Social media ppt

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This assignment will be in the form of a PowerPoint presentation. PowerPoints
should be concise and briefly highlight information. Slides should be presented in APA 7th ed.
format, be clearly presented, free of spelling and formatting errors, information should be
paraphrased and include citations. Images need to be correctly credited and should include a
minimum of 2 images. Turnitin report should be less than 10%

N402 Social Media Power Point Rubric






Insuff. or Not Addressed

Points Possible

Points Earned

Title Slide in APA format

Includes instructor name, course title, student name and date. 1pt.


Social Media Policy:

· Type of facility

· How is social Media used in facility? Refers to facility policy and dates reviewed discuss briefly in 2 slides. 4 points.


Social Medial Risks and Benefits:

· List and describe 2 benefits of social media. 2pt

· List and describes 2 risks of social media.2pt

· Includes 1 reference each for risk/benefits min. 2pt


Moral/Practice Issues:

· Describe at least 2 moral or practice issues related to social media 3 pts

· Includes Min 1 reference 1 pt


Workplace Social Media:

· Presents scenario for workplace social media issue or concern. 2 pts

· Identifies 4 corrective action recommendations for issue/concern. 7 pts

· Includes Citation for white paper article1pt



· Slide that summarizes main points. 2 pts.


Spelling, Grammar, APA format

· Free of Spelling, typographical, and grammatical errors. Slides are clear, concise, and visually interesting. Pictures used are cited/credited to source.

· References all sources: include assignment white paper and min. 3 additional resources


Total Points Earned


N402 Social Media Assignment Instruction

30 Possible Points

Overview: This assignment will be in the form of a PowerPoint presentation. PowerPoints should be concise and briefly highlight information. Slides should be presented in APA 7th ed. format, be clearly presented, free of spelling and formatting errors, information should be paraphrased and include citations. Images need to be correctly credited and should include a minimum of 2 images. Turn it in report should be less than 10%

1. This assignment is based on the following article by the National Council State Boards of Nursing. The article is located in the content area of the course on D2L.

NCSBN. (2011).
White paper: A nurse’s guide to the use of social media.

2. Please review the ANA Factsheet on social media and website found in D2L


Prepare a power point presentation and include the following:

Title Slide: Name of presentation, Student Name, Instructor Name, College and Course, Date.

Social Media Policy: Discuss the types of policies that are used in your place of work. NO AGENCY names, use initials only and describe the facility. For example, small rural hospital, a hospice agency or a nursing home.

Include the date you viewed the policy and when the policy was written/and or reviewed. How is social media being used in your place of work? For your citation and reference use Agency policy and the date on the policy. Policies should be reviewed yearly so it would be a recommendation if they are outdated. Discuss findings in brief. No more than 2 slides.

Social Media Risk and Benefits: List and describe 2 of the benefits of social media for nursing
? Below is a list of possible benefits. List and describe 2 risks of social media?
Minimum 1 reference/citation for benefits and 1 reference /citation for risks. No more than 4 slides total.

1. Keep up with current health issues, trends, and up to date EBM

2. Opportunities to dialogue with colleagues

3. Education and training

4. Instant alerts in cases of disaster management

5. Dedicated phone for emergency calls to MD

6. Professional groups such as LinkedIn or Research Gate.

7. Facebook to recruit and inform public

Moral /Practice Issues: Describe at least 2 moral or practice issues have you seen arise from the use of social media.
No more than 2 slides total with at least one journal reference

Workplace Social Media: In this section identify specific social media use concern or issue for where you currently or formerly work. Illustrate the social media issue concern or issue in the form of a scenario. How will you correct the issue or concern? Examples could include:

· training for staff and what would this training include or the

· development of a departmental/hospital policy and what would need to be included.

Include :

· Recommendations on the use of social media in your place of work. Use at least 4 recommendations based on the literature reviewed. Be specific and these should be clearly stated and reasonable to the identified setting.

No more than 6 slides total for this section with Reference /citation to the reading for this assignment ANA Factsheet on Social Media and NCSBN. (2011).
White paper: A nurse’s guide to the use of social media.

Summary: End the presentation with a short statement of the main points.

References: Make sure to include 3 different references or more from additional scholarly journals or credible websites.

APA: You may lose additional points for not using APA format and citing references appropriately both within the slides and on a reference page.


The number of individuals using social networking sites such as Facebook, Twitter, LinkedIn, and YouTube is
growing at an astounding rate. Facebook reports that over 10% of the world’s population has a Facebook
presence while Twitter manages more than 140 million Tweets daily. Nurses are making connections using

social media. Recently, the College of Nurses of Ontario reported that 60% of Ontario’s nurses engage in social
networking (Anderson & Puckrin, 2011).

Social networks are defined as “web-based services that allow individuals to 1) construct a public or semi-public
profile within a bounded system, 2) articulate a list of other users with whom they share a connection, and 3) view
and traverse their lists of connections and those made by others within the system” (Boyd and Ellison, 2007).

These online networks offer opportunities for rapid knowledge exchange and dissemination among many people,
although this exchange does not come without risk. Nurses and nursing students have an obligation to under-
stand the nature, benefits, and consequences of participating in social networking of all types. Online content
and behavior has the potential to either enhance or undermine not only the individual nurse’s career, but also the
nursing profession.

• Networking and nurturing relationships
• Exchange of knowledge and forum for collegial interchange
• Dissemination and discussion of nursing and health related

education, research, best practices
• Educating the public on nursing and health related matters

• Information can take on a life of its own where inaccuracies

become “fact”
• Patient privacy can be breached
• The public’s trust of nurses can be compromised
• Individual nursing careers can be undermined

ANA’s Principles for Social Networking
1. Nurses must not transmit or place online individually

identifiable patient information.
2. Nurses must observe ethically prescribed professional patient — nurse boundaries.
3. Nurses should understand that patients, colleagues, institutions, and employers may view postings.
4. Nurses should take advantage of privacy settings and seek to separate personal

and professional information online.
5. Nurses should bring content that could harm a patient’s privacy, rights, or welfare

to the attention of appropriate authorities.
6. Nurses should participate in developing institutional policies governing online


Anderson, J., & Puckrin, K. (2011). Social network use: A test of self-regulation. Journal of Nursing Regulation, 2(1), 36-41.

Boyd, S., & Ellison, N.B. (2007). Social network sites: Definition, history, and scholarship. Journal of Computer Mediated
Communication, 13(1), 210-230.

Navigating the World of Social Media

8515 Georgia Avenue, Suite 400
Silver Spring, MD 20910


September 2011

Journal of Practical Nursing | Fall 2011 | 3 1

White Paper: A Nurse’s Guide
to the Use of Social Media

August 2011

The use of social media and other electronic communication is increasing exponentially with growing numbers of social media
outlets, platforms and applications, including blogs, social networking sites, video sites, and online chat rooms and forums. Nurses
often use electronic media both personally and professionally. Instances of inappropriate use of electronic media by nurses have
been reported to boards of nursing (BONs) and, in some cases, reported in nursing literature and the media. This document is
intended to provide guidance to nurses using electronic media in a manner that maintains patient privacy and confidentiality.

Social media can benefit health care in a variety of ways, including fostering professional connections, promoting timely
communication with patients and family members, and educating and informing consumers and health care professionals.

Nurses are increasingly using blogs, forums and social networking sites to share workplace experiences particularly events that
have been challenging or emotionally charged. These outlets provide a venue for the nurse to express his or her feelings, and
reflect or seek support from friends, colleagues, peers or virtually anyone on the Internet. Journaling and reflective practice have
been identified as effective tools in nursing practice. The Internet provides an alternative media for nurses to engage in these
helpful activities. Without a sense of caution, however, these understandable needs and potential benefits may result in the nurse
disclosing too much information and violating patient privacy and confidentiality.

Health care organizations that utilize electronic and social media typically have policies governing employee use of such media
in the workplace. Components of such policies often address personal use of employer computers and equipment, and personal
computing during work hours. The policies may address types of websites that may or may not be accessed from employer
computers. Health care organizations also maintain careful control of websites maintained by or associated with the organization,
limiting what may be posted to the site and by whom.

The employer’s policies, however, typically do not address the nurse’s use of social media outside of the workplace. It is in this
context that the nurse may face potentially serious consequences for inappropriate use of social media.

Confidentiality and Privacy
To understand the limits of appropriate use of social media, it is important to have an understanding of confidentiality and privacy
in the health care context. Confidentiality and privacy are related, but distinct concepts. Any patient information learned by
the nurse during the course of treatment must be safeguarded by that nurse. Such information may only be disclosed to other
members of the health care team for health care purposes. Confidential information should be shared only with the patient’s
informed consent, when legally required or where failure to disclose the information could result in significant harm. Beyond these
very limited exceptions the nurse’s obligation to safeguard such confidential information is universal.

Privacy relates to the patient’s expectation and right to be treated with dignity and respect. Effective nurse-patient relationships
are built on trust. The patient needs to be confident that their most personal information and their basic dignity will be protected
by the nurse. Patients will be hesitant to disclose personal information if they fear it will be disseminated beyond those who have
a legitimate “need to know.” Any breach of this trust, even inadvertent, damages the particular nurse-patient relationship and the
general trustworthiness of the profession of nursing.

Federal law reinforces and further defines privacy through the Health Insurance Portability and Accountability Act (HIPAA). HIPAA
regulations are intended to protect patient privacy by defining individually identifiable information and establishing how this
information may be used, by whom and under what circumstances. The definition of individually identifiable information includes
any information that relates to the past, present or future physical or mental health of an individual, or provides enough information
that leads someone to believe the information could be used to identify an individual.

Breaches of patient confidentiality or privacy can be intentional or inadvertent and can occur in a variety of ways. Nurses may
breach confidentiality or privacy with information he or she posts via social media. Examples may include comments on social


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networking sites in which a patient is described with sufficient detail to be identified, referring to patients in a degrading or
demeaning manner, or posting video or photos of patients. Additional examples are included at the end of this document.

Possible Consequences
Potential consequences for inappropriate use of social and electronic media by a nurse are varied. The potential consequences
will depend, in part, on the particular nature of the nurse’s conduct.

BON Implications

Instances of inappropriate use of social and electronic media may be reported to the BON. The laws outlining the basis for
disciplinary action by a BON vary between jurisdictions. Depending on the laws of a jurisdiction, a BON may investigate reports
of inappropriate disclosures on social media by a nurse on the grounds of:

�� Unprofessional conduct;

�� Unethical conduct;

�� Moral turpitude;

�� Mismanagement of patient records;

�� Revealing a privileged communication; and

�� Breach of confidentiality.

If the allegations are found to be true, the nurse may face disciplinary action by the BON, including a reprimand or sanction,
assessment of a monetary fine, or temporary or permanent loss of licensure.

A 2010 survey of BONs conducted by NCSBN indicated an overwhelming majority of responding BONs (33 of the 46 respondents)
reported receiving complaints of nurses who have violated patient privacy by posting photos or information about patients on
social networking sites. The majority (26 of the 33) of BONs reported taking disciplinary actions based on these complaints.
Actions taken by the BONs included censure of the nurse, issuing a letter of concern, placing conditions on the nurse’s license or
suspension of the nurse’s license.

Other Consequences

Improper use of social media by nurses may violate state and federal laws established to protect patient privacy and confidentiality.
Such violations may result in both civil and criminal penalties, including fines and possible jail time. A nurse may face personal
liability. The nurse may be individually sued for defamation, invasion of privacy or harassment. Particularly flagrant misconduct on
social media websites may also raise liability under state or federal regulations focused on preventing patient abuse or exploitation.

If the nurse’s conduct violates the policies of the employer, the nurse may face employment consequences, including termination.
Additionally, the actions of the nurse may damage the reputation of the health care organization, or subject the organization to a
law suit or regulatory consequences.

Another concern with the misuse of social media is its effect on team-based patient care. Online comments by a nurse regarding
co-workers, even if posted from home during nonwork hours, may constitute as lateral violence. Lateral violence is receiving
greater attention as more is learned about its impact on patient safety and quality clinical outcomes. Lateral violence includes
disruptive behaviors of intimidation and bullying, which may be perpetuated in person or via the Internet, sometimes referred
to as “cyber bullying.” Such activity is cause for concern for current and future employers and regulators because of the patient-
safety ramifications. The line between speech protected by labor laws, the First Amendment and the ability of an employer to
impose expectations on employees outside of work is still being determined. Nonetheless, such comments can be detrimental to
a cohesive health care delivery team and may result in sanctions against the nurse.

Common Myths and Misunderstandings of Social Media
While instances of intentional or malicious misuse of social media have occurred, in most cases, the inappropriate disclosure or
posting is unintentional. A number of factors may contribute to a nurse inadvertently violating patient privacy and confidentiality
while using social media. These may include:

�� A mistaken belief that the communication or post is private and accessible only to the intended recipient. The nurse may fail
to recognize that content once posted or sent can be disseminated to others. In fact, the terms of using a social media site
may include an extremely broad waiver of rights to limit use of content.1 The solitary use of the Internet, even while posting
to a social media site, can create an illusion of privacy.

1 One such waiver states, “By posting user content to any part of the site, you automatically grant the company an irrevocable, perpetual, nonexclusive transferable, fully paid, worldwide license to use,

copy, publicly perform, publicly display, reformat, translate, excerpt (in whole or in part), distribute such user content for any purpose.” Privacy Commission of Canada. (2007, November 7). Privacy and

social networks [Video file]. Retrieved from


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Journal of Practical Nursing | Fall 2011 | 3

�� A mistaken belief that content that has been deleted from a site is no longer accessible.

�� A mistaken belief that it is harmless if private information about patients is disclosed if the communication is accessed only
by the intended recipient. This is still a breach of confidentiality.

�� A mistaken belief that it is acceptable to discuss or refer to patients if they are not identified by name, but referred to by
a nickname, room number, diagnosis or condition. This too is a breach of confidentiality and demonstrates disrespect for
patient privacy.

�� Confusion between a patient’s right to disclose personal information about himself/herself (or a health care organization’s
right to disclose otherwise protected information with a patient’s consent) and the need for health care providers to refrain
from disclosing patient information without a care-related need for the disclosure.

�� The ease of posting and commonplace nature of sharing information via social media may appear to blur the line between
one’s personal and professional lives. The quick, easy and efficient technology enabling use of social media reduces the
amount of time it takes to post content and simultaneously, the time to consider whether the post is appropriate and the
ramifications of inappropriate content.

How to Avoid Problems
It is important to recognize that instances of inappropriate use of social media can and do occur, but with awareness and caution,
nurses can avoid inadvertently disclosing confidential or private information about patients.

The following guidelines are intended to minimize the risks of using social media:

�� First and foremost, nurses must recognize that they have an ethical and legal obligation to maintain patient privacy and
confidentiality at all times.

�� Nurses are strictly prohibited from transmitting by way of any electronic media any patient-related image. In addition, nurses
are restricted from transmitting any information that may be reasonably anticipated to violate patient rights to confidentiality
or privacy, or otherwise degrade or embarrass the patient.

�� Do not share, post or otherwise disseminate any information, including images, about a patient or information gained in the
nurse-patient relationship with anyone unless there is a patient care related need to disclose the information or other legal
obligation to do so.

�� Do not identify patients by name or post or publish information that may lead to the identification of a patient. Limiting
access to postings through privacy settings is not sufficient to ensure privacy.

�� Do not refer to patients in a disparaging manner, even if the patient is not identified.

�� Do not take photos or videos of patients on personal devices, including cell phones. Follow employer policies for taking
photographs or video of patients for treatment or other legitimate purposes using employer-provided devices.

�� Maintain professional boundaries in the use of electronic media. Like in-person relationships, the nurse has the obligation
to establish, communicate and enforce professional boundaries with patients in the online environment. Use caution when
having online social contact with patients or former patients. Online contact with patients or former patients blurs the
distinction between a professional and personal relationship. The fact that a patient may initiate contact with the nurse does
not permit the nurse to engage in a personal relationship with the patient.

�� Consult employer policies or an appropriate leader within the organization for guidance regarding work related postings.

�� Promptly report any identified breach of confidentiality or privacy.

�� Be aware of and comply with employer policies regarding use of employer-owned computers, cameras and other electronic
devices and use of personal devices in the work place.

�� Do not make disparaging remarks about employers or co-workers. Do not make threatening, harassing, profane, obscene,
sexually explicit, racially derogatory, homophobic or other offensive comments.

�� Do not post content or otherwise speak on behalf of the employer unless authorized to do so and follow all applicable
policies of the employer.

6 | Fall 2011 | Journal of Practical 4

Social and electronic media possess tremendous potential for strengthening personal relationships and providing valuable infor-
mation to health care consumers. Nurses need to be aware of the potential ramifications of disclosing patient-related information
via social media. Nurses should be mindful of employer policies, relevant state and federal laws, and professional standards re-
garding patient privacy and confidentiality and its application to social and electronic media. By being careful and conscientious,
nurses may enjoy the personal and professional benefits of social and electronic media without violating patient privacy and

Illustrative Cases
The following cases, based on events reported to BONs, depict inappropriate uses of social and electronic media. The outcomes
will vary from jurisdiction to jurisdiction.

Bob, a licensed practical/vocational (LPN/VN) nurse with 20 years of experience used his personal cell phone to take photos of a
resident in the group home where he worked. Prior to taking the photo, Bob asked the resident’s brother if it was okay for him to take the
photo. The brother agreed. The resident was unable to give consent due to her mental and physical condition. That evening, Bob saw
a former employee of the group home at a local bar and showed him the photo. Bob also discussed the resident’s condition with the
former coworker. The administrator of the group home learned of Bob’s actions and terminated his employment. The matter was also
reported to the BON. Bob told the BON he thought it was acceptable for him to take the resident’s photo because he had the consent
of a family member. He also thought it was acceptable for him to discuss the resident’s condition because the former employee was
now employed at another facility within the company and had worked with the resident. The nurse acknowledged he had no
legitimate purpose for taking or showing the photo or discussing the resident’s condition. The BON imposed disciplinary action
on Bob’s license requiring him to complete continuing education on patient privacy and confidentiality, ethics and professional

This case demonstrates the need to obtain valid consent before taking photographs of patients; the impropriety of using a
personal device to take a patient’s photo; and that confidential information should not be disclosed to persons no longer involved
in the care of a patient.

Sally, a nurse employed at a large long-term care facility arrived at work one morning and found a strange email on her laptop.
She could not tell the source of the email, only that it was sent during the previous nightshift. Attached to the email was a photo
of what appeared to be an elderly female wearing a gown with an exposed backside bending over near her bed. Sally asked the
other dayshift staff about the email/photo and some confirmed they had received the same photo on their office computers.
Nobody knew anything about the source of the email or the identity of the woman, although the background appeared to be a
resident’s room at the facility. In an effort to find out whether any of the staff knew anything about the email, Sally forwarded it to
the computers and cell phones of several staff members who said they had not received it. Some staff discussed the photo with
an air of concern, but others were laughing about it as they found it amusing. Somebody on staff started an office betting pool to
guess the identity of the resident. At least one staff member posted the photo on her blog.

Although no staff member had bothered to bring it to the attention of a supervisor, by midday, the director of nursing and facility
management had become aware of the photo and began an investigation as they were very concerned about the patient’s rights.
The local media also became aware of the matter and law enforcement was called to investigate whether any crimes involving
sexual exploitation had been committed.

While the county prosecutor, after reviewing the police report, declined to prosecute, the story was heavily covered by local media
and even made the national news. The facility’s management placed several staff members on administrative leave while they
looked into violations of facility rules that emphasize patient rights, dignity and protection. Management reported the matter
to the BON, which opened investigations to determine whether state or federal regulations against “exploitation of vulnerable
adults” were violated. Although the originator of the photo was never discovered, nursing staff also faced potential liability for
their willingness to electronically share the photo within and outside the facility, thus exacerbating the patient privacy violations,
while at the same time, failing to bring it to management’s attention in accordance with facility policies and procedures. The
patient in the photo was ultimately identified and her family threatened to sue the facility and all the staff involved. The BON’s
complaint is pending and this matter was referred to the agency that oversees long-term care agencies.

This scenario shows how important it is for nurses to carefully consider their actions. The nurses had a duty to immediately
report the incident to their supervisor to protect patient privacy and maintain professionalism. Instead, the situation escalated to
involving the BON, the county prosecutor and even the national media. Since the patient was ultimately identified, the family was
embarrassed and the organization faced possible legal consequences. The organization was also embarrassed because of the
national media focus.


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A 20-year-old junior nursing student, Emily, was excited to be in her pediatrics rotation. She had always wanted to be a pediatric
nurse. Emily was caring for Tommy, a three-year-old patient in a major academic medical center’s pediatric unit. Tommy was
receiving chemotherapy for leukemia. He was a happy little guy who was doing quite well and Emily enjoyed caring for him. Emily
knew he would likely be going home soon, so when his mom went to the cafeteria for a cup of coffee, Emily asked him if he minded
if she took his picture. Tommy, a little “ham,” consented immediately. Emily took his picture with her cell phone as she wheeled
him into his room because she wanted to remember his room number.

When Emily got home that day she excitedly posted Tommy’s photo on her Facebook page so her fellow nursing students could
see how lucky she was to be caring for such a cute little patient. Along with the photo, she commented, “This is my 3-year-old
leukemia patient who is bravely receiving chemotherapy. I watched the nurse administer his chemotherapy today and it made me
so proud to be a nurse.” In the photo, Room 324 of the pediatric unit was easily visible.

Three days later, the dean of the nursing program called Emily into her office. A nurse from the hospital was browsing Facebook
and found the photo Emily posted of Tommy. She reported it to hospital officials who promptly called the nursing program. While
Emily never intended to breach the patient’s confidentiality, it didn’t matter. Not only was the patient’s privacy compromised, but
the hospital faced a HIPAA violation. People were able to identify Tommy as a “cancer patient,” and the hospital was identified
as well. The nursing program had a policy about breaching patient confidentiality and HIPAA violations. Following a hearing with
the student, school officials and the student’s professor, Emily was expelled from the program. The nursing program was barred
from using the pediatric unit for their students, which was very problematic because clinical sites for acute pediatrics are difficult
to find. The hospital contacted federal officials about the HIPAA violation and began to institute more strict policies about use of
cell phones at the hospital.

This scenario highlights several points. First of all, even if the student had deleted the photo, it is still available. Therefore, it would
still be discoverable in a court of law. Anything that exists on a server is there forever and could be resurrected later, even after
deletion. Further, someone can access Facebook, take a screen shot and post it on a public website.

Secondly, this scenario elucidates confidentiality and privacy breaches, which not only violate HIPAA and the nurse practice act
in that state, but also could put the student, hospital and nursing program at risk for a lawsuit. It is clear in this situation that the
student was well-intended, and yet the post was still inappropriate. While the patient was not identified by name, he and the
hospital were still readily identifiable.

A BON received a complaint that a nurse had blogged on a local newspaper’s online chat room. The complaint noted that the
nurse bragged about taking care of her “little handicapper.” Because they lived in a small town, the complainant could identify
the nurse and the patient. The complainant stated that the nurse was violating “privacy laws” of the child and his family. It was
also discovered that there appeared to be debate between the complainant and the nurse on the blog over local issues. These
debates and disagreements resulted in the other blogger filing a complaint about the nurse.

A check of the newspaper website confirmed that the nurse appeared to write affectionately about the handicapped child for
whom she provided care. In addition to making notes about her “little handicapper,” there were comments about a wheelchair
and the child’s age. The comments were not meant to be offensive, but did provide personal information about the patient. There
was no specific identifying information found on the blog about the patient, but if you knew the nurse, the patient or the patient’s
family, it would be possible to identify who was being discussed.

The board investigator contacted the nurse about the issue. The nurse admitted she is a frequent blogger on the local newspaper
site; she explained that she does not have a television and blogging is what she does for entertainment. The investigator discussed
that as a nurse, she must be careful not to provide any information about her home care patients in a public forum.

The BON could have taken disciplinary action for the nurse failing to maintain the confidentiality of patient information. The
BON decided a warning was sufficient and sent the nurse a letter advising her that further evidence of the release of personal
information about patients will result in disciplinary action.

This scenario illustrates that nurses need to be careful not to mention work issues in their private use of websites, including
posting on blogs, discussion boards, etc. The site used by the nurse was not specifically associated with her like a personal blog
is; nonetheless the nurse posted sufficient information to identify herself and the patient.


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Nursing students at a local college had organized a group on Facebook that allowed the student nurses’ association to post
announcements and where students could frequently blog, sharing day-to-day study tips and arranging study groups. A student-
related clinical error occurred in a local facility and the student was dismissed from clinical for the day pending an evaluation of
the error. That evening, the students blogged about the error, perceived fairness and unfairness of the discipline, and projected
the student’s future. The clinical error was described, and since the college only utilized two facilities for clinical experiences, it
was easy to discern where the error took place. The page and blog could be accessed by friends of the students, as well as the
general public.

The students in this scenario could face possible expulsion and discipline. These blogs can be accessed by the public and the
patient could be identified because this is a small community. It is a myth that it can only be accessed by that small group, and as
in Scenario 3, once posted, the information is available forever. Additionally, information can be quickly spread to a wide audience,
so someone could have taken a screen shot of the situation and posted it on a public site. This is a violation of employee/university

Chris Smith, the brother of nursing home resident Edward Smith, submitted a complaint to the BON. Chris was at a party when
his friend, John, picked up his wife’s phone to read her a text message. The message noted that she was to “get a drug screen
for resident Edward Smith.” The people at the party who heard the orders were immediately aware that Edward Smith was the
quadriplegic brother of Chris. Chris did not want to get the nurse in trouble, but was angered that personal information about his
brother’s medical information was released in front of others.

The BON opened an investigation and learned that the physician had been texting orders to the personal phone number of
nurses at the nursing home. This saved time because the nurses would get the orders directly and the physician would not have
to dictate orders by phone. The use of cell phones also provided the ability for nurses to get orders while they worked with other
residents. The practice was widely known within the facility, but was not the approved method of communicating orders.

The BON learned that on the night of the party, the nurse had left the facility early. A couple hours prior to leaving her shift she had
called the physician for new orders for Edward Smith. She passed this information onto the nurse who relieved her. She explained
that the physician must not have gotten a text from her co-worker before he texted her the orders.

The BON contacted the nursing home and spoke to the director of nursing. The BON indicated that if the physician wanted to use
cell phones to text orders, he or the facility would need to provide a dedicated cell phone to staff. The cell phone could remain in
a secured, private area at the nursing home or with the nurse during her shift.

The BON issued a warning to the nurse. In addition, the case information was passed along to the health board and medical board
to follow up with the facility and physician.

This scenario illustrates the need for nurses to question practices that may result in violations of confidentiality and privacy. Nurse
managers should be aware of these situations and take steps to minimize such risks.

Jamie has been a nurse for 12 years, working in hospice for the last six years. One of Jamie’s current patients, Maria, maintained
a hospital-sponsored communication page to keep friends and family updated on her battle with cancer. Jamie periodically read
Maria’s postings, but had never left any online comments. One day, Maria posted about her depression and difficulty finding an
effective combination of medications to relieve her pain without unbearable side effects. Jamie knew Maria had been struggling
and wanted to provide support, so she wrote a comment in response to the post, stating, “I know the last week has been difficult.
Hopefully the new happy pill will help, along with the increased dose of morphine. I will see you on Wednesday.” The site
automatically listed the user’s name with each comment. The next day, Jamie was shopping at the local grocery store when a
friend stopped her and said, “I didn’t know you were taking care of Maria. I saw your message to her on the communication page.
I can tell you really care about her and I am glad she has you. She’s an old family friend, you know. We’ve been praying for her but
it doesn’t look like a miracle is going to happen. How long do you think she has left?” Jamie was instantly horrified to realize her
expression of concern on the webpage had been an inappropriate disclosure. She thanked her friend for being concerned, but
said she couldn’t discuss Maria’s condition. She immediately went home and attempted to remove her comments, but that wasn’t
possible. Further, others could have copied and pasted the comments elsewhere.

At her next visit with Maria, Jamie explained what had happened and apologized for her actions. Maria accepted the apology, but
asked Jamie not to post any further comments. Jamie self- reported to the BON and is awaiting the BON’s decision.


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This scenario emphasizes the importance for nurses to carefully consider the implications of posting any information about patients
on any type of website. While this website was hospital sponsored, it was available to friends and family. In some contexts it is
appropriate for a nurse to communicate empathy and support for patients, but they should be cautious not to disclose private
information, such as types of medications the patient is taking.

Anderson, J., & Puckrin, K. (2011). Social network use: A test of self-regulation. Journal of Nursing Regulation, 2(1), 36-41.

Barnes, S.B. (2006). A privacy paradox: Social networking in the United States. First Monday, 11(9). Retrieved from http://

College of Nurses of Ontario. (2009). Confidentiality and privacy — Personal health information (Pub. No. 41069). Retrieved from

Royal College of Nursing. (2009). Legal advice for RCN members using the internet. Retrieved from

Eysenbach, G. (2008). Medicine 2.0: Social networking, collaboration, participation, apomediation, and openness. Journal of
Medical Internet Research, 10(3), e22. Retrieved from

Gauthier, M. (2008). Technology and confidentiality. Nursing bc, 40(2), 11-12.

Genova, G.L. (2009). No place to play: Current employee privacy rights in social networking sites. Business Communication
Quarterly, 72, 97-101.

Helliker, K. (2011, January 5). Odd facebook post leads to student’s ouster, suit. Wall Street Journal. Retrieved from http://online.

HIPAA Administrative Simplification 45 C.F.R., Parts 160, 162 and 164 (2009). Retrieved from

Klich-Heartt, E.I., & Prion, S. (2010). Social networking and HIPAA: Ethical concerns for nurses. Nurse Leader, 8(2), 56-58.

Lehavot, K. (2009). “My Space” or yours? The ethical dilemma of graduate students’ personal lives on the internet. Ethics and
Behavior, 19(2), 129-141.

McBride, D., & Cohen, E. (2009). Misuse of social networking may have ethical implications for nurses. ONS Connect, 24(17), 7.

National Labor Relations Board. (2011). Settlement reached in case involving discharge for Facebook comments. Retrieved from

NCSBN. (2010). Summary of social networking survey to boards of nursing. Chicago: Author.

Skiba, D.J., Connors, H.R., & Jeffries, P.R. (2008). Information technology and the transformation of nursing education. Nursing
Outlook, 56(5), 225-230.

Spector, N. (2010). Boundary violations via the internet. Leader to Leader. Retrieved from

Winchester, A.M., & Maines, R.E. (2010, October 6). Harvesting text messages from the sea of text messages. Law Technology
News. Retrieved from

Wink, D.M. (2010). Teaching with technology: Automatically receiving information from the internet and web. Nurse Educator,
35(4), 141-143.

©2011 The National Council of State Boards of Nursing (NCSBN) is a not-for-profit organization whose members include the
boards of nursing in the 50 states, the District of Columbia and four U.S. territories — American Samoa, Guam, Northern Mariana
Islands and the Virgin Islands. There are also nine associate members.

Mission: NCSBN provides education, service and research through collaborative leadership to promote evidence-based regulatory
excellence for patient safety and public protection.

National Council of State Boards of Nursing
111 E. Wacker Dr., Suite 2900 Chicago, IL 60601
312.525.3600 | Fax: 312.279.1032



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Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.

Social Media:
The realities of an online presence for RN’s

Student name

NURS 402-04 Psychosocial/Inter-professional Communication for RN’s

Minnesota State University, Mankato

Instructor Name


Image from Microsoft PowerPoint 365

Social Media Policies

AH, a large, multi-city school district serving several suburbs: Social media policies apply to all employees including the 97 nurses on staff.

Employees should observe the following rules for personal use of Social Media

Consider your role as a school employee before posting any content that would show “obscene, profane, vulgar, harassing, threatening, bullying, libelous, or defamatory or that discusses or encourages any illegal activity, use of illegal drugs, inappropriate alcohol use, sexual behavior or sexual harassment.” (Anoka Hennepin School District #11, 2015, 5.1)

Image from Microsoft PowerPoint 365

Social Media Policies (Contintued)

Views expressed are the employees and do not reflect the district

No disclosure of private, proprietary or confidential information

Employees may not use or post graphic/logo without permission

Employees have responsibility to maintain appropriate student-employee relationships at all times

If an employee chooses to engage with a student group or public group, they do so as an employee

(Anoka Hennepin School District #11, 2015)

Image from Microsoft PowerPoint 365

Social Media Benefits to Nurses

Four domains that are positively impacted by social media


fostering mentors, enhance education in rural settings

Support through transition periods

Reduce geographical separation and stress

Clinical Practice:

Connect and advocate for their profession and patients

(Jackson et al., 2014)

Image from Microsoft PowerPoint 365

Social Media Benefits to Nurses


Broadcast research findings

Monitor health and facility collection


Connect and exchange information

Reduces recruitment barriers for surveys

(Jackson et al., 2014)

(Bethel et al., 2020)

Image from Microsoft PowerPoint 365

Social Media Risks for Nurses

Crossing professional and personal lines

Misinformation spread

Breach of patient and staff privacy

Loss of public’s trust over use of social media

Third-Party use agreements and data breaches

(Geraghty et al., 2021)

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Social Media Risks for Nurses

Loss of in-person interaction can lead to:

Loss of non-verbal and verbal skills

Loss of communication skills

Loss of ability to empathize

Loss of active-listening skills

Disruptions in clinical environment

Loss of situational awareness

Loss of critical thinking

Decreased patient outcome

(Geraghty et al., 2021)

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Moral Practice Issues of Social Media

Social Media posts that breach confidentiality and Privacy:

violations decrease patient trust

18 different patient identifiers including geographical subdivisions smaller than the state (UC Berkeley, 2021)

Patient posts violate nonmaleficence code even if never identified:

Digital information is permanent

Risk of emotional pain or harm always possible

Professional Integrity:

Questionable posts of other nurses

Professional boundaries

Inappropriate posts about patients, employers or profession (Henderson & Dahnke, 2015)

Image from Microsoft PowerPoint 365

Workplace Social Media Concerns

New employee makes one of many possible social media acts of misconduct

New employees are not given training on the employer’s social media policies.

The policies have not been updated since 2015

Workplace Social Media Recommendations

Electronic communication and social media use growing at exponential rate

Ensure nurses understand the appropriate social media use regarding:

Privacy and confidentiality

Possible consequences including Board of Nursing implications or employer consequences

Understand Common Misunderstandings and Myths

How to circumvent issues (National Council of State Boards of Nursing, 2011)

Workplace Social Media Recommendation

Current Social Media Policy should be reviewed every year (Karpman & Drisko, 2016)

Current Social Media Policy should address the following areas:

What is considered social media

Who is authorized to represent employer

What are the legal restrictions, regulations and sensitive information with special section for nurses addressing HIPAA

What is acceptable content and conduct (do’s and don’ts) (FirmPlay, 2021)

Workplace Social Media Recommendations

AH should add new hire orientation on social media

Documentation of expectations given to new employee to read

Documentation of expectations given to new employee to sign and return to employer

Existing AH employees should be given on-line orientation on social media

Documentation of expectations given to new employee to read

Documentation of expectations given to new employee to download, sign and return to employer


Social media is here to stay

Social media, like any other tool, is directed by the intent of use

Employees must be trained in knowledge and use of social media to properly utilize it


Anoka Hennepin School District #11. (2015, October 26). Employee use of social media. Anoka-Hennepin school district.

Bethel, C., Rainbow, J. G., & Dudding, K. M. (2020). Recruiting nurses via social media for survey studies. Nursing Research, 70(3), 231–235.

FirmPlay. (2021). Social media policy 101.

Geraghty, S., Hari, R., & Oliver, K. (2021). Using social media in contemporary nursing: Risks and benefits. British Journal of Nursing, 30(18), 1078–1082.

Henderson, M., & Dahnke, M. D. (2015). The ethical use of social media in nursing practice. MEDSURG Nursing, 24(1), 62–64.

Jackson, J., Fraser, R., & Ash, P. (2014). Social media and nurses: Insights for promoting health for individual and professional use. OJIN: The Online Journal of Issues in Nursing, 19(3).


Karpman, H. E., & Drisko, J. (2016). Social media policy in social work education: A review and recommendations. Journal of Social Work Education, 52(4), 398–408.

National Council of State Boards of Nursing. (2011). White paper: A nurse’s guide to the use of social media. Journal of Practical Nursing.

UC Berkeley. (2021). Uc berkeley committee for protection of human subjects. UC Berkeley human research projection program.





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