Social media makes it easier for relatively small, but vocal, groups of people to shape the conversation around public health issues, such as COVID-19 vaccines and treatments. This can be beneficial if the health information being spread is true, but unfortunately, social media also helps to facilitate the spread of misinformation. Nurses will likely encounter health misinformation at work and in their personal lives- whether it’s on their social media feed, in conversations with friends and coworkers, or in interactions with patients. Nurses should understand the professional risks associated with sharing misinformation, what they can do to spot misinformation, and how they can help stop its spread.
The professional risks of spreading misinformation
Nurses, like everyone else, can be vulnerable to the influence of misinformation online. However, unlike most other people, nurses have a professional, ethical responsibility to provide information to the public that meets professional standards. Holding a nursing license means accepting the responsibility to uphold the ethical and regulatory standards of the profession. Regardless of intention, when a nurse identifies with their profession or uses their credentials to talk about health information, it can be considered nursing practice. Nurses who use their credentials in public forums or on social media to disseminate COVID-19 misinformation violate their responsibility to the profession and the public. The National Council of State Boards of Nursing (NCSBN) has stated that “nurses are professionally accountable for the information they provide to the public.”
In December, the NCSBN made it clear that nurses who spread COVID misinformation online could be disciplined by their State Board of Nursing (SBON). SBON discipline can include fines, public reprimands, continuing education, probation, practice restrictions, or even suspension, surrender, or revocation of a nurse’s license. SBONs often maintain lists of disciplinary actions on state databases, newsletters, or websites as they are considered public information. SBONs also report disciplinary action to NURSYS® and the National Practitioner Data Bank (NPDB). An SBON may report disciplinary action to other agencies, regulatory authorities, or other SBONs, which may decide to initiate their own investigation and take disciplinary action against the nurse. In more severe cases, SBON discipline can result in the nurse being excluded from working for any providers or healthcare facilities who participate in state Medicaid programs, or federal healthcare programs such as Medicare. These sanctions can effectively end a nurse’s career.
Spotting misinformation
With respect to COVID-19, the NCSBN defines misinformation as “distorted facts, inaccurate or misleading information not grounded in the peer-reviewed scientific literature and counter to information being disseminated by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA).” But with so much content available online, it can be difficult to differentiate factual information and news from rumors, opinions, falsehoods, and conspiracy. Here are some tips that can help nurses spot misinformation online:
- Analyze both the content and the source
- Does the author use sensationalistic language or lack specific evidence? Opinion and “news commentary” represent a point of view, while fact-based writing or analysis represent verifiable facts that are framed in appropriate context. Examine supporting evidence to see if the cited sources are reputable and if they support the claims being made. For example, statistics can be cherry-picked out of context to support a particular argument.
- Check if an image, graph, or figure is being represented correctly. Search for an image to see if it has appeared online before and in what context. Graphs or diagrams can be fabricated, and pictures and videos can be edited or shown out of context to mislead viewers.
- Is the source of this information fake news or satire? One easy way to check a source is to visit the “About” or “Contact Us” section of the website. Illegitimate sources often won’t have any information about their mission, staff, physical location, or a way to contact the organization.
- Examine the author
- What other content have they produced in the past? Are they credible enough to speak on this topic? Reviewing an author’s past work can reveal an agenda, point of view, or bias if they have repeatedly published content on the same topic.
- Try to identify the intent behind the post or information. Information can intentionally be distorted to advance a specific agenda, endorse a belief system, or incite strong emotions to get users to click on or share an article.
- Engage in self-reflection
- Evaluate how the information fits into your pre-existing beliefs. People may rely on their personal beliefs to interpret evidence, and confirmation bias leads people to seek out information that supports their preexisting beliefs.
- Evaluate the completeness of your knowledge. Consider whether there may be some relevant information or a different perspective that you may have discounted or dismissed.
Addressing misinformation and misperceptions
Nurses and other health professionals play an important role in countering health misinformation by proactively engaging with their patients. Helping to ensure their patients have access to accurate information that they can understand supports nurses’ duty to protect patients’ right to autonomy and informed consent. While these conversations can take time, a personalized, individual approach can be effective, according to the Office of the U.S. Surgeon General, which developed a Toolkit for Addressing Health Misinformation. Nurses should be careful to avoid using shame or embarrassment tactics because they can shut down dialogue. Instead of trying to fact-check misinformation or misperceptions, ask questions to understand the patient’s concerns. Additionally, many people have experienced discrimination in past interactions with healthcare providers, so it is critical for nurses to approach these conversations carefully to avoid coming across as judgmental or minimizing the patient’s concerns. Nurses should be empathetic to their patients’ intersectional identities and their cultural, social, and emotional needs. If an individual is open to recommendations, a nurse can offer reliable sources or help to connect them with other health professionals who can help answer their questions.
Final thoughts
When posting online about nursing practice or healthcare in general, nurses should consider the source and scientific validity of any piece of health information before sharing it publicly. Failure to do so can put their license and career in jeopardy.
References
Association of State and Territorial Health Officials (ASTHO). (2021). Reducing Vaccine Hesitancy for People Living with Disabilities. https://www.astho.org/globalassets/brief/reducing-vaccine-hesitancy-for-people-living-with-disabilities.pdf.
CNA and NSO. Nurse Spotlight: Defending Your License. https://www.nso.com/nurseclaimreport_defendlicense.
Grace, P.J. (2021). Nurses Spreading Misinformation. Am J Nurs, 121(12), 49-53.
Himmelfarb Health Sciences Library. (2022). Correcting misinformation with patients: Misinformation and cultural competency. George Washington University. Retrieved January 21, 2022, from https://guides.himmelfarb.gwu.edu/correcting-misinformation.
Kiely, E. & Robertson, L. (2016). How to spot fake news. FactCheck.org. https://www.factcheck.org/2016/11/how-to-spot-fake-news/.
Mantzarlis, A. (2021). Spot misinformation online with these tips. Google News Lab. https://blog.google/products/news/fact-checking-tips/.
National Council of State Boards of Nursing (NCSBN). (2021). Policy Statement: Dissemination of Non-scientific and Misleading COVID-19 Information by Nurses. https://www.ncsbn.org/PolicyBriefDisseminationofCOVID19Info.pdf.
Office of the U.S. Surgeon General. (2021). A Community Toolkit for Addressing Health Misinformation. https://www.hhs.gov/sites/default/files/health-misinformation-toolkit-english.pdf.
Syracuse University School of Information Studies. (2021). 5 ways to spot misinformation and disinformation online. https://ischool.syr.edu/5-ways-to-spot-misinformation-and-disinformation-online/.
Villarruel, A.M. & James, R. (2022). Preventing the spread of misinformation. Am Nur J, 17(2), 22-26. https://www.myamericannurse.com/preventing-the-spread-of-misinformation/.
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This risk management information was provided by Nurses Service Organization (NSO), the nation’s largest provider of nurses’ professional liability insurance coverage for over 550,000 nurses since 1976. Reproduction without permission of NSO is prohibited. For questions, send an e-mail to [email protected] or call 1-800-247-1500. www.nso.com.
This article is provided for general informational purposes only and is not intended to establish any standard of care, nor provide individualized business, insurance or legal advice. The content is made available on an “as is” basis, without warranty of any kind. NSO will not be responsible for any loss, damage, cost or expense you or anyone else incurs in reliance on or use of any information contained herein.
