With incidents of poor judgment in social media making the news on a daily basis, educators, employers, regulators and nursing organizations have growing, viable concerns over patient privacy and the possible consequences of social media misuse by their employees. As a result, many nurses and the healthcare organizations that employ them have simply opted out of social media.
However, the Internet in general, and social media in particular, has quickly become a practical resource for people seeking general health information and advice. Since nurses and other healthcare workers are often among those who are most able to give accurate and helpful information, employers and nursing organizations are developing specific guidelines on the use of social media in healthcare in order to avoid any potential damaging issues.
Boards of nursing (BONs) are particularly concerned with potential violations of patient privacy and confidentiality. All patients are entitled to privacy, which includes the right to be treated with dignity and respect. They are also ethically and legally entitled to confidentiality through state and federal laws, including the Health Insurance Portability and Accountability Act (HIPAA).
HIPAA defines individually identifiable information as information that can be used to identify an individual, or information that may persuade someone into identifying an individual. HIPAA also stipulates how this type of information can be used, who can use it and the circumstances under which it can be used.
Nurses are obligated to hold confidential any information that they learn while treating a patient, with few exceptions. Nurses can share confidential information with other members of the healthcare team and with those who have the patient’s consent. They can also share information to comply with legal requirements or if failure to do so will result in harm to the patient.
Patient confidentiality can be inadvertently breached using social media by posting details about patients in enough detail to possibly identify the patient or by posting video or images with patients in them without patient consent.
Consequences for privacy or confidentiality violations can vary based on the nurse’s conduct and involvement in the situation. Some violations may only be reported to the appropriate BON and disciplinary action is determined based on the rules in each BON’s jurisdiction. Consequences can include reprimands, sanctions, fines or suspension or loss of license. If the conduct also violates employer policies, the nurse may face additional penalties from their employer, up to and including termination.
If a nurse violates state or federal law, including HIPAA, the consequences can be severe, including civil and criminal charges, fines and possibly jail time. Violations can also cause the employer or program that the nurse is affiliated with to incur penalties or be named in a lawsuit.
The easiest way to avoid violating patient privacy or confidentiality is to avoid discussing sensitive or protected information online. It’s also a good rule of thumb not to follow or “friend” patients online or comment on patient blogs. Nurses should also avoid discussing co-workers and management decisions online and should refrain from relating any clinical situations. In addition, nurses should also be aware that what’s online often lives forever, even if the nurse deletes the content after posting it. They should have no expectation of privacy as online content can be copied and shared far beyond the scope of their personal network.
Organizations such as the National Council of State Boards of Nursing and Sigma Theta Tau have published guidelines, while others, such as the American Nurses Association, are updating their code of ethics to include social media. Organizations in the United Kingdom and Canada have also either published social media recommendations or are investigating regulatory issues involved in the use of social media. These recommendations and guidelines should allow nurses and other healthcare professionals to be active in social media but still respect the privacy and dignity of their patients.
Social media use is on the rise and is expected to increase. Nurses should be able to use this widespread medium to help educate and inform the public about health-related matters. Social media also benefits nurses by providing them with the opportunity to build a professional support network.
Because of the serious potential consequences to nurses, patients, employers and educators of disclosing patient information online, nurses must be ever-mindful of employer policies, relevant state and federal laws and professional standards, understanding exactly how they apply to social media use. Nurses should also consider the impact that their online activity may have on their employers, their profession and their career before making a post.