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Misuse of social networking may have ethical implications for nurses.

According to Facebook (2009), about 200 million people worldwide use that social networking site and 50% of them log in daily. Nurses are using popular social networking sites like Facebook, MySpace, YouTube, and Twitter to keep in touch and share information. However, the use of Facebook and other social networking sites is raising personal and professional privacy questions. Should patients and nurses be “friends”? What complications might arise from this blurring of boundaries? Does knowing a patient’s political or religious views or social habits have the potential to affect how they are treated medically? When a patient is privy to a nurse’s personal information, can there be an erosion of trust? Consider the case of the nursing student who was expelled from the University of Louisville for her posts on MySpace, where she wrote about her patients, gun rights, and abortion, among other issues (Chronicle of Higher Education, 2009). According to the university, her posts violated the nursing school’s code of conduct. The student is suing the university, alleging that it violated her free speech and due process rights. In another case, two Wisconsin nurses were fired when they allegedly took photos of a patient’s x-ray and posted one on Facebook, according to WISN.com (2009). The case has been referred to the FBI for possible violations of the Health Insurance Portability and Accountability Act (HIPAA). A number of nurses have posted comments on Web sites only to find them being read by a wider audience than originally intended. Although no specific guidelines address blogging, nurses need to remember the constraints of HIPAA and the Family Educational Rights and Privacy Act. Be cautious about patient privacy when sharing something that happened at work. In addition to considering the possible violation of patient, student, colleague, and faculty privacy, it is important to think about the erosion of hospital credibility that could be created by any negative information posted. There can be serious legal consequences to these violations. Another aspect of social networking sites is their ability to blur the lines between personal and professional life. In an article on NursingTimes.net (2009) on how to use social networking sites safely, the author reminded nurses that the public judges them, not just by their demeanor at work, but also by the behavior and values that they demonstrate in their personal lives. Many employers often will have a specific policy about outside activities in their written professional code. Because the issue of social networking is a gray area that can confuse employees and employers, it is up to nurses to use their own judgment and take personal responsibility to apply professional ethics in and outside of the workplace. ✱