Professionalism in nursing 5: social media and e-professionalism | Nursing Times

Digital professionalism contains the competencies and values anticipated of pros when speaking on-line. This article discusses the dangers and advantages of social media use for nurses. This is a Journal Club article and comes with a handout that you can download and distribute for a journal membership dialogue.

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There are many advantages of utilizing social media, together with for nurses and scholar nurses, however warning have to be exerted when doing so as a result of there are lots of challenges that might battle with skilled steerage. This article is the fifth half in a sequence on professionalism; it identifies what social media and e-professionalism are and discusses the dangers and advantages for nurses of utilizing social media.

Citation: Smart A et al (2022) Professionalism in nursing 5: social media and e-professionalism. Nursing Times [online]; 118: 8.

Authors: Alison Smart is lecturer in schooling; Rachel Small is educating assistant; Gary Mitchell is senior lecturer; Johanna McMullan is senior lecturer in schooling; Laura Creighton is lecturer in schooling; all at Queen’s University Belfast.


This article – the fifth in a sequence on professionalism in nursing – discusses social media use and e-professionalism in nursing. The definition of social media is broad and continually evolving. The time period refers to internet-based instruments that, in actual time, enable people and communities to:

  • Gather;
  • Communicate;
  • Share concepts, private messages, info, pictures and different content material (Carr and Hayes, 2015).

A variety of social media platforms exist, together with WhatsApp, Facebook, Twitter, Instagram, Snapchat, TikTok, LinkedIn, Google+, YouTube and different platforms which might be country-specific. The time period e-professionalism refers to digital professionalism and contains the competencies and values anticipated of pros when engaged in on-line communication (McGrath et al, 2019).

Available steerage

Registered nurses and scholar nurses want to know the significance of demonstrating e-professionalism and abiding by the Nursing and Midwifery Council (NMC)’s (2018) Code, which extends to the usage of social media. It is essential to notice that the NMC embraces the optimistic advantages of social media and its function in supporting registered and scholar nurses to attach and share data with others, though it additionally highlights the dangers.

As scholar nurses will not be a part of the dwell register, they aren’t held accountable to NMC requirements; nonetheless, if a scholar nurse demonstrates unprofessional observe via social media, it will likely be investigated by the upper schooling institute (HEI) at which they’re enrolled (NMC, 2018). HEIs, thereby, maintain scholar nurses accountable and guarantee appropriate investigations happen when an absence of digital professionalism is obvious.

Unprofessional digital observe examples embody posting:

  • Photos or feedback that point out drug use;
  • Negative feedback about colleagues, employers or sufferers;
  • Other derogatory feedback or content material;
  • Sexually specific content material;
  • Content that jeopardises affected person confidentiality (McGrath et al, 2019).

In 2019, the NMC produced a doc known as Guidance on Using Social Media Responsibly; the organisation’s code of conduct reinforces this skilled steerage as a result of, as nurses, we should use all types of spoken, written and digital communication – together with social media and networking websites – to advertise skilled observe and guarantee confidentiality. The Code stipulates that nurses should deal with their sufferers with kindness, respect and compassion (NMC, 2018), so it is crucial that social media posts made by nurses will not be seen as discriminatory in the direction of sufferers; Box 1 lists examples of doubtless discriminatory social media exercise.

Box 1. Social media exercise that may very well be seen as discriminatory in the direction of sufferers

  • Sharing confidential info inappropriately
  • Posting footage of sufferers and other people receiving care with out their consent
  • Posting inappropriate feedback about sufferers
  • Bullying, intimidating or exploiting individuals
  • Stealing private info or utilizing another person’s identification
  • Encouraging violence or self-harm
  • Building or pursuing private relationships with sufferers or service customers

Despite the NMC’s clear steerage, there have been a number of investigations into the social media use of registered nurses and different well being professionals. Rimmer (2017) reported that roughly 1,200 NHS employees – together with medical doctors and nurses – had been disciplined for misuse of social media or messaging purposes.

Professional boundaries

Professional boundaries are important for nurses to construct and preserve therapeutic relationships. The NMC (2018) highlights that objectivity depends upon boundaries between nurses and the individuals of their care, together with present and former sufferers, households, carers and companions. However, as private details about well being professionals and shoppers will be accessed simply, the danger of blurred boundaries is excessive (Westrick, 2016). Research has proven that sufferers usually prolong on-line pal requests to their medical doctors, nurses or different well being professionals on social networking websites reminiscent of Facebook (Farnan et al, 2013).

Many NHS healthcare trusts have issued organisational coverage statements strongly discouraging private on-line communication between well being professionals and sufferers; skilled our bodies such because the NMC and the General Medical Council (GMC) have executed the identical (NMC, 2019; GMC, 2013). In addition, nurses who submit a big quantity of extremely private info on social media ought to rigorously contemplate what influence this might need on their skilled relationships (British Medical Association, 2020).


Confidentiality is a key space of dialogue when contemplating social media. The want to keep up confidentiality for sufferers and colleagues can be an essential side of professionalism for nurses; as stipulated by the NMC (2018): “as a nurse, midwife or nursing associate, you owe a duty of confidentiality to all those who are receiving care”. It shouldn’t be acceptable to debate scientific issues exterior of the scientific setting. If a social media submit makes reference to work, that is prone to characterize a breach {of professional} conduct as a result of there’s a must show and respect the appropriate to privateness and confidentiality.

In summer season 2021, Kelly Morris, a registered nurse practising at The Citadel, a nursing facility in Winston-Salem, North Carolina, was suspended after posting a number of movies on her TikTok account about supposedly mistreating sufferers. The movies had been shared together with her 38,000+ followers and included jokes about unplugging a affected person’s ventilator to cost her cell phone and giving sufferers further sleeping tablets to keep away from caring for them (Kilander, 2021). This exercise was deemed unprofessional, as a result of it negatively represented the nursing career and breached the confidentiality of the ability the place she practised.


As mentioned above, there are lots of risks from social media. When contemplating evidence-based observe, a significant limitation of social media is the hazard of studying or sharing sources of poor high quality or reliability. ‘Fake news’ is a time period that has grown in recognition over current years and refers to false or deceptive info offered as information. Fake information usually has the purpose of damaging an individual or entity’s popularity or earning money via promoting income (Ford, 2020).

At the start of the pandemic, Donald Trump made faulty claims that injecting disinfectant and being uncovered to ultraviolet mild may assist deal with Covid-19. Due to this misinformation, many disinfectant producers needed to formally announce that their merchandise weren’t for human consumption, however Trump’s feedback had been broadly shared on social media (Frenkel and Alba, 2020).

In the spring of 2021, the NMC eliminated nurse Kay Shemirani (also referred to as Kate) from its register for spreading misinformation about Covid-19. Communicating together with her 50,000+ Facebook followers, she referred to the pandemic as a ‘scamdemic’ and claimed the Covid-19 vaccination was a approach for governments to invade individuals’s non-public ideas. She additionally stated the usage of face coverings was not evidence-based, was extra prone to make individuals unwell, and that in contrast NHS employees adminstering the vaccine to the actions of the Nazis. The NMC interpreted Shemirani’s lively dissemination of those conspiracy theories to be misconduct as a result of harmful nature of the messages (Baines, 2021).

Educational functions

Although utilizing social media poses dangers for registered and scholar nurses, it have to be burdened that it additionally has a number of benefits. Social media has the potential to attach nurses and nursing college students to their quick colleagues, interdisciplinary colleagues and the general public. The use of social media can be an rising and in style strategy to enhance public understanding about nursing and the advanced roles nurses can occupy (ten Hoeve et al, 2014).

Social media may also be a low-cost strategy to share greatest nursing observe; for instance, it has develop into a lot simpler to stay updated with modifications to pointers, as these are sometimes launched through social media. Engagement with respected on-line publications can even contribute to persevering with skilled improvement and, if mirrored on and documented, can be utilized within the NMC revalidation course of. The Resuscitation Council UK not too long ago revealed a video explaining how one can carry out cardiopulmonary resuscitation through the Covid-19 pandemic and disseminated it through Facebook, Twitter and YouTube.

Social media additionally offers registered and scholar nurses an opportunity to self-publish and share info through blogs. Although blogs are sometimes not thought of to be a sturdy supply of proof, they’ll play an essential function in sharing info and provides customers a platform to convey their message (Moorley and Chinn, 2019). As an instance, within the 12 months after the emergence of Covid-19, nurse lecturers Alison Smart and Deirdre O’Neill wrote a weblog to tell registered nurses, scholar nurses and nurse educationalists concerning the significance of self-care; that is out there on Queen’s University Belfast’s web site.

Recommendations for observe

Maintaining e-professionalism when utilizing social media is a crucial space of schooling for scholar nurses, registered nurses and different well being professionals. As mentioned on this article, there are a number of threats to sustaining professionalism whereas participating with social media; nonetheless, there are additionally essential advantages and, when social media is used professionally, these advantages far outweigh the dangers. Box 2 lists tips for creating and sustaining a high-quality, skilled social media profile; Box 3 suggests some methods of reviewing and assessing social media exercise.

Box 2. Tips on how one can have a high-quality, skilled social media profile

  • Consider separating your private {and professional} social media profiles by, for instance, utilizing Twitter as an expert channel and Facebook as a social channel. This is helpful as a result of every channel can have a distinct viewers
  • Think about your viewers and who you need to have interaction with every social media submit. As an instance, when sharing a helpful article about nursing, contemplate whether or not it’s colleagues or family and friends who will need to learn it
  • Consider the language you employ and watch out to keep away from stereotyping and labelling; for instance, utilizing the time period ‘older people’ as an alternative of ‘elderly people’ is beneficial
  • Be cautious about which social media posts you reshare. People usually understand this as an endorsement and in the event you reshare an anti-vaccination submit, for instance, your social media followers might interpret this as your viewpoint
  • Profile your work on social media by, for instance, posting about passing exams, sharing information of an award or highlighting quality-improvement outcomes (whereas defending the confidentiality of individuals in your care)
  • Use social media in accordance with the Nursing and Midwifery Council’s (2018) Code; for instance, preserve acceptable skilled boundaries with sufferers
  • Participate in persevering with skilled improvement actions utilizing social media, reminiscent of by getting concerned in a Twitter dialog related to your area of observe. This exercise can be utilized as a part of your skilled revalidation
  • Promote social media to your colleagues and sufferers by, for instance, educating sufferers about the advantages of on-line affected person assist from a charity or particular curiosity group
  • Promote the nursing career to your friends, colleagues and the general public
  • Limit display time exterior of labor to 2 hours per day

Box 3. Reviewing social media exercise and assessing boundaries

Reviewing exercise

  • Check the settings on all of your social media accounts:
    • Who can see what you submit?
    • Can somebody tag you in a photograph with out your consent?
    • Do you have got optimum privateness in your social media accounts?
  • Ask a pal to critically overview considered one of your social media accounts and determine any posts that is likely to be thought of unprofessional

Assessing boundaries

Scenario 1

A nursing scholar posts a selfie on Twitter on the final day of their scientific placement.
The ward board is seen behind them and identifies affected person info.

  • Why is that this not an appropriate submit?
  • What elements of the Nursing and Midwifery Council’s (2018) Code does it compromise?

Scenario 2

A scholar nurse you recognize not too long ago accomplished a scientific placement on a neonatal unit, the place a new child they cared for died after issues. The scholar developed a detailed relationship with the infant’s dad and mom and the mom has despatched them a Facebook pal request. Consider the steps the scholar nurse ought to take to keep up skilled boundaries whereas guaranteeing compassionate look after the mom


The skilled use of social media is beneficial for all nurses, scholar nurses and well being professionals. Using social media will help them develop data and expertise that might improve affected person care. However, when nurses use social media, it’s critical they preserve e-professionalism and comply with the NMC’s Code and different relevant steerage.

Key factors

  • Professional nursing steerage extends to social media use, and better schooling institutes maintain scholar nurses accountable
  • There have been a number of investigations into the social media use of registered nurses
  • It is essential to keep up skilled boundaries on social media platforms
  • Nurses should preserve sufferers’ confidentiality and keep away from sharing misinformation on-line
  • Social media can improve nursing observe and contribute to persevering with skilled improvement

Baines E (2021) Police investigating struck-off anti-vax nurse after likening NHS employees to Nazis. nursingtimes.web, 26 July (accessed 28 June 2022).

British Medical Association (2020) Social media as a medical scholar., 1 May (accessed 28 June 2022).

Carr CT, Hayes RA (2015) Social media: defining, creating and divining. Atlantic Journal of Communication; 23: 1, 46-65.

Farnan JM et al (2013) Online medical professionalism: affected person and public relationships: coverage assertion from the American College of Physicians and the Federation of State Medical Boards. Annals of Internal Medicine; 158: 8, 620-627.

Ford S (2020) Fake information on coronavirus may make illness outbreak worse. nursingtimes.web, 17 February (accessed 28 June 2022).

Frenkel S, Alba D (2020) Trump’s disinfectant discuss journeys up websites’ vows in opposition to misinformation., 30 April (accessed 28 June 2022).

General Medical Council (2013) Doctors’ Use of Social Media. GMC

Kilander G (2021) Nurse suspended for TikTok movies about mistreating her sufferers claims they had been comedy skits., 29 June (accessed 5 July 2022).

McGrath L et al (2019) Understanding the advantages and dangers of nursing college students participating with on-line social media. Nursing Standard; 34: 10, e11362.

Moorley C, Chinn T (2019) Social media participatory CPD for nursing revalidation, skilled improvement and past. British Journal of Nursing; 28: 13, 870-877.

Nursing and Midwifery Council (2019) Guidance on Using Social Media Responsibly. NMC.

Nursing and Midwifery Council (2018) The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates. NMC.

Rimmer A (2017) Doctors’ use of Facebook, Twitter and WhatsApp is the main focus of 28 GMC investigations. BMJ; 358: j4099.

ten Hoeve Y et al (2014) The nursing career: public picture, self-concept {and professional} identification. A dialogue paper. Journal of Advanced Nursing; 70: 2, 295-309.

Westrick SJ (2016) Nursing college students’ use of digital and social media: regulation, ethics and e-professionalism. Nursing Education Perspectives; 37: 1, 16-22.


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