Social Media: Handle with Care

In 2014, after treating a patient who had been hit by a subway train, Katie Duke, posted to Instagram a photo of the littered trauma room. Duke was one of the nurse's on the reality TV show New York Med, and though she claimed she was only reposting from a doctor's account, Duke was fired from her job, reportedly for insensitivity. News outlets also reported the doctor received no punishment.

This example shines a light on one problem nurses can face on social media: insider perspective. To someone other than a nurse, Duke’s actions might have seemed to be making light of a serious situation. 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.

Whether or not Duke’s post was appropriate may be a matter of opinion. In other areas, the lines are more clear cut.

Identifying Information

In 2011, the National Council of State Boards of Nursing reported that a student had been expelled from nursing school after posting a picture of a patient on Facebook. What's more, the entire program was thereafter barred from a pediatric unit it had been using for classes.

The American Nurses Association (ANA) recommends keeping offline any material that might allow patients to be identified, by name or face or even the nature of their injuries, as such postings may run afoul of Health Insurance Portability and Accountability Act (HIPAA) regulations.

Crossing Social & Professional Lines

Some nurses, especially in smaller communities, are already friends with people who come to be under their care. They may also become friends with people in their care and/or members of their families.

Given that, it may seem entirely natural to connect with and communicate with them -- possibly even just "check in" on a health condition or healing status -- via social media, where people casually connect every day. Doing so, however, risks violating a nurse’s obligation to confidentiality.

“From a legal perspective, nurses using social media to reach out to patients pose a few major privacy issues," said Ben Miller, a Vanderbilt Law student, in an interview for Nurse Without Borders (NWB). "Since most social media systems present security problems … open sharing of sensitive and confidential information leads to conflict with HIPAA.”

Even when a nurse sends a private message to a patient (vs. communicating in the public forum), that communication can be seen by others in a number of ways. For these reasons, ANA and the National Council of State Boards of Nursing (NCSBN) both advise nurses to not have any online communication with patients that could inadvertently be seen by others.

Staying Social in a Digital World

Given the examples above, it may seem that social media is a minefield of professional disasters just waiting to happen. It can be, but that doesn't mean nurses need swear off it altogether. After all, social media is ingrained in American society and can be an important resource for personal connections and professional support.

According to NWB, blogs offer one way for nurses to connect with other medical professionals online, especially to hone and share their expertise. Twitter can be incredibly valuable for quickly getting information to large numbers of people in emergency situations. Even Facebook can help nurses connect to their communities, just not individual patients.

Know What's Right

Nurses need to stay on top of the technological developments in their field, and social media is no exception. Advancing education, including by completing a Master of Science in Nursing, is one way to stay up to date.

For any nurse, however, it's essential to know what is and isn't allowed -- not just legally speaking, but for individual care facilities. Every health organization should set clear policies regarding the use social media and appropriate channels for communication with patients and their families.

Find yours, ask questions to be sure you understand it, and follow it to the letter. Doing so not only protects you career, it ensures your patients and their families maintain the privacy, respect and care you work so hard to provide.