• Education – Social media allows for learning without boundaries, suspending time and space for educational content. Nurses can access content to support a variety of learning styles with an asynchronous approach that can support them anytime, anywhere. Content is also available in real time, offering an opportunity for learners to access just-in-time education and data.
• Peer Support – Users can benefit from interacting with others online, gaining feelings of belonging and peer support. Social media can foster safe spaces to ask for support and share stories and advice.
• Disaster Response – When disasters occur, social media is often the first place communities share stories and information. During the COVID-19 pandemic, nurses used social media to communicate, educate themselves, and advocate for training and care delivery needs.
• Networking – It can be easy to build professional contacts when time and location aren’t barriers. Nurses can connect with other healthcare professionals, attract potential employers, and leverage an expansive network for professional development and career advancement.

• HIPAA Violations – Sharing protected health information (PHI) and general patient care information. Here are a few examples of social media HIPAA violations:
  • Sharing photographs or any other form of PHI without written consent from a patient
  • Posting what seem like innocent comments or pictures, such as a workplace lunch in the workspace that happens to have visible patient info on a screen in the background
• Violating Employer’s Professional Conduct Policies – Inadvertent violations of professional conduct policies may include:
  • Sharing a company name or logo without permission
  • Posting content created at work while on shift
  • Spreading healthcare misinformation
• Loss of Job or License – Social media posts have led to nurses being fired or even losing their licenses; here are a few examples:
  • Emory Hospital nurses no longer employed after viral TikTok mocked expectant mothers (Atlanta, 2022)
  • Florida nurse fired after posting photos of baby born with birth defect on social media (Miami, 2021)
  • “Nurse Firing Highlights Hazards of Social Media in Hospitals” (New York City, 2014)
• Lawsuits – Nurses can be sued because of their social media posts.

• Assess social media account privacy settings
  • It is essential to know the privacy settings on each platform used. Reassessing those settings occasionally is also essential, as companies may change their policies.
• Know your employer’s social media or professional conduct policies
  • Most healthcare organizations now have social media and professional conduct policies (sometimes known as a “code of conduct”). Employees are held accountable to know their organizations’ policies, and many clauses extend to online activities.
• Be cautious about posting during work hours
  • Know your organization’s social media policy, and check to see if it is allowed to post on social media during work hours. Posting while on shift is another frequent violation of professional conduct policies and can put you in legal liability if an adverse event occurs at the same time you have timestamped activity online.
• Avoid sharing any kind of confidential patient information in any posted content
  • Sometimes, nurses accidentally share PHI. It can be as simple as discussing patient care cases online or not blurring patient information on a computer screen in the background of a posted photo. Employers, regulatory organizations and the legal system can and will hold individuals accountable for those posts, whether accidental or not. Nurses cannot share or post information or images about a patient or information gained in the nurse-patient relationship with anyone else unless there is a patient care-related need to disclose it or a legal obligation.
• Report any violations of patient privacy
  • Even if the content was posted by another healthcare worker, it is imperative that nurses report patient privacy violations per their facility policy and procedure.
• Do not take photos or videos at work
  • It has become increasingly common, but do not do it. This activity typically goes against organizations’ professional conduct policies and often leads to accidental sharing of PHI. If the workplace does allow photos, ensure there are no PHI, patients, visitors or other potentially problematic content in the images.
• Always blur or cover your badge in photos
  • This procedure is important for many reasons, including personal safety, professional conduct and organizational security. Badges can have security or private information that can be extracted from a photo.
• Only share credible information
  • ANA’s “Social Media Principles” notes that disseminating credible and reliable information protects the health and well-being of the public.
• Engage in content in a respectful and professional tone
  • It is best not to post about anyone’s drug or alcohol use. Refrain from speaking poorly of the nursing profession. Do not make insulting or disparaging comments about patients, visitors or colleagues. Avoid making negative comments about an employer. Do not post for or speak on behalf of an employer unless authorized to do so, and then follow all organization policies.
• Be careful if connecting with patients or their loved ones online
  • Relationship lines can get blurred on social media. It is essential to maintain professional boundaries when interacting with patients or their loved ones online. As emphasized by a University at Buffalo School of Nursing blog, exercise extreme caution in every interaction, as even identifying yourself as an online connection’s nurse could breach patient confidentiality.
• Consider the risk of fraud or identity theft
  • When sharing information about themselves online, nurses must consider their own risk of identity theft. Often, data points are collected from social networking sites to commit fraud or identity theft.
• Avoid sharing logos, including your employer’s logo, unless you have written permission
  • Company names and logos are usually trademarked and require written permission before sharing them. Consider if this policy applies to social media content before posting.
• Always identify content that includes compensated endorsements, ads or affiliate links
  • Nurses are participating in online commerce more and more, often as social media influencers. If you’re working as a nurse for an organization while participating in compensated social media content, it is important to identify those relationships and content in every post to avoid potential conflicts of interest at work or other legal issues.

• “American Nurses Association Position Statement on Privacy and Confidentiality”
• American Nurses Association: “Social Media Principles”
• Association of Pediatric Hematology/Oncology Nurses: “Position Paper on the Nurse’s Use of Social Media”
• Healthy Nurse, Healthy Nation Blog: “Social Media Do’s and Don’ts for Nurses”
• International Council of Nurses: Position Statement on Nurses and Social Media
• International Nurse Regulator Collaborative: “Social Media Use: Common Expectations for Nurses”
• National Council of State Boards of Nursing: “A Nurse’s Guide to the Use of Social Media”
• The HIPAA Journal: “HIPAA and Social Media Guidelines”

By Sarah K. Wells (she/her) MSN, RN, CEN, CNL at aacn.org