Guidelines for Using Electronic and Social Media for Nurses (1258 hits)
Social media can be a very effective way of communicating in nursing, but guidelines for appropriate use by healthcare providers are essential. This article briefly introduces the phenomenon of social media and introduces three actual scenarios where nurses unintentionally violated appropriate use of social media in healthcare. The scenarios are discussed related to social media, career, concerns, and nursing regulation.
Incorporating these and other examples with data from board of nursing cases, the nature of complaints against nurses is explored as well as common myths and misunderstandings about using social media platforms. Guidelines for appropriate use by nurses and available resources to inform policy are highlighted. Next steps in social media in nursing should include development of organizational level policies and educational programs on the use of social media. Would you think that a simple entry in a local newspaper's blog could escalate to a complaint to a board of nursing (BON), followed up by an interview with the BON's investigator? That is precisely what happened in a case described in NCSBN's "White Paper: A Nurse's Guide to the Use of Social Media" (NCSBN, 2011e).
Social media can be a very effective way of communicating in nursing, but also presents regulatory concerns. This article briefly introduces the phenomenon of social media and introduces three actual scenarios where nurses unintentionally violated appropriate use of social media in healthcare. The scenarios are discussed related to social media, career concerns, and nursing regulation. The nature of complaints against nurses is explored as well as common myths and misunderstandings about using social media platforms. Guidelines and available resources for appropriate use by nurses and to inform organizational level policy are offered.
Actual Scenarios
Scenario 1: Public Blog
A nurse, who called the physically disabled child she cares for her "little handicapper," commented on the small town newspaper's blog about caring for the child, mentioning the child's age and use of a wheelchair. One of the blog's readers complained to the BON that the nurse was violating "privacy laws" of the child and his family (NCSBN, 2011e). Even without considering the insensitive and unprofessional language, the BON could have taken disciplinary action for failing to maintain the confidentiality of patient information, though it decided a warning was sufficient1. Still, the nurse was shaken and learned a valuable lesson about not posting any information about patients on websites.
Scenario 2: Forwarded Inappropriate E-mail
In one case (NCSBN, 2011e), nurses arrived on their unit to find a picture of a patient, in her hospital gown with her backside exposed, in their emails. The staff who received this email did not know the source, so they forwarded it to others who had not received it to find out who might have sent it. In the course of the morning, this email was the subject of conversation, with some nurses airing their concerns, but others finding it funny. No one reported it to the supervisor. By midday, hospital management became aware of the photo and began investigating because of their concern that the patient's rights may have been violated.
The local media found out and the story was covered so extensively that it made national news. Law enforcement became involved, investigating whether s*xual exploitation occurred. Hospital management placed the nurses on administrative leave while they reviewed the facility's rules that emphasize patient rights, dignity, and protection. Management also reported the incident to the BON, which opened an investigation to determine whether state or federal regulations enforceable by the BON, such as confidentiality of health records, were violated. Eventually the patient was identified and the hospital faced possible legal consequences. Had the nurses acted as professionals and reported the incident, this entire situation could have been avoided.
Scenario 3: Student Nurse on Facebook®
In yet another case where there was no original intent to harm (NCSBN, 2011e), a student nurse wanted to remember the 3-year-old pediatric patient she had been caring for who was receiving chemotherapy for leukemia at a children's hospital. She took his photo, with his room number visible in the background. She then posted his photo on her Facebook® wall for friends to see, writing about how brave her patient was and how proud she was to be a student nurse. This student, like many who are naïve about social networks, did not realize that others can access posts even when appropriate privacy settings are in place. In this case, someone forwarded the information to a nurse at the children's hospital who then contacted her supervisor. Since the nursing program had a clear policy about students not breaching confidentiality and the Health Insurance Portability and Accountability Act (HIPAA) violations (U.S. Department of Health & Human Services, 2012), the student was expelled from the program. Further, the nursing program was not allowed to come back to the children's hospital for pediatric clinical experiences and the hospital faced HIPAA violations.
