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NMC code advice on digital communications

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The Nursing and Midwifery Council’s new code takes the first step in promoting online professionalism and appropriate behaviour in the use of social networking


Nurses and midwives are increasingly using social media as a professional tool. This is reflected in the Nursing and Midwifery Council’s (NMC) new professional code, which says nurses must use social media and other communication responsibly, respecting the right to privacy of others at all times. A growing body of literature documents the positive influence social media, when used appropriately, can have on nurses’ practice and the care they deliver to patients. However, nurses need more guidance and training to ensure online professionalism and appropriate behaviour online. Requiring nurses and midwives to complete an online continuous professional development course on social networking at the point of revalidation could keep them up to date and promote online professionalism.

Citation: Moorley C, Watson, R (2015) NMC code advice on digital commu-nications. Nursing Times; 111: 14, 22-23.

Authors: Calvin Moorley is senior lecturer, adult nursing, Faculty of Health and Social Care, London Southbank University, and Roger Watson is professor of nursing, University of Hull.


A growing number of nurses and midwives are using social networking as a professional tool, either to connect with each other to share information and knowledge, or to support patients and their families in dealing with their diagnosis and treatment. This has been acknowledged in the Nursing and Midwifery Council’s (NMC) new professional code, which for the first time specifically mentions the role of social media and the need for nurses to use it responsibly (NMC, 2015).

The NMC’s code is a tool to help safeguard the public when they come into contact with nurses or midwives, and underpins the regulatory function and validation process for the profession, including a new system of revalidation to be introduced at the end of this year.

In an earlier draft version of the code, the NMC said nurses must not refer to employers, colleagues or anyone they have cared for on social media sites. However, after consultation, including feedback via social media using @WeNurses on Twitter, it reworded its advice in favour of responsible use of social media and social networking (NMC, 2014).

Clause 20:10 of the code, as part of a broader section on communications, says nurses must uphold the reputation of their profession at all times by using “all forms of spoken, written and digital communication (including social media and networking sites) responsibly, respecting the right to privacy of others at all times” (NMC, 2015). This revised wording will be welcomed by the many nurses who use social media in their professional lives.

In a 2011 factsheet on social networking sites, the NMC estimated about 355,000 of the UK’s registered nurses, midwives and health visitors were using Facebook. This was based on UK population figures and NMC registration data (NMC, 2011). This represented about half of all registrants. Anything posted on a social networking site is in the public domain, which means the boundaries between personal and professional are not always clear. There is, therefore, a clear need for guidance on online professionalism and how nurses can make sure their social media profile upholds the standards of their profession.

Guidance is therefore vital on the use of social media and social networking sites, so nurses can ensure digital professionalism and behave appropriately online. Nurses need to make sure their social media profile upholds the standards of their profession, for their own benefit and to protect those in their care.

How do nurses use social media?

Australian nursing journal Collegian recently published a special issue on social media. This showed that although social networking on sites such as Twitter, Facebook, LinkedIn, Myspace, and Instagram is often associated with idle chatter and celebrity gossip, its use for professional purposes is growing (Archibald and Clark, 2014). Another article discussed using Twitter hashtags to connect nurses professionally (Moorley and Chinn, 2014).

The authors found this enabled nurses to share ideas and discuss nursing practice and care in a way that benefitted patients and those in their immediate network, and also to contribute to discussions on nursing policy.

The value of leveraging social media for professional purposes is starting to be recognised in the nursing community (Ferguson, 2013).

However, Jackson and Ferguson warn nurses against sharing research materials at conferences via tweeting and posting on social media sites without the author’s permission (Jackson and Ferguson, 2014). In essence, nurses need to approach using social media with caution, acknowledging rights to privacy, and if attending a conference or society meeting, be sure to ask the presenter if they can tweet or post parts of the talk.

In the UK, as we move towards a system of professional revalidation, nurses and midwives might also consider using blogs in their portfolio to reflect on their practice, along with interactions with other nurses on social media, such as Twitter and Facebook.

Ensuring digital professionalism

NMC guidance on social networking lists those online behaviours that could put the registration of nurses, midwives and student nurses in jeopardy (NMC, 2012) (see Box 1).

Box 1. NMC standards

The NMC says nurses, midwives and student nurses might put their registration in jeopardy 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

Source: NMC, 2012

In nursing and midwifery, unprofessional or inappropriate behaviours outside clinical practice reflect on the profession itself and may have an adverse impact on the quality of care provided by the nurses involved. Nurses’ conduct on social network sites should always adhere to the same professional standards, even when it is for personal use (see Fig 1, attached).

The challenges to nurses presented by digital or e-professionalism, such as managing online relationships, general behaviour and the sharing of information online, should be no different to those in face-to-face, hands-on nursing practice, except that nurses need to apply them to the online environment.

We have no doubt nurses will successfully embrace these challenges, helped by a growing body of guidance and information on online professionalism.

The new NMC code is a start in developing and fostering good online behaviours, but this needs to be developed further through the use of online tools that help acquaint and familiarise nurses with the digital world. Requiring nurses and midwives to complete an online continuous professional development course on social networking at the point of revalidation would keep nurses and midwives informed of what is acceptable or unacceptable behaviour online, and could be continuously updated to keep pace with rapid changes in this area.


Social networking is increasingly being recognised as a tool for professional development. However, nurses and midwives must be mindful of the sensitivity of this work and may need mentoring on good digital practice. Nursing managers should provide training and guidance to help nurses leverage digital spaces for social networking.

The mention of social networking in the new NMC code and the need for nurses to use it responsibly is a positive step, but there needs to be greater acknowledgement of the positive influence it can have on nurses’ professional lives and the care they provide to patients. Guidance is needed that keeps up with the rapid pace of change in this area, with the NMC keeping a critical eye on the implications for nurses, and making recommendations or provisions for developing good digital professionalism.

Key points

  • Nurses and midwives are increasingly using social networks to share knowledge and improve care
  • The new NMC code includes a new requirement to use social media responsibly
  • As the boundaries between personal and professional use can be blurred, the same standards should apply to both
  • The NMC sets out online activity that could put registration at risk, but more professional advice on this is needed
  • Requiring registrants to complete CPD on social networking at revalidation would boost online professionalism 
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