The Nursing and Midwifery Council (NMC) has published new guidance aiming to clarify the boundaries of nurses’ freedom of expression.
The NMC said the guidance – headed ‘Freedom of expression and Fitness to Practise’ – is aimed primarily at decision makers in its fitness to practise process but ‘also provides clarity to nurses, midwives and nursing associates, to support them to express their beliefs appropriately’.
While the guidance reaffirms that ‘everyone enjoys the right to freedom of thought, conscience and religion and freedom of expression’, it warns that the NMC may need to take action if the way someone expresses their belief means there is a risk to the public; public confidence in the profession; or proper professional standards and conduct.
According to the guidance, nurses, midwives and nursing associates are free to express themselves and their legally protected beliefs (religious, political and philosophical) outside of work.
However, if they were to use racist, homophobic, sexist or other discriminatory language; target people using health and care services; or suggest that they would discriminate against others as a result of these views – especially in a professional context – then their fitness to practise ‘could be impaired’.
The NMC said the guidance was developed following engagement with ‘key partners’ and includes examples to help decision makers approach cases ‘in a consistent way that is rooted in the law’.
One of these examples describes a midwife discussing their work with friends in a restaurant and expressing ‘very vocal’ support for a specific political party and claiming that the government is ‘destroying the service and profession they work in’.
In the example, the midwife goes on to criticise their line manager, saying they are ‘part of the problem’.
According to the guidance, regulatory action is unlikely to be taken in this scenario because registered professionals are entitled to hold and express opinions about their work and politics.
However, if the midwife had described their manager using a racial slur or indicated that their patients would be treated differently based on their political views or other characteristics, then action would be likely.
In another example where action would likely be taken, a nurse on duty tries to persuade parents to remove their consent to have their child vaccinated because child vaccination runs contrary to the nurse’s ethical beliefs.
Even though the nurse’s beliefs are protected, by ‘seeking to actively interfere with treatment on that basis’, they would be acting contrary to the NMC’s code and undermining confidence in the profession.
Matthew McClelland, executive director of strategy and insight at the NMC, said: ‘We firmly believe that everyone has the right to freedom of expression. Our code requires nurses, midwives, and nursing associates to put the people in their care first.
’That means treating people with kindness and respect and not expressing their personal beliefs in an inappropriate way.’
Mr McClelland added: ‘Occasionally, concerns are raised about the way in which someone on our register has expressed themselves so it’s important our decision makers in fitness to practise are clear on the right way to reach swift and safe decisions that are rooted in law.’
The full guidance is available to read on the NMC website.