Direct from the Policy & Leadership Blackboard: Social Media Ethics

From couponing and microblogs to wikis and networking, social media is all the rage. MD personalities like Oz, Mercola, and Phil, not to mention high-profile facilities like Mayo and Cleveland are all over Facebook and Twitter dispensing health and wellness advice to the masses. Yet some physicians have had some difficulty adapting to the personal privacy and boundary issues of the new medium, which is surprising for a discipline trained to put beepers and unlisted phone numbers between patient and provider. A study on Twitter use among physicians reveled violations in patient privacy, use of derogatory, profane, and sexually explicit content, unsupported medical claims, and advice in contrast to standards of care (Chretien, Azar, & Kind, 2011). The AMA (2010) has created a policy statement on professionalism in the use of social media highlighting some on the unique personal and professional considerations as well as potential benefits of social media use.

But what about the nursing organizations and the individual (and decidedly non-phenomenon) nurse practitioner?  Despite it's own engagement in multiple mediums, all the ANA has advised is a generic call to follow the code of ethics (American Nurses Association, 2010),  specifically the sections on conflict of interest, accountability for judgement and action, professional growth and maintenance of competency, and preservation of integrity and  (American Nurses Association, 2001)."  Behavior online is not necessarily analogous to behavior in person or even over the phone. Should you "friend" patients, coworkers, or students, and if you do, are you responsible for knowing and responding to their posts? Imagine one of your patients posts suicidal statements on a social media site and you see it. Students may post negative comments on your class or violate the school honor code. Coworkers who begged you to cover when their child is sick may post pictures from Fiji the same day. While some scenarios seem like cut-and-dry common sense, others require professional guidance in terms of best practice.  Moreover, no precedent has been set in regard to liability, and there are plenty of legal considerations in terms of confidentiality, nonmaleficence, veracity, solicitation, and malpractice. 

I personally use social media extensively as a way to promote my business and the profession and plan to continue to do so. Carefully. I think it is important that the ANA address this specific topic in the next edition of the code of ethics to provide a basis of guidance and support for nurses. I would much rather see our governing body set the precedent than the winning attorney of the first lawsuit.

American Medical Association. (2010). AMA Policy: Professionalism in the Use of Social Media.

American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Silver Spring, MD: ANA.

American Nurses Association (2010). House of Delegates resolution: Social networking and the nurse. Kansas Nurse, 85(6), 21-21.

Chretien, K. C., Azar, J., & Kind, T. (2011). Physicians on Twitter. JAMA: Journal of the American Medical Association, 305(6), 566-568.