Can Twitter change culture ?

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Recently my attention was brought to the Government’s response to the Francis report one of my Twitter followers pointed out that #WeNurses and #OTalk are name checked in the document, of course I immediately re checked the document having missed it when I first read it … sure enough both Twitter chats are named.

12850794_sThe response cited multi-disciplinary Twitter chats as being a good example in relation to cultural change. This struck me an interesting thought and it really got me thinking about the role of social media in cultural change.  Cultural change is not my area of expertise so I have to admit to falling back on good old Google and doing a bit of reading around.  In my quest for more knowledge I came across a fascinating blog by Jon Kotter “The key to changing organizational culture” where he states that culture change can be achieved when a “large enough group from anywhere in the organization, decides the old ways are not working, figures out a change vision, starts acting differently, and enlists others to act differently.” And I started to wonder that if in this digital age if the cultural change can be ignited outside of organisations?  And can a spark be lit and that spark can be carried from our digital social spaces and into our actual organisations?

One thing I am very sure of is the effect that communities such as #WeNurses and #Otalk are having on individual healthcare professionals – some of the tweets that I have collated through my work with WeNurses demonstrates this in a very powerful way:
















One of the tweets above that states “the realisation that you are not alone” stands out for me as being so important – the online healthcare community is full of like-minded passionate, proud and knowledgeable healthcare professionals, who are proud to care for people in the very best way they can. Dare I say it’s almost as if Twitter has given passionate professionals confidence that they are not alone and it is a wonderful thing to be caring and compassionate. As one of these professionals I always new we were here, but through the boundary free world of twitter we are united and mobilised.

twugWhilst mulling this over during the past few weeks I remembered another blog that I read a few months ago by Sarah Fraser “Is WeNurses THE social movement?” where she described the WeNurses #nursecommunity as “nurses who don’t talk about what’s wrong, or complain about the reforms. They are asking questions about how they can be better at what they do, how they can get help in understanding changes” I feel that Sarah has pretty much hit the nail on the head here and this is exactly what is happening.  Healthcare professionals are bouncing off each other and sharing, questioning and problem solving with like-minded people.  Sarah went on to conclude “When I’m a patient, I’m going to be looking out for the small #WeNurses badge. If I see a #WeNurses mug on the desk then I’ll know already that this is a good place to be.”

I don’t know if by being online healthcare professionals can be instrumental in culture change but I do know that if a patient has confidence in a #WeNurses nurse then this is something I want to continue to be part of.



Kotter J (2012) The key to changing organizational culture  – Forbes

Fraser S (2013) Is WeNurses THE social movement  – Spread Good Practice

Department of Health (2013) Patients first and foremost: The initial government response to the report of the Mid-Staffordshire Foundation Trust public inquiry

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5 Reasons… (Part 3)

This is the last blog in my 5 Reasons series – a few weeks ago I explored 5 reasons nurses give for why they don’t (or won’t) use Twitter and last week I looked at 5 reasons why nurses should use Twitter. This blog post is all about what nurses should know when starting out on Twitter:

5 things nurses should know when starting out on Twitter

1The NMC advice on social networking – The NMC have published some really great advice on Social Networking and outline the actions very clearly that could put your registration at risk. Their advice has a good common sense approach but there are two pieces of advice that really stick out for me: the first is “If there is any doubt about whether a particular activity online is acceptable, it can be useful to think through a real-world analogy” If ever you are in any doubt if you should post something on Twitter think it through in real terms .. and if it would breach the code offline it will breach the code online. The second piece of great advice that the NMC give is “Presume that everything you post online will be permanent and will be shared.” Even with the strictest privacy settings applied once the tweet has left your keyboard it can still be duplicated and shared beyond your control. The NMC also raise the importance of photographs online – in a world where we have become very trigger happy with our camera phones it is very easy to snap away and post TwitPics … however it is advisable to think twice before posting pictures and ask ourselves are the suitable to share in public? Is there anything in the background that may cause a problem? Do you have permission from the people in the picture to share it online? Does the picture breech patient confidentiality or the code of conduct in any way? I would have to highly recommend the NMC Social Networking Advice as a “must read” for any nurse on Twitter.


2Everything is public, don’t be stupid! – We are all sat in our lounges in our PJs on Twitter (well I am!!) and this lulls us into a false sense of security but we are in a public space. In fact this space is not just public but it is also AMPLIFIED … it is akin to shouting in public! Remember nurse offline = nurse online.


3Listen as well as talk – As with offline communication the talking is only a part of the picture. Tweeting is not just about tweeting but also listening and responding to others and being part of the community. Don’t just churn out tweets … stop and listen to others and help and support where you can.


4If you get stuck … just ask – A great “Go to” for lots of Tweeting know how is the WeNurses website. However the online nurse community is a very generous one so if you get stuck then just send out a tweet, there is always someone who knows the answer. Also its important to remember that you can’t break Twitter … push every button, open every link and if you get lost then just log out and log back in.


5Be a good role model – Ok so you have me here, I have cheated a little and instead of this being something nurses should know about it is something that nurses should do! Social media continues to be a growing phenomenon – Offcom figures stating that 50% of the entire population are using social networking sites. With some age groups social media is their preferred method of communication so as nurses I fell we have a responsibility to not only communicate with people in the way in which the communicate but also to understand social media, to know what’s out there, to be in this space and to use it well. Not only should we act as good role models for more inexperienced or junior nurses on Twitter but we should also be good nursing role models to the wider public…. After all what we post can potentially be seen by the world!

My intention when setting out to write this series of blogs was to give confidence to nurses to enable them to share the #nursecommunity with others. By clearly setting out common reasons why nurses don’t use twitter and outlining why they should and the basic things that they should know about I hope that the #nursecommunity feel empowered to go out and share and advocate Twitter use in their areas. Of course these 15 Reasons (in total) are just my thoughts so please feel free to share your own via the comments box.

Below is an infographic summarising all of my 5 Reasons series:

My Infographic

5 Reasons… (Part 2)

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In my last blog post I explored “5 reasons nurses give for why they don’t (or won’t) use Twitter” and advocated that commonly given excuses are really just excuses … and we can get around them very easily in our quest to show others the value of the nursing community.  So now here comes the fun part … why SHOULD nurses use Twitter ? To be honest with you I could probably rant on about this subject all day to anyone who is willing to listen but in the interests of keeping this blog to a manageable size (bearing in mind you are most likely reading this on your teeny tiny mobile phone screen) I will stick to just 5, however please feel free to share your own reasons via the comments section.


5  reasons why nurses should use Twitter


1Its free and incredibly easyThere aren’t many things in life that are free but Twitter is one of them, all you need is an email address, a password, an internet connection and a bit of courage and you are off.  As for the easy part – I do have to admit that you do need an hour or so at first to get your head around it, so I always advise people to sit down with a clear head and a coffee and have a go ….Press every button, explore every link, watch and lurk and have a good look around and rest assured you can not break Twitter.


2Second by second news relevant to youAs Eric Qualman famously said “we no longer search for the news, the news finds us” Because we build communities of interest via social media our community tells us the news that is relevant to us as it happens.  For example the recent Francis report – even if I had been hiding under a rock and had never heard of the terrible things that happened at Mid- Staffordshire Foundation Trust if I had logged onto Twitter the day the report came out I could not have failed to notice the second by second updates.  As a nurse I knew what was in the Francis report that was relevant to my practice on the day it came out …. I did not have to wait for the newspaper articles or journals.


3SupportNow initially this may not be an obvious one but it is one of the key themes that comes across again and again when I talk to people in the online nursing community.  If we go back to the “Call the midwife” era when nursing (and indeed life) was simpler nurses lived, worked and socialised together however as nursing (and indeed life) became more complex and nursing developed more specialities we grew apart.  Nurses no longer lived, worked and socialised together and our communities drifted apart and dissolved.  With the advent of social media we are able to reconnect with each other like never before and the support that we gain and give from making those personal connections is shining through.


4TweetchatsOf course I would be very remiss indeed if I did not mention Tweetchats when blogging about reasons why nurses should use Twitter! Real time chats around a predetermined subject that is decided upon by the online nursing community where nurses exchange experience, expertise, ideas and resources and use it towards their CPD … what a brilliant idea!! Need I say more?



Connectivity that crosses hierarchiesI can find no other medium in history in which an Agency Nurse can talk to a CNO on an equal level.  The non-hierarchical element of the online nursing community allows for the free flow of ideas and experiences … how can that not be a good thing ?  


There is no doubt that the rise of social media coupled with mobile technology has given us limitless knowledge in the palm of our hands but up until now it has been seen as a frivolous social pastime …. This is no longer the case.  Twitter can be and is professional media. The online nurse community is where nurses can share, learn, grow, support each other and be proud to be nurses.


My next blog post is the final part of the “5 Reasons” series and I will be exploring “5 things nurses should know when starting out on Twitter”

5 Reasons… (Part 1)

Part 1  Share with a

One of the hardest things to do as a nurse that uses and advocates social media is to ignite that spark in others and help them to see the value.  My next three blog posts are entirely dedicated to the excuses, the reasons why nurses should use Twitter and getting started on Twitter in the hope that others will be inspired to share and together we can problem solve in order to achieve our common goal of having more nurses connected via social spaces.

 5 reasons nurses give for why they don’t (or won’t) use Twitter

1I have no timeI have lost count with the amount of times I have heard this one! Do you think that the likes of Florence Nightingale, Mary Secole and Edith Cavell ever used this as an excuse for anything? In addition to this those of us “in the know” can actually see how Twitter saves us time ….. I for one don’t spend time pouring over paper journals or “googling” information any more all of the information I need comes from the online nursing community that I am part of.




It’s not like FacebookNope it is not … you just have to get over this!




3Nurses are always getting into trouble using social mediaMmmmmm I would have to disagree according to a Guardian article “NHS Facebook misuse should be resolved at a local level72 separate actions were carried out by 16 trusts against staff who inappropriately used social media between 2008-09 and October 2011 …. That’s not “always” or even a lot considering the 650,000 nurses in the UK.  I am a realist when it comes to this and think that the chances are these nurses would have behaved unprofessionally anyway so social media is not to blame but rather it is purely and simply down to the behaviour of the nurses involved.  In addition this is a great reason to actually start using Twitter so that you can act as a responsible nurse role model and show others how to use it in a professional manner.



My organisation discourages it – If we always wait for others to change things we will never progress.  Be brave and rock the boat.  NHS Employers have produced a great guide “HR and social media in the NHS” that may help.



I don’t know howAhh now this is the easiest excuse to resolve, all it takes is an hour, a computer, WeNurses Twitterversity and a willingness to learn something new.


My next blog will be looking at 5 reasons why nurses should use Twitter – in the meantime please feel free to share the challenges you have faced and you resolutions via the comments box.