New nurses' guide to not losing face through Facebook

1 July 2012

The first social media guide to help Kiwi nurses avoid stepping over the professional line in their online life has been released.

The guide for nurses and nursing students was prompted by growing evidence, including legal cases, that using social networking media like Facebook and Twitter can pose risks for health professionals.

“Inappropriate online behaviour can potentially damage personal integrity, nurse-patient relationships, nurse-colleague relationships, current and future employment opportunities,” says the guide, developed by the New Zealand Nurses Organisation (NZNO), Nurse Educators in the Tertiary Sector (NETS), and the NZNO National Student Unit.

The 14-page Social media and the nursing profession resource, built on the similarly-named Australasian guide for the medical profession, aims to provide practical guidelines for nurses and nursing students to enjoy online activity while maintaining professional standards.

It defines social media as internet or web-based technologies that allow people to connect and interact in real time, including Facebook, Twitter, YouTube, blogs, forums, and personal websites.

Advice is given on areas like maintaining patient confidentiality, defamation, nurse-patient boundaries, how online postings can impact on future employment and study, checking online privacy settings, and how social media can be used constructively.

The guide advises nurses to take care to “properly de-identify” patient information when posting online as while a single posting about patient X may not identify them, reading it alongside a posting only a “mouse click” away on the same website might.

It also says it is wise to avoid online relationships with current or former patients, including an example of a nurse being de-registered in the United Kingdom after starting a sexual relationship with a former patient after contacting them on Facebook.

A further example given is of a hospice nurse who read a patient’s Facebook posting on pain relief issues and commented about hoping the new drug regime was helping. She subsequently realised how widely her comment could be read and that it had been inappropriate disclosure.

The guide also points out that nursing students are not held to any lesser standards of professionalism than fully qualified nurses, and while students were entitled to an “active social life”, what is viewed as “youthful exuberance” in their early career may not appear in the same light in future years.

An example given of unprofessional activity backfiring was seven nurses and doctors suspended from a UK hospital after a hospital manager saw online photos of them ‘planking’ on hospital trolleys and ward floors.

The guide can be downloaded at the NZNO and NETS websites: and

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