Nurses and Social Media: Guard Your Career and Your Reputation

Social Media Guidelines for Nurses

A tired nurse, just off duty from her shift at a flu-ridden emergency department, posted a video titled "After Work Thoughts" on Facebook, in which she told the public, in bold terms, how to protect themselves from exposure to the influenza virus. She's not the only nurse who is communicating with patients, and the public, through social media. Whether you have a social media site for your business or simply maintain your own personal page or site, here are four guidelines for protecting your career.

Maintain professional boundaries. After you have posted something on social media, it's easy to get drawn into the discussion when a viewer or reader posts a comment. Don't get drawn into arguing back and forth among commenters, patients' family members, or friend/enemy groups in the community. It doesn't matter whether the site is your professional site or your personal site; you're a nurse, and nursing requires nurses to maintain professional boundaries. In one case, a nurse who had counseled a couple later sided publicly with one of them when they were splitting up. That angered the other member of the couple enough to make a report to the Board of Nursing. The nurse was disciplined for failing to maintain boundaries. For more information on the nursing profession's expectations, see the National Council of State Boards of Nursing's A Nurse's Guide to Professional Boundaries.

Protect your professional reputation. It's fine to post a photo of yourself getting an award, giving a presentation, or posing with a professional idol, student, or mentor. But don't post photos of yourself holding a beer, smoking, wearing a T-shirt with a saucy slogan, or screaming with your friends. Yes, nurses are allowed to drink beer when off-duty and they're allowed to wear T-shirts, but it's best for your credibility and your career if you maintain a professional presence online.

Make sure that what you say or write is medically correct. It's fine to use plain language. It's certainly not illegal to use slang, and sometimes slang can be effective, but usually it's more professional not to use slang words.

Don't breach patient privacy and violate HIPAA. If a commenter is also your patient, don't converse through the comments section. If you do, you could be divulging the patient's protected health information. If the patient has posted a question and you want to respond, call the patient and give your answer by phone. If the answer to the question is something that many people would benefit from, you can address the question and answer in a general post without referring to the person who originally posted the question. Here's an example: You are an expert on diabetes and have written a blog on nutrition. One of your patients posts, "Is watermelon OK?" Don't get into an online discussion with that patient. Instead, either call or email the patient with your answer, or write a separate blog, in a week or so, on which fruits are best, in general, for people with diabetes.

Don't establish a "duty of care" through social media. Let's say you posted an article on a health issue, such as how to deal with overwhelming fatigue. Someone posts, "I am tired all the time. What should I do?" You can advise the person to "See your healthcare provider." But if you provide additional medical or nursing advice, the individual relies on your advice, and it turns out that the advice was wrong and the patient suffered an injury, you can be liable if the patient sues you for malpractice, even though the patient wasn't enrolled with your practice and never paid you a penny. You automatically have a "duty of care" to patients who are admitted to your unit at the hospital or who are enrolled with your office practice. But you don't need to, nor do you want to, establish a duty of care with individuals who respond to your social media posts. You can advise commenters to see their own healthcare providers or to go to an urgent/emergency care center. But don't get into taking their history or giving advice through the comment section.

The 'Wash Your Stinking Hands' Viral Video

The nurse who posted the flu-avoidance video complied with each of these guidelines: She gave general, correct advice; her examples of patient behavior weren't identifiable with any individual patient; and she maintained a professional presence overall, even though she used some slang in conveying her frustration with those who come to the emergency department during flu season with non-emergencies.

Nurses have much to offer. It would be a waste of talent to hold back because someone might criticize you. On the other hand, don't jeopardize your career or your professional reputation by posting without thinking it through. If you follow these guidelines, you should be safe.

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