Texas nurses have a duty to maintain professional boundaries. The Texas Board of Nursing (BON) defines professional boundaries as "the appropriate limits which should be established by the nurse in the nurse/client relationship due to the nurse's power and the patient's vulnerability." 22 Tex. Admin. Code § 217.1(29). Professional boundaries are meant to promote the patient's dignity, independence, and best interests. The National Council of State Boards of Nursing (NCSBN) defines professional boundaries as the spaces between the nurse's power and the patient's vulnerability.
The BON issued a position statement to provide guidance to nurses regarding expectations related to professional boundaries. The use of social media by nurses is addressed in the Board's position statement. 15.29 Professional Boundaries including Use of Social Media by Nurses.
Use of Social Media by Nurses in Texas
A survey by the National Council of State Boards of Nursing (NCSBN) revealed that a number of state nursing boards have received complaints about nurses inappropriately using social media sites. In fact, the survey results indicate that nurses have been disciplined by nursing boards, fired by employers, and even faced criminal charges for the inappropriate use of social media.
The Board's position statement on the use of social media by nurses makes it clear that Texas nurses must:
- Be aware of the potential consequences of disclosing patient-related information via social media.
- Always maintain professional standards, boundaries, and compliance with local, state, and federal laws.
- Uphold the obligation to protect their patient’s privacy and confidentiality, which extends to all environments, including the social media environment.
In its position statement the Texas BON expresses support for the guidelines and principles of social media use by the NCSBN and the American Nurses Association. It is the Texas BON's position that:
- Nurses have an ethical and legal obligation to maintain patient privacy and confidentiality at all times. When using social media, nurses do not identify patients by name or post or publish information that may lead to the identification of a patient. Limiting access to postings through privacy settings is not sufficient to ensure privacy. Nurses must promptly report any identified breach of confidentiality or privacy. 22 Tex. Admin. Code § 217.11(1)(E), (K).
- Nurses maintain professional boundaries in the use of electronic media. The nurse has the obligation to establish, communicate and enforce professional boundaries with patients in the online environment. Nurses do not refer to patients in a disparaging manner, even if the patient is not identified or transmit information that may be reasonably anticipated to violate patient rights to confidentiality or privacy, or otherwise degrade or embarrass the patient. 22 Tex. Admin. Code § 217.11(1)(J).
- Nurses must be aware of and comply with all laws and rules, including employer policies regarding the use of electronic devices including employer-owned computers, cameras and use of personal devices in the work place. In addition, nurses must ensure appropriate and therapeutic use of all patient-related electronic media, including patient-related images, photos, or videos in accordance with applicable laws, rules, and institutional policies and procedures. 22 Tex. Admin. Code § 217.11(1)(A).
The Texas BON recognizes the benefits of social media to nurses, patient, and the public, like for the dissemination of public safety announcements and to easily get information to the public during emergencies.
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