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Freedom of Speech! Unless You Are a Professional?

A recent decision by the Queens Bench for Saskatchewan has empowered the reach of the Saskatchewan Registered Nurses' Association interpretation of professional misconduct. This decision allows the Association to examine the conduct of a nurse both professionally and privately and appears to interfere with that nurse's right to free speech.

The concept of evaluating a nurse's behaviour both on and off the job is not a new one, however, to monitor a nurses' right to voice an opinion on social media is a new level of scrutiny. The nurse in question, while visiting her father in the hospital during his last days of life, made comments on social media referring to a substandard level of care he was receiving. The Association then disciplined the nurse for professional misconduct and fined her $25,000. The Saskatchewan Registered Nurses' Association refers to the following when considering professional misconduct:

The Registered Nurses Act, 1998 section 26(1) For the purpose of this Act, professional misconduct is a question of fact but any matter, conduct or thing, whether or not disgraceful or dishonourable, that is contrary to the best interests of the public or nurses or tends to harm the standing of the profession of nursing is professional misconduct within the meaning of this Act.

The act further goes on to provide multiple examples of professional misconduct all of which reflect actions of the nurse while working in the capacity of a nurse, or direct actions by the nurse that has an effect on a patient. This loose interpretation of section 26(1) has now been used to monitor and sensor nurses' outside of the workplace.

A recent article in Advocate Daily quoted Tracey Tremayne-Lloyd, the Principle Lawyer of TTL Health Law, "the role of professional disciplinary committees is to protect the public from incompetent health professionals whose knowledge, skills and judgment might put people at risk". It is suggested that censorship of nurses' opinion of other healthcare professionals or facilities goes beyond the scope or jurisdiction of the Association. However, the Queens Bench for Saskatchewan disagreed and dismissed the nurse's appeal of the Association's decision. This ruling by the Bench may indeed open Pandora's Box to additional levels of censorship or scrutiny by the Association, or what other professional bodies consider when disciplining their members.

Professional individuals, like frontline healthcare providers, are generally working in trenches of the system. They see what is going on, although sometimes passionate about how things are said their opinion generally reflect the reality of our health system and how that affects patient care. To have that voice removed by the threat of fines and/or loss of licences sounds a lot like a restriction of freedom of speech. That said, we have been always been told to know your audience. We just have to accept, in this modern age of social media, we can never know who our audience is anymore.

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