Nurses should embrace social media – carefully


This is a guest post by Victorian nurse Tara Nipe – an article she wrote on her blog 2014 Victorian Election Countdown – a nurse’s countdown. Tara is a clinical nurse specialist on a mixed medical specialty unit at the Alfred in Melbourne,  one of Victoria’s most acute hospitals.

Since Tara wrote this post, only a few weeks ago, the ANF (Vic) has changed its name to Australian Nursing and Midwifery Federation (ANMF) (Vic), so we have changed all references, even historical, to that new name.

Two weeks ago I attended the ANMF (Vic branch)’s annual delegates conference. This year one of the most interesting presentations was about the use of social media by health care staff. The presentation caused me to reflect on the growing presence of soocial media and what that may mean for us.

There is a lot of concern about health professionals – particularly
nurses and midwives – using social media. There’s no question that, both in our profession and across other industries, people have lost jobs, careers, reputations and relationships over ill-considered social media use.

In consequence, there are some who advise nurses and midwives to avoid social media use altogether – or to use pseudonyms. Quite clearly that’s not my position – I use my own name here and on Twitter and though I don’t advertise my workplace, it’s easily found on a Google search.

I believe that social media is increasingly a part of our lives – from the prominent platforms, like Facebook, to applications you may not think of as social media, like Pinterest, blogs, websites like AllNurses and even comments on digital articles. We need to embrace and utilise it, not fear and avoid it.

Nursing and midwifery are professions that encompass an enormous variety of populations – some, like myself, utilise multiple social media platforms, while others check email once a week and that’s it. Most of us, though, fall somewhere in the middle – perhaps a Facebook account and a LinkedIn profile, for example.

Social media can be a valuable tool – Facebook and MySpace help maintain relationships with friends and former colleagues; Twitter is a great source of news and activism; LinkedIn can help you develop a professional network and generate job offers; while YouTube, Pinterest, Tumblr and Vimeo can be valuable sources of information, but also eat vast chunks of time!

However, an increasing number of employees are finding themselves in disciplinary action over inappropriate use of social media. These range from derogatory remarks about a supervisor to action that could lead to deregistration, including inappropriate relationships with patients and breaches of confidentiality.

The first thing is to check your privacy settings – who has access to your posts or data? On Facebook you can check what a stranger or any specific friend can see. If you click on the padlock icon, then ‘who can see my stuff?’, the option View As comes up. This shows you what your page looks like to someone you haven’t friended.

However strong your privacy settings are (and with Facebook they’re frequently reset, often without notice), anyone you’re friends with can take a screenshot of your page. Or, as I was reminded while I was typing this, by sharing your post. I don’t swear on publicly-accessible social media but I do on my own Facebook page and 15 minutes ago a friend reposted something I’d written that was more sweary than I’d like out in the general domain.

However, I don’t ever write anything in the first place that I wouldn’t be okay with being made public. I’ve certainly written things in private messages that would be personally embarassing if they were made public – but nothing that would embarass my employer, any organisation with which I was affiliated (like my university or my union) or anything that breaches my duty of confidentiality. Because even if you delete a post, nothing’s really gone once it’s sent out into the world.

I try to live my life with integrity and I firmly believe that my online interactions shouldn’t be separate from that – social media is a part of my life, not an entity separate from it. It seems to me this is rarely the way social media is viewed, however, particularly when organisations draft policy.

Nurses and midwives have at least two policies that their social media use may be held up against – their employer’s and AHPRA‘s. The former tends to deal with patient and organisational confidentiality; the latter is significantly restrictive, has been broadly criticised and is back under review. I found the most useful discussions about AHPRA’s draft policy were by Ian Miller at ImpactedNurse and Melissa Sweet on Croakey. In addition, I strongly recommend reading the ANMF Vic. Branch’s advice.

What safe social media use boils down to is using common sense: don’t do anything online that is unprofessional or that you would be embarrassed to have made public.

On the most obvious front that includes measures to safeguard the public – don’t post photos from work that show you acting unprofessionally; don’t post identifiable information about a patient, staff member or family member (this is particularly a problem in rural workplaces – but wherever you work, even if you don’t identify your workplace in that post, it may be clear from other posts or your profile); don’t post photos of patients.

The second layer of caution concerns how you portray your own professionalism: don’t post if you’re on sick leave; be cautious about posts that, though not at work, may lead to speculation about your reliability (referencing recreational drug use, for example). Be aware that posting a status about how drunk you are at 2am may be a problem if you make an error during a morning shift six hours later. And recognise that employers increasingly Google potential staff, often prior to interview. Try putting your name into a search engine – you may be surprised by what comes up!

Finally, remember that digital photos contain metadata – when the photo was taken and, with newer technology, where. This has caused disciplinary issues for staff who’ve called in sick for work then posted photographs of themselves during that time – even if the post was made some time afterward.

All of that can make it sound as though nurses and midwives really should avoid social media! But it boils down, as I said, to using common sense – if you’re not sure whether or not to post something, wait.

Social media is a valuable tool that can enhance both your personal and professional lives. It can allow you to seek and share information at an amazing pace; it can allow you to become informed about issues you knew little about; it can connect you with like-minded people and introduce you to ways of thinking alien to your own.

But it is a double-edged sword that should be used with caution. Remember that nothing is really private and no account is really anonymous. If you wouldn’t say something publicly, you shouldn’t broadcast it electronically – and you can be in both professional and legal trouble for things you publish or re-publish electronically, including libellous or defamatory statements.

Provided you can keep those caveats in mind, social media has the capacity to enhance your life – while siphoning awy hours of it!

I am indebted to fellow nurses and enthusiastic supporters of social media Paul McNamara (whose recently wrote on nursing and social media), and Damien Hurrell for a brief but useful exchange earlier today – the hypertext links go through to their Twitter accounts, if you’re looking for great people to follow.

Further reading:

– Nurse Uncut’s commenting guidelines

– Australian College of Nursing’s social media guidelines

– NSWNMA privacy policy and terms of use of social media


  1. I should chip in here from a management perspective.

    Firstly, in my last management position, we sacked two nurses because of what they put on social media. One posted case details and grossly defamatory comments about one of the surgeons in the hospital, the other called in sick and then took off to the races for the day. We don’t normally scour Facebook for our nurses’ home pages: these came to our attention because one of their Facebook ‘friends’ saw their posts, ran off a screenshot of each and slipped them into a hospital internal mail envelope addressed to management.

    Remember: most of your Facebook friends aren’t really your friends (even Facebook tell you that), so be careful what you post.

    Another point here is that managers DO look at the Facebook and Linkedin sites of around 90% of all applicants for mid and senior level management jobs (not just in nursing but in all careers), and this habit is moving downward, so applicants for entry level nursing jobs are sometimes being subject to this degree of scrutiny (and if you have a public Facebook page, its all quite legal). What they see there inevitably influences their opinion of you. So if you lead a trashy life, make your Facebook page visible to friends only.

    Finally, virtually all commercial email servers now have back end facilities that not only allow you to see if an email you sent has been opened and when it was opened, but also let people like me track the source of the email, including the originating computer’s IP. I can take that IP and use one of the countless IP address trackers available on the web and actually trace down the physical location of the originating device. So if you send nasty emails to anyone or to management, it takes about a minute to find out where that email came from and hand the data over to the police.

    Social media has become an incredible force in our culture today, but indiscreet or inappropriate use will lead to problems for you.

    Let’s say you are 25 now and posting about everything you do on Facebook and your opinion about people you work with. Now let’s imagine you’re 45 and you’re applying for a job as the GM of a major hospital. The interview panel WILL do a Google search on your name and see what comes up and they MIGHT look at your Facebook page and scroll back through the years. If there’s trash there or you bag off colleagues or describe patients, then you’ve really shot yourself in the foot.

    Finally, remember that once it’s on the web, it’s there forever, even if it doesn’t come up on a Google search today. When we recruit for out Board, we use DeepDiver to do an archival web search, and can pull up postings in Internet Forums, old and now closed social media pages and closed down personal blogs from Australian and international websites.

    Just be careful what you put up there on the web: it all can come back to haunt you one day.

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