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Nursing Education 2.0:

The Need for Social Media Policies for Schools of Nursing

DIANE J. SKIBA
NE ISSUE DISCUSSED AT THE MASSIVE HEALTHCARE

tution, the University of Colorado, does not have specific policies in

INFORMATION AND SYSTEMS SOCIETY ANNUAL

place, just guidelines for using information technologies, such as accept-

MEETING IN FEBRUARY WAS THE ROLE OF SOCIAL MEDIA

able use and privacy. In conversations with colleagues, we agreed that we

IN HEALTH CARE. A funny video introduced at the meeting, starring

must address the issue before something happens at our school, landing

Phil Baumann, RN, is titled LOL Hospital Social Media and Lack of

me on still another task force at the College of Nursing!

Social Media Policy. I suggest you check it out. It is online

at

http://healthissocial.com/healthcare-social-media/hospital-social-mediapolicy/.
About a week after the conference, I received the latest issue of

My first stop in my search for literature was the Educause website

(www.educause.edu). A search revealed several publications, presentations, and social media policies posted by universities
(www.educause.edu/node/645/tid/36576?time=1300123040). Mitrano,

Educause Review, with an article on the need for student social media

director of IT policy at the Educause/Cornell Institute for Computer

policies. Given this convergence and with the placenta incident fresh

Policy and Law (2006), offers an excellent overview of the issues related

on my mind, it seemed clear that it is time to learn more about social

to social networking from the perspective of policy and law. Among the

media policies.

other presentations on the site, I particularly liked the comprehensive

Did you miss the placenta incident? If so, here, briefly, is the story.
Four nursing students posted a picture of themselves, with a placenta, on

nature of Duke Universitys policy.

My next journey was an examination of social media policies in

Facebook and were expelled from the nursing program. Suing the college

health care institutions. It is important that, as our students go to their

for reinstatement, one student stated that her instructor had given her

clinical sites, they recognize that agencies may have specifc social media

implicit permission to post the photos and that the college had violated

policies. I hope that my findings can be useful teaching tools as you pre-

her due-process rights in dismissing her (Chronicle of Higher

pare students for their clinical experiences.

Education, January 2, 2011). On January 6, the Chronicle reported that

Bennett has tracked the use of social media by health care institu-

the judge stated the key issue in the case was the students belief she

tions for years, and his website (http://ebennett.org) provides a wealth

had permission from her instructor and that the college had not estab-

of information. Bennett tells us that many hospitals have established

lished that the students action was a clear violation of professional con-

Facebook accounts and use other social networking tools for interac-

duct. This was not the first incident of unprofessional behavior on social

tions with the public or for their specific patient populations. A leader

media sites, and the judges ruling was a wake-up call for higher educa-

in the field is the Mayo Clinic, one of the first hospitals to hire a direc-

tion and health care.

Starting my quest with a literature search, I found a study by
Thompson and colleagues (2011) that analyzed the legal and ethical
issues related to protected health information on social networking sites.

tor of social media. Cook (2010) has written about the establishment of
the new position of social media manager within health care in
American Medical News.
Social media polices for various hospitals provided on the Bennett

Thompsons research team examined Facebook pages of 2007 and 2009

website include that of Danbury Hospital, where I was born (well pre-

medical students to identify potential violations of protected health

Facebook, of course). According to the website, the Ministry Health Care

information such as portrayals of people, names, dates, or descriptions of

and Affinity Health System has the most comprehensive policy, outlined

procedures. The study had some interesting findings. First, the number

in a blog by chief information officer Will Weider. See Social Media

of medical students and residents with Facebook profiles increased from

Policy and Employee Guidance at http://candidcio.com/2009/08/12/

44 percent in 2007 to 84 percent in 2009. Second, more students and

social-media-policy-and-employee-guidance/.

residents in 2009 made their profiles private. Third, the potential viola-

The Centers for Disease Control and Prevention, which has

tions were not text, but photos of clinicians providing care, in particular

embraced the use of social media, has a good site for social media

for patients while on a medical mission. The study concluded that

guidelines and best practices. The CDC offers best practices for a vari-

although medical education had made great strides in teaching patient

ety of social media tools and a Social Media Security Mitigations

privacy, there was no education that adequately impressed upon stu-

Document at www.cdc.gov/SocialMedia/Tools/guidelines/

dents and residents that online social networking sites and blogs are, in

?s_cid=tw_eh_78. Another useful resource is the Social Media

essence, broad communities with a public audience.

On my mission to examine how higher education and health care
were addressing the issue of social media policies, I noted that my insti-

1 2 6 N u r s i n g E d u c a t i o n Pe r s p e c t i v e s

Governance website, which maintains a database of policies across a

variety of industries, including academia and the government
(http://socialmediagovernance.com/policies.php). It is extremely inter-

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esting to see the variety as well as the diffusion of social media across
our society.
A study by Kind, Gerrich, Sodhi, and Chretien (2010) reports on an

EMERGING TECHNOLOGY

3. Make sure the policy emphasizes how social media can be used for
the development of students as responsible members of the community
while allowing students, as learners, to explore the opportunities afforded

analysis of websites of 132 accredited schools of medicine. Nearly all

by social media. Guide rather than restrict.

schools (95 percent) had some form of social media, primarily Facebook

4. The finished product should be readable, accessible, and jargon-

pages, for student groups and alumni associated with their webpage, with

free (Junco, 2011 p. 61).

a smaller percentage having Twitter accounts. Although most of the

Junco (2011) also provides some good advice on suggested content.

schools had online student policies, only 10.16 percent had any policies

1. Guide rather than sound restrictive. This should give students, fac-

or guidance related to the use of social media. There is a good analysis of

ulty, and staff the feeling that the policy supports them to explore and

the social media policies in the article.

I did a quick Google search for nursing and other health care schools

participate in the environment.

2. Make the connections between this policy and the code of conduct

with social media policies. Some of those I found are listed here. I am

you already have in place, for example, the National Council of State

sure there are others and I hope you will share.

Boards of Nursings document on establishing boundaries as a nurse.

Goldfarb School of Nursing at Barnes-Jewish College Social Media

Connect any policies you may have related to hate speech or other issues.

Policy, www.barnesjewishcollege.edu/?id=5501&sid=1

3. Be proactive, sound positive, and recognize that connecting, collabo-

Purdue University School of Nursing Student Handbook,

rating, and communicating with the learning community are important for

www.nursing.purdue.edu/academics/undergraduate/handbook.pdf

professional growth.

Vanderbilt University Social Media Handbook,

4. Acknowledge the value of sharing and communicating ones opinions.

www.vanderbilt.edu/publicaffairs/webcomm/vu-resources

Be sure to clearly state boundaries and remind social media users of the

/social-media-handbook/

tone of their remarks.

DePaul University, http://brandresources.depaul.edu

5. Have a clear statement of expected behaviors that should guide inter-

/vendor_guidelines/g_socialmedia.aspx

actions and communications, such as be respectful, be responsible, and

Medical University of South Carolina,

be accountable (p. 61).

http://academicdepartments.musc.edu/webcopyright/socialnetworking.html
Here are some suggestions for the steps we should all be taking. First,

6. Be sure to enforce policies related to privacy and confidentiality.

Remind health care professionals of the HIPAA rules.

contact the academic computing center or the student affairs office at

7. Provide guidance on how to handle negative situations and whom to

your university or college and ask if there is a social media policy. If

contact for help.

there is none, the next step will be to decide if the nursing department or

8. Make sure you state clearly what the consequences will be if inappro-

school wants to be proactive in the creation of a policy. An analysis of

priate use, actions, or behaviors are exhibited.

social media policies by Boudreaux (2009) found that most policies (48

As we progress on our journey, I will share with you our experiences.

percent) were neutral in tone (respect people, respect copyrights) and 38

As always, you know how to reach me to share yours. Write to

percent were proactive (focus on the positive). Being proactive means you

Diane.Skiba@ucdenver.edu or contact me on Facebook.

NLN

can focus on the benefits of social media and how they can be used properly without being reactive and exclusionary or restrictive. Boudreaux

References

also recommends developing two policies one for the personal use of

Boudreaux, C. (2009). Analysis of social media policies: Lessons and best practices.

individuals (students, staff, faculty, and administrators) and one for those
using social media as part of their work (student advising, teaching with
social media, or recruitment).
Junco (2011) offers the following suggestions for the policy develop-

Retrieved from http://socialmediagovernance.com/downloads/\download-socialmedia-policy-study.shtml

Cook, B. (2010, November 8). Hospitals new specialist: Social media manager.
American Medical News. Retrieved from www.ama-assn.org/amednews/2010/
11/08/bisa1108.htm

ment process:

Junco, R. (2011). The need for student social media policies. Educause Review, 46(1),

1. Create a committee with all the stakeholders at the table, such as fac-

60-61.

ulty, students, administrators, student affairs, and the academic comput-

Kind, T., Genrich, G., Sodhi, A., & Cretien, K. (2010). Social media policies at US medical schools. Medical Education Online. doi 10.3402/meo.v15i0.5324.

ing department. Include not only tech-savvy people, but also those who

Mitrano, T. (2006). Youth, privacy and social networking. Educause Review, 41(6), 16-29.

are less tech savvy to provide the broadest perspective. Be sure to invite

Thompson, L. A., Black, E., Duff, W. P,, Paradise Black, N., Saliba, H., & Dawson, K.

students. They will want to be involved.

(2011). Protected health information on social networking sites: Ethical and legal

2. Use social media tools to keep the community updated on your com-

considerations. Journal of Medical Internet Research. Retrieved from

mittees progress and solicit their feedback through social media.

www.jmir.org/2011/1/e8/.

Remember to be a good role model.

March / April 2 0 1 1 Vo l . 3 2 N o . 2 1 2 7

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