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- [voice over] Emily was a nursing student in a pediatric rotation. She cared for
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Tommy, a five-year old patient who was recently diagnosed with type one diabetes.
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Tommy was going home soon so she took a cellphone picture of him to remember him
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by. That evening, she posted his picture on her Facebook page commenting how brave
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he was when he got his insulin injections. Two days later, Emily was called into her
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dean's office. A nurse from the hospital had seen the photo and caption and
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reported them to hospital officials. Emily was informed that her actions were a
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breach of her patient's confidentiality and a violation of federal privacy laws.
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Even though Emily had an excellent record as a student nurse, and had only had the
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best intentions in her post, she was expelled from her nursing program and the
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program has barred from using the pediatrics unit for their students.
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- Hi. I'm Kelly, a staff nurse here at the hospital. If you use social media
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properly, what happened to Emily will never happen to you. Nurses are
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increasingly utilizing social media not only for personal use but also as a way to
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foster professional connections and timely communications with patients and their
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families. But social media used inappropriately can result in disclosing
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too much patient information and violating their rights to privacy and
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confidentiality of information. This is what happened to Emily. Healthcare
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organizations typically have clear policies governing employee use of
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electronic and social in the workplace. It is out side the workplace however, where
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policies are often less clear and the potential for inappropriate use of social
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media is greatly increased. Effective nurse-patient relationships are built on
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trust. A cornerstone of that trust is patient privacy. Which is a key part of a
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patient's expectation to being treated with dignity and respect. Any patient
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information that a nurse has access to during the course of treatment must be
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safeguarded. With very limited exceptions, such information may only be disclosed to
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other members of the healthcare team for the purpose of providing care for the
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patient. Improper use of social media by nurses may
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violate state and federal laws. Including the health insurance portability and
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accountability act or HIPA. Which was enacted to further protect the patient
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privacy. Additionally, inappropriate uses of electronic and social media maybe
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reported to the Board of Nursing resulting in possible disciplinary action for
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unprofessional or unethical conduct, breach of confidentiality, or other
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infractions. Well, it's true that some intentional or malicious misuses of
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social media do occur, the majority of inappropriate disclosures or postings are
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unintentional. Usually they're the result of the mistaken belief that the
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communication or posting is private and accessible only by the intended recipient.
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That content deleted from the site is no longer accessible, for that it is
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acceptable to discuss or refer to a patient in a posting if they're not
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identified by name. By being cautious and alert to potential or improper uses of
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social media, you can avoid inadvertantly disclosing confidential information
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concerning your patients. Remember, you have an ethical and legal obligation to
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maintain patient privacy at all times. This means that you should never take photos or
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videos of patients using your cellphones or other personal devices. Be sure to
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follow employer policies for taking photos or videos of patients for treatments or
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other permissible purposes by using an employer provided devices. Even
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experienced nurses should be vigilant about avoiding serious violations of
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patient confidentiality as Jason learned.
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- [voice over] Jason has been a nurse for 12 years and is working in hospice care.
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One of his current patients, Maria, maintains a hospital sponsored online page
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to keep her family and friends updated on her battle of cancer. One day, she posted
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something about her depression and the difficulty of finding effective treatments
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for her physical pain. Jason saw the post and responded by writing a comment to
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Maria. He wrote that he understood her last few days have been difficult and he
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was hopeful that the new medication along with the increase dose of morphine will
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provide some needed relief. The next day, Jason ran into a friend who said she saw
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his post. She said Maria was an old family friend, was sad to hear of her condition
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and asked Jason how long he thought Maria had left. Now, fully realizing the
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implications on what he had done, immediately went home and tried to remove
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his post but was unable to do so. Besides, even if he had been successful in
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removing it. It may have already been copied by others and posted elsewhere. At
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his next visit with Maria, Jason told her what had happened and apologized. Jason
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then self-reported his breach of patient confidentiality to his Board of Nursing
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and is awaiting the board's decision concerning any disciplinary action.
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- Jason learned the importance of carefully considering the full
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implications of posting any information about patients on any website, including
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hospital sponsored sites. It may at times be appropriate for nurses to express
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empathy and support for patients on a website but they must be careful not to
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disclose private patient information. Inappropriate use of social media can
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derail someone's dream to be a nurse as it did for Emily.
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But even for experienced nurses like Jason, who have exceptional work
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histories, inappropriate use of social media can and does happen. Remember,
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increased access to communication through social media does not change the
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healthcare professional's responsibility to protect patient information. In fact it
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actually makes it easier to inappropriately share information. By
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carefully following standardized guidelines, healthcare professionals can
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responsibly use social media to improve the coordination of patient care. For more
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information, please visit the website of the National Council of State Boards of
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Nursing.
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