A Facebook Photograph . A junior nursing student provided nursing care to a 3-year-old leukemia patient 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, commenting about the bravery of the child and how proud she was to be a nurse. The patient’s room number was clearly visible in the photo. 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 clinical rotations for their students; and the hospital faced a HIPAA violation (National Council of State Boards of Nursing, 2018). The nursing student meant no harm, but naively breached confidentiality according to the HIPAA Privacy Rule. Additionally, the nursing program in which the student was enrolled had a clearly stated policy about students not breaching confidentiality and HIPAA (National Council of State Boards of Nursing, 2018). Another example is Jane, a nurse working at a long-term care facility, who arrived at work one day and found a photo of one of the residents’ buttocks on her computer screen. Jane sent the photo to several colleagues who also forwarded the photo. One nurse posted the photo to her Facebook page, saying, “This is what we have to deal with on a daily basis!” By noon, all the nurses and unlicensed personnel were snickering and talking about the photo, and eventually their supervisor was alerted. Being concerned about protecting the residents’ rights, the facility began an investigation and alerted the BON. Local media reported on the incident and law enforcement became involved to investigate whether sexual exploitation had been committed. By the end of the day, it made national news and the family threatened a lawsuit. The nurses involved were fired and had to appear before the BON. All of this could have been avoided if Jane, the first nurse, had promptly reported finding the photo to her supervisor and not shared it (NCSBN, 2018c). A Blog Entry . A nurse blogged on a local newspaper’s online chat room about taking care of a client. She referred to the client as her “little handicapper” and mentioned the child’s age and using a wheelchair. The description made the client identifiable in the small town in which the nurse worked. A reader of the blog complained to the BON that the nurse had violated privacy laws. 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. The nurse could have faced severe disciplinary action and was considerably shaken. She learned a lesson about privacy violations as well as the use of unprofessional language (little handicapper’ National Council of State Boards of Nursing, 2018). Consequences of the misuse of social media The ease and instant communicability of posting information on social media can lead to serious professional consequences. The NCSBN advises nurses to avoid posting information about patients electronically and on any type of social media. They should be aware of and adhere to all employers’ policies regarding social media and promptly report any breach of client confidentiality or privacy. The following are some possible consequences of misusing social media (National Council of State Boards of Nursing, 2018a): Nurses must report any violation of privacy or confidentiality that others make against patients. Failure to do so could result in employer or BON disciplinary action and the filing Impaired nurses Substance use disorders are still stigmatized for nurses, which could cause them to be hesitant to reach out for help (Webster,
of civil or criminal penalties against the nurse who failed to report such violations. ○ Online posts about coworkers—such as intimidation, threats, or humiliation—could be viewed as lateral violence even if posted from home or other private locations during off-duty hours. Such posts are referred to as cyberbullying. ○ Employers must also be cautious in their use of social media. Posting comments about patients, family, or employees may also result in legal action. ○ Faculty members are another group who must be mindful of how they use social media. Students are more frequently reporting that faculty members are asking for students’ social media passwords or to be friended to bypass privacy settings. Students were not comfortable doing this but were also not comfortable refusing the requests. Faculty must not only instruct student about the proper use of social media but also use social media in an appropriate manner themselves. Nursing consideration: In addition to disciplinary action by employers and BONs, nurses who violate privacy via social media can face civil or criminal penalties that could include monetary fines or imprisonment (National Council of State Boards of Nursing, 2018a). Myths surrounding social media Finally, healthcare professionals as well as students can be naïve when it comes to the use of social media. Here are some common myths regarding the use of social media. Myth : Communication posted on social media is private and accessible only to the intended recipient. Reality : Content, once posted or transmitted, can be sent to others and is usually not under the control of the original writer. Some social media sites even have a very broad waiver of rights to limit use of transmission or posting of content (National Council of State Boards of Nursing, 2018a). Myth : Content deleted or removed from a social media site is no longer accessible or recoverable by others. Reality : As soon as something is posted, it exists forever and can always be discoverable by a court of law (National Council of State Boards of Nursing, 2018a). Myth : It is OK to post private information about patients as long as the communication is accessed only by the intended recipient. Reality : Posting such information is still a confidentiality breach. It is also unacceptable and inappropriate for nurses to discuss or refer to patients, even if such patients are not identified by name but referred to by room number, diagnosis, condition, behavior, or even a nickname. This constitutes a breach of confidentiality (National Council of State Boards of Nursing, 2018a). Self-Assessment Quiz Question #7 Tom, who is an RN, has had a really rough day and feels the need to vent. He states how short the staffing is on his unit, names his unit, uploads a picture of the staffing and states most of his patients were combative on his private Instagram account. Which of the following is one of the issues with his post? a. Breach of confidentiality.
b. Breach of nurse/nurse patient information. c. Breach of protected hospital information. d. Breach of nurse-to-nurse confidentiality.
2022). Rates of reported substance abuse are the same as the general population at around 6% to 8%, however, about 18% of
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