Social media is an internet based tool that allows people to communicate (Ventola, 2014). Means of communication can be through blogs, wikis, media-sharing sites and social networking platforms (Ventola, 2014). Individuals can communicate with these tools by sharing information, ideas and images (Ventola, 2014). Many individuals use social media personally however the use of social media professionally can be complicated, especially for healthcare workers (Burton, McLemore, Perry, Carrick & Shattell, 2016). Appropriate professional social media use for nurses must be evaluated through examining the risks, benefits, policies and ethical considerations. The purpose of this paper is to examine the implications of professional social media use in nursing practise. This paper aims to highlight the benefits, risks, policies and ethical considerations regarding the use of social media in nursing practise. It will also examine leadership styles and strategies for implementation that promote appropriate use of social media in the healthcare environment
Impacts of Social Media
When exploring the implications for social media use in nursing practice it is crucial to determine the impact on every individual in the health care system. Dangers of social media for registered nurses include damage to professional image, breaches of patient privacy, violating the nurse patient boundary and finally legal issues (Ventola, 2014). Nurse leaders play a crucial role in the incorporation of social media as a tool in nursing (Burton et al., 2016). When nurse leaders are competent and well informed regarding the code of ethics and policies set to safe guard social media use, there are numerous benefits to its use in the nursing profession. These benefits include professional education, professional networking and even patient education and care (Ventola, 2014). But regardless of the benefits to health care professionals, patient rights and best interests veto the professional benefits. In order to draw a conclusion in regards to whether or not nurses should use social media professionally the benefits and risks must be examined.
Risks Associated with Social Media Use in the Health Care System
Nurses face a variety of risks to their profession when posting on social media. A major risk is posting unprofessional content that can reflect poorly on the nurse and the affiliated institution (Ventola, 2014). Posting on social media conveys and individual’s personality, values and priorities (Ventola, 2014). Unprofessional behavior may be displayed on social media by the use of inappropriate language, sexual suggestive content or negative comments about patients (Ventola, 2014). Posting of negative comments about patients is a common occurrence on the Instagram application. There are several accounts that are targeted for nurses to follow. After an initial posting on any popular nursing account, thousands of nurse’s reply with inappropriate comments. Nurses should always be cautious when posting on social media regardless if it is in a personal or professional nature, in order to display a respectful and professional identity online. According to Adams, Foss-Durant, Pugh & Scruth (2015), “The spaces between the nurse’s power and the patient’s vulnerability are defined as the professional boundaries that cannot be violated” (p. 10). With the accessibility to online information and personal social media accounts, violation of the nurse-patient boundary is another risk. This risk has greater possibility of occurring with personal social media accounts. Nurses establish trusting and therapeutic relationships with their patients, but extending this relationship to contact on social media is a violation of the boundary (Canadian Nurses Association, 2012). Nurses can avoid this situation by setting their accounts to private and declining any friend request from past or current patients, as maintaining the professional boundary is the nurse’s responsibility (Canadian Nurses Association, 2012).
Nurses are guided by a set of ethical values and commitment to individuals receiving health care (Canadian Nurses Association, 2017). Ensuring patient privacy and confidentiality is an ethical responsibility for all nurses (Canadian Nurses Association, 2017). However, breaches to confidentiality are one of the most serious risks of social media in the health care system and has great potential for repercussion (Ventola, 2014). Breaches in patient confidentiality can occur even when the name of the patient is not disclosed, any identifiers that can make the patient identifiable to viewers is considered a breach in confidentiality (Canadian Nurses Association, 2012). This has a negative impact on the nurse and their professional image, health care institution and most importantly the patient (Ventola, 2014). For health care professionals using social media professionally the posting of any identifiable health information such as an unusual diagnosis or symptoms that could potential identify the patient, can only be shared with consent from the patient (Canadian Nurses Association, 2012). There are great risks to posting on social media, however using diligent judgment and following the set policies to safe guard social media use, the impact of social media in the nursing profession could be extremely beneficial.
Benefits Associated with the Use of Social Media in the Healthcare System
When used properly social media provides many benefits to nurses that can enhance their practice. Social media allows for nurses to share knowledge, information and ideas as well as engage in continuing education (Canadian Nurses Association, 2012). Professional networking on social media allows nurses to discuss clinical topics, ethics and even politics (Ventola, 2014). Social media can also be used for education, 53% of nursing schools are now using social media as an educational tool (Ventola, 2014). Media sharing sites like Youtube can be particularly beneficial, there are several educational channels that allow students to learn through video. For nursing students, video and visual education are essential when learning about assessment techniques and assessment findings as objective data can be difficult to understand through linguistic means.
Social media does not only benefit health care professionals, it also has benefits for the health care consumer. Social media can raise awareness about public health issues (Ventola, 2014). Organizations such as Canadian Blood Services have accounts on Facebook and Twitter, this increased awareness of the organization can potentially increase the number of donations. There is no limit to the amount of awareness and education that can be created in the community through the use of social media. A major concern for health care consumers is that medical information is readily available on the internet. According to Ventola (2014), “60 per cent of respondents who access the internet to obtain health information reported that such health related searches influenced their decision about how to treat an illness or condition” (p. 7). The credibility of this health information is often unreliable and thus can put the health care consumer at risk (Ventola, 2014). There is obvious potential for social media to play a role in educating health care consumers. Few Canadian healthcare organizations have already taken an advantage of this opportunity by creating forums to share information and keep patients educated (Ventola, 2014). There is opportunity for nurses to also be involved with educating patients through social media by providing credible and reliable information.
Social Media and Ethical Nursing Practice
The Code of Ethics is intended for all domains of nursing practice and all levels of decision making, thus nurses must abide to the code when interacting on social media (Canadian Nurses Association, 2017). Maintaining privacy and confidentiality is the central concern for social media use in the nursing practice (Canadian Nurses Association, 2012). If a nurse chooses to use social media, they are required to protect the privacy and ensure confidentially of the patient and their colleges (Canadian Nurses Association, 2017). Social media encourages open interaction and sharing of personal information, it could be argued that the obligations of registered nurses to follow the code of ethics restricts their right of exercising freedom of speech (Canadian Nurses Association, 2012). However, the ethical obligations regarding patient confidentiality and privacy of nurses does not restrict their right to freedom of speech (Canadian Nurses Association, 2012). As with any profession posting on social media displays personal values and beliefs, posting is up to the individual’s discretion and inappropriate content can reflect unprofessionalism. With the decision to use social media it is the nurse’s responsibility to balance information sharing and the protection of patient rights to privacy and confidentiality.
Policies
Set policies regarding the use of social media in the health care environment minimize the risks associated with its use. The Code of Ethics for Registered Nurses provides the ethical responsibilities of nurses in order to maintain privacy and confidentiality. Nurses who follow the responsibilities in the code can ensure that the privacy and confidentiality of their patients is maintained. In Saskatchewan, The Health Information Protection Act legislates privacy protection and the obligations of trustees in the health care system (Government of Saskatchewan, n.d.). The act places duties and responsibilities on the organization and registered nurses are consider trustees under the act, they are responsible for protecting all health information and specific rights of patients in their care (Government of Saskatchewan, n.d.). The Code of Ethics for Registered Nurses and Health Information Protection Act protect the health care organization, registered nurses and patients when social media is used by health care professionals. Nursing leadership can also be implemented to ensure appropriate use of social media.
Leadership Styles to Promote Appropriate Use of Social Media
Social media use in nursing practice comes with risks and the technology is constantly evolving which is creating more potential benefits, this is an opportunity for nurse leaders to promote the appropriate use of social media themselves (Risling, 2016). Some nurse leaders have suggested banning social media use in order to minimize the risks associated with it (Simpson, 2014). A disadvantage of this leadership style is that by limiting the use of smart phones and social media, there is also a restriction on finding evidenced based practice materials (Piscotty, Voepel-Lewis, Lee, Annis, Voepel-Lewis & Kalisch, 2015). By banning the use of smartphones and social media nurse leaders are also reflecting they are reluctant to change. A major role of leaders it to adapt and manage change. Due to the constantly evolving nature of social media, the leadership style that would be most beneficial in promoting appropriate use is the transformational leader. This leader challenges the process in which things were done and is creative about new solutions, they also model the way and take an active role in the process of change. (Evans, 2015). This leadership style would also be beneficial in influencing followers to use social media appropriately and professionally (Olu-Abiodun & Abiodun, 2017).
Nurse leaders who choose to enhance the use of social media should be visible role models of its appropriate use and accessible to followers if they should have any questions or concerns (Moorley & Chinn, 2016). Establishing guidelines will help followers understand how they can connect with the work community through social media, what privacy and confidentiality standards must be followed and what use is permitted during work hours (Risling, 2016). Guidelines should put emphasis on the use of appropriate language that is professional and engaging in order for users to maintain a professional identity (Risling, 2016). Organizing orientation sessions that provide information regarding how to utilize social media in the work environment can enhance the followers understanding and influence them to accept change (Risling, 2016). Nurse leaders and their followers who accept process of change will be able to utilize its benefits.
Conclusion
After examining the risks, benefits, ethical considerations and leadership strategies related to social media use, the impact on nursing practice is extremely beneficial. Although social media and technology continue to evolve and present more ethical challenges, what is posted on social media is the decision of the users themselves. As long as social media users adhere to the code of ethics and policies set to safeguard patient confidentiality and privacy, the risks related to social media use in nursing practice are significantly minimized. To further minimize the risks of social media, nurse leaders are in an optimal position to lead by example and educate their followers. Social media can be used to educate patients, engage in professional networking and continue education. Like any issues in nursing practice, nurses must follow the policy’s surrounding social media, in order to ensure its use is beneficial and in best practice.