- BCCNM's role and your responsibility
BCCNM's role is to protect the public by setting standards, providing guidance, and addressing concerns when professional conduct, including online behaviour, creates risks to client safety or public trust.
When online conduct falls under BCCNM's mandate
BCCNM's authority applies when a nurse or midwife's online actions:
- Involve clients or client information;
- Occur in a professional context (e.g., workplace or client interactions);
- Refer to or use their professional title (NP, LPN, RM, etc.); or
- Undermine public trust in the professions.
Personal online activity unrelated to professional practice is generally outside BCCNM's scope unless it raises concerns about public safety or professional integrity.
Your responsibility
You are accountable for ensuring your use of digital tools aligns with professional, ethical, and legal expectations. Reflect regularly on how your online presence demonstrates professionalism, integrity, and cultural safety and humility.
E-professionalism is about extending your professionalism into digital spaces—protecting clients, respecting diversity, and upholding the public's trust in nursing and midwifery.
- Understanding e-professionalism
E-professionalism is how you demonstrate professional values, ethics, and accountability and responsibility when using digital tools such as:
- Social media (Facebook, Instagram, TikTok, LinkedIn, etc.)
- Email, text, and instant messaging
- Online client portals and documentation systems
- Virtual care and professional health-care platforms
- Artificial intelligence
E-professionalism means applying the same standards of professionalism expected in person—respect, integrity, confidentiality, cultural safety, and sound judgment—in all digital environments.
While technology makes communication easier, it can blur boundaries between personal and professional life. What you post, like, or share online becomes part of your professional identity and can influence how clients, colleagues, and employers perceive your professionalism.
Reflect:
How might something you post, like, or share reflect your professional image? Would you be comfortable if it appeared publicly with your name and professional title attached?
Scenario 1: A seemingly harmless post
A nurse/midwife posts online about a difficult shift, mentioning that she's “never seen such a complicated delivery." Although no names are used, others in her small community can identify the client. A complaint follows.
Learning point: Even when posts seem harmless, identifiable details can breach confidentiality and public trust. Pause before you share.
Scenario 2: The friendly follow
A nurse/midwife follows a client's social media account to stay connected after discharge. When the client posts about a complication, the nurse/midwife comments to offer reassurance. The client later reports feeling uncomfortable.
Learning point: Maintaining professional boundaries includes online relationships. Good intentions can still create boundary issues.
Scenario 3: Posting about a cultural event
A nurse attends a community event hosted by the?Akisq'nuk First Nation. Excited to share her experience, she posts a photo on her professional social media account, without asking permission, showing attendees and Elders during ceremony. Later, community members express concern that the photo was taken during a private cultural moment.
Learning point: Even when sharing positive experiences, posting without consent can violate cultural safety and Indigenous protocols. Always obtain explicit permission before taking or posting photos of cultural events, ceremonies, or clients, and reflect on whether sharing is appropriate or necessary.
Scenario 4: Using unsecured forms
A midwife uses a free online survey form to collect client intake information. The form is not encrypted, data is hosted in the United States, and other users can access submissions. A client discovers this and files a complaint.
Learning point: Even with positive intent, using unsecured digital tools breaches privacy obligations. Always use secure, encrypted systems that meet legal and professional standards.
- Protecting privacy and confidentiality
Confidentiality and privacy responsibilities apply in all forms of communication, that is, spoken, written, or digital. Nurses and midwives must ensure client information is secure and used appropriately.
In practice:
- Treat all digital communications as public and permanent.
- Never post or discuss client information online — even without names or faces.
- Obtain informed consent before emailing or texting client information.
- Use encryption or password protection for attachments.
- Avoid public Wi-Fi when transmitting client information.
- Document all electronic communication related to client care in the health record.
- Use only PIPA and HIPPA complaint platforms with
end-to-end encryption for collecting client and prospective client data, including intake information. Use Canadian-based or Business Associate Agreement (BAA)-backed health platforms (e.g., Ocean, Jane, InputHealth).
Scenario 1
You receive a text from a client asking for their lab results. It's your day off, but you can access the results through your phone. What do you do?
a) Text the results — the client asked directly.
Incorrect. Even if the client requested the information, texting personal health details is not a secure method of communication. Text messages can be intercepted, misdirected, or viewed by others. Always use secure, approved communication channels and document the exchange in the client record.
b) Ask them to contact the clinic through secure channels.
Correct. Electronic transmission of personal health information must be done securely and with informed consent. Texting results breaches privacy and documentation standards. Directing the client to use clinic procedures protects their privacy and ensures communication is properly documented.
c) Email a screenshot of the result to their personal account.
Incorrect. Emailing screenshots of client records to personal accounts violates privacy and confidentiality standards. Unless secure encryption and consent are in place, this action risks unauthorized disclosure of personal health information.
Scenario 2
You're setting up a new online intake form for your midwifery practice. A colleague suggests using Google Forms because it's easy and free. The form will collect names, addresses, PHNs, and date of birth. What do you do?
a) Use Google Forms and add a disclaimer about privacy.
Incorrect. Adding a disclaimer does not make the form secure. Google Forms does not offer end-to-end encryption and using it to collect sensitive health information violates
PIPA and HIPAA standards.
b) Choose a platform with verified end-to-end encryption and consult your privacy officer.
Correct. Protecting client information is a legal and ethical obligation. Using a secure platform and seeking expert guidance ensures compliance and safeguards against data breaches.
c) Use Google Forms temporarily and plan to switch later.
Incorrect. Even temporary use of insecure platforms can result in privacy violations. Sensitive data must be protected from the outset.
- Maintaining professional boundaries online
Professional boundaries protect clients and ensure care remains therapeutic. Online interactions can blur these lines if not managed intentionally.
In practice:
- Communicate with clients only through authorized, professional channels.
- Do not initiate or accept personal social media connections with clients or their families.
- Avoid sharing personal details about yourself online in ways that may affect the therapeutic relationship.
- Use professional accounts or pages if sharing educational content publicly.
Reflection: How can I ensure my digital interactions remain respectful, objective, and focused on client well-being?
Which of the following actions maintains professional boundaries?
a) Accepting a client's friend request so you can message them about appointments.
Incorrect. Accepting friend requests from clients blurs the line between personal and professional relationships. Even if your intent is practical or supportive, communicating through personal social media platforms can compromise confidentiality, privacy, and professional boundaries.
b) Following a client's business page to be supportive.
Not recommended. While your intention may be kind, interacting with a client's personal or business page can create a perception of favouritism or dual relationships. Maintaining clear, professional distance helps preserve trust and objectivity in the therapeutic relationship.
c) Declining the request and communicating only through workplace channels.
Correct. All client communication must stay within professional, secure, and documented systems. Using approved workplace channels ensures accountability, confidentiality, and clear professional boundaries are maintained.
- E-Professionalism and cultural safety
Digital professionalism includes how you demonstrate respect, inclusion, and cultural humility online. The language, images, and content you share can either promote or harm cultural safety.
Indigenous clients and communities have a long history of having their voices and experiences misrepresented or dismissed within health systems. Health professionals may post, share, or comment online and perpetuate harm or mistrust.
In practice:
- Practise cultural humility; recognize that you are always learning about others' experiences and perspectives.
- Reflect before posting or sharing, especially if content relates to culture, community, or identity.
- Avoid generalizations or stereotypes about Indigenous Peoples or any cultural group.
- Be aware of power and privilege in digital spaces and how your words may be received.
- Amplify Indigenous voices respectfully by sharing verified content created by Indigenous authors, organizations, or health leaders, and give credit appropriately.
Anti-racist digital practice
E-professionalism also means actively addressing racism and discrimination when they occur online. Remaining silent when witnessing harmful or racist content can be perceived as acceptance.
In practice:
- Call out or report racist or discriminatory comments in groups or online discussions.
- Avoid humour, memes, or “likes" that reinforce stereotypes or marginalize communities.
- Use your professional presence to model respectful, inclusive language and advocate for equity in online spaces.
- Communicating electronically
Electronic tools like email, text, and messaging apps can improve access to care, but they also carry risks.
In practice:
- Obtain and document client consent before using email or text.
- Confirm recipient details and verify message delivery.
- Include a confidentiality disclaimer in emails.
- Avoid discussing diagnoses, lab results, or sensitive topics via text.
- Create written protocols for all team members who send or receive electronic communications.
Spot the risk
Which messages would you send?
a) “Hi — your appointment is at 9 a.m. tomorrow. Reply YES to confirm."
Correct. This message contains only logistical information and avoids disclosing personal health details. Appointment reminders are acceptable if the message does not include sensitive information or identifiers beyond what is necessary.
b)
“Your test came back positive. I’ve attached your lab results.”
Correct. This is a safe and professional response. It acknowledges the client while maintaining confidentiality. Following up by phone or through secure channels ensures sensitive information is shared appropriately and documented in the client record.
c) “I’ll call you shortly to discuss your results.”
Incorrect. This message shares confidential health information through an insecure communication method. Emailing results or attachments without encryption or client consent breaches privacy standards and the
Personal Information Protection Act (PIPA). Always use secure systems to share health information.
- Professional integrity and public trust
Professional integrity extends beyond the workplace. Online conduct, whether professional or personal, can influence public confidence in nursing and midwifery.
In practice:
- Refrain from posting derogatory, discriminatory, or unprofessional comments.
- Avoid sharing confidential, offensive, or inaccurate information.
- Consider how your tone and language reflect on the profession.
- Model respectful dialogue and promote evidence-based information.
Reflection: Think of a time you saw (or could imagine) an unprofessional post by a health professional. What impact could it have on clients or the profession?
Everyday actions that support e-professionalism
|
Action |
Example |
| Think before you post | Pause and re-read before sharing or commenting. |
| Separate personal and professional | Use distinct accounts or pages for work-related content. |
| Protect client information | Use secure networks and encryption. |
| Be respectful | Communicate professionally in all settings. |
| Follow standards and policies | Align digital conduct with BCCNM and employer expectations. |
| Document care-related communication | Record relevant messages or emails in the client record. |
| Model integrity | Share credible, inclusive, and culturally safe information. |
- Learn from practice scenarios
The following real cases show how everyday online actions can have serious professional implications.
As you read each one, think about:
- What standards were not met?
- What could the person have done differently?
- How might this situation affect client trust or public confidence in the profession?
Use these examples to reflect on your own digital practice and how to make safe, ethical choices online.
|
Scenario |
Key Issue |
Outcome / Learning Point |
| Posting photos | Nurse/midwife shared client photos online believing anonymity was preserved. | Breach of privacy and boundaries → reprimand and education. |
| Connecting with clients | Nurse/midwife sent a “friend request" to a client. | Boundary violation → reprimand and consultation. |
| Disrespectful comments | Nurse/midwife posted derogatory remarks about clients.
| Four-week suspension → remedial education in ethics and professionalism.
|
- Reflection: My next step
Take a moment to think about what you've read and how it applies to your everyday online interactions.
Reflect
- How does my current digital presence reflect my professionalism and cultural humility?
- What habits or settings could I change to better protect privacy, boundaries, and public trust?
- How can I model respectful, culturally safe communication online — especially with Indigenous clients and communities?
- How will I take action if I witness racism or discrimination?
My next step
Identify one practical action you'll take to strengthen your e-professionalism this week — for example, updating privacy settings, reviewing workplace policies, or reflecting before posting or sharing online.