nursing.elitecme.com Page 9 Complete Your CE Test Online - Click Here best interest of the client (National Council of State Boards of Nursing, 2014). Ethics and the law: Social media The use of social media and other forms of electronic communication is a critical component of professional nursing practice. Occurrences of inappropriate use of electronic media have been reported to state BONs, reported in the nursing and general public media, and, in some cases, have resulted in severe disciplinary action. The NCSBN has published a white paper entitled A Nurse’s Guide to the use of Social Media (National Council of State Boards of Nursing, 2011). Although many, if not most, healthcare organizations have policies that address employee use of social media during work hours, many do not address the use of such media outside of the workplace. When using social media outside the workplace, the nurse is still vulnerable to accusations of professional misconduct such as violations of client’s rights and confidentiality. This white paper attempts to address some of these occurrences. A nurse’s use of social media is still guided by professional, legal, and ethical standards. Client information must be protected regardless of whether or not the nurse is on or off duty. Privacy refers to the client’s expectation and right to be treated with dignity and respect. Federal law reinforces such privacy through HIPAA. Breaches of client confidentiality and privacy can be intentional or accidental and can occur in a multitude of ways. However, even non-intentional breaches leave the nurse vulnerable to legal and other forms of disciplinary action. This includes posting information via social media (National Council of State Boards of Nursing, 2011). A BON may investigate reports of inappropriate disclosures on social media on the grounds of (National Council of State Boards of Nursing, 2011): ● ● Unprofessional or unethical conduct. ● ● Moral turpitude. ● ● Mismanagement of client records. ● ● Revealing privileged communication. ● ● Breaching confidentiality. Nursing practice alert! Improper use of social media by nurses may violate state and/or federal laws thus making the nurse vulnerable to personal liability claims (National Council of State Boards of Nursing, 2011). Here are a few well-publicized examples of misuse of social media as described in the NCSBN white paper on the use of social media (National Council of State Boards of Nursing, 2011): ● ● A junior nursing student provided nursing care to a three-year-old leukemia client as part of her pediatric clinical rotation. When the child’s mother was out of the room, the nursing student took his picture with her cell phone and posted the photo on her Facebook page and commented about the bravery of the child and how proud she was to be a nurse. A nurse from the hospital was browsing Facebook and found the photo. The nurse reported it to hospital authorities. Although the student did not mean to do so, she had violated a client’s confidentiality. She was expelled from the nursing program; the nursing program was barred from using the pediatric site for future student clinical rotations, and the hospital faced a HIPAA violation. ● ● A nurse blogged on a local newspaper’s online chat room about taking care of a client. The description made the client identifiable in the small town where the nurse worked. The BON issued a warning to the nurse, advising her that further evidence of release of personal information about clients would result in disciplinary action. ● ● A nurse working at a long-term care facility arrived at work and found an e-mail on her work laptop. The e-mail, sent during the previous nightshift, contained a photo of an elderly female wearing a gown with her backside exposed. The e-mail and photo were forwarded throughout the facility. Some employees were outraged, while others found the photo funny. No staff members brought the photo to the attention of a supervisor. By mid-day, the director of nursing and management had become aware of the incident and began an investigation into the matter. The local media became aware of the incident, as did local law enforcement personnel, who began an investigation as to whether any crime involving sexual exploitation had been committed. The incident was also reported to the state’s BON, which opened an investigation of its own. Although the original source of the photo distribution was never discovered, nursing staff faced potential liability for their willingness to share the photo within and outside the facility and for their failure to bring it to the attention of management according to facility policies and procedures. The client was eventually identified and the family threatened to sue the facility and all staff members involved. Several staff members were placed on administrative leave while the incident was under investigation. The BON complaint, as of this writing, is still pending. The incident was also referred to the agency that oversees long-term care facilities in that geographic region. The NCSBN advises nurses to avoid posting information about clients electronically and on any type of social media. They should be aware of and adhere to all employer policies regarding social media, and promptly report any breach of client confidentiality or privacy. Conclusion Nursing has consistently been rated among the most trusted professions in the United States and other countries. To maintain this trust, nurses must, at all times, function in a manner that adheres to legal and professional standards. Nurses have legal and ethical obligations to always act in the best interests of the client. They must make themselves aware of their NPAs, BON position statements and rules, professional boundaries, and standards of practice published by professional and specialty nursing associations and practice according to these mandates. They must be aware that ignorance of laws and standards is no excuse for their violation. References Š Š American Nurses Association (ANA). (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. Š Š Coalition for Nurses in Advanced Practice. (2017). 2017 Texas legislative session. 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