ONA Position on Social Media in Health Care: Safeguarding Healthcare Staff

ONA Position on Social Media in Health Care: Safeguarding Healthcare Staff
Developed: 2015
Approved by ONA BOD: 3/2015
Reaffirmed by ONA BOD: 6/2020

The ubiquitous use of smart phones and computer technology by the American consumer means
that mobile technology enters a hospital, outpatient clinic, or counseling session…essentially any
healthcare setting…with the patient, family, or visitor.

While the need for protection of patient privacy in electronic communications is well established in
health care environments, consideration of the intrusion electronic media may have on employees
is not as well developed. Staff may be subject to photography, video, and audio recording by
patients, family, or visitors without their knowledge or consent. Occasionally, healthcare providers
may be video-taped with the express aim of pinpointing errors or questionable care that may lead
to threats and intimidation of the employee. In rare cases, inappropriate pursuit of a staff member
by a patient, family member, or visitor via electronic means has resulted in harassment very similar
to stalking.

Healthcare employees may also be asked to transmit patient data via unsecure devices or answer
personal phones when another staff member is unavailable. Often, the request comes from
someone the staff member may consider a supervisor or someone in a superior role. Can the staff
person refuse such a request? Is there a policy for handling these kinds of issues in your facility?
The following are some suggested steps that a healthcare facility may take to implement
protections for their employees, some of which are already being used by facilities around the

• Determine what kinds of limits on the use of mobile devices or other electronic technology
by patients, family, and visitors are appropriate within your facility. Certainly, limits will be
different in maternal-child health versus medical-surgical units.
• When determining appropriate limits, include consideration of the rights and safety of
employees/caregivers, other patients, family, or visitors that may be inadvertently “caught”
in photographs or videos.
• Inform patients, family members, and visitors of limitation on the use of mobile devices by
including the information in patient handbooks, admission forms, and through the use of
signs placed in hallways, patient care areas, offices, reception, and elevators.
• Employees/caregivers should never use personal devices for patient care or to transmit
patient information. If the facility requires this, the facility should provide the equipment.
• Consider limiting the use of electronic devices to non-patient care areas only such as a
lobby, cafeteria, or gift shop.
• Define procedures for managing violation of the policy, including who will be responsible for
enforcing the policy and how violations will be handled, from simply “forgetting” to
egregious flaunting of the policy.
• Educate all staff and employees on the purpose of the policy and how violations or concerns
are to be communicated, including the appropriate person or office to receive the report.
• Provide a means of regular review of the policy, challenges and successes, and how it might
be improved. Include staff and employees across a wide range of positions to capture input
and perspectives across the spectrum of persons working in the healthcare environment.
• Provide positive and constructive support to any employee, whose security or safety is
being challenged by inappropriate or threatening behaviors via any form of electronic
media, including the pursuit of criminal investigation as indicated.
Additional policies to address appropriate use of mobile technology, colleague-to-colleague, would
also be helpful.
• Develop a policy regarding coverage of phones/phone calls during events in which the
owner of the device is unavailable. Preferably, calls should be diverted to a colleague who is
familiar with the same group of patients or concerns. Covering calls should not be the
responsibility of the nearest hospital employee who would otherwise not be expected to
have first-hand knowledge of the patient care involved and/or is unable to respond to
callers without back and forth communication between the intended recipient of the call
and the caller.
• Provide clear directions on appropriate use of mobile devices/electronic technology for the
transmission of patient information between colleagues, including when it is acceptable to
refuse requests such as transmitting a picture of the patient, or sending information via
unsecure methods. Occasionally, a staff member is requested to transmit information in an
inappropriate or unsecure manner for the convenience of a colleague, usually someone that
holds a superior position and therefore is difficult to refuse.
• Educate all staff, including physicians, in the appropriate use of mobile technology and the
facility policy.
• Healthcare employers should collaborate with professional and trade associations, as well
as regulatory boards, in developing uniform policies addressing the appropriate use and
controls of electronic communication devices.

Healthcare facilities can develop a culture that supports both patients and employees and
safeguards the privacy of both through well-developed and enforced media policies.