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NMC issues Facebook and Twitter warning


Nurses who use social networking websites, such as Facebook, Twitter and Linked-In, have been warned they could be struck off the nursing register if their usage is deemed inappropriate by the Nursing and Midwifery Council.

The regulator has confirmed that “a number” of nurses are currently being investigated for their activity on such websites and, as a result, it launched guidance specifically on social networking this week.

The guidance recommends that nurses ensure they use privacy settings when visiting such sites, and that they do not post anything they would not want others to see. In a few previous cases, the NMC said nurses had used such sites to pursue inappropriate relationships with service users, or posted photographs that breach patient confidentiality.

A spokesman for the regulator told Nursing Times: “The last thing we would want is a mass exodus from using these sites. They are useful for services and for nurses, but nurses need to continue to uphold the NMC code online as they do face to face.”

In an NMC statement on the guidance, the regulator’s chief executive Professor Dickon Weir-Hughes said: “The NMC is committed to public protection and ensuring nurses and midwives make the welfare of those in their care their first priority at all times.

“I would advise nurses and midwives to exercise caution when using social networking sites. They could risk their registration if they share sensitive information, make inappropriate comments, or befriend patients online.”

The NMC advice on social networking sites includes the following suggestions:

  • Never put confidential or sensitive information on social networking sites, especially if it identifies patients.
  • Whether or not you identify your work role online, be aware that all your activity online can reflect on your professional life.
  • Don’t accept friend requests from patients, or use social networks to build or pursue relationships with patients or clients, even if they are no longer in your care.
  • Do not post pictures that have patients in them.
  • Keep personal and professional social networking as separate as possible.
  • Consider everything you post as public, even in ‘private’ Facebook discussions.
  • Social networking sites should not be used for whistle-blowing or raising concerns – instead follow the NMC’s guidance on raising and escalating concerns.
  • Don’t discuss work online, and especially avoid talking about patients or colleagues.
  • Don’t simply accept the preset privacy and sharing settings on Facebook, think carefully about what you want to share with different kinds of friends.
  • Remember you can take action if you find you are the target of abuse; there are options available for blocking people from interacting with you.

Readers' comments (106)

  • Steve Williams

    "nurses need to continue to uphold the NMC code online as they do face to face.”

    Is this Orwellian double-speak bollox or just another example of Martin Niemoller... yet again...


    First they came

    First they came for the Jews, and I didn't speak out because I wasn't a Jew.

    Then they came for the trade unionists,
    and I didn't speak out because I wasn't a trade unionist.

    Then they came for the communists, and I didn't speak out because I wasn't a communist.

    Then they came for me and there was no one left to speak out for me.


    First the PC Thought Police came for FaceBook

    Then they came for Twitter...

    Next they will be on here... violating your right to free speech!

    The NMC is a no-brain collection of dinos that are not only out of touch with modern nursing but also technology and social trends.

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  • And the witchfinder generals are out again.

    They don't want a mass exodus from the sites? What do they expect to happen when we know they can throw the book at us for any slight THEY feel is wrong? They can make up the rules as they go!

    This just proves many of the points I was making before the webchat with the NMC last week. They should be bloody ashamed of themselves. And NT, if you want more people to contribute on here, or participate in other media such as twitter, you may need to get to grips with this with the NMC.

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  • If you read the story carefully you'll see that the guidance was written because nurses have been struck off for using Facebook to pursue inappropriate relationships or post pictures of patients. That's nothing to do with being PC. Surely you don't think it's ok to do that? It seems reasonable for the NMC to offer advice on this given that some people have been stupid enough to do that. I don't think they are saying we can't use FB etc - just that we shoulod think about what we do.

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  • Jenni Middleton

    I think everyone needs to be aware that this isn't a witchhunt for those voicing opinions - but there are some serious cases that do need to make every nurse stop and think. One nurse (and this was in America, so it wasn't an NMC case), posed with a patient's placenta and uploaded it on her Facebook page, while another nurse here in the UK started a relationship with a mental health service user through Facebook, and then blocked them, causing the service user to self-harm and a lot of distress. I think this isn't about freedom of speech, this is about appropriate behaviour.

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  • I think that as nurses we have to remember that our code of professional conduct is paramount at ALL TIMES !! I am a huge advocate of nurses using social media especially in a professional capacity and regularly tweet and blog about the development of #nurseuk in crreating an online nurse community, but there have to be clear boundaries - social media is a public forum and should be respected as such, the rules of confidentiality and our code of conduct apply to social media as much as they apply to any aspect of our lives.

    There is a wealth of information that we can share as nurses using social media and this can aid with development and training. We must not let a few inappropriate nurses put us off using these tools as i believe that social media has a very important role to play in the future of nursing and nursing communities.

    For more information

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  • I agree that care must be taken when using social media, but not just for the obvious breaches of patient dignity and confidentiality (which have been perpetrated by a very small minority of twits).

    Much more worrying, and I agree with Mike on this, is the NMC's interpretation of what merits innappropriate usage. Big Brother is watching you. This organisation is rotten to the core, unfit for purpose, DOES conduct witchhunts (whilst ignoring serious issues like Winterbourne), and needs to be scrapped and replaced by something that works for the public and the profession.

    I'm not interested in using social media for 'development and training'. I want to keep up to date with my family and friends, some close-by and some far-flung, swap news and have a laugh. That's got NOTHING to do with the NMC. It can shove its guidance. Last time I looked, freedom of expression hadn't been completely eroded in this country.

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  • Anonymous | 8-Jul-2011 4:50 pm, whilst I agree that there are a few extreme cases that warrant attention as you and others say, these are in the extreme minority. My issues with this are that as I said earlier, it is the fact that we are being judged outside of work as well as what we do at work, as well as the interpretation of what justifies acceptable when that interpretation lies solely with the NMC, who I'm sorry Jenni, DO have a reputation for witch hunting. It is a very slippery slope.

    Another point Jenni, this isn't simply about appropriate behaviour, although that is certainly an issue in some extreme examples, this is about a gross invasion into our private lives too. For every extreme example you can name, I will bet there are a number of grossly unfair and invasive 'investigations' too. Just look at the NMC list of people being investigated (again, I do not think people being investigated should be named either), there are a lot of spurious reasons on there. I mean by what right does the NMC have to snoop on a private conversation between a group of friends on face book? Who says it is wrong for a Nurse to have a private life and post a few drunken pictures of themselves on a night out on the 'wall' or whatever it is called (and yes, there have been investigations into that too, by using the catch all 'bringing the profession into disrepute'.) We have a right to a private life too. Our so called professional body should have no right to judge on actions OUTSIDE of work, and that includes on social media.

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  • dam right i whole heartedly agree with mags and mike

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  • I think this is going the direction of invasion of privacy. However the idiots who decide to put pictures of patients on facebook or conduct inappropiate relation ships with patients should obviously be struck off however these type of people would have conducted this type of relationship without facebook. Nursing is stressful enough as it is when you finish work the last thing you need to be worrying about is who is monitoring pictures or comments on FB, twitter etc. As long as your job or patients you encounter in the NHS is not ever mentioned.

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  • Quite rightly, people in the nursing and allied professions should be aware of what they post on social networking sites. Those who breech patient confidentiality, or choose to conduct INAPPROPRIATE relationships with patients online should be reprimanded. There are rules and a little thing called THE CODE OF CONDUCT, now whether or not you agree with what is written in the code is irrelevant, it is up to each member of the nursing profession to uphold and abide by these rules if you want to keep your job, and if you have a grievance or a concern then to go through the appropriate measures to change things. Some of the code MAY BE inappropriate and outdated now, but the code of conduct is there to protect PATIENTS at the end of the day, not for your own ends. If you were to work elsewhere, and that 'elsewhere' has rules, then they are usually there for a good reason like the protection of consumers or clients, not just for the sake of being there, or for those who write/devise them to massage their own self righteousness. I do not believe this is an exercise in NMC snooping, but an attempt to protect those we are supposed to care for. Just be careful of your social net work input, that is not too much to ask, is it?

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  • there does not seem to be any reason to mix professional life and social life. If this is respected there should be no difficulties and any breach should be investigated by employers and the NMC.

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  • Anonymous | 9-Jul-2011 11:13 pm

    You admit that some of the rules within the "... little thing called THE CODE OF CONDUCT...." , "..MAY BE inappropriate and outdated now..".
    Well in 1998, the UK incorporated the European Convention, and the guarantee of freedom of expression it contains in Article 10, into its domestic law under the Human Rights Act.
    Dangerous statements like, " whether or not you agree with what is written in the code is irrelevant, it is up to each member of the nursing profession to uphold and abide by these rules if you want to keep your job,...." reek of sinister undertones. Really? You want everyone to uphold a code of conduct that, by your own admission might be outdated and inappropriate? Well you can follow it robot-fashion, (whilst creating an aura of mistrust) if you like. However, there is a little thing called FREEDOM OF SPEECH enshrined in law. Keep it in mind. That's not too much to ask, is it?

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  • There is a public consensus of opinion, I think, about how all members of professions would be expected to behave socially and professionally. Why does this not include the nursing profession? Mike. As both a nurse and
    a patient I would expect this. I do not think it is demeaning or inhuman to expect standards of conduct from nurses on public social chat sites and hope that behaviour that falls below this is monitored and yes reported! I think this is what is part & parcel of belonging to a profession bound by a code of conduct. No problem .

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  • I think the point is being missed here. No one has posted in support of those who act in breach of patient confidentiality or dignity. And no one is advocating that we act in an unprofessional manner.

    What some of us are warning about is just who is 'monitoring' and standing in judgement regarding our 'behaviour' on social networking sites? If it is the ineffectual NMC, then that is very worrying.

    It is apparently "No problem" to some and good luck to them. I wonder how they'll feel when that perfectly innocent comment or photograph posted on their FB wall is deemed inappropriate by some 'monitor'....."and yes reported"!

    One commenter even admits that "...Some of the code MAY BE inappropriate and outdated now,...." and yet states, " whether or not you agree with what is written in the code is irrelevant, it is up to each member of the nursing profession to uphold and abide by these rules if you want to keep your job,...". Astonishing!!!!! Are we happy throw free speech out of the window and become a profession of sheep? Well I'm bloody not!!

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  • Anonymous | 10-Jul-2011 10:05 pm you have completely missed the point here. Yes as a professional there are standards of behaviour IN WORK that we adhere to, there are also certain acts outside of it, breaking certain laws, breaching confidentiality etc, that we can and should be held to account on. HOWEVER, what right does ANY professional body have to effectively snoop on our PRIVATE lives, what right does any professional body have to deem what is and what isn't acceptable OUTSIDE of their remit of work (again with the exceptions stated above). I mean, where does it end? Who holds those regulators to account when they can effectively change the goal posts at any time? Are we not allowed a right to a private life? No, sorry, that picture you took on a drunken night out is 'bringing the profession into disrepute'. Are we not entitled to free thought or opinion? No, those opinions don't agree with the party line, off the register you go. Who the hell do these people think they are? Oops, I used a naughty word, that isn't upholding my responsibility to effective communication in an understanding manner, hey I'm now struck off!

    Yes we uphold our code of conduct and professionalism AT WORK, but then when we take the uniform off, we have a private life too. And NOONE, not even the witchfinder generals at the NMC, has the right to dictate what we say, think or do within that private life.

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  • The NMC is lazy and corrupt. Don't forget that it also got ripped apart in a verbal statement in the House of Commons about its culture of institutional bullying.

    I know from experience that many members of the NMC are more political than practical and some cases have been decided on the basis of politics rather than actual facts, and just in case anyone needs anymore indication of the occassional unjustness of their activities did you know that there is no appeal against the findings of a fitness to practice panel except via the High (now Supreme) Court on matters of procedural Law?

    The NMC is living in a glass house, and it has now started throwing stones.

    Lets have a list of every member of the NMC's staff published (you know - just like they do with RN/RMs) and lets see how they conduct themselves on social media.

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  • NMC needs more transparency on its activities, finances and staff.

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  • But surely there are other agencies that scan these chat sites too. Members of the public and former patients for instance, Journalists looking for emerging scandals!!.
    It is not just the much maligned NMC who consider they have a duty of care to report unacceptable revelations about the behaviour of public officials such as nurses.
    Unfortunately people will always be on the lookout to chastise and report people in responsible jobs. Good governance is surely about setting boundaries too. There should be agreement about what is acceptable conduct and which of course must be subject to public scrutiny too. Even if the NMC is replaced, a new body will still have a regulatory role. That has to be accepted or you end up being governed by civil servants via Ministers in the department of health. Or worse still no regulatory powers and very dodgy characters running around and calling themselves 'nurses'. No one will
    allow that to happen!.

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  • I can't believe that so called professionals can get so upset by being asked to be careful and make sure that they do not use social media sites inappropriately.
    I also can't believe that you are all stupid enough not to have realised that these sites are monitored by many different people e.g. potential employers, managers, police, governing bodies, criminals etc. No one is suggesting that you shouldn't have a life out of work but you should also get some common sense and be careful what you coose to share with all and sundry. Considering that there are quite a few nurses that use these sites inappropriately I am sure that our patients are pleased that the NMC are monitoring the sites and disciplining nurses.

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  • The NMC is our governing body.

    If we want to be seen as professionals then that is how we should behave at all times.

    If nurses resort to using these social networking sites and breach professional behaviour, then the NMC has every right to seek out the culprit and take action.

    I dont see it as big brother, I see it as attempting to maintain professional behaviour.

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