The utilization of social media is increasing rapidly with the increasing availability of applications, social media applications and platforms (Suby, 2013). Health care professionals also have access to social media tools which includes blogs, virtual reality, wikis, media sharing sites, micro-blogs and social networking platforms (Rolls et al., 2016). In order to prevent these risks, guidelines have been issued by the professional organizations and health care institutions (Peate, 2015). In this paper, the author will analyze the importance of social media and also the pros and cons of using social media medium in health-care as well as responsibilities as registered nurse while using social media. 

According to Niedermeier, Wang and Zhang (2016), social media are preferably the tools that are computer-mediated that allows companies, individuals and organizations to exchange, create and share information, pictures or videos, ideas and career interests in virtual networks and communities. Hotta (2014) defines social media as internet based tools which allow the communication between the individuals or the communities in order to share personal messages, information, images and ideas. It is also helps in real time collaboration with other users. Social media (Web 2.0) applications that are internet based and user generated content which includes digital video posts, text as well as digital photo (Mitchell, 2012). Chretien and Kind (2013) states that health professionals take part in social media all the time, using professional networking sites to know more about the improving health outcomes, latest research and networking etc. Social media is also used to provide health care information, such as Heart Foundation, Lung Foundation Australia and Stroke Foundation which is just three examples of quality health care information provided (Antheunis, Tates and Nieboer, 2013). Over the years, social media has become a social mainstream activity which resulted in its evolution (Hamm et al., 2013). Evolution of social media will be seen overtime. The changes and improvements that take place everyday cause of the social networks and networking sites is a proof that the social media will enhance in the upcoming years (Peate, 2015). 

The use of social media would be very advantageous in the field of health-care. Ventola (2014) explains that it provides quick dissemination of medical information to improve general health and well being. It also provides the patients a reliable platform from which they can get healthcare related information as there are various unaccredited and wrong medical information online that could be bad and irrelevant and patients would consume this information at their own risk (Lipp et al., 2014). Hamm et al. (2013) supports the use of social media in health care by arguing that it enables health-care access across vast distances by presenting an opportunity to diagnose, prevent as well as treat diseases (Gupta, Tyagi and Sharma, 2013). It can also save lives in some instances. With the adoption of social media tools one can personally provide advice and care to the individuals who may otherwise not have access to medical advises (Antheunis, Tates and Nieboer, 2013). Puljak (2016) argues that it provides mechanism for cost control as the most cost effective way to encourage a message is social media. Chretien and Kind (2013) supports this view by arguing that, to dispense and monitor health-care services, incredibly cost effective way are provided by collaboration tools and social media and through its use, health-care organizations can differentiate themselves as providers of low cost and good quality medicine. As social media is of collaborative nature, firms other than health-care save technological advances for later use in the industry of health-care (Koumpouros, Toulias and Koumpouros, 2015). The power of social media can be harnessed by the incredible opportunities by the health-care organizations. If there is a slow investment in the functions and tools of health-care organizations to respond to health-care consumers then there are chances that their brand is overtaken by the social media. It also increases interaction among the people (Koumpouros, Toulias and Koumpouros, 2015). It can be a source for support and patient information. Patients are now able to find and engage with people who suffer from same health condition (Ventola, 2014). Google is being used by the patients to diagnose. Searches related to health in Google, gives over 900 medical conditions. Using social media in health-cares provides tailored and shared information to patients; it also increases accessibility to emotional/social/peer support. It also has the ability to influence health policies and promote public health surveillance (Rolls et al., 2016). 

The use of social media for health-care can also carry various cons. According to Suby (2013) some of the disadvantages may be limits on holistic patient information, privacy concerns, social stigma and lack of proper training in technology use. Most of all, the information about health is not reliable and lacks quality on social media and the online sources. In social media sites there might be authors of medical information who are known to have limited information or may be unknown. Moreover, the medical information may be informal, unreferenced or incomplete (Lau et al., 2012). However, Lipp et al. (2014) states that, these problems can be addressed through some of the measures. The patients can be guided by HCPs to the websites which contains relevant information. Internet Corporation is requested by the World Health Organization to assign names and numbers to create a domain suffix that would only contain relevant health information (Puljak, 2016). The use of social media by health care professionals might also lead to Unprofessional behaviour such as negative comments about patients, the usage of discriminatory language, violation of patient privacy and images of intoxication or sexual suggestiveness. Such public missteps along with posting “tweets” posing with weapons or alcohol or physicians taking digital photographs during surgery have been documented by HCPs (Gupta, Tyagi and Sharma, 2013). It is also not recommended to air frustrations regarding patients but it also occurs in online forums. Even-though the online communication is initiated by the patients, the interaction of HCPs with their patients can violate the patient-HCP boundary (Lau et al., 2012). It has also been studied that patients often try contacting their physicians on social networking sites where most of them decline or do not respond. It would bring about a negative impact on the HCPs to interact with their patients on social media. Online interaction between HCPs and patients is therefore discouraged by the organizational policy statement (Ventola, 2014).

The fourteen National Boards that regulate the Australia’s registered health practitioners inclusive of the registered nurses as well as the students (with the exception of psychology as they have provisional psychologists) have the responsibility to register them (Saver 2012). They set standards that are required to be met by the registered nurses. They also manage the notifications or the complaints related to the performance, conduct, or the health of the registered nurses. 

The AHPRA (Australian Health Practitioner Regulation Agency) has partnered with the National Boards in implementing the National Registration and Accreditation Scheme that comes under Health Practitioner Regulation National Law (Nursingmidwiferyboard.gov.au, 2016).

With the use of social media, the registered nurses should take into account the National Law and its Guideline for the advertisements of health service that are regulated, code of ethics and professional conduct by the National Board. 

The information should also be posted by the registered nurses that have not breached these obligations with (Fedoruk and Hofmeyer, 2014):

• Compliance with the obligations related to their professions
• Compliance with the privacy obligations and confidentiality (such as case studies, pictures of procedures being posted or no discussion with the patients, sensitive materials that may be enabling the identification of the patients without obtaining their consent in the situations that were appropriate)
• Information is presented in the context that are based on evidence and unbiased and
• Unsubstantiated claims are not made (Saver 2012).

The availability of the additional information is obtainable from the employers and/or the professional bodies. This aims for supporting the registered nurses’ social media use. However, the professional, ethical, and legal obligations which the registered nurses must be adhering to have been set out in the Advertising guidelines and Code of conduct of the National Board.  

The most important objectives of the National Board and National Registration and Accreditation Scheme have been the protection of the public. The National Board has developed the guidelines and the codes and the National Law that has relevance in relation to the social media consideration. The explanation of this policy is related to the way the existing guidelines and the codes and the National Law have been related to the social media (Nursingmidwiferyboard.gov.au, 2016):

The main objective of this scheme is to project public. The following code of conduct was created:

• National Law (section 133) established the obligations by the registered nurses with regards to the advertising, and Advertising guideline, and
• Code of conduct of the National Board that are relevant.

There should be awareness of the registered nurses with regards to the regulatory and ethical responsibilities when they interact online in same way as when interacting in person. This policy is responsible for providing guidance to the registered nurses so that they understand the obligations and responsibilities when they communicate on and use social media.

With regards to the use of the social media by the registered nurses, it is important that they have the awareness of the Advertising guidelines, Code of conduct of the Board and the National Law and other legislations that are relevant such as privacy legislation.

The obligations are stated below (Nursingmidwiferyboard.gov.au, 2016):

1. Professional obligations

The Code of Conduct guides the registered nurses related to the professional behavior standards when they interact online or in person. There is also articulation on the Code of Conduct related to the professional conduct with respect to the patient information confidentiality, which includes in the usage of social media. For instance, the posting of the patients’ photographs that are unauthorized is a breach of confidentiality and privacy of the patient. The posting of these unauthorized photographs can include personal or group Facebook site even when there is highest setting of the privacy settings (Ford 2012).  

1. Obligations related to advertising

The National Law’s section 133 has the imposition of the limits related to the way the delivery of the health services by the registered nurses can be advertised. The application of these limits includes all advertising forms that are inclusive of internet and social media. For instance, there is prohibition in the National Law related to the testimonial usage in advertising. The guidance is provided by the Advertising guidelines related to the legal restrictions on advertising under the National Law and other legislations that are relevant and the way they are applicable to the social media (Ford 2012).

The prudent and wise use of social media platforms offers the capability to enhance professional advancements and developments as well as individual and public health. If these are used carelessly, it would have formidable impact on the HCPs. Likewise, social media have the capability to strengthen personal relationships and health-care consumers will be provided with valuable information. It also acts as an interface for the registered nurses to interact with colleagues all over the world. Nurses should be aware of the consequences caused if patient related information is disclosed through social media and should also be aware of the policies of the employer, the relevant federal and state laws, confidentiality of patient privacy and its social media application. The nurses may enjoy benefits that would be personal and professional by being careful and conscious and by not violating the privacy and confidentiality of a patient.

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