Breaching Confidentiality Through Social Media

Are you a nurse on social media?

The use of social media has become part of everyday life for most people. This method of communication can connect old friends and strengthen relationships. Social media is a good tool for creating professional connections and networking. It provides a venue for nurses to express feelings and seek support and understanding from other professionals.

However, if not careful, nurses can find themselves in the middle of a legal and ethical issue due to breach of client or employer confidentiality. A nurse should know her employer’s policies, as well as state and federal laws and professional standards concerning client privacy and confidentiality.

Federal law defines privacy through the Health Insurance Portability and Accountability Act (HIPAA). HIPAA regulations are for the protection of client privacy by defining what client information can and cannot be shared, how this information can be shared, and under what circumstances. Confidential information should only be shared with the client’s informed consent and when legally required. Otherwise, the nurse’s duty to protect confidential information is expected. Nurses may breach confidentiality when posting to social media, information about a client with adequate detail so that the client can identify. Referring to clients in a demeaning manner, or posting video or photos of clients, is also considered a breach of confidentiality.

Inappropriate use of social media may be reported to the state’s board of nursing. Charges differ from state to state but can range from unprofessional conduct to breach of confidentiality. Disciplinary actions may include a reprimand, fine, or temporary to permanent loss of licensure. Additionally, nurses may face civil and criminal punishment ranging from fines to incarceration. The client may sue the nurse for defamation, invasion of privacy, or harassment. Further, the nurse can be charged with client abuse.

Nurses also need to be mindful of breaching the confidentiality and privacy of their employer and other employees. Violating employer policies can lead to termination. Posting inappropriately on social media can damage the institution’s reputation. Comments about co-workers can be construed as “bullying” and “lateral violence,” according to a report by the NCSBN.

Social Media Misconceptions

1. Social media posts are private and only seen by the anticipated recipient. The fact is that once posted, the information can be circulated to others.
2. Posts can be deleted from a site and are then no longer accessible. Nothing is permanently deleted from the internet.
3. If client information is only sent to the anticipated recipient, it is not a breach of confidentiality. This is still a breach of confidentiality.
4. Clients can be discussed as long as no identifying information is provided. This is also a breach of confidentiality.

February 11

Debra S. McDonough, RN, MSN, EdD