A nurse has admitted to professional misconduct over taking a photo of a surgical team carrying out an organ retrieval procedure in an operating theatre and later posting it on social media.
A fitness-to-practise inquiry of the Nursing and Midwifery Board of Ireland (NMBI) heard there was no clinical justification for the nurse to take the photograph on 22 May 2023 and to subsequently post it on her Facebook and Instagram accounts.
Counsel for the NMBI, William Martin-Smith BL, said the nurse had also failed to respect the privacy and dignity of the patient and his family.
The nurse also faced similar allegations of professional misconduct in relation to her taking of a "selfie" on the same date when she was in scrubs in the staff tearoom in the hospital and posting in on social media.
Mr Martin-Smith said the nurse's actions also constituted several breaches of the NMBI’s Code of Professional Conduct and Ethics.
The name of the nurse and the hospital where she works cannot be identified as a result of a direction of a NMBI fitness-to-practise sub-committee.
The inquiry arose after a formal complaint was made to the NMBI by the hospital’s director of nursing.
It heard that the photo from the operating theatre with the caption "organ retrieval" allowed one male theatre nurse to be identified, although emojis covered the faces of other staff.
Mr Martin-Smith said the photos were taken down from social media within nine hours after the nurse was requested to remove them.
The nurse said there were no "likes" of the photo of the operation and she did not believe the photos had been shared. One or two likes were received to her "selfie" on Instagram.
'Annoyed and traumatised'
The inquiry heard that the patient’s family were "annoyed and traumatised" after being informed about the photo.
The nurse was issued with a final written warning and required to complete further training after a disciplinary process within the hospital.
Mr Martin-Smith said staff were also reminded of the hospital’s policy that there should be no phones in any clinical area, while there was also a presentation about its policy on use of social media.
The nurse, who has worked at the hospital for eight years, issued a "sincere and heartfelt" apology to her colleagues, the hospital, the NMBI and the family of the deceased for what she described as "a moment of madness".
The nurse told the inquiry that she was deeply sorry for her lapse in judgement and observed that it had never been her intention to cause any harm, disrespect or breach of trust.
"I was simply moved by the incredible teamwork and compassion I witnessed during the procedure - moments that reminded me why I became a nurse," the nurse said.
She added: "I felt immense pride in being part of something so meaningful and I wanted to honour the beauty of that selfless act of organ donation."
The nurse apologised to the patient’s family for any pain and suffering she caused.
She told the inquiry that the matter had profoundly affected her, and she now had a deeper understanding of the confidentiality and professionalism expected beyond providing care.
The nurse said she had learnt an invaluable lesson and now understood that even when actions were well-intentioned, they were "always seen through the lens of public trust".
She remarked that she had always taken great pride in being a "compassionate and dedicated nurse" but had been "devastated" that her actions had fallen below the standards she held for herself and her profession.
Her solicitor, Thomas Cochrane, said the nurse, who was pregnant at the time, was exceptionally tired and under personal and professional stress.
Mr Cochrane said she was not seeking to excuse her actions but to provide some context for them.
He pointed out that the photos were only posted on social media to her friends as a "story" which meant the time and number of people who could have seen them were limited.
The inquiry also heard that character references provided to the nurse highlighted how she was an excellent professional with "a long-standing record of safe and exemplary practice".
Mr Cochrane claimed what happened was a "single isolated incident" and asked the sub-committee to consider dealing with the case by way of an undertaking and a consent by the nurse to a sanction of censure.
Very serious
The solicitor said the nurse was undertaking not to repeat the conduct that was the subject of the inquiry and to complete any further training recommended by the NMBI or her employer as well as familiarising herself with the HSE’s policy on use of social media.
However, Mr Martin-Smith opposed the application because of the very serious nature of the nurse’s actions and the need for any sanction to protect the public as well as maintain public confidence in the nursing profession and its regulatory process.
While Mr Martin-Smith said the NMBI was not recommending any specific sanction, he proposed it should not be "at the lower end of the scale."
The NMBI’s fitness-to-practise sub-committee rejected the nurse’s application on the basis that the case warranted formal findings.
The inquiry’s chairperson, Mary Leahy, observed that the nurse’s use of social media had caused great upset to the patient’s family and the infrequent nature of the procedure could have led to him being identified.
Ms Leahy also noted that the nurse no longer had control of how the photos could be used once they were published on social media.
The sub-committee found that the allegations of professional misconduct were proven based on the nurse’s own admissions.
Ms Leahy said a report, which will include a recommendation on sanction, will be forwarded to the NMBI board in due course.
