Thank you to all in eci831 for your valuable comments. It would seem like my questions are shared by others and is a hot area for discussion by many different groups and organizations. For those interested in exploring the issue about privacy and confidentiality related to patients/patient care, there is an article in Sunspots that discusses many concerns related to social media and privacy. The article also discusses other related potential problem as a breaching a duty of loyalty of an employer, possible defamation/libel and others. Above all, as Registered Nurses we are required to promote and uphold our ethical standards which includes preserving the dignity of patient and understanding the ethical and legal considerations in maintaining confidentiality in electronic forms of communication is essential. The CNPS also has policy statements about this issue. I continue to look forward on your comments about this area as it so important as we need to start the conversation and include patients in this discussion.