[Reputational risks associated with nurses' presence on social media: proposed actions following the Vall d'Hebron case].

Background: A Spanish nurse posted a video on TikTok criticizing the requirement of a certain level of Catalan to work in the public health system of Catalonia (Spain). The video went viral, eliciting reactions from social media users, politicians, and professional nursing organizations. This study aims to evaluate the reputational damage suffered by the nurse, her hospital, and the nursing profession, with the goal of proposing actions to prevent, avoid, or manage similar situations.

Methodology: A sequential exploratory mixed-methods design was used to analyse the content of the video, its impact on the press and social media, and the management of the communication crisis by the hospital and nursing organizations involved.

Results: The nurse exercised her right to freedom of expression. However, her choice to convey the message, wearing the uniform that identified her as a staff member of a specific hospital, and her criticism of the language level requirement, led to reputational damage after the video spread via the press and Twitter/X. The hospital's reputation was affected due to the nurse being identified as one of its employees. In contrast, the reputation of the nursing profession was not significantly harmed, as multiple information sources suggested the incident was isolated. The creation of a safe, self-regulatory framework and training in social media and communication management are proposed as measures for healthcare centres, nursing organizations, and academic institutions to implement.

Conclusions: The reputations of both the nurse and her hospital were impacted. A methodological model for analysing similar situations is proposed.