Running head: SOCIAL MEDIA IMPLICATIONS IN NURSING

Implications of Social Media Use in Professional Nursing Practice

Halea Dardin
Auburn University NURS 4910

SOCIAL MEDIA IMPLICATIONS IN NURSING

Abstract
In a society with an ever-growing presence of electronic information and use of social media, it
is important that nurses and other healthcare providers understand the possible implications of
online actions. Social media, which includes networking sites, email, text messages, and any
alternative form of technology used to communicate with others, can create positive implications
such as enhanced education and communication opportunities among healthcare providers and
patients, as well as negative implications such as unprofessionalism and privacy concerns. These
concerns have become issues for individuals as well as healthcare organizations, and in may
cases, have lead to the prevention of employment and advancing clinical opportunities. The
Health Insurance Portability and Accountability Act (HIPAA) outlines rules and regulations for
healthcare organizations to ensure the protection and confidential care of protected health
information. As a healthcare provider, it is the nurses responsibility to take certain action to use
social media to its fullest extent to improve the efficiency and quality of care while also
maintaining professional boundaries and keeping patients information safe.
Keywords: social media, implications, nursing, professional practice

SOCIAL MEDIA IMPLICATIONS IN NURSING

Implications of Social Media Use in Professional Nursing Practice

With the widespread use of social media in society, nurses must be aware of possible
implications of this resource and prevent its use from interfering with or disrupting professional
nursing practice. While social media can provide excellent sources for education, it can also
become an easy place to violate a patients rights. According to the article, Issues and answers
(2011), social media is considered any electronic and/or web-based technology used by people to
communicate with others, including social networking sites, video/movie sites, cell phones,
photographic or video cameras, blogs, and other applications. The purpose of this paper is to
review the positive contributions social media can have towards nursing, the potential harm
social media can cause towards nursing, and the ways in which healthcare providers can prevent
HIPAA violations and harm to their patients when social media is involved.
Positive Contributions of Social Media
The use of technology in the healthcare system is growing rapidly, on both personal and
professional levels. According to Weaver, Lindsay, and Gitelman (2012), 17% of adult cell
phone owners use their phones to look up health or medical information. Dual functionality of
networking sites, such as Facebook, is also beginning to emerge as healthcare providers are
connecting with other providers via group pages. Healthcare workers can use these pages to ask
questions about common practice, to seek advice for rare findings and difficult cases, and to
gather insight from those who may be using different methods and skills in different areas around
the world. Although these pages may not represent research based best practice, nurses and
physicians are able to consider alternative options that can be utilized to further local research.
Social media opens up conversations and addresses points of view that may be beneficial to
different facilities and need to be explored in more detail. It also allows for healthcare providers

SOCIAL MEDIA IMPLICATIONS IN NURSING

to discuss feelings and to obtain support from colleagues and peers. Social media pages may act
as outlets and support groups for nurses needing encouragement or to discuss feelings or issues,
such as feelings towards nurse burnout. According to Barry and Hardiker (2012), the
accessibility of information for nurses also makes social media sources useful for nursing
research. For example, Twitter may be used to predict and track disease outbreaks such as
influenza.
In addition to providing enhanced access to information, social media provides a specific
outlet for education and communication. The positive implications extend from healthcare
provider to patient as well as for education and communication for healthcare provider to other
healthcare providers. Patients often actually prefer the use of social media, such as email, for
communicating with nurses and physicians. Weaver et al., (2012) discovered that 80% of
patients in a family practice clinic chose email as the main form of communication with the
healthcare provider over home address or home phone. This is likely due to the benefits of
email, which include increased efficiency, strengthened patient/provider communication, and
more informed decision-making. In addition to the positive contributions of email, the use of
cell phones can be beneficial for communicating between healthcare providers throughout busy
shifts. Many clinics and offices have begun using text-messaging systems as a dominant form of
communication with patients. Text messages are used to schedule appointments, to send out
appointment reminders, to inform patients when prescriptions are ready for pick up, to send out
alerts, and to address frequently asked questions (Weaver et al., 2012). The use of text
messaging may also allow nurses to reach more rural populations. A study performed by
Kratzke, Wilson, and Vilchis (2013) examined the use of the Internet and text messages to
provide breast cancer prevention information to women in rural areas. The study found a high

SOCIAL MEDIA IMPLICATIONS IN NURSING

interest in receiving breast cancer prevention text messages among the women in the study and
that health educators may be encouraged to reach lower income populations by using these text
message systems. While communicating with the patients is a huge benefit, quicker, more
efficient communication among staff is also enabled when using personal electronic devices. In
a study at Sarasota Memorial Healthcare System, nurses used Ipod Touches to decrease the
number of overhead pages over an eight-hour shift from 172 pages to 38 pages (Weaver et al.,
2012). The use of this system and social media as a whole is creating more efficient
communication methods among healthcare providers, extending the boundaries of
communication and education with patients, and most importantly, improving the quality of care
delivered in healthcare facilities across the United States.
Negative Implications of Social Media
The use of social media, as advanced and educational as it may be, still remains to be
problematic in regards to professionalism and privacy concerns. The ease of access to social
media can create an atmosphere of unprofessionalism and it is the responsibility of the healthcare
provider to maintain professional boundaries while using and posting things on social media
sites. According to Barry and Hardiker (2012), an evaluation of social networking sites
concluded that 70% of medical students and residents social media accounts include photos
containing alcohol, racially toned language, or foul language. The unprofessional portrayal of
employees creates a bad image for the individual as well as the organization, and these
representations via social media accounts greatly affect job opportunities and employment. In
the hiring society of today, employers are turning to social media sites to view the potential
employees Internet presence and portrayal, and most employers have social media policies in
place. Barry and Hardiker (2012) emphasize caution for nurses regarding posts on social media,

SOCIAL MEDIA IMPLICATIONS IN NURSING

as defaming comments made about another person or institution may violate organizational
policies and can be used in civil lawsuits against that nurse. To highlight this importance,
schools are now including social media use in curriculums for healthcare professionals, as court
rulings place responsibility on the institutions to teach professional behavior and conduct to
students (Rice, 2013).
As professionalism is a concern, privacy violations can also create serious implications
for both the individual and the healthcare organization. The use of electronic devices has
increased the ability and ease of capturing and transmitting information and pictures in the
clinical setting and privacy breaches can occur in many different ways (Rice, 2013).
Unprofessional posts may include undignified comments about patients, pictures or videos from
clinical settings, or comments or discussions with patient identifying information. In a survey
conducted around the misuse of social media networking sites, 33 state boards of nursing stated
that they had received complaints about nurses violating patients privacy through posts on social
media sites and 26 of those boards took disciplinary action (Barry & Hardiker, 2012). As
Nursing is such a trusted profession, patients rely on their privacy being maintained and
confidential, but the increasing presence of social media and electronic devices in the healthcare
world will heighten the risk for the patients as well as the healthcare providers.
Protecting Ones Nursing License
In order to maintain professional boundaries and protect patients privacy, certain steps
can be taken by nurses and healthcare providers to assure that confidential matters remain safe
and private. The Health Insurance Portability and Accountability Act (HIPAA) was enacted to
ensure the protection and confidential care of protected health information. Nurses should
follow procedures and protocols to prevent HIPAA violations, which can result in the revoking of

SOCIAL MEDIA IMPLICATIONS IN NURSING

the nurses license. An article by the Ohio Nurses Review, Issues and Answers (2011) outlines
ways in which nurses can keep themselves and their patients safe. The review states that as a
registered nurse, one should: avoid filming, recording, or photographing care situations without
informed consent and institutional authorization, establish and maintain separate personal and
professional use of social media, use professional titles when communicating for professional
purposes, be familiar with social media policies of the institutions of employment, divulge all
personal conflicts of interest, maintain confidentiality of all patient information and identifiers,
and one should not friend patients on social media (Issues and answers, 2011). Nurses
should keep in mind that any forms of patient identification should be kept confidential and
should not be discussed or posted on any social media outlets. Healthcare providers must also
keep in mind what constitutes social media and not discuss or post patient information of any
form via email, cell phone calls, messages, apps, Internet posts, message boards, etc. With the
use of group pages, the line of confidentiality may be pressed, but above all, the healthcare
provider is responsible and accountable for any and all information released through these thread
discussions and must not violate any HIPAA guidelines.
Conclusion
From this research, I have learned that while social media can have many beneficial
elements for learning and communicating, even larger risks are associated with potential
unprofessionalism and privacy concerns. In regards to my future nursing practice, a good rule to
follow may be to not post any work related information or questions on social media sites.
Instead, one should turn to research and scientific evidence. To positively utilize social media
without crossing professional boundaries and violating patients privacy, healthcare providers
should continually be aware of the regulations in place by HIPAA and steps to take to decrease

SOCIAL MEDIA IMPLICATIONS IN NURSING

any associated risks. This will, overall, improve the quality of care while maintaining safe and
efficient patient-centered care.

SOCIAL MEDIA IMPLICATIONS IN NURSING

References
Barry, J., & Hardiker, N. R. (2012). Advancing nursing practice through social media: A global
perspective. Online Journal of Issues in Nursing, 17(3), 5.
Issues & answers. Social media: Implications for nursing: Nursing practice statement NP 85.
(2011). Ohio Nurses Review, 86(2), 6-7 2p.
Kratzke, C., Wilson, S., & Vilchis, H. (2013). Reaching rural women: Breast cancer prevention
information seeking behaviors and interest in internet, cell phone, and text use.
Journal of Community Health, 38(1), 54-61 8p. doi:10.1007/s10900-012-9579-3
Rice, M. J. (2013). Social media in healthcare: Educational policy implications. Archives of
Psychiatric Nursing, 27(1), 61-62. doi:10.1016/j.apnu.2012.11.001
Weaver, B., Lindsay, B., & Gitelman, B. (2012). Communication technology and social media:
Opportunities and implications for healthcare systems. Online Journal of Issues in
Nursing, 17(3), 3.