Melissa Ann Lynn PhD, RN, CMSRN, CHSE

Social media use has grown exponentially world-wide. Nurses in the United States participate in social media for both professional and personal purposes. Positive and useful professional interactions often occur to foster relationships and share information, while personal interactions allow nurses to remain connected to friends and family. Often, boundaries between professional and personal opinions become easily blurred when using social media, and nurses who post uncivil and unprofessional content may face harsh consequences such as loss of employment. The COVID-19 pandemic has further increased social media use. For this research, a qualitative grounded theory approach was used to seek an understanding about the decision-making process by which active practicing professional nurses evaluate ethical choices when participating in social media and how the COVID-19 pandemic changed nurses' social media use. According to the participants in this study, nurses have multidimensional identities and interact on social media with differing enticements and motivations. These motivations combined with fear of consequences for unprofessionalism are balanced by the knowledge of professional laws and expectations. The outcomes of social media interactions, whether directly experienced or indirectly witnessed, impact future social media behaviors. A secondary analysis of the data revealed how the COVID-19 pandemic impacted the purpose for which nurses interacted in social media, changed the nurses' perception of the public opinions of nursing, and united nurses together.