Facebook has 400 million users. Twitter users send 55 million tweets a day. Social networking websites are great for staying in contact and meeting new people. They are useful and fun, but RTs need to consider the appropriateness of their posts before hitting the send button. 

Here is a list of dos and don'ts for social networking sites based upon mistakes made by other health care professionals.

Don't deliberately disclose protected health information

We all know that we cannot disclose a patient's protected health information. Evidently, spite can make at least some people forget their obligations. A hospital employee deliberately accessed the records of a relative, by marriage, and then posted information about the relative's sexually transmitted disease and presumed infidelity on a MySpace page. The hospital employee used a phony name to create the site but apparently failed to remember that hospitals can track all access to a patient record.

Don't discuss "OMG" clinical situations

Don't post descriptions of clinical situations, no matter how shocking, even if you omit the protected health information. A hospital fired two nurses for taking pictures of a patient's X-ray with their cell phones that showed a sex toy lodged in the patient. The nurses denied posting the picture on Facebook, but at least one admitted to discussing the patient on her Facebook page. The hospital reported the incident to the FBI as a possible HIPAA violation.

Another hospital fired five nurses for discussing patients on Facebook. No patient identifying information was disclosed by the nurses, but the nurses were fired anyway. The important point is that all these employees were fired for inappropriate conduct regardless of whether protected health information was disclosed.

Do consider whether those compromising spring break pictures are really going to enhance your social standing

Sixty percent of medical schools reported incidents of medical students, arguably the best and the brightest, using social networking sites to depict and discuss lewd behavior and to make discriminatory statements, according to a survey published in the Journal of the American Medical Association. The medical students thought their posts were only visible to their friends. Social networking sites are not as private as most users think. Additionally, many state licensing boards are now asking for access to private social networking sites as part of the application process. Spring break party pictures are probably funny until your licensing board asks for them.

Do use restraint when discussing your personal opinions

Blogging is a great way to express an opinion in a public forum, and a micro blog such as Twitter is quick and easy. Besides, this is America, and we have a right to free speech. Before posting that expose, RTs need to know that the First Amendment has limitations; it applies to government institutions and not private employers.

A nursing student was expelled from her nursing program for characterizing patients who had attempted suicide as sucking up the nursing aides' time. The student also posted her negative opinions on patients who were seeking abortions. Furthermore, any personal opinion you post should be the product of careful thought and not something you wrote in the heat of the moment.

Don't expect any privacy when using your employer's computer or mobile device

Employees using their employer's computers and mobile devices for personal reasons cannot expect their use to remain private. More than 75 percent of employers monitor the websites visited by their employees, and 50 percent of employers keep and review their employees' e-mails, according to a survey by the American Management Association and ePolicy Institute.  RTs need to know what their employer's policies and procedures are concerning computer and Internet usage. Remember, you can get fired for unprofessional conduct even if you did not disclose protected health information.    

Michael L. Smith, JD, RRT, is board certified in health law by The Florida Bar and practices at The Health Law Firm in Altamonte Springs, Fla. This article is for general information only and is not a substitute for formal legal advice.