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Nurses breaching online rules


More than 40% of nurses say a colleague has inappropriately posted details of patients or colleagues on social media sites such as Facebook or Twitter, an exclusive Nursing Times survey has revealed.

The poll of nearly 1,000 Nursing Times readers is the largest snapshot to date of how nurses view and use social networking sites.

3% said colleagues had used social media to pursue a sexual relationship with a patient or service user

It follows the publication earlier this month of guidance by the Nursing and Midwifery Council, which was sparked by a rise in disciplinary cases relating to the use of social media by health professionals.    

The majority of nursing organisations, including the NMC, have used social networking to improve communication with members and have encouraged individuals to use it to build professional networks.

But the survey results show many in the profession are yet to be convinced of the potential benefits.

While 59% of survey respondents said they used a form of social media every day, nearly the same proportion believed it would not help them improve clinical practice to become a better nurse.

A majority - 56% - of nurses thought, overall, that social media was a positive development for the nursing profession but 44% disagreed.

In addition, 32% of respondents felt nurses were sharing too much information about work issues.

Most significantly, 42% of respondents were aware of colleagues in their ward or team having used social media inappropriately, for example to criticise a named colleague or patient. This would breach the NMC code of conduct.

Of those reporting inappropriate use, 75% said team members had discussed the behaviour of colleagues and 32% said they had discussed patients.

More than one in 10 said colleagues had taken photographs of patients or service users, and 3% said colleagues had used social media to pursue a sexual relationship with a patient or service user - practices banned by the NMC.

Andy Jaeger, NMC assistant director of professional and public communications, pointed out that sexual relationships with patients were “never going to be acceptable”, whether social media was used or not.

He warned that taking photographs was a significant issue due to advances in mobile phone technology. Nurses were increasingly “walking around with mobiles in their pocket”, which made taking pictures much easier, he said.

He said any picture taken in the care environment represented a “clinical record and should be treated as such”, and staff should also follow employers’ guidance.

But only 35% of survey respondents said their employer had a policy in place on the use of mobile phones in clinical settings - a further 36% said they did not know.

Fewer than half of respondents - 46% - said their employer had a policy in place for using social media.

Sue Sleeman, a barrister with Doughty Street Chambers who represents nurses and midwives in NMC hearings, said employer guidance was often limited to telling staff not to use social media sites during work hours.

She said the NMC advice was “helpful” but that higher profile education on social media should be prioritised, particularly by employers.

Last year, the NMC struck off Timothy Hyde, a community psychiatric nurse at Wells community team and Glastonbury health centre in Somerset, after he used Facebook to begin a relationship with a patient - the regulator’s first case directly involving social media.

But Ms Sleeman said she thought such examples were likely to be in the minority. “It would have to be a pretty serious misuse of Facebook to result in a strike off. Most of the time it’s going to be a caution,” she said.

She added using a “pen name” when using such sites could be a way of mitigating disciplinary action. By “taking the trouble to anonymise themselves”, a nurse might argue they had “tried not to bring the profession into disrepute”, she said.

But she noted that the best mode of protection was to avoid using social media - in the same way that civil servants were advised not to. She said: “If you don’t use it, you can’t get into bother.”


Readers' comments (19)

  • There is a facebook user named "The Midwife" who makes all sorts of remarks about their apparent day to day practice. Being outside of that particular professional group I have no idea if the content is by a modern day "Sister Plume" or someone with genuine insight into the daily trials and tribulations of the Midwife.

    Actually that's a point. Sister Plume did disappear rather suddenly from the pages of NT, I wonder if she fell foul of some pre-internet policing of unguarded public writing?

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  • I am amazed the these nurses using various sites don't understand their code of conduct and confidentiality let alone anything else.

    Do the universities who educate these nurses communicate enough about confidentiality and ethical considerations.

    Are nurses intelligent enough to understand what confidentiality and Human Rights (the absolute right to privacy means).

    This is absolutely appalling.

    NMC please do a trawl of Facebook and any nurse that you find is discussing or showing confidential type material PLEASE be proactive and discipline them.

    You could do this as a research project first if you say that you do not have capacity.

    Come on.......
    This is outrageous.

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  • is commenting on websites such as this one also counted as social media?

    how anonymous is anonymous really?

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  • further question from above?

    does the use of a pseudonym have the same level of protection as 'anonymous'?

    if anon is safe what is to stop individuals publishing anything they wish?

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  • The universities are quite clear about the Code of Conduct. We are all accountable for our own behaviour and should accept the consequencies if we breach them. Social networking sites are perfectly acceptable if used with a bit of common sense.

    This debate has been well discussed elsewhere on NT website. No one (before it all starts up again) on any side of the debate has found breaches of conduct to be acceptable behaviour. However, aside from clear breaches, there are very serious questions about just what is considered inappropriate use of a social networking site by a nurse. It isn't as clear as the examples given in the article; and can be very subjective, whilst not being illegal or in contravention of the code. And who is fit to judge that? Certainly not the NMC. Before the outrage over criticism of the our regulator begins, please go to the website of the Council to Healthcare Regulatory Excellence(CHRE) and read about the serious concerns that exist regarding the NMC's culture of bullying, poor decision making and lack of transparency. (Remember, this is the report from their regulator)

    It is too easy to make statements which encourage blanket trawling of social networking sites. That is just as dangerous behaviour as unacceptable breaches. Human rights legislation is there to protect everyone. I defy anyone who contributes on these forums to categorically state that they have NEVER done ANYTHING in their lives that could be considered by someone else to be in contravention of the code of conduct. Turn yourselves in today!

    This survey was carried out on 1,000 NT readers. There are many ten of thousands more nurses than that using Facebook, etc regularly. This is a not very reliable snapshot.

    Of course Nurses, along with every other person who uses FB and others, have to behave responsibly and legally when using these sites. But simply saying that we shouldn't use them (when the vast majority innocently use them to keep up with family, friends,etc), starts to bring another side to the "Human Rights" argument.

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  • Surely it is not beyond the wit of Registered Nurses to use Facebook and not say anything stupid.

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  • From the guidelines issued by the NMC:

    "Social networking sites should not be used for raising and escalating concerns"

    The RCN have a Facebook page about the case of Margaret Haywood, the Nurse struck off for whistleblowing. What are you going to do about that NMC? Haul Peter Carter before a disciplinary hearing? Na....thought not.

    Anonymous | 26-Jul-2011 11:43 am

    "NMC please do a trawl of Facebook and any nurse that you find is discussing or showing confidential type material PLEASE be proactive and discipline them."


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  • If nurses are encouraged to use these sites for professional networking and have done so, there really needs to be better guidance. What about the case of a core group of ward staff having a Facebook site set to secret who use it for education and debriefing? Both are not provided by their employer. The only education provided is mandatory training.

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  • Just how inaccurate are these figures, yet NT is putting them forward as an accurate portrayal of the whole profession? Ridiculous!!!!!

    Anonymous | 26-Jul-2011 5:25 pm well said. Outside of clear breaches, the term 'inappropriate use' is just far too subjective, and far too subjective to ever be judged by the already heavily criticised NMC, as you state.

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  • what was the useful purpose of this survey?
    was it mere journalistic curiosity?

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