We post; we blog; we tweet. We’ve moved beyond email to an electronic world that makes friends and colleagues more accessible, where communication of our thoughts and opinions is instantaneous, and the sharing of information knows no bounds.
Recently the American Nurses Association (ANA) and the National Council of State Boards of Nursing (NCSBN) 
mutually endorsed each organization’s guidelines for upholding professional boundaries in the social networking environment. Nursing organizations and health care facilities nationwide are learning how to incorporate and work with social media with everything from job postings to hiring; education to hands-on training; and patient care to team communication.
Because the use of social media is radically changing the mechanisms of health care, it’s important to understand the benefits and risks. This month we’ll take a look at how recruitment can be supported by social media; how people looking for jobs need to present themselves through social media, and how personal information can infiltrate social media potentially jeopardizing patients’ privacy and, thereby, nursing careers. Infractions are usually unintentional and without malice, but can carry serious penalties. Student nurses must understand the implications of all electronic communication.
THE JOB SEARCH
Tip #1 – Become familiar with social media.
The first rule of working with social media is to recognize that it’s not going away. We all use email, and most of us have been on sites like Facebook at least to explore if not to participate. Human Resources departments are increasingly turning to sites to post jobs. Monster and Career Builder are now vying with Facebook, Twitter and LinkedIn® for advertising job postings. Nursing is a competitive job market, and quick responses to job postings are vital; it’s very important to stay informed.
One example comes from a hospital that has fully embraced Facebook as a recruiting tool. In fact, since July 1, 2011, this hospital has had 3,068 clicks to its career site and has made 41 hires from Facebook.1 In addition to keeping on top of social media, recruiters advise students to start the job search early because job hunting through social media is a much quicker process than the newspaper ads of the past. “My advice to nursing students is to work for a healthcare facility as a nurse tech or extern while still in school. New nursing graduate positions are becoming more competitive, especially in specialty areas of the hospital. Having experience in a healthcare environment is great for networking as well as building confidence,” says Teresa Featherly, nurse recruiter, RN, BSN, at Mercy Health Center in Oklahoma City, Oklahoma. “Many students want to wait to pass boards so they can go on cruise or go to friend’s wedding, but the positions [at Mercy] are filled in March or April for May and July grads,” she adds.
Tip #2 – Consider the implications of every post, tweet and comment. Your information stays electronic even if you delete it, and employers interested in hiring you can check up on you.
In speaking with hospital recruiters nationwide, we’ve learned that there is an increase in consulting social media sites to 
learn more about potential candidates. “Social media represents a potential employee’s ‘branding,’” says Robin Yeager, MSN, RN, full-time hospital simulation coordinator and orientation educator, as well as a Kaplan Nursing educator and career seminar instructor. People want social media to reflect a personal “branding” that marks them as popular, adventuresome, perhaps even a little bit of a risk taker. Hospitals want nurses who fit a social norm and aren’t risk takers. This conflict is what makes navigating social media tricky. “What people advertise on social media may not truly reflect who they are, but it’s what employers see,” says Yeager. “What you post is your moral and ethical circle, and potential employers are looking for a moral and ethical match to their principles.”
What employers don’t want to see is candidates posting negative things about their employers/former employers or co-workers; party pictures or any photos that are compromising. It’s important for people to take a look at their pages from 10,000 feet up. Does a person’s Facebook page give the indication that a patient would be safe in his or her care? Is this person a great representative of his or her employer? “The same courtesy and professionalism we expect in an interview is the same courtesy and professionalism we want to see on social media sites,” says Nancy Roper RN, BSN, CHCR, Nurse Recruiter at Saint Francis Hospital in Tulsa, Oklahoma.
Tip #3 – Use electronic communication wisely when job hunting.
Be careful when responding to potential employers. Because people use social media sites informally to keep in touch with friends, people sometimes forget to revert to professionalism when communicating with potential employers. Employees need to use a different mode of communication in the professional world. “The first thing to do is to make sure you have a professional sounding email address,” says Yeager. “Keep the fun address for your friends, but don’t use it on your resume.” If you are emailing a potential employer, remember to use proper language and grammar….no texting abbreviations, please!
“We don’t interact in person as much with social media,” says Yeager. Candidates need to remember the rules of etiquette in a phone or in-person interview. “Don’t call an employer by his or her first name until you ask for permission,” cautions Yeager, “and definitely remember to send a thank you note after the interview.” Not all employers may want to rely only on electronic communication. Take the lead from the prospective employer. If the person uses the phone or regular mail, respond in kind.
JOB GUIDELINES
Once a nurse has gotten the job there will be times when he or she will want to share the good and the bad with friends and
colleagues. This is when nurses can be at greatest risk. Sharing the joy of saving a patient can result in accidentally sharing confidential information; discussing an error can put an employer at risk; forwarding a questionable email or photo can make the forwarder just as guilty as the person who originally sent the material.
To protect nurses, health organizations and employers have established guidelines to help people know what is and is not permissible. It’s imperative that nurses make sure they understand the guidelines their employers have set, and that they use caution when communicating through social media. The guidelines established by NCSBN, as well as their white paper, and even a Social Media Toolkit from ANA show how significant social media has become, and while people will continue to embrace its convenience and connective power, we remind nurses that “Think before you send!” is the new “Think before you speak!” What a person posts in haste will be permanent.
1Because of the statistical information provided, the hospital has asked to remain anonymous.
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