• What Not to Share on Social Media: A Nurse's Guide

    By Jennifer Larson, contributor

    Facebook, Twitter, YouTube, LinkedIn, Tumblr, Foursquare, Pinterest…as the number of social networking outlets grows, so does the number of users. As of September 2013, 73 percent of online adults were using social networking sites, according to the Pew Research Center’s Pew Internet Project.

    Methods of communicating and sharing information have certainly changed, but, as professionals, nurses need to be mindful about what they’re putting out there on various social media platforms and sending via text message. A key point: Remember at all times that you’re a nurse and you represent your profession.


    Betsy Kennedy, MSN, RN
    Betsy Kennedy, MSN, RN, said that, despite the changes brought about by social media, professional standards for nurses haven't changed.


    “There are not different professional standards when you’re online than when you’re on the job,” said Betsy Kennedy, MSN, RN, assistant professor in Vanderbilt University School of Nursing’s pre-specialty program. “So it’s about maintaining professionalism.”

    According to Pamela Katz Ressler, MS, RN HN-BC, one of the best rules of thumb when it comes to participating in social media is this: If you wouldn’t want your mother or your boss to read or see it, don’t post it.

    “And then you really can’t get into that much trouble,” said Ressler, an adjunct faculty member at Tufts University School of Medicine and University of Massachusetts (Boston) College of Nursing and Health Sciences, who regularly speaks about the intersection of social media and healthcare.

    The ‘What Not to Share’ List

    Here are five key things that nurses are better off not sharing online (or via text messaging), even if you’re counting on privacy settings to protect you.

    1. Photos taken at work.
    In the past, patients had to sign photo releases for hospitals to use their pictures. But with the rise in smartphone use, everyone is suddenly a photographer. Consider this scenario: You snap a quick photo of your colleagues at work — and a patient appears in the background. Even if you can’t see his face, he may still be identifiable. This is a big no-no because it can violate your patients’ rights to privacy and confidentiality. In fact, it could tread on violating HIPAA.

    Even if patients don’t appear in the photos, the hospital name on a colleague’s scrub top might be visible, or a viewer might recognize other features and figure out where the photo was taken. If your hospital or clinic has a policy that forbids photography or restricts social media use, these pictures might be a violation.


    Mavis Schorn, PhD, CNM
    Mavis Schorn, PhD, CNM, suggested that nurses be mindful of what they post, regardless of their privacy settings. "Everything is public," she said.


    The simplest way to avoid potential issues is to keep your camera or camera phone put away while at work. “Just don’t take pictures,” said Mavis Schorn, PhD, CNM, assistant dean at Vanderbilt. “You can’t control everything in the background.”

    2. Complaints about your co-workers, boss or job.
    Remember that your boss could be reading what you post. Even if you think your Facebook has the most stringent privacy settings, someone can always share a post, and it could get back to your supervisor. It’s even easier for your boss to read what you’re posting on platforms like Twitter.

    “No matter what your privacy controls are, assume everything is public,” Ressler said.

    So if you’ve just typed out a rant about your long, harried day or a frustrating case, stop and re-read it, take a deep breath, and ask yourself if you really want this to be public. Then consider hitting “delete.”

    3. Proprietary or potentially negative information about your employer.
    Christina Thielst, author of Social Media in Healthcare: Connect, Communicate, Collaborate, reminds nurses not to divulge too much information about their employer. "Don't share any proprietary business information — such as merger discussions, physicians/practices being recruited, organizational strategies, financial information, etc."

    There are other things on the taboo list, as well. "Don't share anything that could be sensitive or could put the organization or services in a negative light: survey visit outcomes, significant unanticipated events, emergency situations, complaints, etc.” Thielst pointed out that these types of things are the responsibility of the public information officer.

    4. Too much information about your personal life.
    Many social media experts advise healthcare professionals to separate their personal online activity from their professional online presence. This might entail setting up a professional Facebook page or Twitter account and a personal one, or using LinkedIn for professional reasons and saving your personal activity for Facebook.

    But that doesn’t mean you can feel free to post whatever you want on the personal side. Even if your patients won’t see those statements, others will, which can impugn your professionalism. For example, if you’re posting status updates about needing a drink to make it through your shift — whether it is a joke or not — it can give a bad impression about you and the profession of nursing.

    “What you post personally has an effect on your professional life,” Ressler said.

    If someone else posts unappealing photos or information about you online, you can also request that they remove your name. On Facebook, you can “untag” yourself. Ressler also suggested conducting regular Google searches on your name to see what turns up, so you can monitor what’s out there that you might not know about.

    5. A diagnosis or patient-specific medical advice.
    Even if you are posting in an official capacity as a nurse on a social media site, it’s important to remember to not write anything that could be construed as a diagnosis. As a nurse, you can educate and guide and provide information to a general audience. Be sure to check with your employer, however, before using the name of your institution.

    And always remember that information about specific patients or cases is not to be shared with anyone outside of the care team.

    Nurses can also refer to the American Nurses Association’s social media principles for additional guidance.


    What Not to Share ... in certain circumstances

    In addition to the basic guidelines above, there may be certain times when nurses need to be careful not to share information. For instance, have you ever received a friend request from a patient on Facebook?

    “As a general rule, I think nurses should not ‘friend’ patients” on Facebook, said Vanderbilt’s Kennedy.

    But she and Schorn both noted this can be a gray area. And if you live and work in a small town, it may be impossible to separate the personal from the professional.

    When you do receive friend requests, Kennedy recommends using discretion about accepting — and then remembering those people are watching when you do post. She added that you can also kindly explain to a patient why you are refusing their request.

    If you ever “check in” on Facebook or Foursquare, a tag is applied to your post to signify your current location. Just remember that this information may not be something you want to share with everyone who can see your profile.

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