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NMC guidance in brief

Social networking: avoiding the pitfalls


NMC guidance advises nurses on the use of social networking

These days most people have an account with at least one social networking site. Most organisations, including nursing bodies, use them as a means of engaging and informing professionals. Use of these sites does not come without pitfalls, however, and the Nursing and midwifery Council has issued guidance for nurses, midwives and students who use websites such as Facebook, Twitter and LinkedIn (see

The regulator has warned nurses they could be struck off the nursing register if their usage is deemed inappropriate. It has said in a few cases that nurses have used such sites to pursue inappropriate relationships with service users, or posted photographs that breached patient confidentiality.

The NMC issued its guidance in response to “a number” of nurses being investigated over their social networking activity. It recommends that registrants make sure they use privacy settings when using social networking sites, and do not post anything they would not want their employees, some colleagues, patients or service users to see. 

Applying the code

The NMC’s guidance sets out how The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives (NMC, 2008) can be applied in thinking about social networking sites, and provides advice for using them responsibly. It addresses issues that are specific to social networking sites but its principles can be applied to all types of online communication, such as personal websites and blogs, discussion boards, email groups and instant messaging. The guidance covers content shared online, including text, photographs, other images, videos and audio files.

The Code states nurses and midwives must “uphold the reputation of your profession at all times” (NMC, 2008), while students must “uphold the reputation of your chosen profession at all times” (NMC, 2009). In terms of the guidance, this means conduct online and in the real world should be judged in the same way, and be of a similarly high standard.

The NMC warns that nurses and midwives will put their registration at risk, and students may jeopardise their ability to join its register, if they:

  • Share confidential information online;
  • Post inappropriate comments about colleagues or patients;Use social networking sites to bully or intimidate colleagues;
  • Pursue personal relationships with patients or service users;
  • Distribute sexually explicit material;
  • Use social networking sites in any way that is unlawful.

The list is not exhaustive so, if there is any doubt over whether an online activity is acceptable, nurses should think how it would be perceived in the real world. For example, manipulated photos intended to mock individuals would be considered offensive if printed and pinned on workplace
noticeboards, and are no less offensive when shared online – even if shared privately between friends.

Taking precautions

The NMC offers the following advice to nurses using social networking sites:

  • Keep your personal and professional life separate as far as possible – for example keep Facebook for close friends and family and use LinkedIn for building professional relationships;
  • If you identify yourself as a nurse or midwife on Facebook, or similar sites, you should act responsibly at all times and uphold the reputation of your profession;
  • Protect your own privacy – think thoroughly about what kinds of information you want to share and with whom, and adjust your privacy settings accordingly;
  • Do not use social networks to build or pursue relationships with patients and service users, even if they are no longer in your care;
  • Do not discuss work-related issues online, including conversations about patients or complaints about colleagues, even when anonymised;
  • Never post pictures of patients or service users, even if they ask you to do this;
  • Social networking sites should not be used for raising and escalating concerns;
  • Remember that everything you post online is public, even with the strictest privacy settings;
  • You can take action if you find yourself the target of complaints or abuse on social networking sites – you can remove someone from your friend list and block them from interacting with you, and most sites include mechanisms to report abusive activity and support users who are subject to abuse from others;
  • If you are concerned about another health professional or student’s behaviour online, you should raise your concerns, even with their university or employer if necessary. In the most serious circumstances, for example if someone’s use of a social networking site is unlawful, you should also report the incident to the police.

The guidance stresses that social networking sites are relatively new, so norms of conduct and behaviour are still evolving. The NMC will regularly review its advice and welcomes feedback on its use in practice.

The full NMC guidance on social networking sites is at



Readers' comments (6)

  • I am not on facebook etc but think those that are need to be aware, if not already, of the guidance. Very often, things that are posted on message boards can easily be misconstrued and hence leaves those that post the comments, very vunerable and therefore, at risk of repercussions.

    I am not sure whether I agree with any professional being on facebook for the very reasons I have stated but realise, with so many people having facebook accounts, it would be difficult to stop/prevent it.

    Be interesting to know what others think about this issue, especially those who use social networking sites.

    Although I have a twitter account, it was set up as a pilot study in university, as an aid to learning. I follow many nursing/meds sites etc, which I have found beneficial and helpful during my training but, do not put anything of a v personal nature on there - who wants to know what Im doing every minute of the day? surely not very many?!!

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  • This subject has been discussed thoroughly on several threads in the last couple of months. There are very strong views on both sides.

    Personally, I use Facebook responsibly and have every right to use it. I have a life outside of Nursing and I don't take kindly to the 'not fit for purpose NMC' (documented culture of bullying and gross incompetence in handling its affairs), or any of its patronising little robots telling me what I can or cannot do. There is a huge issue around the competence of the organisation which would be passing judgement on nurses who use social networking sites. Even the suggestion that an attempt should be made to prevent/stop professionals using the sites makes my blood boil. Take the book-burning mentality somewhere else.

    Oh, and by the way, the RCN used Facebook successfully to campaign for the reinstatement to the register of Margaret Haywood. That would appear to be in contravention of the NMC's guidance : "Social networking sites should not be used for raising and escalating concerns"!

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  • Yes, I hear what you are saying, and I respect your reviews. If everyone used social networking sites responsibly,like yourself, then there would not be a problem - unfortunately, many people don't, they absue it.

    15 + years ago (?) there were never such things - do we really need them and are they that important ?? I do not think they are - to me and many others, they seem to cause more harm that good - I could give a list of the harm they have caused by users (not necessarily professionals), inappropriate use of them.

    The issue will remain a hot topic - and there are those that will think they are great and those, like me, that think the beneifts are minimal. As for the RCN using facebook for the Margaret Haywood campaign - I personally did not agree with their decision - again, I do not see the need for organisations to use them - maybe im living in the dark ages or something simiilar, but I dont care, think there is something to be said for good old fashioned communication!! It is fast becoming a thing of the past which saddens me, esp for young people - many of whom find it easier to talk in cyperspace than face to face!! or by standard means of communication.

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  • Debra Smallbone | 18-Sep-2011 12:10 pm

    "15 + years ago (?) there were never such things - do we really need them and are they that important ?? I do not think they are - to me and many others, they seem to cause more harm that good - I could give a list of the harm they have caused by users (not necessarily professionals), inappropriate use of them."

    Backward thinking. The same could be said of any form of communication eg. telegraph, phone or just plain talking. What next? Do away with phones, TV, don't allow people to gather for exchanges of ideas? This tiresome argument rears its unwelcome head everytime there is an advance in communication. Just ask Amnesty International if social networking sites are important! The Arab Spring and Libyan freedom fighters this year alone used social networking sites to get news out and organise themselves effectively. Burma, China, etc. I have an endless list.

    Freedom of speech comes at a price. Oppression (which, let's be clear, is being advocated here) is not the answer. Thankfully, the blinkered thinkers will not succeed.

    The RCN were absolutely correct in using Facebook to expose the unjustified and excessive actions against a woman trying to fight for the rights of patients. A job the NMC should have been doing! Ludicrous!

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  • I respect your views but, think we are going to have to agree to differ - like I said, there are people that will advocate for social networking sites and those that do not. Yes, used sensibly, they can be a useful tool but, but I think the negatives outweigh the posiitives - and just for the record, I am not into oppression and was in no way advocating it! and I am saying no more on the subject.

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  • "I am not sure whether I agree with any professional being on facebook for the very reasons I have stated but realise, with so many people having facebook accounts, it would be difficult to stop/prevent it."

    You might disagree with it, but why would you want professionals to be stopped or prevented from using Facebook? That's oppression!

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