Social media background checks for nurses and healthcare jobs

Do healthcare employers check social media?

It's common enough that large screening vendors market social media screening specifically to healthcare employers. It's usually run through a screening company, not a recruiter scrolling your profile, and vendors pitch it as a way to catch harassment, discrimination, threats, and posts that expose patient information before someone is hired.^[1][2]

When a third-party vendor runs the check, it's a consumer report under the Fair Credit Reporting Act. That means you should see a disclosure and sign an authorization first, and you're entitled to a copy of the report and a chance to respond before an employer acts on it.^[3][2] See your rights in a social media background check.

What they look for

The core categories are the same ones used in every industry: harassment and trolling, intolerance, threats, violence, illegal activity including drug use, and sexually explicit content.^[4][5] Healthcare adds weight to a few things other fields don't worry about as much:

• Patient privacy. Posts that describe a patient, a case, or an incident in enough detail that someone could recognize who it was, even without a name.^[1][2]
• How you talk about patients. Mocking or venting about specific patients or families reads very differently when the reader is deciding whether to put you at a bedside.
• Professional boundaries. Friending, messaging, or following current patients crosses lines that nursing regulators treat seriously.^[6]

Nurses have a second audience: the board of nursing

For licensed nurses, social media isn't only a hiring question. The National Council of State Boards of Nursing says inappropriate posts can be reported to a board of nursing, and depending on the state, discipline can range from a reprimand or fine to temporary or permanent loss of license.^[7]

This isn't hypothetical. In a 2010 NCSBN survey of boards of nursing, 33 of the 46 boards that responded had received complaints about nurses posting patient photos or information on social media, and 26 of those 33 had taken disciplinary action.^[8] NCSBN also treats improper social media use and boundary crossings as violations of the nurse practice act that can lead to discipline and termination.^[6]

Physicians have a licensing board too

The Federation of State Medical Boards adopted a model social media policy in April 2012. It says state medical boards may discipline physicians for inappropriate or unprofessional online conduct, with sanctions that range from a letter of reprimand to revocation. The conduct it lists includes breaching patient confidentiality, derogatory remarks about patients, depicting intoxication, discriminatory language, and misrepresenting credentials.^[9]

The policy cites a 2010 survey of state medical board executive directors: 92% reported violations of online professionalism in their jurisdiction, and 71% reported holding formal disciplinary proceedings. Among the outcomes reported, 44% involved a license limitation, 29% a suspension and 21% a revocation.^[9] Treat those numbers with care. The survey is more than 15 years old, it reports what board directors said rather than audited case counts, and it covers online conduct in general, not only posts a board found by searching an applicant's accounts.

Examples

Illustrative examples, not from real users.

What PruneSocial catches, and what you need to check yourself

PruneSocial scores supported text from your own account exports against the seven behavior categories screening vendors publish, including all of the core ones above. See the methodology for how.

It does not have a patient-privacy check. A post about a patient that doesn't insult anyone or describe illegal conduct will usually come back Clear. So if you work in healthcare, do this one check by hand:

1. On each platform, search your own posts and comments for work words: patient, shift, unit, ER, floor, room, code, and the name of your hospital or unit.
2. Delete or archive anything that describes a patient, a case, or an incident, even without names. Location, timing, and details are often enough to identify someone.
3. Check your photos from work. Whiteboards, monitors, charts, and wristbands in the background are easy to miss. PruneSocial doesn't read images yet, so photos need a look by hand.
4. Look at who you're connected to. Current or former patients in your friends or followers list are worth a second look under your employer's policy.

Before you apply: a short plan

1. Request your exports from every platform you use, starting with Reddit, which can take the longest. Our export guides walk through each one.
2. Run your report and work through anything flagged, strongest first.
3. Do the patient-privacy check above.
4. On Facebook, consider the "Limit past posts" setting, which makes all your past public posts friends-only in one step.
5. Re-scan before your next application, since new activity adds up.

Related guides

• Social media background checks for teachers
• What can employers see on your social media?
• Which employers check your social media before hiring?
• How to clean up your social media before applying

Sources

1. First Advantage: How your employees are putting your healthcare business at risk
2. GCheck: Social media screening in healthcare
3. FTC staff closing letter to Social Intelligence Corp., May 9, 2011
4. Fama: How Fama's online screening solution detects misconduct at work
5. Checkr: Social media search
6. NCSBN: Professional Boundaries
7. NCSBN: A Nurse's Guide to the Use of Social Media
8. NCSBN White Paper: A Nurse's Guide to the Use of Social Media (2011), including the 2010 board of nursing survey
9. FSMB: Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice (April 2012; Journal of Medical Regulation 98(2))