I am a nurse, and I have a passion for technology. I see social media tools being used powerfully by other sectors, but not by nursing—the area I am most interested in seeing professional information delivered. By relating my experience with social media, I will try to convince you that nursing leaders need to learn these tools and engage with them.

After his presentation on social media, Robert Fraser talks with a member of the audience at Sigma Theta Tau International's 2009 Biennial Convention.

First, a disclaimer: It’s not my IQ that allows me to develop online resources, nor is it my nursing experience. It’s the fact that I’m looking at social media tools, realizing their potential and finding ways to create something valuable I can share with others.

Second, I do have a bit of a technology bias. You might hold that against me, but I think technology enables me to spend more time with friends and with patients. I use technology to increase what I’m doing with people; it’s not something I’m dependent on.

Finally, these are my ideas and my experiences—I’m an n of 1. Hopefully, after reading this you will be interested in helping me increase that number.

Social media as evolution, not invention
Social media is not new, and it’s not scary. Social media is an evolution of the way we capture content and share ideas. In the past, people have shared ideas using hieroglyphics, parchment, printing presses and computers. Facebook, Twitter and all sorts of digital devices are causing this current shift in the way we share ideas. We can’t ignore these new technologies and wait until they’re fully ready to implement—we have to see why people are interested in them and start to use social media for nursing and health care purposes. 

One of my favorite definitions describes social media as Internet and mobile-based tools for sharing and discussing information among human beings (Wikipedia, 2009). Social media is not just the Internet; it’s about people sharing ideas and using technology to dialogue and give feedback.

Sharing information is shifting from books toward online methods such as blogs and videos. With online media, we all have the power to create and share content, and others can more easily find it. Instead of presenting once a year at a conference, you can connect frequently with people you are interested in doing research with. Or, you can just talk about things that fascinate you, because sometimes it’s not the academic papers that really drive our inspiration.

I consider myself part of the iPod generation. I don’t like the term millennial, because I don’t think it’s about age. I see people older than me engaging with these tools more effectively than I do, because they have that experience and knowledge. Individuals who look at technology and see the potential for it to suit their needs comprise what I call the iPod generation.

Three faculty members from Ryerson University's School of Nursing attended Robert Fraser's presentation. From left: Don Rose, associate professor; Sharon Paton, instructor; Fraser; and Linda Cooper, professor. Fraser received his BScN from Ryerson in 2009.

Unlike most teenagers, I didn’t get my first iPod to listen to music; I wanted to learn. I listened to anything interesting I could find, usually audio books or physics and business lectures. When I began studying nursing, I couldn’t find leadership talks to listen to online at my convenience. We have great people in nursing, and we have excellent information. It frustrates me that this content isn’t being shared to the fullest extent.

Seeing this gap, I wanted to start doing something with technology. In my fourth year of nursing school, I recognized that I was able to participate more in classes because I was very involved in student leadership. I was attending events and hearing nurse leaders talk about the passion they have for their research. I thought that I could use social media to communicate that passion to other students and nurses.

Tools of the trade
I looked at the tools I could use to share this information. I knew that writing is not my strength. What works for me is video. I encourage you to do the same with social media: Pick the tools that best suit your needs and your strengths.

In September 2008, I attended a Registered Nurses’ Association of Ontario (RNAO) event and heard a great talk about health inequalities by really passionate, inspired nurses. Afterward, we discussed how we could share this. I decided that I would create a video interview that night. I took Doris Grinspun, RNAO’s executive director, up to her office, sat her down in a chair, stacked books on a desk and opened my laptop, which I had in my bag that day. Using my webcam, I asked her questions about what her organization was doing and how students could get involved. That is how I got my first interview. It was a bit rough but it worked.

Now I had the video, but I needed tools to share it. My first thought was YouTube. Some people don’t consider YouTube as “being published”—it’s not a peer-reviewed journal. But, it’s still sharing information. Why did I put it on YouTube? Because it’s on the Internet. I see so many people putting content on their intranet—behind a firewall, where others can’t find it. I wanted to put the video where other people could do a search and find it. 

Another advantage: YouTube is free. We’re always constrained by costs, so consider how we can use these free tools instead of saying, “We need an IT consultant.” All of a sudden, you hear, “Cha-ching!” An IT consultant might say, “We can do this, but if you want to do that, it’s going to cost more.”

I published the interview on blip.tv, because I could create a video podcast for free. Now, when people search for “nursing” in the iTunes store, they can find quality resources, because it’s there. And, it doesn’t cost anything.

Once I had the video posted, I realized I needed to do more. If people are inspired by the interview and become interested in the topic, you have to hit them while you have their attention. I wanted to manage content and put resources with the video; that’s why I needed to start a Web site. I chose a blog—it’s not the best, but it works, and again, it’s free.

My Web site, www.nursingideas.ca, has a basic framework. Each post contains a video, and underneath are links to all the resources discussed and a section for comments. If someone in Iran or the United States makes a comment, everyone can see that other people are looking at this content. This is why I want nurses to buy into the idea that it’s important to make comments. The next nurse who visits the site will see that someone from Holland has made a comment and can then share his or her perspective on the topic. This is a huge progression from the time when exchange of international nursing knowledge took place only during conferences, symposiums or exchange trips. Having this content online in this format enables many new possibilities.

Many nurses are scared or overwhelmed at the thought of putting content online because they think of HTML, but you don’t need a coding background or experience to use social media tools. Most of these tools have interfaces to control them. It seems very complex at first, but then it becomes more intuitive. The software tells you when you need to update, and it’s very easy to do. You just click “Add new” when you want to post something. You can edit, add tags, categorize and make it searchable and easy to find on the Web. And when people subscribe to your site, they will automatically get an e-mail when you put new content up. This is why we can’t just wait for someone in IT to do it for us. We have to see where these trends in media are going and start using them, because nursing needs to share ideas faster. We need to develop ideas well, and we need to make sure they are communicated broadly.

Exploding connections
One of the misconceptions in social media is that it is just about connecting to more people. However, just connecting to everyone doesn’t do anything. The value of social media is being able to have influence and relationships, and finding people based on shared values. At nursing conferences, you can meet someone and get their card, and that’s great. But on the Web, you can post a profile and I can see who you are linked to—maybe you have a friend who is a professor or an educator in my field. That gives me permission to say to them, “I’m interested in that area—what are you doing?” Participating in social media says you’re open to being found and encourages engagement. You create your biography and profile and give others the ability to contact you.

There are many social media sites. With FriendFeed, you can aggregate up to 58 social tools. Instead of having to log on to each service, you can follow individuals across their different social media accounts. Similarly, you can post one update across your different accounts.

STTI social technologies The Honor Society of Nursing, Sigma Theta Tau International (STTI) uses social technologies to connect nurse leaders around the world. STTI currently uses several platforms and invites members and interested parties to join: Facebook—More than 4,700 STTI members network on this popular site and discuss chapter operations, upcoming events, nursing trends and much more. Search for “Sigma Theta Tau International” to join the group. LinkedIn—663 members use this professional site for discussion boards, job postings and networking opportunities. The group name is “Sigma Theta Tau International.” Who are you linked to? Twitter—The honor society, http://twitter.com/STTI, and its publications department, http://twitter.com/STTIPub, tweet at events and share upcoming news and information. YouTube—Find STTI on www.YouTube.com by visiting the STTIHeadquarters channel. You will find videos from convention, congress and other events. Testimonials and other special videos are also located on this site for your viewing pleasure. —Michelle Lilly, marketing and communications specialist

LinkedIn, another social networking site, is a professional version of Facebook—a résumé and a way to keep connections, even when work e-mail addresses or phone numbers have changed. If people you met at a conference get a new job, you still have their contact information and know what they’re doing, and you can also share what you’re up to. When I make a new connection or update my status in LinkedIn, a notice goes out to people in my professional network.

LinkedIn helps you sustain off-line relationships. People sometimes think technology relates only to being online, but it’s also about sustaining real relationships between individuals. Think about how you could send a congratulatory note to a friend who got a new job. 

On Facebook, another popular site, you can now create a page for your chapter or organization. Members can see an aspect of the organization that they can’t see on the Web site, such as knowing which of their friends are supporters of the organization or are attending the events. And, you can give regular, easy updates on what the organization is up to and strike up relationships with members.

Twitter is the one that turns a lot of people off. I’ve personally benefited from using Twitter, including connecting with [past STTI President] Dan Pesut, and getting a fellowship, but I’m still skeptical about how to best use it. That’s OK—we need to be skeptical. But, that doesn’t mean nurses can disengage! You have to actively figure out why other people are getting value out of it and consciously make a choice about its relevance to your work.

Basically, Twitter is microblogging. You write updates, which are limited to 140 characters. When you want to, you can go to Twitter and see what your stream of interesting friends or your organization is up to.

Like LinkedIn and Facebook, Twitter helps sustain off-line relationships. You need to know that a person three cubicles from you, or someone at another university, is working on a research topic that you’re interested in. That’s an opportunity to build a relationship and share resources. I used Twitter to ask people how they check placement of NG tubes, and I got 23 quick responses.

Increasing analytics
Once you decide to participate in social media, it’s important to find ways to measure or approximate what you are doing. To do a quantitative analysis of the videos on nursingideas.ca, I can look at reports of visitors to the Web site using Google Analytics, and the number of downloads and views is reported by Viddler.

Web analysis gives you rich feedback. Google Analytics is a free tool that you can use easily, without a lot of technical knowledge. I was able to see that, in the first month my site was up, 360 people came to my Web site, and with a bit of work I pulled out further insights. Not everyone stayed to watch the video but, in Singapore, someone watched interviews for 45 minutes. You can tell what pages people are actually looking at, versus what you think is your best resource. This information told me that the time and effort I had spent to create these videos were worth it. It was incredibly rewarding to know that individuals I could never meet as a fourth-year student were spending time listening to my interviews.

Placing your content on the Web in a number of channels is important, because more people have the opportunity to find it. There are numerous tools specific to different formats of content that allow you to easily disseminate your material. Video can be posted on viddler, blip.tv, YouTube, etc. PowerPoints can be posted on SlideShare and Scribd.

For each medium, there are different ways to share the resources you create. Again, the goal is to make your content findable, so when people are looking for information, the best possible resource is there.

For a qualitative perspective of my site, I can look at comments. For example, a friend used Facebook to say her professor showed one of my videos in his class. There could have been 20, 50 or 100 people in that class. In that situation, the views shown in the analytics don’t give a full, accurate account of how many people have seen the interview, but the comment provides huge insight into who is watching the interviews and how content is being used.

As nurses, we need to figure out how to use social media tools for our organizations, relationships, research, public communication and knowledge translation. I’m always happy to connect with others in nursing and health care to talk about how we can use these technologies to share, connect and inspire others. RNL

Robert Fraser, RN, BScN, is working toward a master’s degree in nursing administration at the University of Toronto, Canada. He is a fellow at Health Strategy Innovation Cell, a research analyst at de Souza Institute and a multimedia editor for Journal for Health Professions Education.

Adapted from a presentation by Robert Fraser at the 40th Biennial Convention of the Honor Society of Nursing, Sigma Theta Tau International. Former STTI President Daniel Pesut observes of Fraser: “He was actively roaming and scanning the convention—backpack over one shoulder and tripod grasped in his right hand. ... It was amazing to me how passionate he is about using technology to inspire, connect and help create nursing-knowledge networks.”

Reference:
Wikipedia. (2009). Social media. Retrieved 1 November 2009 from http://en.wikipedia.org/wiki/Social_media

Resources:
Novice nurse; master of media

Robert Fraser’s Web site: http://www.nursingideas.ca

Video of Robert Fraser’s convention presentation