Nurses' freedom of expression: Rights, obligations and responsibilities.

Aim: This commentary aims to spark debate on the ethical, legal, professional and institutional challenges faced by nurses' use and interactions when using traditional, mass and social media.

Background: Freedom of expression is a core value of democratic systems. However, it appears to be a complex right when exercised by nurses in traditional media and/or during online interactions. Active use of these types of media can help promote healthcare incentives and reach larger audiences, or even influence public policy. Nevertheless, with the increase in social media use, some nurses have been found to have engaged in unprofessional practices, which, in some serious cases, have led to their dismissal.

Evaluation: We identified specific instances of conflicts-most commonly related to breach of privacy, inappropriate interactions on social media or a simple lack of knowledge or guidance regarding its use-and formal complaints concerning nurses' freedom of expression.

Key Issues: While nursing codes do exist, professional guidelines concerning the use of mass and social media are still much needed. With the advent of social media, there may be ambiguity regarding how nurses engage with and make use of these platforms. In order to ensure that nurses interact professionally with any form of media, clear ethical, legal and professional frameworks of use are needed. Specific codes exist, such as the new ICN code of ethics or the NMC code, among other initiatives, but more comprehensive guidance is needed in order to support nurses in using better judgement regarding their media interactions. While the existence of such frameworks may not fix the problem of incorrect use, it can help those nurses looking for clear guidance when interacting with mass media or using social media. Also, it is important that more professionals are aware that such guidance exists, since understanding the limits and dangers of certain interactions would ultimately protect nurses' and patients' rights.

Conclusion: The increasing use of media platforms by nurses calls for further professional guidance regarding its professional utilization. To date, limited guidance exists to support media interactions. In an interconnected world that favours media interaction in both professional and private spheres, the development and widespread dissemination of clear guidance for professionals must also detail two essential points: how professionals can better interact with media platforms and also how they can avoid having unethical media interactions in the first place.

Implications For Nursing Management: The existence of a solid, comprehensive framework for generalized media use should ensure that nurses can exercise their right to freedom of expression. Clearer limitations should support nurses' professional presence and interactions in the media.