Background The conduct of healthcare organisation employees on social media can impact both their personal reputation and that of the organisation. However, social media has blurred the lines between professional and personal communication, and what is acceptable and ethical conduct is not always clear. Furthermore, the global COVID-19 pandemic has changed how healthcare organisations and their employees approach the use of social media, expediting the need to ensure that employees communicating health-related information adhere to employee codes of conduct. Aims This review aims to investigate the challenges associated with healthcare organisation employees’ use of social media for sharing health-related information, identify the crucial elements for inclusion in social media codes of conduct for healthcare organisations, and examine the enablers for good codes of conduct. Methods A systematic review of the literature from six research database platforms on articles related to codes of conduct addressing the use of social media for healthcare organisation employees was conducted. The screening process yielded 52 articles. Results The key finding in this review focuses on privacy, protecting both patients and healthcare organisation employees. While maintaining separate professional and personal social media accounts is a much-discussed approach, training and education on social media codes of conduct can clarify acceptable behaviour both personally and professionally. Conclusion The results raise essential questions about healthcare organisation employees’ use of social media. It is evident that organisational support and a constructive culture will enable healthcare organisations to fully realise the benefits of using social media.