Chapter 1 – Introduction to Communication and Communication Theory in Nursing

Social Media

Many people use social media (e.g., TikTok, Instagram, Twitter, Facebook, WhatsApp) as a way to share and engage with others and as a form of education and entertainment. However, as a nursing student, you are legally obligated to uphold a Code of Conduct in both personal and professional social media posts.

A Code of Conduct is a standard of practice that sets expectations and outlines norms and responsibilities of a professional. It establishes and formalizes common values within the profession and is intended to govern behaviour. The College of Nurses of Ontario (CNO, 2019a) has articulated a Code of Conduct with six guiding principles:

  1. “Nurses respect the dignity of patients and treat them as individuals.”
  2. “Nurses work together to promote well-being.”
  3. “Nurses maintain patients’ trust by providing safe and competent care.”
  4. “Nurses work respectfully with colleagues to best meet patients’ needs.”
  5. “Nurses act with integrity to maintain patients’ trust.”
  6. “Nurses maintain public confidence in the nursing profession” (CNO, 2019, p.4).

As a nursing student, you are expected to uphold the same practice standards as a Registered Nurse.

With the advent of social media, as a Registered Nurse and a nursing student you are expected to uphold the Code of Conduct now more than ever. Even though you may use social media in your personal life, you are still expected to maintain professionalism. For example, under the Code of Conduct, nurses and nursing students are expected to treat their colleagues with respect on social media. Nurses and nursing students who use social media are not allowed to share patient information or post confidential information, even on private accounts.

The CNO (2019b) Practice Standards documents states “nurses have a duty to uphold the standards of the profession, conduct themselves in a manner that reflects well on the profession, and to participate in and promote the growth of the profession” (p. 11).  As such, there is a collective responsibility to contribute to the positive image of the nurse, and actively promote the reputation of a nurse. Posting information on social media that is unethical, unlawful, and disgraces a colleague in your practice or educational institution or dishonours the image of the nurse could result in serious consequences to licensure.

Case Example

In 2015, a Registered Nurse from Saskatchewan took to social media to air her grievances about the quality of care her grandfather received in long-term care. In her Facebook posting, she named the institution that cared for her grandfather and urged the institution do better in future patient care. In her posting, she did not explicitly name any healthcare providers, nor did she use inflammatory language, but she referred to her grandfather’s care as “sub-par”. In 2016, she was found guilty of professional misconduct by the Saskatchewan Registered Nurses Association (SRNA) and was ordered to pay a $1,000 fine and $25,000 towards costs for the tribunal. In 2020, Saskatchewan’s highest court overruled the disciplinary decision and fine.


The nurse in this case was originally found guilty of misconduct for harming the reputation of nurses by going to social media to make complaints. It was also noted that other formal complaint channels (such as managers of the institution), would have been a more appropriate alternative to make change. Furthermore, the legal team for the SRNA argued that all facts should have been collected before making allegations against the institution. Ultimately, the decision was overturned, however this case emphasizes the importance of being intentional, deliberate, and professional when engaging on social media.

Your employer or educational institution may or may not have specific policies related to the use of social media outside of the workplace. It is important as an employee or a student to be aware of any institutional guidelines for social media use. Furthermore, the CNO will consider situations of misconduct as a regulatory body.

Examples of violations on social media:

  • Posting confidential information about a client (e.g., diagnoses, events, family situations).
  • Sharing explicit material (including sexually explicit).
  • Engaging in personal relationships with clients online.
  • Posting unfavourable information about colleagues, professors, or institutions (such as hospitals or universities/colleges).
  • Cyber bullying or intimidating colleagues or clients.


Points of Consideration

24-hour Rule

Part of the lure of social media is the immediacy with which you share information or receive feedback. Social media has also become a common place to air grievances or share complaints. You can rally support or oppose views with the click of button. However, given that a social media post can have serious repercussions on your career as a nurse and a student, it is important to give additional consideration to what you post online. One strategy to assist is the 24-hour rule, which means when you are uncertain of the effects of your post or you sense that your words may be provocative, wait 24hours and think through your decision. It does not hurt to seek feedback from trusted peers as well.


Additionally, if you have a grievance or a complaint, it is best to address it directly with the person or institution involved. Recall how to address conflict through a positive lens.


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Introduction to Communication in Nursing Copyright © 2020 by Edited by Jennifer Lapum; Oona St-Amant; Michelle Hughes; and Joy Garmaise-Yee is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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