Navigating digital ethics: Experiences of nurse digital content creators

Background Social media has revolutionized healthcare communication, giving nurses unprecedented visibility and influence in shaping public perceptions of health and professionalism. Among these emerging figures are “nurse digital content creators”—nurses who use social platforms to communicate health information, advocate for the profession, and engage with large online audiences. Yet, their online presence challenges traditional ethical frameworks and professional boundaries. Aim This study explores how Italian nurse digital content creators perceive and negotiate ethical and professional boundaries in digital environments, focusing on their motivations, challenges, and the implications for nursing ethics and public health. Research design A qualitative reflexive thematic analysis was used to capture the lived experiences of four Italian nurse digital content creators. Participants and research context Participants were purposively selected based on defined criteria and interviewed through semi-structured video calls. Data were transcribed verbatim and analyzed using Braun and Clarke’s six-step thematic analysis. Rigor was achieved through member checking, peer debriefing, and transparent coding. Ethical considerations Ethical approval was obtained. Participants provided informed consent electronically. All data were anonymized during the analysis. Results Five interrelated themes emerged: (1) Professional Purpose and Digital Advocacy ; (2) Ethical Boundaries and Institutional Silence ; (3) Privacy, Confidentiality, and Self-Protection ; (4) Emotional Labour and Public Exposure ; and (5) Health Misinformation and Moral Duty . Participants viewed digital communication as an ethical extension of care but struggled with ambiguous institutional guidance, fear of reputational risk, and the emotional toll of constant visibility. Conclusion Nurse digital content creators play a crucial role in improving health literacy and reshaping the image of nursing in society. However, their engagement raises ethical questions that demand updated professional guidelines and institutional recognition. Integrating digital ethics and social media communication into nursing curricula and institutional policies is essential to safeguard professional integrity and enhance the educational potential of online engagement.