ICN position: The International Council of Nurses (ICN) believes that social media can be a powerful tool for rapidly communicating, educating and influencing and has a significant potential to strengthen the nursing profession. ICN supports the use of social media by nurses to stay abreast of recent health care developments, to enrich practice and to dialogue with the professional community and the public. ICN recognises the benefits of using social media for health promotion and illness prevention and to promote health programmes and services. Social media, when used appropriately, can increase access to timely and credible health information and provides healthcare consumers and providers with tools by which they can share this information with a large audience. It can also be used as a mechanism for sharing the contributions of nursing with the public and to strengthen the image of nursing globally. Although social media has much to offer, it is important that nurses understand their professional responsibilities regarding its use1 . Nurses need to be aware of and understand the benefits and risks of its use both inside and outside the workplace. ICN calls on nurses, health care provider organisations, educational institutions, professional associations and regulators to consider and address the professional, ethical, regulatory and legal issues associated with the use of social media. ICN believes that: Nurses need to: ? Educate themselves about both the opportunities in the use of social media in relation to enhancing knowledge, informing practice and health care teaching and also the risks related to its use. ? Adhere to legal, regulatory, institutional and/or organisational standards, guidelines, policies and codes of conduct with respect to the use of social media and apply these codes, standards, guidelines and policies equally to online activities as they do in other activities. ? Ensure they have the required competencies, are practicing within their scope of practice, and are legally authorised to do so if providing health information, advice or services through social media. ? Be aware of the quality and reliability of information online and recognise how this information affects patients’ health and illness experiences.
? Inform and educate patients regarding both the opportunities and risks related to social media in the context of their health. ? Keep personal and professional use of social media separate and refrain from using social media for personal use while at work. ? Maintain patient privacy and confidentiality at all times and not discuss issues related to their workplace online or post any information relating to patients or their families. ? Formally seek approval if they are going to record or archive interactions with patients and be aware of the legal position in terms of access to such material in conduct cases or when there are legal proceedings. ? Respect the boundaries of the therapeutic nurse-patient relationship and not connect with or accept patients or former patients as electronic ‘friends’ on personal social media sites due to the risk of breaching therapeutic relationships. ? Refrain from posting defamatory or offensive comments about employers, educational institutions, colleagues or patients and be aware that an unnamed patient or person may be identifiable from posted information. ? Report identified breaches of privacy or confidentiality. ? Be aware of and use privacy settings in order to maintain control of access to personal information. ? Be aware of copyright restrictions and the risks to breaching copyright when posting information online. ? Be aware of the rapidity of communication through social media outlets and the possibility of instant reposts or retweets and therefore the importance of being thoughtful of what is being communicated before posting. ? Recognise that everything posted online is public and permanent, even if deleted and that using pseudonyms does not provide anonymity. ? Be aware of the image they are portraying when posting content even when not work related and help reinforce a positive global image of nursing. Healthcare Provider Organisations and Educational Institutions should: ? Integrate key points regarding the use of social media in undergraduate, graduate and continuing education programmes and in contracts of employment and confidentiality agreements. Educate students and nurses in the appropriate ethical and responsible application of social media in practice and develop and disseminate proactive policies and guidelines for the use of social media.
? Link social media policies to existing policies relating to privacy and confidentiality. ? Promote the use of appropriate social media platforms that inform practice, improve the quality of care and patient safety and provide mechanisms for nurses to access approved social media in workplace. ? Have in place clear controls relating to non-approved websites. ? Explicitly identify if digital records and transcripts are to be electronically retained and if so the rights of parties to access these. Professional Associations and Regulatory Authorities should: ? Raise awareness of the power of social media and highlight both its benefits and risks if not used appropriately. ? Develop and widely disseminate clear social media standards, policies, guidelines and resources and provide guidance to nurses regarding their application in practice. ? Integrate these social media standards, policies and guidelines in organisational practices related to social media usage. Background ‘Social media’ describes the online and mobile tools that people use to share opinions, information, experiences, images and video or audio clips and includes websites and applications used for social networking. Common sources of social media include, but are not limited to, social networking sites such as Facebook and LinkedIn, blogs (personal, professional and those published anonymously), and microblogs such as Twitter, content-sharing websites such as YouTube and Instagram, and discussion forums and message boards2 . Social media continues to rapidly advance as a mechanism for communication, is being embraced globally and is popular among healthcare professions, including nursing. Social media has benefits for healthcare providers and consumers alike. When used appropriately, it fosters professional relationships through online communities of practice where information is shared and discussed and can inform and correct misinformation in disaster and emergency situations. It also represents an opportunity to promote healthy attitudes and behaviours. Individuals who have similar health concerns can form virtual communities through which they can connect, interact and share experiences thus creating a sense of empowerment and reducing isolation. While there are benefits to the use of social media both by the general public and nurses, there are also risks. Areas where social media has been inappropriately used by healthcare professionals, in addition to breaches of privacy, include bullying of colleagues and peers, online criticism of colleagues or employers, and unprofessional behaviour that may be in breach of codes of conduct. These actions can have a profoundly negative impact on nurses, patients, colleagues, educational institutions, employers and the nursing profession and have resulted in nurses being involved in disciplinary and criminal proceedings. As a result, educational institutions, healthcare employers, professional associations and regulatory authorities are increasingly developing standards, polices and guidelines regarding the use of social media. It is essential that these documents are regularly updated, incorporate all generations of providers in their update and keep pace with socio-technical advances and educational, employment, regulatory and legal decisions that are made regarding social media use. The continuously expanding use of social media provides unprecedented opportunities for rapid and wide-reaching communication and information sharing and it is essential that nursing and healthcare communities capitalise on and safely harness the power of social media for global outreach. Adopted in 2015