Common Sense Rules for Using Social Media with Healthcare

Social media is useful – and ubiquitous. But Facebook, Twitter, Instagram and other applications for digital interaction present potential peril for nurses and other healthcare professionals.

One need look no further than the 2014 case of the New York City emergency department nurse – a public figure who gained a measure of fame on the reality TV show New York Med – who was fired after she posted a photograph on Instagram of an empty treatment room in the aftermath of life-saving efforts for a man who was struck by a subway train.

The image posted by the nurse did not depict the patient, or even provide the man’s name. If it had, the nurse would have been potentially guilty of a HIPAA violation, which is against the law and punishable by civil fines of between $100 and $50,000, potential loss of license and even imprisonment.

Rather, she was relieved of her duties for being “insensitive.” The caption she wrote to accompany the picture of an emergency department floor strewn with hastily discarded paper and other material: “Man Vs. 6 Train … The After.”

The nurse expressed contrition publicly and landed a new job at a different hospital. She remains a prominent fixture on social media, with more than 32,000 followers on Facebook and more than 86,000 on Instagram.


Still, her case is a cautionary tale for healthcare professionals who lose sight of the fact that they must be sure not to blur the line between personal life and professional life on social media platforms.

Social Media Tips for Nurses

The widespread use of Facebook (more than 2 billion users), Twitter (330 million) and Instagram (800 million) sometimes makes it seem as if social media has always been around.

In fact, it is a relatively new phenomenon. Facebook launched in 2004 and became available to anyone 13 or older in 2006. Twitter debuted on March 21, 2006, and Instagram followed on July 16, 2010.

As early as 2011, less than a year after Instagram’s debut and only five years after Facebook use took off, the American Nurses Association (ANA) began to provide social media usage guidelines for its members.

The ANA cautions nurses that “online content and behavior has the potential to enhance or undermine not only the nurse’s career, but also the nursing profession.”

The ANA’s original principles for social networking say that nurses:

  • Must not share online individually identifiable patient information.
  • Must observe ethical patient-nurse boundaries.
  • Should be aware that patients, colleagues, institutions and employers might view social media posts.
  • Should use all relevant privacy settings in order to maintain separation between personal and professional information.
  • Should alert the appropriate authorities about content that could harm a patient’s privacy, rights or welfare.
  • Should contribute to the development of institutional social media policies.

In addition, the ANA suggests that nurses remember that the same professional standards that govern in-person interactions apply to online social networking. Online contact with patients blurs the established boundaries between them and healthcare professionals and should be avoided, according to the ANA.

All of that said, many healthcare agencies recognized early on that social media launched a different patient-healthcare communication dynamic. In a 2012 study on healthcare and social media, Price Waterhouse Coopers reported that 1,200 hospitals had begun to incorporate social media into their business models.

It is notable that as early as 2012, social media’s utility as a “natural habitat for health discussions” already was gaining traction with healthcare providers and consumers.

Constructive Healthcare Uses for Social Media

By 2014, the potential benefits of social media networking had begun to influence how healthcare workers used Facebook, Twitter and the professional networking platform, LinkedIn. A 2013 thought piece published by the Journal of Advanced Nursing encouraged nurses to use social media to establish themselves as healthcare experts and advocates.

A year later, a study in the Online Journal of Issues in Nursing highlighted the ways nurses could use social media to benefit themselves personally and professionally. These included accessing new information and sharing best practices with peers, as well as seeking support and offering support to peers.

The journal article also pointed out that social media can be used to enhance knowledge in four critical areas for professional development: clinical practice, academics (continuing education), administration and research.

The potential benefits of social media use for nurses include:

  • Access to expert information not otherwise available
  • Sharing of accomplishments and new skills
  • Developing support networks and communities within a particular specialization

Facebook and LinkedIn, in particular, provide opportunities for community interaction. LinkedIn offers groups for career networking, nursing school alumni groups and more. Facebook also provides a platform for a number of nursing groups across a broad variety of specializations.

These groups usually are governed by a group administrator and, even though the content is not typically shared with the general public, any interaction within social media groups should be treated with the same caution as any publicly shared social media posts.

The bottom line when it comes to social media use for nurses and other healthcare practitioners: Feel free to engage in social media networking, but be mindful of your employer’s social media policies and always let common sense guide your posting.


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