Social Media 1 – Networks 0

Having completed the survey by the NHS Commissioning Board “Compassion in Practice” I must admit I audibly sighed that the theme of the survey leant towards the use of closed networks and I recall a blog I wrote a few months ago which was posted on the WeNurses website and which I have re- posted below: 

“Over the last year or so I have been party to many conversations that have debated the virtues of “closed private networks” against “public social media” within both the social media and nursing world. I am often a long thinker, by which I mean that I will often take a long time to mull things over and form an opinion, and I have listened to healthcare professionals who have raised concerns over the public nature of social media and I have also listened to those in the social media world who extol the virtues of all social media. However when it comes to healthcare the virtual space in which we live becomes a particularly important issue: we have conflicting priorities of connecting with as many people as we can versus observing confidentiality and protecting our patients.
I think that one of the basic questions we must ask ourselves is what are we sharing as healthcare professionals? Well, from the majority of networks that I have accessed it seems that we are sharing ideas, knowledge, expertise, experience and resources… so what’s wrong with sharing that in a public space?


The phenomenon of social media means that word of mouth quickly becomes world of mouth (Eric Qualman) – information is spread wide and fast in social media communities and beyond. The fact that there is ease of access means that connecting with the community becomes … well easy ! We have sites such a Facebook and Twitter in the palm of our hand, we need no complicated log in process we can access these sites at the touch of a button. The success of the nurse community on Twitter is down to the fact that nurses can connect anywhere at a time of their choosing, they can opt as to their level of connection, with whom they connect and the can choose to read only the information they want to read. Because of the ease of access the uptake of social sites is huge – according to Offcom figures (2011) just under 50% of the population use social media, on closer inspection of those who are in the working age bracket (18-64 year olds) the figure is from 72% – 92% of the population… I would challenge any closed network to top that potential reach.

Ease of access is extremely important if we want to achieve a world of mouth phenomenon with our messages. Ease of access turns what could possibly be a chore – sitting down at your PC, logging in, remembering the password and trawling through a complex and unfamiliar site – into a time saver – standing in the bus queue jumping onto Twitter at the touch of a button and asking the community for the piece of information you want and reading what like minded people are sharing.

There are other benefits to being in a public social media space, the transparency that social media creates means that the nursing message is spread both widely in the nursing community and also beyond the nursing community – you only have to read Laura Cleverys blog “ Becoming @type1nurse ” or to see the work of Mandy Hollis and the NHS Change Model and 6 C’s to see the positive effects of transparency. Of course transparency does have its drawbacks, which we will conveniently skip over … for now!
If we want to spread our messages throughout the nursing world and allow the nursing world to spread their messages we need to be in a space where nurses are, we need to “cash in” on ease of access and we need to embrace the transparency and use the world of mouth phenomenon – which means that in my opinion for the sharing of nursing ideas, knowledge, expertise, experience and resources public social media wins hands down.”


I hope that another closed network for nurses is not going to be developed and that people start to see the value of transparency, world of mouth and accessibility in social media platforms. Social media works because these things exist, when you shut the doors you limit the access and the possibilities. 

The Nursing Process

I recently had a conversation with a group of nurses and their comms department – The nurses were really fired up about social media and wanted to tweet and share and explore, however the comms department were slightly more risk orientated and wanted to control everything.  The solution the comms department came up with was for them to run a generic nursing Twitter account and the nurses email them their tweets whilst the nurses wanted to create their own Twitter accounts, for their departments, independently tweeting from them.  What stuck me about the situation was the whole lack of strategy towards social media from both parties and it made me think about the approach that I take towards social media.

Ida jeanI have always taken a very process driven approach to most things and social media is no exception; using a model that I am familiar with and works in my professional nursing life – The Nursing Process. The Nursing Process is a tried and tested logical approach to problem solving in nursing and as per my previous blog “The Wheel” sometimes in a social space we need to recycle, share and apply old concepts in new spaces.  In the same way that “The Nursing Process is a systematic approach to planning and delivering nursing care” (Holland et al 2008) it can provide a systematic framework for the existence of organisations within a social space.  It is a process that has been around since, what seems like, the dawn of time – according to Wikipedia  since 1948 with Ida Jean Orlando (pictured above) being the first person to describe nursing practice in this way.

Holland et al (2008) describe 4 main steps to the nursing process – Assessment, Planning, Implementation and Evaluation and as in nursing when existing in a social space these steps are not only cyclical but are also closely related and touching one another … allowing for a continuous and seem less but effective process.

The logic that the nursing process gives when applied to a social space allows for us to take a metaphorical step backwards instead of steaming headlong into things because it’s “what everyone else is doing” or is currently “en vogue” It allows us to explore all angles and apply what we know works and explore further where we need to.  One of the key reasons why healthcare organisations are struggle in this space is because we are failing to identify the complexity of engaging using social media – tweeting as an organisation is much more than merely writing 140 characters and hitting the tweet button! In order to have meaningful, valuable and worthwhile engagement with the right people at the right time and in the right place it takes so much more. 

In my next blogs series I will be exploring each of the stages of the nursing process and applying them to social media, sharing my thoughts and approach to those interested in using social media to spread value and achieve social media success …. if it transpires that social media is the right way to go !



Holland K, Jenkins J, Soloman J and Whitman S (2008) (p12) Applying the Roper, Logan, Tierney Model in Practice, 2nd Edition. Edinburgh, London, New York, Oxford, Philidelphia, St Louis, Sydney. Churchill Livingstone


The Question

Will the transparency that comes with social media offer our patients greater protection? This was a question that was tweeted to WeNurses this morning, and at the start of the week that sees the release of the Francis report it is a very interesting question indeed.

With social media comes transparency, there is no doubt about that … existing in a very public space as an organisation you can only be transparent and honest because if you are not someone will very quickly hold you to account. However we need to explore in more detail as to whether it offers the people we care for greater protection:

So what would happen if the Mid Staffs journey started here, today, this minute? Concerns over Mid Staffs started in 1999 which was pre social media taking off I big way and before mobile technology gave us information and connectivity at our fingertips….so would social media have escalated and brought concerns to light quicker, would it have identified early patterns and nipped Mid Staffs in the bud? Social media has the capability to do this but that currently within healthcare we do not take it seriously enough to use it in this way.  Social media is often seen as a toy and until healthcare organisations start to see it is a professional tool we are just pushing water uphill.

It is obvious that the people we care for are talking about their care on social media, a quick search of the word hospital on twitter confirms this:

In order to make social media work for healthcare and use it to protect our patients and provide the best possible care we need to consider these three points:

Be here !! – Be where the people we care for are, exist in the same space as them … there is no point is us communicating in smoke signals when our patients are using social media, we need to communicate with them in the way in which they are communicating.


Listen – listening is a fundamental social media skill. We need to be listening to each and every individual but also we need to be listening en masse.  We need to be aware of what is happening and map any trends, be aware of keep track of the normal and know when there is any deviation.  There are tools that allow us to be location specific, gender specific and sentiment specific in our listening these are the technologies we need to be looking towards.

React – Reactivity is key to any interaction, not just social media, however there is no point in listening and gathering information if we do not use it to improve.  Action is needed both when faced with individual concerns and with looking at trends.  In order to improve our service and protect our patients listening is certainly key but it is nothing with reactivity.

So back to the original question – Will the transparency that comes with social media offer our patients greater protection? My answer is yes it can but we have to ensure it does by being here, listening and reacting.