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Social Media in the workplace, Is it a good thing or bad thing? Well, I believe it’s about policies and perspective.

By Michelle Dillinger

EMA Emergency Management, EMS Emergency Medical Services, FD Fire Departments, Law Enforcement, badges article logo label

Recently a nurse was fired for posting a comment to her Facebook page.

FB Post by Amanda Francis: On Jan. 13, Amanda Francis wrote,
"Soooooo sleepy here in the ICU. Will someone please code and give me something exciting to do? #isthatbad?"
Elizabeth Reed, writes:
"The post insinuates a patient would need to die to give Francis something to do at work.”

I don’t believe that nurses do what they do every day in hopes someone will die on their shift. I believe that Amanda Francis simply just wanted something more to do. “Sounds like, she was bored.”

My perception of the nurses’ use of the word “code” is not how it seems to have been portrayed in the article covered by

Again it goes back to “Perspective and Policies.”

Research shows that UNM Sandoval Regional Medical center did in fact have a general policy on the use of social media in place and states that social media use is prohibited. Research also shows that UNM has since recently updated and revised their social media policy which may have been a result of lessons learned from incidents involving the use of social media in the workplace.

Social media is not merely a driving force in everyday life, but one that fits seamlessly into how communication is transmitted.

Nurses who use blogs, social networking sites, video sites, online chat rooms, and forums to communicate both personally and professionally with other nurses can use social media in a responsible manner that fosters congenial interface with other professionals. An outlet where nurses can share workplace experiences, particularly those events that are challenging, can be as invaluable as journaling and reflective practice, which have been identified as effective tools in nursing practice. Social networking provides means by which nurses can connect with others, such as the discussion board on NurseConnect and receive support needed in this high stress and emotionally charged profession. (Bulman & Schutz, 2008)

Participating in social media is not a problem as long as nurses always remain cognizant of their professional obligations. Nurses must always be aware of potential consequences of disclosing patient-related information via social media and mindful of employer policies, relevant state and federal laws, and professional standards regarding patient privacy and confidentiality.

Social media can be a highly effective mechanism that allows for the cultivation of professional connections; promotes timely communication with patients and family members; and educates and informs consumers and health care professionals. For example, in 2010 at Jewish Hospital in Louisville, Kentucky, the health care team performed a double hand transplant, which at the time was only the third such surgery in the US. It is a lengthy surgery and involves teams of experts rotating in and out of the surgical suite. During the surgery, senior hand fellows sat outside the surgical suite with a laptop and tweeted updates for the family to read. (Yin. 2010)

A lot of cases illustrate that many of the social media situations involving nurses can begin without malicious intent. However, events can quickly escalate into serious situations where patient confidentiality and privacy are violated and nursing careers are in jeopardy. Two surveys were sent to the Board of Nurses (BONs) in November 2010 and again in March 2012 to examine the extent of nursing regulatory complaints against nurses who misuse social media. Of the 462 executive officers who responded in 2010, 67% reported that they received complaints about nurses misusing social media, and of those, another 67% reported that they disciplined nurses for this infraction. At that time, only 7% of the BONs had specific social networking guidelines in place, though many reported that they can use their general patient privacy protection laws. (NCSBN, 2010; NCSBN, 2012)

By March 2012, not much had changed at BONs. Of the 30 executive officers who responded to the survey, 63% reported that they received complaints against nurses for inappropriately using social media, and of those, 64% reported that they disciplined nurses for this. BONs reported a wide range of complaints, such as nurses inappropriately posting patient photos or posting patient information on blogs, Facebook, or other platforms. The action taken by BONs ranged from cautionary letters to suspension. By 2012, however, 17% of the BONs reported having specific social networking guidelines in place. (NCSBN, 2012)

Federal law reinforces and further defines privacy through HIPAA. HIPAA regulations are intended to protect patient privacy by defining individually identifiable information and establishing how this information may be used; who may use it, and under what circumstances it can be used. 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. (U.S. Department of Health & Human Services, 2012)

Breaches of patient confidentiality or privacy are serious and can be intentional or unintentional. Nurses may breach confidentiality or privacy in a variety of ways, including with information they post via social media. Sometimes the cases are egregious, and the nurse should realize that what he or she is doing is wrong. NCSBN's whitepaper on social media are somewhat more subtle and therefore more likely to happen in everyday situations.

Nursing organizations are beginning to develop social media guidelines so that social media can be used to its fullest potential in communicating with patients. NCSBN’s guidelines can be found online. (NCSBN, 2011e)

In light of examples brought forth by the use of social networking, other nursing organizations have addressed the issues surrounding this pervasive concern as well. The American Nurses Association published the Principles for Social Networking and the Nurse, which are available to their membership online. ANA has endorsed NCSBN’s social media guidelines, and NCSBN has endorsed ANA’s social media principles (ANA, 2011); (NCSBN, 2011c).

The National Student Nurses Association recently published a white paper on social media, Recommendations for Social Media Usage and Maintaining Privacy, Confidentiality and Professionalism. Internationally, the Royal College of Nursing in the United Kingdom has published legal advice on using social media appropriately and Canada has been exploring the issue from a regulatory perspective. (NSNA, nd.); (Royal College of Nursing, 2009), (Anderson & Puckrin, 2011).

The bottom line is individuals in the First Responder Community must use good judgement and professionalism while using social media platforms. Organizations must implement and enact policies and procedures on the use of social media in the workplace so that First Responders can protect those they already serve and protect; organizations to protect the company and also to protect you!


American Nurses Association. (2011). Social networking principles toolkit.

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

National Student Nurses Association. (n.d.). Recommendations for: Social media usage and maintaining privacy, confidentiality and professionalism. Retrieved from NSNA

NSCBN. (2011b). A nurse’s guide to the use of social media.

NCSBN. (2011c). ANA and NCSBN unite to provide guidelines on social media and networking for nurses.

NCSBN. (2011d). Social media guidelines for nurses.

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

NCSBN. (2012). Social media survey. (Unpublished survey). Author, Chicago, IL.

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

U.S. Department of Health & Human Services. (2012). Understanding health information privacy.

UNM Hospitals Policies and Procedures, Administration- UNMH IT and Security – Professional, Business and Social Media & Human Resources, HR 130- Discipline

Yin, S. (2010). Surgeons use Twitter during double hand transplant at Jewish hospital.

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