program had its access to a pediatric unit for classes revoked after the student posted a picture of a patient on Facebook. Sharing any information about patients, whether of a personal nature of not, should be strongly discouraged to avoid running into problems. Posts that allow any possibility for patients to be identified, from their name or face to the nature of their injuries, has the potential to run afoul of Health Insurance Portability and Accountability Act (HIPAA) regulations. The American Nurses Association (ANA) recommends keeping any material of this kind offline.

Reaching out can be dangerous
Some HIPAA violations are obvious, such as sharing a patient’s name or photo. However, social media offers ways for nurses to violate confidentiality without even realizing they’re doing so.

“From a legal perspective, nurses using social media to reach out to patients pose a few major privacy issues. Since most social media systems present security problems (in how they’re ‘built’, infrastructure and/or how the user interacts with the specific social media system), open sharing of sensitive and confidential information leads to conflict with HIPAA,” Ben Miller, a Vanderbilt Law student, told Nurse Without Borders (NWB).

Even when a nurse sends a message directly to a patient, that communication can be seen by others in a number of ways. Making contact with patients online in any way risks violating a nurse’s obligation to confidentiality. The National Council of State Boards of Nursing (NCSBN) and ANA both advise nurses to establish professional boundaries and not have any communication with patients that could inadvertently be seen by others. Nurse Without Borders said that health organizations should set clear policies regarding both how employees should use social media and how patients should use such channels to communicate with the organization.

Staying social
Social media can be a minefield of privacy breaches, but nurses don’t have to swear it off altogether. According to NWB, personal blogs can allow professionals to hone and share their expertise, while platforms like Twitter can quickly get important messages out to large numbers of people in emergency situations. The personal nature of Facebook can lead to problems, but the site can also be used to help nurses connect to the community.

As social media continues to evolve, nurses will want to stay on top of the latest technological developments in their field. Advancing their education by pursuing a Master of Science in Nursing is one way they can stay up to date.

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