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As a nurse off-duty, how can you maintain professionalism when asked for health advice by friends and family?
As a nurse, it is par for the course that friends and family ask you for health advice. People often assume you will have an in-depth knowledge of all their ailments and illnesses. So, how can nurses navigate these sometimes difficult situations without putting their relationships – and their registration – at risk?
Nursing Older People. 36, 5, 10-11. doi: 10.7748/nop.36.5.10.s4
Published: 30 September 2024
Your professional opinion being sought might be flattering, but beware the pitfalls. When friends and family ask for health advice, it can put you in a tricky position.
Responding to a clear emergency such as choking, cardiac arrest or an accident where someone has stopped breathing is unambiguous – immediate action from any healthcare professional who happens to be present is required. But other, less serious or urgent situations, such as a friend asking for thoughts on their recurring headaches, require a more considered response.
The Nursing and Midwifery Council (NMC) code states nurses must treat people with kindness, respect and compassion, working in partnership and empowering people to share decisions about their treatment and care.
With this in mind, discussing healthcare problems and offering advice might seem like a good thing to do.
You might also feel flattered that a friend has approached you for advice and trusts you with their personal issues. But there are pitfalls that nurses could encounter even if they have good intentions.
I remember picking my children up from school years ago and one of the mums at the school gates asking me about a rash on her child’s face. I immediately went into ‘nurse mode’ thinking of allergies, infectious diseases and a whole host of options but managed to stop myself in time to signpost her to the local pharmacy for advice.
I don’t think our relationship was ever the same after that because I didn’t offer the help she expected. But I instinctively felt uncomfortable answering personal, medical questions in such a public setting. And it is even more important to be cautious when queries are about something potentially controversial, such as views on vaccination, which might start a heated debate.
The NMC code details the professional standards that must be adhered to by registrants. There is no scope for negotiation or cherry picking the parts to adhere to. Nurses must always work within the limits of their competence.
First, to ensure we are compliant with the Code, we must practise effectively. This includes staying within the boundaries of our profession and working within our remit. Our liability insurance might not cover us if we cause harm because of a well-meaning conversation with a friend and this could have financial implications.
Second, we must preserve safety. Offering advice in a non-clinical context runs the risk of providing out-of-date or non-evidence-based information. We may not necessarily know what medication or other health conditions people might have, meaning any contraindications are not taken into account.
Finally, we must promote professionalism and trust. This means upholding standards and being aware of the public perception of our profession. There may be a conflict of interest because personal feelings might affect the advice offered.
‘Our liability insurance might not cover us if we cause harm because of a well-meaning conversation with a friend’
‘Offering advice in a non-clinical context runs the risk of providing out-of-date or non-evidence-based information’
An example might be a friend who is overweight who may not take kindly to suggestions that they would benefit from losing weight even when they have asked for health advice.
Fiona.parkinson ‘I will offer advice within my scope but always tell them to go to their GP for a diagnosis’
Derrynursejenni ‘If it’s within my remit I’m happy to help. If not, I advise where is best to seek help or advice’
Priya_2 ox ‘I just say, “I’m off-duty, sorry!”’
Jackieberry_05 ‘I respond and help if I can’
Steph.evans65 ‘I tend to signpost unless it’s simple. I am an advanced nurse practitioner but I’m aware I am not an expert’
Coeliac_pooks76 ‘I’m not a doctor! If it’s relatively straightforward I’ll give advice’
Jess_and_ben4 ‘Sorry, I won’t advise [to avoid] conflict – I really do encourage you to see a professional’
Champagnenurse ‘I do all I can to help’
Source: @nursing_standard
While it might feel that helping friends and family with their healthcare issues is a kind thing to do, there is a possibility we would be practising outside our sphere of accountability – and outside the boundaries of the Code – if it is not an emergency situation where life is at risk and does not require an urgent response.
You can still help friends and family by listening to them and signposting them to appropriate services such as the NHS website, explaining it is not appropriate for you to provide advice.
You could also suggest they seek medical advice in an appropriate setting, such as their GP, a walk-in centre or, if appropriate, the emergency department.
