A message from your PDCs: Evidence over influence – social media, professional accountability, and safe practice

The third article from a series on the 2025 NMBI Code of Professional Conduct and Ethics

The expansion of social media has fundamentally altered how patients access, interpret, and act upon health information. Digital platforms now play a significant role in shaping public understanding of health, influencing behaviours, treatment expectations, and attitudes towards healthcare professionals. While social media can support health promotion, patient education, and accessibility of information, it also presents considerable challenges relating to misinformation, unregulated treatments, confidentiality, and patient safety.

For general practice nurses (GPNs), this evolving digital landscape requires heightened professional awareness, critical thinking, and strong governance practices. The Nursing and Midwifery Board of Ireland (NMBI) Code of Professional Conduct and Ethics (2025)¹ reinforces the nurse’s responsibility to uphold professional standards across all areas of practice, including online and digital engagement.

“Social media extends beyond major platforms to include blogs, forums, messaging apps, and other tools for sharing information.”¹ Our online behaviour must meet the same professional standards as our in-person care, and we must endeavour to keep our professional and personal identities separate.

This article explores the implications of social media use for contemporary nursing practice through the lens of the NMBI Code (2025),¹ the HSE Social Media and Data Protection Policy (2025),² the National Consent Policy (HSE, 2024),³ and obligations under the General Data Protection Regulation (GDPR).⁴

It highlights the importance of professional accountability, evidence-based communication, patient confidentiality, and safe digital practice as applied to general practice nursing.

Professional governance: A key development in the NMBI Code (2025)

A significant development within the 2025 NMBI Code¹ is the enhanced emphasis on professional governance. Governance extends beyond our clinical competence and incorporates accountability for our communication, professional behaviour, ethical decision-making, digital conduct, and maintenance of public trust.

This reflects the reality of modern nursing practice, where professional influence increasingly extends beyond face to face clinical encounters into online and social media spaces. Nurses are now visible participants within broader health conversations, and our online activity may directly influence patient beliefs, healthcare choices, and public perceptions of the profession. NMBI advises that our social media profile clearly states that our views are personal.

Professional governance therefore requires that as GPNs, we critically evaluate the accuracy, credibility, and potential impact of the information we share or endorse online. Even indirect engagement (eg, tagging or liking) with misinformation or non-evidence-based content may compromise our professional credibility and public confidence in all nursing as a regulated profession.

Patient safety and professional integrity

Patient safety remains our primary professional obligation as a GPN. Social media introduces unique and often indirect risks to safe care, particularly where inaccurate health information may influence patient decision-making. Patients may present with beliefs shaped by influencers, unregulated online forums, commercial advertising, or anecdotal health advice circulating on digital platforms.

These influences may contribute to:
✽ Vaccine hesitancy
✽ Misconceptions regarding national screening programmes
✽ Mistrust of evidence-based medicine
✽ Requests for unlicensed or inappropriate treatments
✽ Delayed engagement with appropriate healthcare services.

This is challenging, and at times difficult, in the GPN role, as we have to balance our often long-standing relationships with our patients with our professional responsibility to respond respectfully and therapeutically while maintaining an evidence-based approach. Our professional responses should be grounded in respect, non-judgmental communication, and evidence-based explanations, while maintaining the therapeutic relationship and preserving the trust of our patients who may stridently present misinformation.

At the same time, as registered nurses, we must protect the integrity and reputation of our profession. Public confidence in nursing relies upon visible adherence to professional standards, ethical conduct, and evidence-based practice, both offline and online. The requirement for accurate, evidence-based information to counter misinformation highlights the importance of accessing clinical evidence from validated and trusted sources, and in maintaining our continuing professional development and education.

Social media, consent, and confidentiality

Digital proficiency also requires careful consideration of patient confidentiality, together with our consent and data protection responsibilities. The HSE National Consent Policy (2024)³ emphasises that consent is an ongoing communication process founded in respect for autonomy, dignity, and informed decision-making. Within digital environments, this includes safeguarding patient information shared via messaging platforms, photographs, telehealth interactions, and social media communication.

Even where patient identifiers are removed, online discussion of clinical situations may inadvertently compromise confidentiality. We must remain aware that patients, families, colleagues, or communities may still recognise individuals or circumstances from partial information.

Similarly, GDPR legislation and the Data Protection Act⁴ place legal obligations on healthcare professionals regarding the processing, storage, and sharing of personal health information. Health data is classified as sensitive personal data and requires strict protection. Inappropriate sharing of information online, including images, screenshots, or informal case discussions, may constitute both professional misconduct and a breach of data protection law.

GPNs must therefore ensure that:
✽ Patient information is shared only through approved and secure IT systems eg, Healthlink
✽ Confidentiality is maintained in all online and digital interactions
✽ Explicit patient consent is obtained where required, in line with national policy
✽ Digital communication complies with organisational policies and GDPR principles
✽ Personal and professional online boundaries are maintained.

Our professional duty of confidentiality applies equally in digital environments as it does in direct/face to face clinical care.

Responding to social media influences in practice

Patients increasingly attend consultations having researched symptoms, treatments, or health conditions online. While this may encourage health literacy and patient engagement, it can also lead to confusion, anxiety, or unrealistic expectations.

Professional responses should remain grounded in:
✽ Respectful communication
✽ Evidence-based explanation
✽ Compassionate listening
✽ Shared decision-making
✽ Patient-centred education.

The aim is not to dismiss our patients’ concerns, but to support informed and safe healthcare decisions. This aligns closely with the principles of the National Consent Policy,³ which emphasises dialogue, understanding, and collaborative decision-making between healthcare professionals and patients. Many key national agencies have official social media channels, eg, X and Instagram, and as GPNs we should signpost our patients to these sources. The National Immunisation Office, for example, uses YouTube to share best practice information.

Patient safety risks: Medicines and treatments

The procurement of medicines and cosmetic treatments through social media or unregulated online suppliers represents a growing patient safety concern.

Examples increasingly encountered in practice include:
✽ Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) obtained without prior assessment or medical supervision
✽ Anabolic steroids purchased online
✽ Botulinum toxin (BOTOX) administered in non-clinical settings
✽ Unregulated supplements and compounded medications promoted by influencers.

Risks associated with these products include counterfeit or contaminated substances, incorrect dosing, unsafe administration, adverse reactions, medication interactions, and absence of clinical oversight or follow-up care. As GPNs, we must respond by prioritising patient safety, practising within our professional scope, and providing or signposting our patients to evidence-based education regarding risks, regulation, and appropriate clinical pathways.

The Health Products Regulatory Authority (HPRA)⁵ is an example of an evidence-based resource and it continues to warn against purchasing medicines through unverified online sources, particularly where products are promoted through social media platforms without appropriate regulatory oversight.

Evidence-based practice and authoritative resources

In an era of digital misinformation, evidence-based practice is more important than ever. As GPNs, we must actively engage with validated, current, and trusted professionally recognised resources to support safe clinical
decision-making and patient education.

Key resources include:
✽ HSELanD training and education programmes
✽ National Clinical Programmes
✽ National Immunisation Advisory Committee guidance⁶
✽ National Immunisation Office⁷
✽ CervicalCheck guidance⁸
✽ HPRA resources
✽ HSE library services⁹
✽ Irish Nurses and Midwives Organisation library resources¹⁰
✽ World Health Organisation infodemic management guidance.¹¹

These resources support standardised, accountable, and evidence-informed care while strengthening our professional confidence in responding to the misinformation we encounter in practice. A link to these resources can easily be stored in a folder on our clinic room PCs for ease of access and sharing with our patients.

Governance in practice

Strong governance structures are essential within general practice settings to support safe and professional digital engagement. Practices should maintain clear policies relating to:
✽ Social media use
✽ Digital communication with patients
✽ Data protection and confidentiality
✽ Photography and recording
✽ Consent processes
✽ Documentation standards
✽ Professional boundaries online.

These policies can be adapted for use in practice from HSE and verified national and European sources. Ongoing education in digital professionalism and data protection should form part of continuing professional development for all nursing staff.

Professional responsibility: Pause first, type second

A critical aspect of professional governance is our responsibility to pause, reflect, and critically appraise before engaging online. This applies to both our personal and professional use of social media and includes consideration of:
✽ Accuracy of information
✽ Evidence-base
✽ Professional implications
✽ Confidentiality risks
✽ Public interpretation or perception
✽ Potential impact on patient safety and public trust.

Digital communication is immediate and far-reaching. Once published, content may be difficult or impossible to retract. Our professional accountability, therefore, extends to every online interaction, endorsement, comment, tagging, or shared post. Such posts may be available and may be cited in the event of any claim against us as healthcare professionals.

The principle of ‘pause first, type second’ reflects the need for thoughtful, ethical, and professionally responsible digital engagement.

Conclusion

The NMBI Code of Professional Conduct and Ethics (2025) reflects an important evolution towards broader professional governance in nursing practice. In an increasingly digital and socially influenced healthcare environment, the role of the GPN continues to expand beyond traditional clinical boundaries.

Our professional accountability now includes digital conduct, responsible communication, protection of confidentiality, and the promotion of evidence-based healthcare information. The integration of the National Consent Policy, GDPR obligations, and organisational governance frameworks in the NMBI Code (2025) further reinforces our role in safeguarding patient rights, dignity, privacy, and safety.

As misinformation and commercial influence continue to shape public health behaviours, we must remain central advocates in our GPN role for safe, ethical, and evidence-based care. Our practice must continue to be guided by professionalism, integrity, critical thinking, and compassion, thereby ensuring that verified evidence, rather than digital influence, remains at the centre of our patient care.

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Authors

Marie Courtney, RGN, BSc (Hons), MSc, HDip Teaching and Learning, FFNMRCSI, Professional Development Coordinator for General Practice Nursing, Cork and Kerry; and Kathy Taaffe, RGN, PG Dip in Primary Healthcare Sciences, Certificate in Integrated Care, Professional Development Coordinator for General Practice Nursing, HSE North West