Risk managers should make a point of cautioning young nurses about the risk of social media, suggests Georgia Reiner, risk specialist for the Nurses Service Organization in the Healthcare Division of Aon Affinity insurance services.

Nurses new to the field should be reminded about the risk to their own careers from careless or unwise posts on social media, which also will help protect the hospital or health system from associated liability, Reiner says.

Common problems with social media involve unprofessional conduct, such as posting images or remarks about excessive alcohol use or illegal drugs, profanity, sexually explicit material, racial slurs, threatening or harassing comments, and negative comments about co-workers or patients.

Another area of concern is inappropriate posting of information about patients, Reiner notes. This could include photos of patients or any information that might be used to identify a patient.

Nurses are likely to respond to any warning about the danger of social media posts that do not involve the workplace or patients by saying their work and private lives are separate, that they should not be punished for what they do on their own time. But real life doesn’t play out that way, Reiner says, and nurses need to know that.

“Courts have supported disciplinary action taken against nurses for what they do in their personal lives, including posting on social media,” Reiner says. “The California Supreme Court upheld a ruling that allowed the state nursing board to discipline a nurse who had been caught driving drunk, even though the arrest had nothing to with her job. The result is any nurse in the state of California who is arrested for DUI can have her nursing license suspended by the board of nursing.”

Younger nurses are particularly vulnerable to social media faux pas because they grew up using the outlets and consider posting information about themselves second nature, Reiner says. They pose a higher risk for incidents that could not only damage their careers, but also turn into lawsuits against their employers.

“As these younger nurses are brought into the profession, we’re going to see more and more professionals who are using social media and not exercising appropriate caution,” she says. “More and more healthcare organizations are implementing social media policies, but there needs to be training to back up those policies and enforce them.”

Reiner recalls a case in which a nursing assistant went into labor at work and her co-workers posted video photos online, mocking the woman in labor. Several employees were terminated and investigated by the nursing board.

Reiner suggests including the following fundamentals in a social media policy and reinforcing them with education targeted specifically to younger nurses:

• Always maintain patient confidentiality. Never post patient photos or information, or anything that might be used to identify a patient.

• Don’t refer to patients in a disparaging manner, even if the patient is not identified. It does not reflect well on the nurse or the employer. It is wise to simply avoid posting about patients.

• Do not post inappropriate comments about colleagues or your employer.

• Do not post medical advice, or anything that could be construed as medical advice, even to friends and family.

The increased use of social media makes it more important for nurses to carry their own malpractice insurance, Reiner says, because there will be more claims related to online posts.

“If the nurse were to be involved in some kind of civil litigation, the employer’s nursing policy may not cover them if they were found to be acting outside the scope of their employment,” she says. “If they violate the employer’s social media policy, the nurse would be left on their own to defend the civil claim.”