Situation
You log into a closed group on a social networking site and read a
posting from a fellow nursing student. The posting describes in detail
the complex care the student gave to an older patient in a local
hospital the previous day. The student comments on how stressful
the day was and asks for advice on how to deal with similar patients
in the future.
Ethical/Legal Points for Consideration
• Protecting and maintaining patient privacy and confidentiality
are basic obligations defined in the Code of Ethics for Nurses,
which nurses and nursing students should uphold.
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• As outlined in the Health Insurance Portability and
Accountability Act (HIPAA), a patient’s private health
information is any information that relates to the person’s past,
present, or future physical or mental health. This includes not
only specific details such as a patient’s name or picture but also
information that gives enough details that someone may be able
to identify that person.
• You may unintentionally breach privacy or confidentiality by
posting patient information (diagnosis, condition, situation) on a
social networking site. Using privacy settings or being in a closed
group does not guarantee the secrecy of posted information.
Others can copy and share any post without your knowledge.
• Potential consequences for improperly using social networking
vary based on the situation. These may include (1) disciplinary
action by the state board of nursing; (2) being disciplined,
suspended, or fired by an employer; (3) dismissal from a nursing
program; and (4) civil and/or criminal charges.
• A student nurse who experienced a stressful day and is looking
for advice and support from peers (e.g., “Today my patient died.
I wanted to cry.”) could share the experience by clearly limiting
the posts to the student’s personal perspective and not sharing
any identifying information. This is 1 area in which it is safest to
err on the side of caution to avoid the appearance of impropriety.
Discussion Questions
1. How would you deal with the situation involving the fellow
nursing student?
2. How would you handle a situation in which you saw a staff
member who violated HIPAA?
