March 08, 2018

Should you accept a patient’s friend request on social media?

Social media use has moved far beyond being just a way to communicate with your friends. It’s now used regularly in most professional settings, including health care. As a result, nurses are facing increased requests from patients to connect on not only professional social media accounts, but on their personal ones as well. So, while trying to balance privacy and boundary requirements, how do you know what social media activity is acceptable and what’s not?

The answer is actually straightforward... 

Social media use has moved far beyond being just a way to communicate with your friends. It’s now used regularly in most professional settings, including health care. As a result, nurses are facing increased requests from patients to connect on not only professional social media accounts, but on their personal ones as well. So, while trying to balance privacy and boundary requirements, how do you know what social media activity is acceptable and what’s not?

The answer is actually straightforward.

Never accept a patient’s friend request on your personal social media accounts

A nurse should not enter into a friendship or other personal relationship with a patient, their family members or their substitute decision-makers. Always keep your personal and professional lives separate.

By connecting on or corresponding over your personal social media account, you are crossing the boundary where the professional therapeutic nurse-client relationship changes to unprofessional and personal.

Use a professional account separate from your personal one if needed

Many health care organizations or nurses in independent practice have professional social media accounts. They use these accounts to build professional connections, educate the public, and communicate with members of the public, including patients or patients’ family members.

When using a professional social media account, you must ensure you are not violating patient privacy and confidentiality, or crossing the therapeutic nurse-client boundary. Understand what is needed for a patient and their family to consent to their image or information being used on a professional social media account. Leaving out a patient’s details when you post information or images does not protect patient confidentiality.

Know and follow your employer’s policies

If you communicate with patients via a professional social media account, follow your employer’s policies on using social media, photography, computers and mobile devices.

More information

The Code of Conduct states that nurses are accountable for maintaining professional boundaries with patients and that nurses should not share personal patient information on social media.

In addition, the International Nurse Regulator Collaborative, a group of seven nursing regulators that includes CNO, has released a position statement on the use of social media by nurses. Read these recommendations to learn about respecting boundaries, acting professionally and maintaining patient privacy (as well as your own) while blogging, sharing photos or posting on social media.

Our social media webcast, Social Media: Reflect Before You Post, shows you how to use CNO practice standards and reflective questions to assess situations before engaging in any social media activity.

About CNO

The College of Nurses of Ontario (CNO) is the regulator of the nursing profession in Ontario. It is not a school or a nursing association. CNO acts in the public interest by:

  • assessing qualifications and registering individuals who want to practice nursing in Ontario.
  • setting the practice standards of the profession that nurses in Ontario are expected to meet.
  • promoting nurses' continuing competence through a quality assurance program.
  • holding nurses accountable to those standards by addressing complaints or reports about nursing care.

The College was founded in 1963. By establishing the College, the Ontario government was acknowledging that the nursing profession had the ability to govern itself and put the public's well-being ahead of professional interests.

For the latest information, please see our Nursing Statistics page.

Anyone who wants to use a nursing-related title — Registered Nurse (RN), Registered Practical Nurse (RPN) or Nurse Practitioner (NP) must become a member of CNO.

Frequently Asked Questions

Go to the public Register, Find a Nurse, to conduct a search for the nurse. Contact us if you can't find the person you are looking for.

All public information available about nurses is posted in the public Register, Find a Nurse, which contains profiles of every nurse in Ontario. Publicly available information about nurses include their registration history, business address, and information related to pending disciplinary hearings or past findings.

Unregistered practitioners are people who are seeking employment in nursing or holding themselves out as being able to practice nursing in Ontario, but who are not qualified to do so. They are not registered members of CNO. Only people registered with CNO can use nursing-related titles or perform certain procedures that could cause harm if carried out by a non-registered health professional. CNO takes the issue of unregistered practitioners seriously. See Unregistered Practitioners for more information.

To ensure procedural fairness for both the patient (or client) and the nurse, the Regulated Health Professions Act requires that information gathered during an investigation remain confidential until the matter is referred to the Discipline Committee or Fitness to Practise Committee. CNO will not disclose any information that could identify patients (or clients) or compromise an investigation. See Investigations: A Process Guide for more information.

Information obtained during an investigation will become public if the matter is referred to a disciplinary hearing. If a complaint is not referred to a hearing, no information will be available publicly.

See CNO's hearings schedule, which is updated as hearing dates are confirmed. Hearings at CNO are open to the public and the media. For details on how to attend a hearing, contact the Hearings Administration Team.

A summary of allegations and the disciplinary panel outcomes can be found on the public Register, Find a Nurse. Full decisions and reasons are also available.

Where a disciplinary panel makes a finding of professional misconduct, they have the authority to reprimand a nurse, and suspend or revoke a nurse's registration. Terms, conditions and limitations can also be imposed on a nurse's registration, which restricts their practice for a set period. Nurses can also be required to complete remedial activities, such as reviewing CNO documents and meeting with an expert, before returning to practice.

For detailed information see the Sexual Abuse Prevention section.

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