Arizona Board of Nursing — Edition 30
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From the Executive Director
Joey Ridenour

According to the U.S. based National Council of State Boards of Nursing (NCSBN) (2011), breaches of privacy and confidentiality can be intentional or inadvertent and can have serious implications for nurses, their patients, and their employer. These breaches can occur in a variety of ways, including comments on social media sites in which a patient is described in sufficient detail to be identified; referring to a patient in a degrading or demeaning manner; or forwarding videos or photos of patients to colleagues.

In a survey conducted by NCSBN around the misuse of social networking, 33 state boards of nursing (of the 46 that responded) indicated having received complaints about nurses who had violated patient privacy by posting information on social networking sites. Twenty six of those boards took disciplinary action (Cronquist & Spector, 2011). A 2010 survey of Canadian nursing regulators revealed similar concerns about socialmedia activities including posting pictures of clients, posting descriptions of identifying events, and using social networks to air grievances and complaints about colleagues, clients, and employers (Anderson & Puckrin, 2011).

Nurses are professionally accountable for developing an understanding of the boundaries between private, public, and professional life and acting accordingly. However, as online activity increases, such boundaries can become blurred (Anderson & Puckrin, 2011).

Jean Barry, MSN, RN, Nicholas R. Hardiker, PhD, RN (2012), referenced five areas of practice implications that are particularly important for nurses to adhere to:

• Be aware of and adhere to legal, regulatory, educational institution, and/or employer requirements, guidelines, and polices. Legal authority is of particular importance when providing health information, advice, or services through social media, as the recipient of these services could reside outside the area in which the nurse is licensed to practice.
• Maintain patient privacy and confidentiality at all times. Do not take photographs or videos of patients on personal devices, including cell phones. Do not distribute by any electronic media, any patient-related image, or information that may be reasonably anticipated to violate a patient’s rights to privacy or confidentiality, or otherwise degrade or embarrass the patient (NCSBN, 2011).
• Do not discuss work-related issues online, including conversations about patients or complaints about colleagues (NMC, 2011).
• Be aware that everything you post online is public, even with the strictest privacy settings. Once something is online, it can be easily copied and redistributed. Presume that everything you post online will be permanent and will be shared (NMC, 2011).
• Report objectionable material (ANA, 2011; NCSBN, 2011) and take action if you are the subject of complaints or abuse via social media (NCSBN, 2011).

Social media continues to evolve over the past five years and its use will continue to increase exponentially. In this edition of the Arizona Regulatory Journal, the NCSBN White Paper: A Nurse’s Guide is provided to communicate clearly and effectively to nurses about the appropriate use of social media. It is essential that healthcare organization policies and guidelines continue to advance to keep pace with socio-technical advances and with employment, regulatory, and legal decisions that are made regarding its use. Individual nurses need to avoid the pitfalls that surround the use of social media. Social media misuse can negatively and profoundly impact patients, colleagues, educational institutions and employers.