Nurses and Social Media: A Professional Responsibility

Article Categories: Legal and Ethics & Nurse On the Job

One of the benefits of the Internet is the ability to connect with others and share details about your day. Besides social media favorites, such as Facebook and Twitter, nurses can swap stories and tips in the specialized forums available on nursing websites.

With so many ways to interact with family, friends, and colleagues around the world, it can be easy to slip and mistakenly provide Protected Health Information (PHI) while describing a special patient or asking for advice during an online exchange. The American Nurses Association (ANA) has issued guidelines to remind all nurses of their obligation to uphold HIPAA standards, even away from the bedside.

The ANA’s “Principles of Social Networking” provides clear points for nurses, nursing students, and all healthcare providers:

1. NEVER share anything online that contains a patient’s PHI. This includes any information or photos that the patient has directly shared with you. It is still considered confidential.

2. Always maintain professional nurse-patient boundaries, including online or electronic. Even if you develop a friendly relationship, medical ethics dictate that you should not permit any type of virtual “friendship” with a patient.

3. Nurses should use appropriate privacy settings on their social media accounts to keep personal and professional lives separate. Even though you are not sharing PHI with friends, your patients should not be able to learn details about your personal life. And, of course, you are always prudent in what personal information you place online; employees have been fired for indiscrete or inappropriate posts.

4. Be aware that anything you post may possibly be viewed by patients, co-workers, supervisors, and employers. Do not make harsh or unkind comments about patients or colleagues, even if you don’t identify them. It’s not worth it…and it’s too difficult to disguise your targets. Rule of thumb: If you wouldn’t say it in a crowded elevator, don’t put it in a post.

5. Report any HIPAA violations or breaches of confidentiality to the proper authorities. As a professional, you are obligated to report content which could threaten a patient’s privacy or welfare.

In a recent post on, author Dave Ekrem offered a good example of an unintentional, but still harmful, HIPAA violation:

“For example, it’s pretty obvious that no thinking person would post this: “Dave Ekrem was in the Emergency Department last night with alcohol-induced liver disease.”

But this could also identify your patient: “We had a fifty-year-old male in the ED last night with alcohol-induced liver disease.” (Somebody’s going to say “Really? In Boston? Hey, where was Dave last night? He’s fifty. Oh, I feel sorry for the kids.”)”

The consequences of inadvertently sharing PHI are severe. Penalties can include steep fines, as well as termination of employment. Nursing is considered to be the most trustworthy profession; maintaining strict professional boundaries protects the reputation of all nurses.