Purpose – The purpose of this paper is to explore and describe online communication about the experiencesand attitudes toward Swedish Healthcare Direct, a national telephone advice nursing (TAN) service.

Design/methodology/approach – A descriptive research design was adopted using a six-step netnographicmethod. Three Swedish forums were purposefully selected and data from the virtual discussions were collected.

Findings – Three themes emerged: expectancy and performativity of the nurses, absurdity in accessibilityand the scrutinizing game. The most prominent finding was the scrutinizing game, which included aspects ofbidirectional mistrust from both nurses and callers. Another salient finding was the attitudes that callers heldtoward nurses who used a technique interpreted as “passing the buck.”

Research limitations/implications – The use of a nethnographic method is novel in this area of research.Consequently, the body of knowledge has regarding telephone advise nursing service has significantly beenbroadened. A limitation in this study is that demographic data for the posters are not available.

Practical implications – Bidirectional distrust is an important issue that must be acknowledged by TANservices, since it might damage the service on a fundamental level. Healthcare providers, politicians, andresearchers should account for the power and availability of virtual discussions when seeking consumers’opinions and evaluating the quality of the care provided.

Originality/value – This analysis of the ongoing discussions that take place on the internet provides insightinto callers’ perceptions of a national TAN service. The bidirectional mistrust found from both the nurses andthe callers might be a threat to callers’ compliance with the advice given and their care-seeking behavior.