Think before you send: Professional conduct and online communication

Health practitioners, nurses and midwives are bound by a code of conduct and professional standards. In addition, many workplaces will have policies setting out the standard of behaviour expected with regard to electronic communication with colleagues, patients, clients and residents as well as their families and representatives.

During the period of lockdown, we have all relied on electronic communication- both to work and to stay in touch with friends and family. It’s been a great tool and we’ll all come out of this with new found digital skills.

However it is also timely to remember that the boundary between your professional life and your personal one can sometimes be blurred and when devices are our main means of communicating, the risks of stepping over the professional line are greater than ever.

Two recent disciplinary board hearings involving health practitioners illustrate the risks. In the first (1), a nurse in charge at an inpatient treatment unit was found guilty of unsatisfactory professional conduct because his judgement and care exercised in the practice of nursing fell significantly below the standard expected.

While on duty, the nurse used his phone to send his partner a sexually explicit picture. He left his phone at the nurses’ station desk with the image still displayed. Patient A, who was admitted for drug and alcohol detoxification saw the photo and asked the nurse to send him the photo and also sought personal contact with the nurse. The nurse sent Patient A the photo. He did not report the incident and later said he felt pressured and scared. He resigned before the matter was heard.

At the hearing, the nurse’s conduct was found to be unprofessional because he ought not to have been viewing and sending material of a sexual nature at work, ought not to have left his phone available and should not have sent the photo to the patient. His failure to report the incident was a failure to respond appropriately. The Tribunal determined to suspend the nurse’s registration for two years.

The second case (2), concerned a medical practitioner working as a doctor in a public hospital. The doctor was well regarded in his practice and by his colleagues and had no complaints about his practice. The doctor posted highly inflammatory sexist and racist comments in online chat forums that were based overseas. It was clear from the posts that the doctor was an Australian medical practitioner.

The doctor admitted to his posts being inappropriate and that he was not sufficiently aware of the Code of Conduct or workplace policies in relation to online communication. He stated that he did not believe his overseas posts would impact his practice.

The Medical Board observed that although the posts were not made in connection to his practice and were made after hours, they nevertheless did impact his practice. The Board held that the posts were ‘expressions inconsistent with the good repute of medical practitioners and the relationship of trust between medical practitioners and patients, who are of course, members of the public’. The Board suspended the doctor for six weeks.

These cases illustrate that personal communication can be the basis of a finding of professional misconduct even where the origins of the communication are private and not made in connection with the health professional’s practice. While the conduct in these cases is clearly inappropriate, it is not difficult to see how professional boundaries can be blurred particularly when we are working at home. Risks might include:

  • Using work devices and servers for personal communication which means your employer can access this communication;
  • Leaving confidential patient/client information open where other members of your household may be able to view the material;
  • Having shared family passwords that may give access to confidential and private work information;
  • Communicating with patients online may make the usual professional boundaries provided by working in an office, consulting room or ward with colleagues harder to maintain. The ability to draw the line between professional and personal communication can be a lot more difficult in an online setting.

Online communication has never been more important for us to stay connected professionally and personally but it is vital to keep the two distinct. It is important to remember to be aware of both where and how you communicate, regardless of the location of your office and the forum of communication. The obligation to observe professional boundaries and standards remains the same.

1 Health Care Complaints Commission v Keegan [2018]NSWCATOD3
2 National Board of Australia v Christopher Kwan Chen Lee [2019]TASHPT3

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