Social Media as a Nursing Student

Many people use social media (e.g., TikTok, Instagram, Twitter, Facebook) as a way to share and engage with others and as a form of education and entertainment. However, as a nursing student, you are legally obligated to uphold ethical practice in both personal and professional social media posts.

The College and Association of Registered Nurses of Alberta (CARNA) (2021) has established Social Media Guidelines. Student nurses are expected to adhere to the 6Ps of social media

• Social media posts need to be Patient free and client free. This includes keeping appropriate boundaries, and not ‘friending’ patients. You can also expect that your instructors cannot accept your friend or follow requests. Posts should never contain details or data about patients or clinical experiences.
• Social media posts need to be Professional. “Nursing is a trusted and respected profession and nurses are held to a standard of professional accountability and responsibility. As a regulated health professional, nurses are expected to maintain professionalism, including when using social media” (CARNA, 2021, p. 3). Liking, sharing, and participating in misinformation, disinformation, and non-evidence informed discussion jeopardizes the trust in your future profession. ‘Venting’ should never occur in the public sphere. If nurses, or students, have concerns with care of others, workplaces, or education, they should use the appropriate channels to address the concern.
• Social media posts should protect Privacy. Avoid posting any thing (including photos) that could breach client confidentiality. You should ensure that your own social media accounts are kept secure as well.
• Permission  to use social media as a designated professional representing an agency should be sought from the employer/agency. If clients attempt to solicit for health related advice, the nurse should avoid doing so. Remember that the client is not bound by the same expectations of confidentiality.
• Pause and be positive. Avoid posting in anger or frustration, as this does not reflect well on the profession. Even as a student “A nurse’s social media accounts may be interpreted as a reflection of both their personal and professional lives” (CARNA, 2021, p. 8).
• Consider the Protection -benefits and risks of social media. Even after being deleted, the internet is forever.

As a nursing student, you are expected to uphold the same practice standards as a Registered Nurse.

Even though you may use social media in your personal life, you are still expected to maintain professionalism. For example, under the Social Media guidelines, nurses and nursing students are expected to treat their colleagues with respect on social media. Nurses and nursing students who use social media are not allowed to share patient information or post confidential information, even on private accounts.

Case Example

In 2015, a Registered Nurse from Saskatchewan took to social media to air her grievances about the quality of care her grandfather received in long-term care. In her Facebook posting, she named the institution that cared for her grandfather and urged the institution do better in future patient care. In her posting, she did not explicitly name any healthcare providers, nor did she use inflammatory language, but she referred to her grandfather’s care as “sub-par”. In 2016, she was found guilty of professional misconduct by the Saskatchewan Registered Nurses Association (SRNA) and was ordered to pay a $1,000 fine and $25,000 towards costs for the tribunal. In 2020, Saskatchewan’s highest court overruled the disciplinary decision and fine.

Analysis

The nurse in this case was originally found guilty of misconduct for harming the reputation of nurses by going to social media to make complaints. It was also noted that other formal complaint channels (such as managers of the institution), would have been a more appropriate alternative to make change. Furthermore, the legal team for the SRNA argued that all facts should have been collected before making allegations against the institution. Ultimately, the decision was overturned, however this case emphasizes the importance of being intentional, deliberate, and professional when engaging on social media.

Your employer or educational institution may or may not have specific policies related to the use of social media outside of the workplace. It is important as an employee or a student to be aware of any institutional guidelines for social media use. Furthermore, the CNO will consider situations of misconduct as a regulatory body.

Examples of violations on social media:

• Posting confidential information about a client (e.g., diagnoses, events, family situations).
• Sharing explicit material (including sexually explicit).
• Engaging in personal relationships with clients online.
• Posting unfavourable information about colleagues, professors, or institutions (such as hospitals or universities/colleges).
• Cyber bullying or intimidating colleagues or clients.