by Teresa Chinn and David Foord
Over the past 5 years nursing has travelled significantly from a profession where we blatantly discouraged and admonished the use of Twitter to one that has embraced and is encouraging a permissive use of Twitter. Senior leaders within the NHS, who are starting to use social media more, advocate its use with nurse leaders such as Jane Cummings, NHS England Chief Nursing Officer, and Viv Bennett, Department of Health & Public Health England Director of Nursing, using Twitter and extolling its virtues. Dean Royles, NHS Employers Chief Executive, sums this up nicely by stating: “It is clear that we as a community of healthcare professionals are starting to see the benefit of engaging in open space. The fear, anxiety and nervousness senior staff felt about being accessible is being replaced by an understanding of the benefits of engaging in open spaces, having natural conversations as we would offline with little effort and resulting in an increased level of engagement with many more people.”
It’s not just the senior people within healthcare who see the benefit, there are many different types of nurses across the hierarchical system that exists in healthcare and throughout the UK (and the world) that are seeing the value in Tweeting. A recent transient hashtag promoted by @WeNurses clearly demonstrates the value that these nurses get from Twitter:
However through our experience and online conversations we have found that there are still many nurses who despite overwhelming encouragement from colleagues still refuse to even toe-dip into Twitter. We believe that some of this resistance is down to the misconceptions and “myths” surround Twitter. So in an effort to not only debunk these myths but also to arm those Twitter evangelists out there here are some of the common myths and, in contrast, the reality:
- Twitter is just for people who want to know what Stephen Fry had for breakfast
Yes, Twitter is used by celebrities to share what they’ve just eaten; however, it is so much more: somewhere to meet new people, to re-meet people you’ve known for ages, to chat or keep up with people you know outside of Twitter. It’s a place to share, to learn, to have conversations, to join in with conversations, to find people with similar views, to find people with different views and to keep up to date amongst many other things. At the very least, Twitter is a tool to use: to find and engage with people and discuss shared interests, which may be Stephen Fry’s favourite marmalade.
- I’m too old for Twitter
No you’re not! There are many nurses of all ages using Twitter at all stages of their careers. It is a great place to talk to and learn from student nurses, newly qualified nurses, experienced nurses, nurse lecturers, directors of nursing and the Chief Nurse for NHS England and Director of Nursing at the Department of Health. In a recent WeNurses survey that was only publicised on Twitter 65 per cent of respondents were aged 35-54 years old – firmly busting the myth that you need to be young to use Twitter; not that we’re saying 54 is old, but Twitter certainly isn’t just for teenagers.
- I’m a busy nurse I don’t have time for Twitter
Using Twitter is not about doing more, but about being more effective at what you already do; says Dean Royles, Chief Executive, NHS Employers. The greatest benefits of using Twitter come when you see it as an additional tool in your communication toolbox. It’s a really effective way to find out views, opinions and mood. Many people on Twitter are very generous with their sharing, analysis and collation of information, views and resources and will actively share these. Twitter is often the place that news first breaks and information is first shared. Dean goes on to say that he finds using Twitter actually saves him time and this is the experience of many nurses too. It’s important to find the right balance for you personally in how much you want to use it, as you would with any information resource or communication tool.
- Twitter is full of trolls
Firstly let’s define a ‘troll’; this is someone who spends their time on the Internet or social media deliberately starting arguments, causing upset or being inflammatory. Yes, there are some unpleasant people who use Twitter, as there are in real life. They are a tiny minority of the many people who use Twitter in a generous and altruistic way. The majority of Twitter users’ experience, the majority of the time, is positive and if you are unfortunate enough to come across a troll, you’ll find much support from other Twitter users and plenty of advice on how to deal with the situation, such as this in the Telegraph.
- Twitter isn’t a serious way to communicate
“This ‘telephone’ has too many shortcomings to be seriously considered as a means of communication.” — Western Union internal memo, 1876.
Many communication tools have been dismissed as fads, trends or irrelevant in the past, but social media and Twitter in particular has now reached a point where it can no longer be ignored. There are over half a billion registered users worldwide, 135,000 new users registering each day (source Media Bistro). With over 5,000 tweets per second, it’s a serious way to communicate for some! WeNurses discussions have been used in research projects, have fed into Department of Health and NHS England consultations and nurses have shared tweets from events such as The Chief Nursing Officers Summit, RCN Congress and the House of Commons Select Committee all having far reaching value. All of this results in some pretty serious communication albeit in 140 characters. In fact a whopping 84 per cent of WeNurses survey respondents stated that something they had learnt on Twitter had impacted their nursing practice – now that’s serious!
- You can’t learn anything from Twitter
If you know everything and there’s nothing more you can ever learn from any source, then you’re right, Twitter isn’t for you, don’t read further, just sit back and wallow in your allknowingness. The reality is that the day we stop being open to learning is the day we should stop nursing. As Twitter is only one of many ways to communicate, it is also only one of many ways to learn. If someone said to you: “there’s a learning resource that you can ask any question you want, connect with nurses world-wide, chief executives, patients, public, join journal clubs, have group supervision and many other things,” you would want to know more wouldn’t you? Well this is just some of what Twitter can offer as a learning resource.
- Nurses are always getting into trouble by using Twitter
My mother told me a million times not to exaggerate! There are some high profile examples of nurses doing less than sensible things in many walks of life and Twitter is no different; however, to say they are ‘always’ getting in trouble is over-stating things. If that were the case, because to the number of nurses on Twitter, the Nursing and Midwifery Council (NMC) would collapse under the weight of Fitness to Practise cases and HR departments would melt-down with misconduct disciplinary hearings. To avoid getting into trouble, you should do two things: firstly be aware of your employer’s and the NMC’s guidance on applying The Code to social networking sites; and secondly follow these two simple rules: 1. Remember everything’s public and 2. Don’t be stupid!
- I have nothing interesting to say, people won’t follow me
Do you think the same thing when you’re talking in person with colleagues, friends, family or patients? Twitter is a place for conversation, so if you’ve got anything worth saying out loud, it’s probably of interest to others on Twitter. All Twitter users were new to tweeting at some point and as it’s not that old, this is more recent than you’d think for most people.
- My patients don’t use Twitter
Oh yes they do! Whether as individuals or part of groups, patients are coming together on Twitter for peer support, engagement, education and to engage with professionals. An example of this is the online community of people with diabetes - Great Britain Diabetes Online Community. Every Wednesday at 21:00 people with diabetes or with an interest get together on Twitter to connect, share, support and be supported. At the last chat before writing this, 52 people joined tweeting a total of 502 messages to each other and the world on the topic of "Treatment or Care; What do you get/want/expect”. When engaging with patients on Twitter, do ensure you’re aware of your employer’s social media policy and the NMC’s guidance on applying The Code to social networking sites.
- I can't do social media because not everyone has access to the Internet
It wasn’t that long ago when adult literacy levels were similar to current levels of Internet access. There wasn’t a similar attitude that printed public health information shouldn’t be produced to support work to reduce inequalities and improve the health of the nation. Internet access is improving and in the last Office for National Statistics (ONS) survey, November 2013, 86% of the adult population had accessed the Internet. We shouldn’t let the fact that social media is still relatively new and is unknown to some put us off when significantly more than half of the UK population (57 per cent and growing) were social media users according to an ONS study last summer. In a recent thought-provoking tweet, Stuart Berry, a GP, said in response to the question of whether we should engage on social media: “Why have car parks at GP Surgeries? Many patients don't have access to their own car or can't drive?”.
Twitter is a tool to add to your communication toolkit, it is not a fad or the only way to engage with people. It’s valuable for learning, support and engagement with family, friends, colleagues, patients and the public. There are many myths about Twitter and the more salacious stories end up in the media, but these are the exception not the rule and are just that, myths. There’s a great nursing community on Twitter waiting for you to join in!
Teresa Chinn – Registered Nurse, Professional Social Media Community Development and blogger WeNurses
@AgencyNurse was an agency nurse who found herself professionally isolated and reached out to social media to connect with other nurses. Teresa runs WeNurses which is primarily a Twitter-based real time weekly discussion that enables nurses to share ideas, information, experience and expertise around a predetermined subject. @WeNurses has grown and developed significantly and now has a following of over 11,000 and uses a range of social media to engage them including Twitter, Facebook, Pinterest, Vimeo, Blogs and Prezi. In addition to running WeNurses Teresa has become a social media specialist and now works with healthcare organisations delivering workshops, seminars, speaking at conferences and providing social media consultancy.
David Foord - Director of Quality, Luton Clinical Commissioning Group
@DGFoord is a nurse with a range of experience working in private healthcare and NHS provider and commissioning organisations in managerial, executive and non-executive roles. He is currently Director of Quality & Clinical Governance at Luton Clinical Commissioning Group. Passionate about the benefits social media can bring to patient's experience and outcomes, David connects this with his role working in commissioning. He is keen to use social media to learn and grow whilst supporting others to develop. David currently blogs weekly about his experience as a Director in the NHS having previously written a daily blog for the first 100 days in his current role.