Exploring public perspectives of e-professionalism in nursing.

BACKGROUND: E-professionalism is a term used to describe the behaviours of healthcare professionals, including nurses, in the online environment. While a range of professional guidance on the use of online social media platforms is available, there has been little research into the perspectives of patients and the public more generally on nurses' e-professionalism. AIM: To explain what, how and why the public make decisions about the acceptability of nurses' online behaviours and e-professionalism, and to make recommendations for nurses on managing the information they share online. METHOD: This was a mixed-method critical realist study. Participants in a survey ( n =53) and two focus groups ( n =8) discussed and rated the acceptability of five vignettes related to nurses' online behaviours based on real-life examples. FINDINGS: The participants generally thought that nurses are entitled to have a personal life and freedom of speech and to promote causes they believe to be important, even if these were not aligned with their own beliefs. Participants unanimously considered the use of profane language against any individuals or groups to be unacceptable. CONCLUSION: The public make decisions on the acceptability of nurses' online behaviours based on a range of complex factors, including social and individual values, attitudes and beliefs, as well as their intent and consequences. Recommendations for nurses on how to manage the information they share online include: using separate platforms for personal, educational and professional purposes; using functions that control who can 'tag' and share their posts; and ensuring any information they share that relates to healthcare or nursing practice is up to date and evidence based.

When can I say no?

If the professional relationship between a nurse and a patient has broken down through no fault of either party, it is often more appropriate for the patient's care and treatment to be provided by another nurse. This could be initiated by the nurse or the patient.

Copyright query.

If you don't own the copyright to the chart, you are not entitled to payment when it is reproduced. Factors that need to be considered to determine whether you own the rights to the chart include whether it was designed as part of your working duties, whether you used other charts to help you design the new one, and what is stated in your contract.

Cautious about consent.

Any interaction with a patient requires the patient's consent. Where the patient cannot give consent, it must be sought from their appointed representative. If neither of these is possible, the interaction must be in the patient's best interests.

Rules are forcing nurses to attempt futile CPR.

There have been two separate cases recently of nurses in care homes being reprimanded by the Nursing and Midwifery Council (NMC) for not attempting to resuscitate patients they thought had died.

Approaching the issue.

Pre-registration students are not registered with the Nursing and Midwifery Council (NMC), so you cannot report them to the regulator. The NMC issues guidance on professional conduct for nursing and midwifery students, but it cannot take any action until the person is on, or applies to join, the register.

I'm not married - will my partner get my pension?

Most occupational pension schemes, such as that for NHS employees, ask members to declare who they wish the benefits to be paid to if they die. These are known as 'expressions of interest' forms or something similar, and in them you state who you wish to receive your benefits.

Confidentiality issues.

The first thing you need to do is seek approval from the relevant person at the practice. This could be your line manager, the practice manager or one of the partners. Once permission is in place, and if you want your son's friend to observe you as you work, there are two main areas that could pose a problem: patient consent and confidentiality.

Should I cancel my NMC registration?

To practise as a nurse, you must be registered with the Nursing and Midwifery Council (NMC). Your entry on to the register shows you have met the competencies and standards required to practise as a nurse.

Perils of gifts and loans.

Let's assume that this is not a reference to copyright infringement issues and that you are not going to let your patient keep the DVDs but are just loaning them for a specified period. Your manager is likely referring to an inverse gift-giving scenario - instead of you receiving a gift from your patient, it is you who is giving the gift, even though it is just a loan and not a permanent gift.

Your duty to report.

Anyone raising a concern about colleague should be able to do so with the expectation that their concern will be taken seriously and dealt with appropriately, and that they themselves will be supported. As a registered nurse, you have a duty under the Nursing and Midwifery Council (NMC) code to raise concerns if you believe patient safety, or the safety of others, is at risk.

Stick to the facts.

There are many instances where someone could be asked to write a report on an incident they were not directly involved in. This could be to obtain an objective overview of the incident or, as a manager of a unit, you may need to gather the views of a number of different people.

Can my boss force me to have the flu jab?

Two legal and ethical issues arise from a campaign that uses pressure to 'persuade' nurses to receive a vaccination they may not want. The first relates to the individual nurse's consent to the procedure, and the second to the legal and ethical position of the person providing the vaccination.

Time to raise a glass?

There is no Nursing and Midwifery Council rule that states you cannot have a drink at work, but this would be covered by your overall responsibility to maintain a professional standard and be fit and competent to practise safely.

Should I lend a student one of my projects?

Helping a student is to be applauded and there is nothing legally or ethically wrong with what you propose, but there is an issue with potential plagiarism, whether intentional or not.