- [voice over] Emily was a nursing student in a pediatric rotation. She cared for

Tommy, a five-year old patient who was recently diagnosed with type one diabetes.

Tommy was going home soon so she took a cellphone picture of him to remember him

by. That evening, she posted his picture on her Facebook page commenting how brave

he was when he got his insulin injections. Two days later, Emily was called into her

dean's office. A nurse from the hospital had seen the photo and caption and

reported them to hospital officials. Emily was informed that her actions were a

breach of her patient's confidentiality and a violation of federal privacy laws.

Even though Emily had an excellent record as a student nurse, and had only had the

best intentions in her post, she was expelled from her nursing program and the

program has barred from using the pediatrics unit for their students.

- Hi. I'm Kelly, a staff nurse here at the hospital. If you use social media

properly, what happened to Emily will never happen to you. Nurses are

increasingly utilizing social media not only for personal use but also as a way to

foster professional connections and timely communications with patients and their

families. But social media used inappropriately can result in disclosing

too much patient information and violating their rights to privacy and

confidentiality of information. This is what happened to Emily. Healthcare

organizations typically have clear policies governing employee use of

electronic and social in the workplace. It is out side the workplace however, where

policies are often less clear and the potential for inappropriate use of social

media is greatly increased. Effective nurse-patient relationships are built on

trust. A cornerstone of that trust is patient privacy. Which is a key part of a

patient's expectation to being treated with dignity and respect. Any patient

information that a nurse has access to during the course of treatment must be

safeguarded. With very limited exceptions, such information may only be disclosed to

other members of the healthcare team for the purpose of providing care for the

patient. Improper use of social media by nurses may

violate state and federal laws. Including the health insurance portability and

accountability act or HIPA. Which was enacted to further protect the patient

privacy. Additionally, inappropriate uses of electronic and social media maybe

reported to the Board of Nursing resulting in possible disciplinary action for

unprofessional or unethical conduct, breach of confidentiality, or other

infractions. Well, it's true that some intentional or malicious misuses of

social media do occur, the majority of inappropriate disclosures or postings are

unintentional. Usually they're the result of the mistaken belief that the

communication or posting is private and accessible only by the intended recipient.

That content deleted from the site is no longer accessible, for that it is

acceptable to discuss or refer to a patient in a posting if they're not

identified by name. By being cautious and alert to potential or improper uses of

social media, you can avoid inadvertantly disclosing confidential information

concerning your patients. Remember, you have an ethical and legal obligation to

maintain patient privacy at all times. This means that you should never take photos or

videos of patients using your cellphones or other personal devices. Be sure to

follow employer policies for taking photos or videos of patients for treatments or

other permissible purposes by using an employer provided devices. Even

experienced nurses should be vigilant about avoiding serious violations of

patient confidentiality as Jason learned.

- [voice over] Jason has been a nurse for 12 years and is working in hospice care.

One of his current patients, Maria, maintains a hospital sponsored online page

to keep her family and friends updated on her battle of cancer. One day, she posted

something about her depression and the difficulty of finding effective treatments

for her physical pain. Jason saw the post and responded by writing a comment to

Maria. He wrote that he understood her last few days have been difficult and he

was hopeful that the new medication along with the increase dose of morphine will

provide some needed relief. The next day, Jason ran into a friend who said she saw

his post. She said Maria was an old family friend, was sad to hear of her condition

and asked Jason how long he thought Maria had left. Now, fully realizing the

implications on what he had done, immediately went home and tried to remove

his post but was unable to do so. Besides, even if he had been successful in

removing it. It may have already been copied by others and posted elsewhere. At

his next visit with Maria, Jason told her what had happened and apologized. Jason

then self-reported his breach of patient confidentiality to his Board of Nursing

and is awaiting the board's decision concerning any disciplinary action.

- Jason learned the importance of carefully considering the full

implications of posting any information about patients on any website, including

hospital sponsored sites. It may at times be appropriate for nurses to express

empathy and support for patients on a website but they must be careful not to

disclose private patient information. Inappropriate use of social media can

derail someone's dream to be a nurse as it did for Emily.

But even for experienced nurses like Jason, who have exceptional work

histories, inappropriate use of social media can and does happen. Remember,

increased access to communication through social media does not change the

healthcare professional's responsibility to protect patient information. In fact it

actually makes it easier to inappropriately share information. By

carefully following standardized guidelines, healthcare professionals can

responsibly use social media to improve the coordination of patient care. For more

information, please visit the website of the National Council of State Boards of

Nursing.

♪ [music] ♪