Social Media

I manage several RNs who are active on social media. Recently I have seen some conversations that include negative postings about our workplace and several of our clients. What standard are RNs held to when their personal and professional lives mix because they self-identify or reflect on being an RN in a social media setting?

• Ethically and legally, RNs have an obligation to maintain professional boundaries, client privacy, confidentiality and security by complying with legislation, practice standards, ethics and organizational policies at all times (1 & 2), in all practice settings.
• Registered nursing is a highly respected profession. Our clients come to us in their most vulnerable state and trust us with their most personal information. As such, RNs are always accountable to their practice standards that include demonstrating a professional presence, practicing with integrity in all their professional interactions and modelling professional behaviour (3 & 4).
• RNs should treat the virtual world of social media with the same professionalism as shown in the physical world. If you would choose not to say something about a client or colleague in front of others in an elevator, then avoid posting that same information in the cyber world (5 & 6). The CRNS Social Media resource includes additional tips for using social media.
• Confidential client information must not be posted. Even an unnamed client can be identified by others if confidential information about them or their family is disclosed (7 & 8).
• RNs are expected to avoid using social media to make disparaging remarks about employers or co-workers, to vent or negatively discuss work-related events, or to comment on similar posts by others (7 & 8). Work related issues should be dealt with in a respectful and constructive manner in the work setting.
• RNs are expected to advocate for high standards of care and improvements in the health care system at all levels in the best interest of clients, especially when they are unable to advocate for themselves (9).
• RNs advocate for health equity for all, particularly for vulnerable and/or diverse clients and populations (10).
• RNs are expected to address concerns about standards of care through the proper channels, not via social media (11).

What is the expectation for RNs who want to speak out about unacceptable practices in or out of the workplace?

RNs are expected to advocate for high standards of care. Often RNs identify gaps in care or issues with the care that is being delivered, when others do not. RNs contribute to quality improvement initiatives that positively impact client care. The CRNS expects RNs will follow the proper channels to resolve identified concerns about client care from a system perspective and will attempt resolution at the lowest level. One resource available to guide and support RNs in addressing concerns is Resolving Professional Practice Issues: A Toolkit for Registered Nurses, 2024.  

How can I as a manager support RNs to speak out in a professional manner about unacceptable practices that are impacting or have the potential to impact client safety or outcomes?

• Address the concerns in a broad communication about professionalism.
• Address RNs’ specific concerns privately and offer support.
• Inform the RN of available internal reporting procedures.
• Encourage and implement low level resolution whenever possible.
• Arrange for educational presentations from an ethics consultant or legal perspective.

RNs should explore the most appropriate resources given their care concerns, attempts at resolution and context of care.

CRNS Resources

CNA Code of Ethics for Registered Nurses (2017)

Registered Nurse Practice Standards (2024)

Registered Nurse Entry-Level Competencies (2024)

Resolving Professional Practice Issues: A Toolkit for Registered Nurses (2024)

Social Media, 2021

External Resources

CNPS InfoLaw: Social Media

NCSBN Social Media Guidelines for Nurses

NCSBN A Nurse’s Guide to the Use of Social Media

BCCNM Article: Am I a Nurse 24/7?