NMC Code Section 20: Uphold the Reputation of the Profession

Section 20 opens Pillar 4 (Promote Professionalism and Trust) with the broadest professional-conduct obligation.

“Uphold the reputation of your profession at all times.”

Sub-clauses:

• 20.1 Keep to and uphold the standards and values set out in the Code.
• 20.2 Act with honesty and integrity at all times.
• 20.3 Be aware at all times of how your behaviour can affect and influence the behaviour of other people.
• 20.4 Keep to the laws of the country in which you are practising.
• 20.5 Treat people in a way that does not take advantage of their vulnerability or cause them upset or distress.
• 20.6 Stay objective and have clear professional boundaries at all times with people in your care (including those who have been in your care in the past), their families and carers.
• 20.7 Make sure you do not express your personal beliefs in an inappropriate way.
• 20.8 Act as a role model of professional behaviour for students and newly qualified nurses to aspire to.
• 20.9 Maintain the level of health you need to carry out your professional role.
• 20.10 Use all forms of spoken, written and digital communication (including social media and networking sites) responsibly.

Section 20 has the widest range of sub-clauses in the Code. It covers everything the public might judge a nurse by, on and off duty.

What it means in practice

Three behaviour categories sit under Section 20:

Professional integrity. Honesty in records and statements, no exploitation of patient vulnerability, clear professional boundaries (no inappropriate relationships with patients or former patients within a reasonable period).

Public conduct. Behaviour outside work that bears on public trust: criminal convictions, public statements, conduct in healthcare settings outside the registrant’s employment.

Communication conduct. Social media especially. The NMC’s social media guidance is explicit: identifiable patient content is forbidden; criticism of colleagues by name is risky; statements inconsistent with the Code can lead to fitness-to-practise referral.

Common breaches

• Inappropriate relationships with patients or recent former patients.
• Social media posts that identify patients, criticise colleagues, or express views incompatible with the Code (racism, transphobia, anti-vaccine misinformation are recurring examples in published cases).
• Criminal convictions for dishonesty, violence, or sexual offences.
• Inappropriate use of position: accepting gifts of significant value, financial relationships with patients.
• Public statements undermining trust in colleagues or institutions.

CPD that maps to Section 20

• Professional boundaries training.
• Social media use for healthcare professionals.
• Code of conduct refreshers.
• Professional accountability.
• Reputation management awareness for senior nurses.

Common reflective account themes

Strong Section 20 accounts describe:

• A boundary-testing situation with a patient and how you maintained the boundary.
• A social media incident (yours or a colleague’s) that prompted reflection on professional conduct.
• A moment when professional integrity required uncomfortable action.

Where Section 20 connects to other sections

• Section 21 (uphold position): overlap on positional integrity.
• Section 5 (privacy): social media confidentiality breaches.
• Section 23 (cooperate with investigations): Section 20 issues often trigger Section 23 obligations.

The next chapter covers Code Section 21 on upholding your position as a nurse.