My wife barely knows I have this blog—one I update more regularly than our shared calendar. It’s been a quiet space to reflect, share thoughts, and document the highs and lows of working in healthcare. Until recently, I assumed it was a well-kept secret. Turns out… not so much.

Luckily, I don’t just write about work. In fact, a lot of the blog is dedicated to my hobbies—like board games, chess, and the occasional detour into niche interests that keep me sane.

The Message That Started It All

A few days ago, I received a message from one of my surgical consultants. It was about the blog.

Apparently, someone in communications at the hospital had come across it and read the entry where I discussed the complexities of setting up an ambulatory pancreatitis service in Somerset. They were interested. In fact, they wanted to know if I could write something official about the project, since we’re already running clinics and beginning to establish the service.

Before We Write Anything…

At first, this felt… surprisingly positive. Slightly surreal, yes—but flattering, nonetheless. It’s affirming when someone values your reflections, especially when that someone is from within the very system you’re writing about. Being asked to contribute to a more formal piece was both unexpected and welcome.

That said, before I begin drafting anything about our progress, I’ve decided it’s best to meet with my consultant—likely sometime after Easter—to clarify what’s being asked, and to discuss the scope of what we should write.

The clinics are still in their infancy, and any formal communication should reflect both the cautious optimism and the realistic limitations of a service still finding its feet.

Which brings me to the next following thoughts – well 2 with some sub-questions to be more precise

a) How Did They Find My Blog?

That’s the part that gave me pause. I don’t advertise this blog. It’s not linked on my LinkedIn profile, it’s not attached to my email signature, it’s not in my X bio and I certainly haven’t passed it around in clinic. So how did it surface?

The truth is, very little is truly hidden online. Whether by chance, search algorithms, or a helpful nudge from a colleague, content has a way of making itself discoverable—especially when it touches on something topical or institutionally relevant. This isn’t necessarily a bad thing. But it is… revealing.

b) What If I Had Written Something Negative?

This was my next thought. The entry they read happened to be constructive. But had it taken a more critical tone—pointing out delays, structural barriers, or internal frustrations (my view on PA’s for examples)—would I have been met with the same enthusiasm? Or with a quiet meeting about “professional boundaries”?

This isn’t just theoretical. As a registered healthcare professional, I have both legal and ethical responsibilities regarding what I share online. The Nursing and Midwifery Council (NMC) is clear about the need to uphold professionalism in all forms of communication.

From their Code of Conduct (2018):

“You must use all forms of spoken, written and digital communication (including social media and networking sites) responsibly.”

And from the NMC’s Social Media Guidance:

“Any comments posted on social media that can be identified as being made by a registered nurse, midwife or nursing associate can be viewed as professional practice.”

In other words, what I post—even here—can reflect on my professional identity. Commentary that breaches confidentiality, undermines patient trust, or casts the profession or employer in a negative light can have real consequences.

I discussed this with a childhood friend—now an academic at a German university with more letters after his name than most departments—and he put it simply: He explained that regardless of disclaimers or personal context, writing connected to one’s professional identity is always subject to institutional scrutiny. Online spaces may feel personal, but they are, in effect, public.

Even disclaimers can only take you so far.

About That Disclaimer

Like many reflective blogs, I include a line that states:

“What I write is fictional and any resemblance to actual persons, living or dead, or actual events is purely coincidental.”

It’s a standard clause, and one I hope offers a layer of narrative distance.

But legally? It’s no shield.

If readers—especially colleagues—recognize real-world services or people, and the content could reasonably be interpreted as critical or identifying, disclaimers lose their protective value.

Why Employers Monitor Digital Content

Some might wonder: why would a hospital—or its communications team—be looking for staff content online in the first place?

In the UK, it’s increasingly standard practice for employers to be aware of their staff’s public digital presence.

This isn’t about surveillance—it’s about reputation management. For NHS organizations, where trust and transparency are crucial, any online content that could affect patient perception or public confidence is relevant.

Staff blogs, tweets, or videos—even those shared in personal capacities—can quickly go viral. And once that happens, it reflects not just on the individual, but on the entire organization.

It makes sense that trusts would want to engage early, especially if the tone is positive and there’s an opportunity to share good work more widely.

In the End, Big Brother Does Find Out

This experience reminded me that, however quietly you publish, nothing online is truly invisible. A blog can be a private outlet—until it’s not.

That doesn’t mean I’ll stop writing. Reflective practice matters. But I will move forward with a slightly sharper awareness of my audience—both known and unknown.

So yes, I’ll likely contribute a piece on our developing pancreatitis service. It’s a great initiative, and the team has put a lot of effort into getting it started. But I’ll be doing so thoughtfully—balancing openness with the realities of early-stage service delivery, and always remembering who might be reading.

As always, all views are my own, written in a personal capacity, and any resemblance to real people or services is purely coincidental. Probably.

References

Nursing and Midwifery Council (2018). The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates.

NMC. Social Media Guidance.

NHS Employers. Social Media Guidance for NHS Employees.