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Patient confidentiality matters in cyberspace too


Ever taken a picture of a really interesting leg wound and shown it to a friend at a party?

Ever uploaded a picture of yourself and a patient on Facebook? Ever tracked a service user down using social media? All of that may leave you spiralling into orbit at the suggestion that you’d behave with such disregard for patient confidentiality, dignity and your own professional status. But there are nurses who have done all of those things. The NMC is investigating an increasing number of referrals about nurses’ fitness to practise in relation to their social media usage. So much so that last week it issued guidance about how nurses and student nurses should behave on Facebook, Twitter and LinkedIn .

According to the NMC’s Andy Jaeger, assistant director, professional and public relations, who wrote the guidance, the rise in inappropriate usage is down to a lack of understanding about just how public the information you share in cyberspace really is and how to manipulate your privacy settings. He confirms the NMC is investigating “several” cases around social media usage.

Despite policies about mobile phone usage, often nurses have their mobiles on them at all times, giving them the ability to photograph, share information and relay opinions without taking a moment to stop and think whether they really should. In the US, nurse Doyle Byrnes posed with a patient’s placenta and posted it on Facebook, while in the UK, nurse Timothy Hyde was struck off the register last year as a result of misconduct involving Facebook.

The NMC suggests that with around 78,000 UK Facebook users listing their profession as nurse, midwife or health visitor (and it believes 355,000 Facebook users are from the professions), such cases are only likely to increase. So think carefully about what you upload. Sounding off about a bad day may be tempting, but it could be construed as breaching patient confidentiality and land you in hot water. You may be a model nurse in the workplace, but make sure you are in cyberspace too.



Readers' comments (26)

  • No, no, no!!!! I understand that there are a few, well lets just say idiots, out there who HAVE gone to the extreme of posting pictures of patients, conducting relationships etc, and yes these should be dealt with when reported but these are in the minority. The vast majority of us would not dream of doing that, nor would we be so stupid.

    We understand what social media like facebook is, and we know how dangerous it can be, that is why personally I am not on it. But the vast majority of Nurses (and other professionals) who are on it use it sensibly, and there is a vast, vast difference Jenni between uploading pics of a patients placenta, and sounding off about a bad, stressful day. In what way is ranting that you are stressed and have had a bad day breaching confidentiality if no names, patient details or specifics about conditions are used? Why is it construed as 'bringing the profession into disrepute' if a Nurse decides to post a few pictures of a night out? (it has happened)! Who is to say that many of our posts on here, mine included, sounding off about poor staffing levels, lack of decent pay, etc etc, will not be taken exception to by trusts who do not want their reputations sullied (despite them being legitimate points in an argument) and the NMC won't come after us on here next?

    You see, this is the danger, isn't it. As I said, there are a few extreme cases, yes, but you cannot apply that rule to everyone!!! It is then that monitoring these sites becomes a very sinister thing indeed. Outside of work, we have a right to a private life and free speech, and as long as that does not breach specific confidentiality or the other examples we have mentioned, then no professional body should have the right to judge on that.

    It is just becoming very, very sinister when we have to watch what we say and do outside of work too, and it is not just about being 'professionals' at all times, (we are only human, remember), because there are no goalposts here that the NMC cannot and will not change to suit their purposes. That sentence you wrote 'it may be construed as' is a very very dangerous one.

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  • There are no problems with people saying they have had a bad day, or stressed with work, it is the breach of confidentiality and data protection that we are being reminded to adhere to. There should be no problem with that as most companies and workplaces are subject to some sort of clause regarding this.

    It is the stupid people that this is aimed at when they use names and situations which leave no doubt as to where they work and who was involved. The NMC are providing guidelines and we will probably see the RCN doing the same thing soon, if they haven't already.

    This is not a subject aimed at removing free speech, it is aimed at protection of vunerable adults which we have to respect when we are in this profession.

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  • It is also for our own protection as those who do not respect the rules will be investigated with the risk being struck off the register.

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  • Hey mike, didn't you get all hot under the collar about this stream back in April?
    I seem to have read all this before....

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  • Big Brother is watching you ......

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  • Jenni Middleton

    Mike - I wasn't suggesting that you shouldn't be able to sound off about a bad day. I should have been clearer. I meant that nurses should not sound off about a bad day if what they say breaches a patient's confidentiality. I wouldn't suggest you can't use social media to share, inform and engage with other nurses. I think it's important to make the most of new technology - socially and professionally.

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  • It's alright Jenni, Mike is on one of his 'You are all against the nurses' rants and actually forgets that we need guidelines and that the public need protecting. In Mike's world there are only defamations against nurses and everyone is allowed to do whatever they want.

    I think Mike should be allowed to have freedom of speech and discuss patients on the web. So long as all his personal and medical issues, private finances and personal life details are discussed daily on the web too. Then let us see him start whinging about that too.

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  • desertdeserter and Jenni, I agree with the basic tenets of the code when it relates to confidentiality etc, that is not my point, my problem with this is that there are no rules, there are no set goalposts that our regulators have to adhere to, there is absolutely NO difference between explicitly breaching patient confidentiality etc or 'simply sounding off about a bad day' online, when the regulators interpret any post/misdemeanour/whatever in any way THEY choose, and there is no comeback or redress to that.

    Anonymous | 13-Jul-2011 12:57 pm, would it be 'bringing the profession into disrepute' if I replied to your 'post' the way I wanted to?

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  • It goes without saying that Nurses shouldn't breach confidentiality. There can be no argument about that.

    However, I have a very big problem with those in the NMC who interpret this guidance. And, more to the point, HOW they interpret it. I really want us to have a transparent and efficient regulator. That would be better for our patients. There is a perception here, and elsewhere, that anybody who expresses an objection to these NMC guidelines, thinks that we should be allowed to breach confidentiality online!! Utter nonsense. I simply don't trust the NMC to effectively manage these 'guidelines'. And I shouldn't be made to feel threatened, because I express this view.

    I have posted elsewhere about the RCN Campaign on Facebook to have Margaret Haywood reinstated after being struck off by the NMC. The campaign was successful. This goes against these NMC guidelines about raising concerns online. Are the NMC going to go after the RCN? Of course not. They only go after individuals.

    Anonymous | 13-Jul-2011 12:57 pm

    Childish, vacuous and offensive comments. Might be an idea to actually read and attempt to understand the content of someone's post, before turning on the bile. By all means disagree with someone. It's a shame that you couldn't discuss the issues in an appropriate manner.

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  • Going on FB and saying that you had a bad day at work is fine but once you go into any detail at all about what caused your bad day is likely to be a breach of confidentiality. You are not anonymous on FB and that is the difference about saying what you think on this site, you can remain anonymous if you want to. And signing in with you first name, Mike, Mags is still being anonymous.

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