Social media can be a beneficial tool for nurse practitioners; providing a way for NPs to not only connect and network with others from the medical community but to seek and gain support from friends, family and other peers after a long day of seeing patients. Not to mention, who doesn’t love the convenience of keeping up with friends and family with a quick scroll through your newsfeed during some well deserved downtime? While it may seem like all fun and games, posting the wrong thing on social media has the potential to seriously harm your career as a nurse practitioner.

Recognizing the danger that social media imposes upon providers and patients alike, many hospitals and healthcare organizations have found it necessary to create their own policies on the proper use of such sites. And as technology advances, each state nursing board also has created it’s own set of guidelines for social media, as well as their own opinions about what kinds of social media activity are acceptable from providers and what would prompt an investigation. A mix of different guidelines, opinions and interpretations can certainly make navigating through the do’s and don’ts particularly difficult; making you question whether a social media account is really worth it. So just where do the boundaries of professionalism lie and how can you avoid coming under scrutiny with your social media accounts as a nurse practitioner?

Always protect the privacy and confidentiality of your patients

Nurse practitioners have an ethical and legal obligation to protect patient privacy and confidentiality at all times, on and off the clock. Information contained in a social media post that relates to the past, present, or future physical or mental health of a patient, or that provides enough information to identify an individual breaches HIPAA regulations and is highly likely to trigger an investigation.

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Limiting access to postings through your account privacy settings is not sufficient enough to ensure against a breach in confidentiality; and bear in mind that anything deleted from a personal account lives on a server that can always be discoverable in a court of law. The safest bet is to avoid discussing patients or cases on your personal social media account altogether. But if you chose to talk about your day, never identify patients by name, or post or publish information that could lead to the identification of the patient. Even if you’ve taken all the necessary precautions to ensure that the patient is not identified, do not refer to the patient in a derogatory way; no matter how upset he or she may have made you! Doing so calls into question your professionalism as a nurse practitioner and could come back to you in the event that a complaint arises.

While professional networking sites such as LinkedIn are useful places for interactions and can provide support from other nurse practitioners and providers alike on those hard cases, it is still your obligation to ensure that your discussions are keep private and that your interactions are compliant with HIPAA regulations as well.

As a rule of thumb, never take photos, post photos or exchange photos of patients whatsoever on personal devices, including cell phones. Photos can be inadvertently shared, violating the patient’s rights to confidentiality and privacy and could otherwise be degrading or embarrassing for the patient. If you must take photos or videos of patients for treatment or other legitimate purposes, only use employer-provided devices.

Discuss medicine appropriately and with caution

Whether intended or not, sharing medical topics and posts with your insight on social media can be easily shared throughout various networks of friends, friends of friends, and so on, and your opinion has the potential to be taken out of context or misconstrued. Before discussing medicine on your personal account, ensure that anything you share is accurate, concise, up-to-date and supported by current medical peer-reviewed literature; as well as that it originated from a recognized body of scientific and clinical knowledge.

… And avoid giving out medical advice

As with sharing medical topics, medical advice given on a social media platform also can become available to anyone and everyone who comes across the post, and it could easily be misinterpreted. Whether a friend asks you outright for your opinion or simply posts a general statement on social media about an ailment they have, think before jumping onto the discussion thread as giving out “free” advice comes with the potential for an array of problems, no matter how well meaning your efforts are.

Bearing in mind that a relationship between a patient and provider can begin without a personal encounter, online interactions do constitute the beginning of a provider-patient relationship. Remember that anytime a provider enters into a relationship with a patient, whether it’s electronically or in person, the provider should abide by the same rules or statutes established by the state board and HIPAA.

You as the provider are also unable to accurately assess the patient’s symptoms in order to give a proper diagnosis. Likewise, your friend is not able to accurately verify your qualifications just by looking at your personal social media page. While it’s tempting to help out a friend in need, it’s best to keep the same standards of care as you would if the friend were a patient in your clinical environment no matter how casual the conversation.

Don’t request or accept patients as friends or followers

While you and a patient may have a great rapport with one another in the clinical setting, even seemingly harmless online interactions with patients, both past and present, violate the boundaries of a proper provider-patient relationship and create the potential for a breach in the patient’s confidentiality. Requesting a patient to be your friend on Facebook puts them in an awkward spot and is inappropriate, again calling into question your professionalism. And while you may think it’s okay if the patient is the one to initiate the online friendship request, it still creates for blurred boundary lines and increases the potential for HIPAA violations.

The only time that online interaction with a patient is acceptable is for the discussion of the patient’s medical treatment within the provider-patient relationship, and this type of interaction should never occur on a personal social networking account.

Maintain professionalism

Even if you’re not friends with past or present patients or colleagues on your social media accounts, you’re still representing the nurse practitioner profession and any unprofessional appearance could call into question your competency as a medical provider, on and off the clock. While the occasional photo of you in a social setting with a cocktail in your hand won’t get you into trouble per se, a photo of you clearly intoxicated or otherwise acting inappropriately may come back to haunt you. Should the post get reported or a complaint about you arise, it could show to those investigating you that your actions off the clock are indicative that your behavior is reckless and thus has the potential to cause harm to your patients.

Most of all, use common sense on your social media accounts. Act with the same integrity and professionalism on your social media account as you would in your clinical setting. And always adhere to the rules and regulations that your employer and the board of nursing for your state have for posting on social media.


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