WHEN MY GRANDPARENTS were children, they communicated
in person or by letter. In my parents’ generation, the telephone became popular.
Today, much of our communication takes place through social media—namely, social networking websites
and services. Websites such as Facebook® and LinkedIn® and social media services such as Twitter® let us connect with a network of friends and colleagues to share ideas, updates, and events in a virtual community. Many nursing organizations are accessible on these sites. For instance, if you use the microblogging service Twitter, you can get up-to-the minute mini-messages (“tweets”) on your cell phone from colleagues, or you can follow organizations such as the American Nurses Association (ANA) and Sigma Theta Tau International (STTI).
Using social media for professional networking with
colleagues worldwide is proving to be an effective way
to advance your career. It’s easy and free, too. Social
networking helps nurses think more globally and understand
nursing perspectives in other parts of the
country and world. Online nursing groups give you unlimited
opportunities to network with like-minded nurses
in your profession or specialty.
To network with peers in your specialty, you can
join a nursing group or form your own specialty nursing
group. You can stay in touch with group members
by registering with the social media websites they use
and creating a profile. Use of these websites is fairly intuitive
for the average computer user.
FaceBook, the largest social networking site, claims
to have more than 500 million active users around the
world connecting to an average of 80 community
pages, groups, and events. Professional nursing associations
such as the ANA and journals such as American
Nurse Today have Facebook pages that allow users to
connect with an online community of nurses.
LinkedIn claims it has 100 million members worldwide and is gaining about 1 million new members every week. It maintains it gives users the keys to controlling their online identities because its subscriber profiles rise to the top of Google and other search engine results.
With its job search tools and company pages, LinkedIn is a great site if you’re looking
for work or exploring career options. You can search for employers you want to
research and find out which companies’ profiles are the most viewed, fastest growing,
and most connected. Posting your profile (which should include a photo of yourself, your current position, where you work, past work experience, and education) helps the right people and opportunities find you.
Twitter users can send and receive tweets (up to 140 characters) via the Twitter website, compatible external applications such as smart phones, or the Short Message
Service (SMS). While Twitter use is free, accessing it through SMS may incur phone-service provider fees. Tweets communicate up-to-the-moment updates of any person or organization you’re following. ANA and STTI are a few of the nursing organizations that can tell you “what’s happening” on Twitter.
Some organizations are trying out their own social networking sites, such as STTI’s The Circle (www.nursingsociety.org/Pages/TheCircle.aspx). These sites require you to be a member of the organization.
Social media and nursing education
Social media can enhance nursing education. Some
nursing schools have started to use social media to enhance
their classrooms. For instance, Mesa Community
College in Arizona has a manikin named Stella Bellman
who has her own Facebook page. Stella provides welcome
messages and notices about exams; more importantly,
she provides simulation scenarios for students.
Harriet L. Schwartz, PhD, assistant professor of professional
leadership at Carlow University in Pittsburgh,
calls Facebook her “cyber hallway” where she provides
relational mentoring to her students.
Hospital networking sites
Many hospitals and other healthcare organizations are
creating their own social networking sites and blogs as
a marketing and outreach tool. As of May 2011, 965
U.S. hospitals were using social networking. One example
is the Mayo Clinic (http://sharing.mayoclinic.org),
which has blogs where patients and others can share
their stories of strength and hope.
Make sure to find out your employer’s policies on
using social media. Many healthcare organizations prohibit
employees from using social media at work or using
an organizational handle on a social networking
site (such as Mary.nurse@hospitalxyz.org).
Privacy concerns
Sharing information on social networking sites is
easy—too easy, some might say. Health care is one of
the most regulated professions in the United States, and
nurses are held to the highest standard of confidentiality.
When using social media, always adhere to the
Health Insurance Portability and Accountability Act
(HIPAA) regulations and maintain professional boundaries
of the nurse-patient relationship.
Revealing private patient information is a leading
type of social-networking misuse. The National Council
of State Boards of Nursing (NCSBN) has published
“Professional boundaries: A nurse’s guide to the importance
of appropriate professional boundaries,” which
addresses some of the issues involved. Currently, the
ANA is revising its Code of Ethics for Nurses to include
principles of social networking.
The distinction between the privacy of one’s personal
life versus one’s work life is a gray area poorly defined
by current laws. Consider this: Should your patient
be your Facebook friend? Patricia Sullivan, APN,
FNP-BC, states, “accepting a patient’s ‘friend’ request
can damage the nurse-patient therapeutic relationship.”
When a patient becomes privy to a nurse’s personal information,
erosion of trust may occur.
Control how much you share
Social networking sites offer tools that let you control
how you share your information and communications;
options include sharing with everyone and sharing with
friends only. Sharing with friends only is recommended
as the default—yet making it your default doesn’t
guarantee your posts will stay between friends. For example,
suppose you post something witty about a challenging
patient, while withholding names and identifying
remarks. Your friends find your comments amusing
and repost it on their Facebook “walls,” where friends
of their friends see it and repost it on their own sites.
Now your friends-only message has gone viral and is
circulating around the social-media universe—and potentially
can get back to the patient or your supervisor.
Nurses have been terminated for posting even seemingly
harmless statements, such as “My job is boring.”
Five California nurses lost their jobs and are facing disciplinary
action for discussing a patient on Facebook
even though their posts included no names, photos, or
identifying information.
Tom Breslin, Associate Director of Labor Education
for the Massachusetts Nurses Association, suggests following
these rules when using social networking sites:
- Assume anything you post will be read by everyone,
especially those you don’t want reading it. - If there’s something you don’t want your employer
to read or to know about you, don’t post it. - Don’t post anything you wouldn’t want your spouse,
child, parent, or employer to read. (See Social networking:
Some do’s and don’ts by clicking the PDF icon above.)
Realize the risks
Most employers can terminate employees for making
disparaging comments about their employer, coworkers,
or patients. Posting defamatory remarks on the Internet
can lead to civil lawsuits alleging defamation or
slander. What’s more, postings to social media sites
generally are considered permanent, even if you delete
them. Electronic information is easily distributed,
archived, and downloaded, and copies of your deleted
posts may still exist on search engines or in friends’
electronic files.
You might ask, “What about my freedom of speech?”
Privacy in the United States is a given natural right
guaranteed by several constitutional amendments. But
U.S. laws regarding digital rights vary by jurisdiction.
The National Labor Relations Board (NLRB) has been
working actively with employees who believe they’ve
been terminated unjustly for social networking activity.
A Connecticut ambulance driver was fired for
posting negative comments about her supervisor on
Facebook; the case was settled by the NLRB more
than 6 months later, but the employee’s reputation
has been damaged.
Is your boss watching?
Nursing recruiters pore over social networking sites for
new nursing hires. Many nursing employers use these
sites to do background and character checks, scanning
them for questionable posts or photographs of employees
or applicants. In multiple cases, nurses have been
terminated for violating employers’ Internet communication
policies, and some employers have rejected applicants
based on Facebook or other postings that cast
the applicants in a bad light.
Social networking is a great tool you can use to expand
your professional network, connect with colleagues,
and increase your nursing knowledge. But using
it carelessly can imperil your job and livelihood. Let
common sense and discretion guide you online. Maintain
appropriate boundaries and privacy and adhere to
your employer’s code of professional conduct and social
networking policies. Remember—you’re a professional
nurse 24/7.
Note: This article is not meant to constitute legal advice.
Selected references
American Nurses Association. Principles: social networking and the
nurse. (Draft for public comment). April 25, 2011. www.nursing
world.org/MainMenuCategories/ThePracticeofProfessionalNursing/
NewCNPE/CNPEMembersOnly/Principles-Social-Networking-and-
Nurse.aspx. Accessed May 25, 2011.
Breslin T. When social networking enters the workplace. Massachusetts
Nurses Association. September 15, 2009. www.massnurses.org/
news-and-events/p/openItem/3013. Accessed May 25, 2011.
McBride D. Misuses of social networking may have ethical implications
for nurses. ONS Connect. 2009; 24(7):17.
Saver C. Social responsibility: social media opportunities and pitfalls.
iNurse.com. August 9, 2010. http://news.nurse.com/apps/pbcs.dll/
article?AID=2010108090045. Accessed May 25, 2011.
Tariman JD. Where to draw the line: professional boundaries in
social networking. ONS Connect. 2010;25(2):10-13.
Anita Prinz is a certified wound ostomy continence nurse educator at Memorial
Hermann Home Health in Houston, Texas.
