The Career Coaching Corner
Being Smart About Social Media
Beth A. Brooks, PhD, RN, FACHE
B
y the time this article appears in print, we will
not only be preparing for the “regular” flu
season, we may also be encountering a second
wave of the COVID 19 virus (and as I write this column there is an alarming resurgence of the first wave
in certain parts of the country). For me, it is always
reaffirming whenever health care and other front line
workers are recognized on television news, in online
and newspaper stories, blogs and social media for the
amazing work they have done and continue to do. Yet
at the same time I am frustrated, angry and worried
about health care and front line workers fearing for
their own and their patients’ safety due to insufficient
testing, limited supplies of personal protective equipment (PPE), or staffing and equipment shortages. My
emotions, and likely yours as well, swing from one
extreme to another. It’s been an emotional few months.
Early this spring as the true magnitude of the
pandemic was being experienced daily by physicians,
nurses, emergency medical technicians and others, the
news media began to solicit the opinions of health care
providers and other first responders while, concurrently, many health care workers began to (in near real
time) post their daily experiences on personal social
media outlets like Facebook, Twitter, and YouTube.
Many needed to vent about being overwhelmed
emotionally, to raise awareness about the lack of
appropriate PPE, to inform the public about the risks
of reusing PPE, or to share some of their own “new
normal” such as routines they needed to adopt in order
to keep their own families safe. I can only imagine how
desperate and scared many of these professionals were
in order to risk speaking publicly about those daily
challenges. I suspect most of the social media posts
were well intended, trying to raise the public’s awareness about the real severity of COVID-19 or to reinforce public health messages about sheltering in place
and the need for social distancing and face masks. One
thing that likely never crossed their minds was that
such postings could be potential violations of their
employers’ media, social media and privacy policies.
I remember watching the network news one evening and saying to my husband, “Wow.I can’t believe
all this social media activity hasn’t been more curbed
by these health care employers.” Sure enough, later on
in March, news stories began to appear about employers suspending or even terminating employees who
were posting on social media. In the heat of the
moment you may feel a need to speak out, but
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problems can arise whenever your own personal
opinions negatively impact, for example, your employer’s reputation in the community. To prevent any
one from losing their job for violating an organization’s
media, social media, patient privacy and confidentiality
policies, this month’s column is meant to serve as an
important reminder on the potential conflicts between
employees’ rights to use social media and employer
rights to protect their reputations and other business
interests.
A REFRESHER FOR STAFF
By now, nurse leaders have already reminded their staff
about the policies related to information sharing; e.g.
contact with the media and the use of social media, and
how doing so may violate a patient’s right to privacy.
Hospitals tend to have long-standing policies prohibiting staff from speaking to news media, requiring that
only a duly authorized representative of the organization ever communicates with the media on behalf of
the organization. Likewise, the organization’s communications, marketing or public relations departments are typically responsible for the social media
domain, which can include the monitoring of employee
social media posts in order to assure organizational
policies aren’t being violated. For example, during the
early stages of the pandemic, an emergency room
nurse was suspended for violating HIPPA when he
posted on Facebook that the COVID unit he was
assigned on had nurses continuing to work even though
they had fevers of their own. Another nurse’s
employment was suspended for making public appeals
for equipment on a private Facebook group and on her
own public home page. Yet another nurse made a
Facebook post about insufficient social distancing and
safety precautions in her workplace actually being
enforced as part of the employer’s Covid-19 protocols.
It may seem counterintuitive for nurses to be disciplined simply for raising external awareness on a private Facebook page about coronavirus exposure at
their employer. Then there are examples of nurses who
have posted social media selfies where their employee
identification badge is clearly visible—in effect, such
postings not only reveal the identity of the employer,
but could also result in the public erroneously
perceiving that such that these nurses are speaking on
behalf of their organization. Not a good idea.
Perhaps not as evident to nurse leaders, let alone
front-line staff members, is that any inappropriate use
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of social and electronic media may also be grounds
for being reported to their individual state’s Board of
Nursing (BON). While laws outlining the basis for any
disciplinary action by a BON varies from state to state
to state, a BON may investigate reports of inappropriate disclosures on social media sites by a nurse on
the grounds of: unprofessional or unethical conduct,
moral turpitude (defined as conduct considered as
contrary to community standards of justice, honesty
or good morals), mismanagement of patient records,
divulging a privileged communication, and breach of
confidentiality. The National Council for State
Boards of Nursing publishes a social media guide for
nurses.1
BE FULLY INFORMED BEFORE SPEAKING OUT
A person’s social media activity is easily accessible to
any member of the public these days, and with the
integration of personal and professional networks
across various media platforms, an employee’s posts
have also become more accessible to an employer or
to a fellow employee. Some nurses will continue to
post on their personal social media accounts under a
(potentially erroneous) assumption that their freedom
of speech is always protected by the First Amendment.
In actuality, while the First Amendment prohibits the
government from abridging freedom of speech in
most circumstances, it does not apply to private employers. Adding to such potential confusion within the
health care world, in academic medical centers, where
many of the practicing physicians and nurses are also
on the faculty, some of them expect that the
commitment to “academic freedom” comes with an
unfettered right to freedom of speech and expression.
But what must also be appreciated here is the difference between freedom of expression and freedom
from the accountability for any type of expression that
is disparaging, egregiously offensive, knowingly or
maliciously false or hateful.
Certain types of employee speech are indeed protected by law, but under the National Labor Relations
Act (NLRA). Even this protection is balanced by the
rights retained by an employer to establish guidelines
and policies covering their employees’ social media
usage. A quick summary on the law’s protections in this
area: the NLRA protects employees who engage in
what are called “concerted activities” which includes
acting with co-workers or colleagues to address work
related issues such as wages, benefits or other working
conditions. This can also protect discussions an
employee might have with the media or that same
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October 2020
employee taking to social media to air any grievances
about employer safety practices.
Perhaps some examples of employer rules that
likely would be permitted versus likely unlawful ones
would also be helpful. An employer rule prohibiting
the use of employer logos and the use of employer
names in social media account handles or in URLs
would likely be permitted, as would one that prohibited
the disclosure of confidential business information,
including any photos that might reflect that information. Likely unlawful rules would include a general
prohibition on complaining about the employer or its
working conditions, and prohibiting the disclosure of
any and all employee information, including employee
contact information or information about wages or
employee pay.
SUMMARY AND CONCLUSION
Given that nursing is the most trusted profession, patient family members and the public are going to ask
you for your opinions or for advice about COVID. Any
response you provide needs to balance your obligations
to your patient, your ethical and legal obligations to
maintain patient privacy and confidentiality, and an
expectation that you will generally support any positions staked out by your employer. As licensed professional registered nurses, we have obligations to speak
the truth and advocate when asked by family members
or the public about the need for social distancing and
face masks. But since we also need to advocate for the
best public health strategies that empirical evidence has
shown decreases the spread of COVID 19, this is also
the time to leave politics and any personal agendas or
biases at the door.
REFERENCE
1. National Council of State Boards of Nursing, Inc. A Nurse’s
Guide to the Use of Social Media. Chicago: National Council of
State Boards of Nursing; 2018. Retrieved on July 6, 2020 at
https://www.ncsbn.org/NCSBN_SocialMedia.pdf.
Beth A. Brooks, PhD, RN, FACHE, was presented with
AONE’s Mentor Award in 2017. Dr. Brooks is President
& CEO of The Brooks Group, LLC, a Chicago-based
career coaching, personal brand, and consulting firm.
She can be reached at bethbrooks@thebrooksgroupllc.
net.
1541-4612/2020/$ See front matter
Copyright 2020 by Elsevier Inc.
All rights reserved.
https://doi.org/10.1016/j.mnl.2020.07.002
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