Social media is a broad term used to describe an array of online communication platforms and applications, which promote and enhance the sharing of information. People who use these applications often form online communities with other members from across the world, reaching people of varying cultures, religions and languages.
Common types of platforms include blogs or microblogs, discussion forums, chat platforms, social networking and content sharing sites. Social media platforms like LinkedIn, Facebook groups and online forums provide opportunities for nurses to connect with friends, family, colleagues, organizations and the public, to share their knowledge or perspective or to learn more about specific topics.
Over the last decade, online platforms have evolved dramatically. What began as casual social interaction has grown into a complex web of online communication, public engagement and professional branding. Today, a single post can reach thousands, even millions, of people in seconds. That reach can influence public perception, shape health care conversations and inspire community change. It also means your words, images and actions online are visible, often permanent and subject to public and professional interpretation.
When using social media nurses should consider the following:
Public Perception
Nurses must be mindful of when they are identifying, or can be easily identified, as members of the nursing profession on social media, including on their personal profiles and posts. Nurses are responsible for maintaining an appropriate image of nursing. Your online conduct should reflect the same standards of behaviour expected in your nursing practice, as outlined in the Code of Conduct, specifically Principle 2. This includes avoiding posting or reposting any content that could be perceived as disrespectful, discriminatory or unprofessional.
Nurses are trusted professionals. Anything a nurse posts, likes, shares or reposts can impact the public’s trust in nursing. Therefore, the information posted by nurses must be evidence-informed and aligned with the standards of practice of the profession.
Video – Professionalism/Employer Policies
Practice Standards
All nurses are accountable to the College of Nurses of Ontario’s (CNO) professional standards of practice and employer policies. Practice standards set clear expectations around professionalism, boundaries and confidentiality and privacy. They also communicate to the public what they can expect of nurses. You must apply these accountabilities to your online activities, just as you would in a traditional work setting.
CNO’s practice standards do not apply to all aspects of a nurse’s private life. However, when nurses communicate with the public, they invoke their professional position as a nurse and are therefore accountable for contributing to the public perception of the profession, to CNO and to the public it protects. While CNO rarely turns its attention to member behaviour outside the practice setting, it may follow up when a nurse’s conduct outside of the workplace creates concern with their practice.
Code of Conduct
CNO’s Code of Conduct is the central practice standard that describes all nurses’ accountabilities to maintain professionalism, competence and ethical behaviours. Principle 4.5 speaks directly to social media use: Nurses demonstrate professionalism and treat all health care team members with respect in all contexts, including on social media.
Confidentiality and Privacy – Personal Health Information
Nurses are cautioned against sharing client information, even if they remove names or other personal identifiers, regardless of whether the platform is private or public. This is because a story, image, or comment may be identifiable and inadvertently lead to a privacy breach. Information contained within a client’s health record would never be appropriate to share on social media. This includes diagnostic images, test results or unique findings.
Many incidents of privacy breaches are unintentional. It is important for nurses to reflect on their surroundings and on how or whether information they may be sharing could be identifiable. Lack of intention does not mitigate the impact of a privacy breach or negate accountability, should the information be shared.
Even when a client consents to having their information shared, nurses must recognize that consent can be revoked at any time, and the permanent nature of the internet poses ongoing risks to the client’s privacy and dignity, should consent be rescinded. Once posted, content may be copied, reshared, or remain accessible indefinitely, even if deleted.
Video - Confidentiality
Professional Boundaries and Nurse Client Relationships
Connecting or interacting with current or former clients on social media can blur boundaries, compromise care and erode trust in the nursing profession. This includes activities such as following, engaging with their posts or responding to messages. Nurses are accountable for keeping the relationship professional and for communicating the boundaries and limitations of the relationship, including providing clarification to the client when there is potential for uncertainty. CNO’s Professional Boundaries and Nurse-Client Relationships practice standard outlines that nurses must refrain from connecting with clients, following clients or accepting friend requests from clients on their personal social media accounts.
Video – Professional Boundaries
Reflective Practice Guidance
Before posting, nurses should engage in reflective practice and consider how their content aligns with ethical obligations, regulatory expectations, and the public trust in the nursing profession. Online actions must reflect the same professionalism, confidentiality, and respect that guide in-person care.
Before you post, reflect on these seven questions:
- Is this post respectful and professional?
- Am I upholding my obligations of maintaining privacy and boundaries?
- Could this content harm the public’s trust in nursing?
- Does this post align with CNO practice standards and guidelines?
- Does this post comply with relevant legislation (e.g., PHIPA) and employer policies?
- Would I be comfortable if this post were seen by a client, colleague, employer or a regulatory body?
- Would I be comfortable defending this post publicly or in a disciplinary hearing?
If in doubt — leave it out.
Information and Resources
To learn more about your accountabilities, review the following resources:
CNO Resources
External Resources