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Letter to the Editor

Social Media and Nurses: Insights for Promoting Health for Individual and Professional Use

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Jennifer Jackson, BScN Hon, RN
Robert Fraser, MN, RN
Peter Ash, B.Mgmt


Social media use can have a significant impact on the health of nurses, both at the individual level and in the workplace. There are positive and negative consequences of social media use for nurses, including potential health consequences. This article provides a brief overview of social media and then explores nursing health and social media and risks for nurses. Social media use also extends to healthcare organizations; with implications for consumers of healthcare delivery. A variety of emerging best practices can guide social media use for nurses. The authors also discuss suggestions for using social media carefully, and future directions for research.

Citation: Jackson, J., Fraser, R., Ash, P., (September 30, 2014) "Social Media and Nurses: Insights for Promoting Health for Individual and Professional Us" OJIN: The Online Journal of Issues in Nursing Vol. 19, No. 3, Manuscript 2.

DOI: 10.3912/OJIN.Vol19No03Man02

Key words: social media, nursing, healthcare, workplace, health, risk, best practice

Information communication technology has become a regular part of daily life... Information communication technology has become a regular part of daily life, both at work and at home. This is true for nursing, where the application of technology is an integral part of the profession. Nurses are increasingly expected to develop competencies in informatics (Remus & Kennedy, 2012). The Technologies Informatics Guiding Education Reform (TIGER) Initiative is one example of how nurses are focused on advancing the integrations of technology into practice (McBride, Tietze, & Fenton, 2013). The decreased cost of personal computing and internet connectivity has increased the impact of technology on nurses, beyond enterprise technology, such as electronic charting systems. One major change that has emerged in technology use is social media. A study in 2013 found that 73% of adults in the United States use social media and almost half participate in multiple networking sites (Duggan & Smith, 2013). As the use of this technology grows, the impact it has on nurses becomes an increasingly important issue (Weaver, Lindsay, & Gitelman 2013).

Social media impacts the health of individuals and groups, and specifically has the potential to have a lasting impact on nurses’ health. Social media impacts the health of individuals and groups (Fox & Duggan, 2013a), and specifically has the potential to have a lasting impact on nurses’ health. In this article, health is defined using Huber et al’s definition “health, as the ability to adapt and self-manage” (2011, p. 2). Use of social media may impact the health of both individual nurses and their workplaces. However, a discussion of social media and nurse health is very complex due to the variety of applications and levels of use. For example, many nurses use social media for both personal and professional reasons. Employers of nurses use social media to engage/support their nursing workforce and consumers of their services. Finally, use of social media has many potential health benefits, but also potential risks. This article will provide a brief background of social media and nursing; explore individual and workplace implications of social media and the health of nurses; offer selected best practices to guide usage; and conclude with suggestions for research.

Social Media: A Brief Overview

A broad conceptual definition of social media is the online and mobile accessible services that enable individuals to connect, collaborate, and share with others in real time. Communication has been permanently changed by social media. A broad conceptual definition of social media is the online and mobile accessible services that enable individuals to connect, collaborate, and share with others in real time (Ressler & Glazer, 2010). Common examples include Facebook®, Twitter®, and Google+®. Social media is about the ability to easily connect, save, and access content through services that enable information sharing and collaboration with others.

Under this broad understanding, social media can be used in many different ways. The most obvious impact of these technologies is social opportunities. A prime example of social media is Facebook®, a service focused on social networking by allowing the user to connect with family and friends. Since its initial launch, Facebook® has added other features (e.g., sending electronic gifts, planning events). There are a growing number of social media tools that focus on digital services (e.g. creating a professional documents, uploading pictures, getting travel directions) and then build in social components to enable feedback, collaboration, and sharing amongst users.

Social media is also expanding into different areas related to health. For example, PatientsLikeMe® (2014) is a newly created service that allows patients to monitor their disease, treatments, and self-reported experiences. The social component allows users to share information with other patients that have the same medical condition, as well as with health researchers and healthcare providers. There are a growing number of sites for health and healthcare related purposes, such as tracking health measures, rating healthcare providers, and hospital services (Fox & Duggan, 2013b). Social media is being used by people across the healthcare system, so it is prudent to discuss the benefits, risks, and best practices for social media amongst nurses.

Nursing Health and Social Media

Nurses can use a variety of social media programs to advance their personal and professional goals. Ferguson (2013) provides a call to action for nurses to step forward and be leaders in using social media. Nurses can access information for their workplace or personal lives, connect with colleagues, share information about best practices, and advance health through personal and professional means. This section of the article will begin discussion about health implications of using social media for nurses, both individually and in the workplace.

Individual: Supporting Personal Health Needs of Nurses

Social media can support nurses in numerous ways on a personal level. Moorehead et al. (2013) highlight several, such as increased a) number of interactions with others, b) shared and custom health content, c) access and availability of health information, and d) peer and social support. Jensen and Serensen (2013) found that social media use strengthened preexisting ties among friends and family members. As adults move and transition from communities where they have had strong relationships, social media makes it easier to sustain communication with important peer supports. A study of 205 individuals found use of internet was associated with decreased levels of loneliness (Cotten, Anderson, & McCullough, 2013). The potential of a promising relationship between use of social media to stay connected and improved mental health is growing.

There are also numerous social media applications (apps) available that nurses and/or patients can use to improve personal health status. A study on what type of apps are available found services such as healthy eating, physical activity, and personal health and wellness were more common than apps for more challenging health issues such as “substance abuse, mental and emotional health, violence prevention and safety, and sexual and reproductive health” (West et al., 2012, p. e72). The early growth of apps to support preventive health behaviors is a positive indication for the impact of social media on health. However, the lack of apps to support areas like mental health demonstrates that the use of apps in healthcare is still developing.

Workplace: Improving the Health of the Nursing Profession

Social media is linked closely to a nurse’s professional development across four domains of nursing: clinical practice, academics, administration, and research. Social media is linked closely to a nurse’s professional development across four domains of nursing: clinical practice, academics, administration, and research. In clinical practice, nurses can access information in real time, allowing unprecedented accessibility of cutting-edge information. Some research supports social media as an effective tool for nursing students to develop their knowledge in a clinical setting (Green & Hope, 2010). Nurses can use social media to access continuing education resources and tools to support skill development (Barton, 2011). The benefits of this may include reducing anxiety by providing access to experts; building personal and professional self-image by sharing accomplishments and skills; and developing local support networks and communities of practice.

In academics, there are a host of benefits for social media use in nursing. Bassell (2010) demonstrated the efficacy of using social media for nursing faculty, through its implications for mentoring. Social media has been used to deepen and enrich education of doctoral of nursing practice students in rural settings, and reduce the associated geographical isolation and stress (Rutledge et al., 2011). Educators are investigating how social media can be used to support nurses through transition periods (e.g., entry to practice, change of practice areas), and improve nurse competencies and patient outcomes.

Social media allows for nurses to connect with others across organizations and borders... Nurses working in administration may also experience benefits of social media use. The online communities #hcsm (Symplur, 2014) and also #hcldr (Healthcare Leadership, 2014) connect Twitter® users in conversations about healthcare policy. When discussing issues of national importance, such as the Canada Health Accord (Health Canada, 2004) or Patient Protection and Affordable Care Act (2010) in the United States. It is possible to use social media to hear nursing contributions nationally. Social media allows for nurses to connect with others across organizations and borders, to exchange information and ideas in ways that would not have been possible just a few years ago.

For nurses working in research settings, there are also benefits associated with using social media. A key factor is the ability to share research findings. Archibald and Clark (2014) highlight the ease of using Twitter® to help disseminate research findings. Social media also creates possibilities for monitoring health and facilitating data collection. A telephone survey of adults in the United States found that 69% of adults track at least one health measure (Fox & Duggan, 2013b). As more social media sites allow health indicators to be tracked, more data becomes available to nurse researchers. Using social media, interventions can be studied at lower costs and with larger populations.

Social media is a powerful tool for advocacy... Across all domains of practice, nurses are able to connect with each other, and advocate for their profession and their patients. Advocacy is central to the practice of nursing (Bu & Jezewski, 2007). Social media is a powerful tool for advocacy, and has been used in a variety of campaigns. For example, healthcare professionals rallied around Doctors for Refugee Care, a campaign to restore healthcare access for refugees in Canada (Ganesh, 2014). Another powerful example is The Truth About Nursing (2014), a website that advocates for an accurate portrayal of nursing in visual media. These types of advocacy tools can give individuals a great sense of influence and empower nurses that feel voiceless on important professional issues. In sum, prudent use of social media to support various elements of nursing as a profession has the potential to contribute to a healthy workplace for nurses.

Risks for Nurses Using Social Media

While the variety of social media discussed above has great potential to improve the health of nurses, it has become common knowledge to all that there are also risks associated with the use of information communication technology. The section will discuss several risks inherent to use of social media.

Individual: Potential Harm to Nurses’ Health

Constant availability and increasing participation of social media may have detrimental effects. Many individuals are not aware of the impact of social media upon their sense of self (Tuten & Angermeier, 2013). Social media can perpetuate negative societal attitudes through information that is shared. For instance, Pearl, Puhl, and Brownell (2012) found that participants who viewed stigmatized images of obese persons, presented through social media, experienced more negative feelings towards obese persons than those who viewed non-stigmatized images. Additionally, advertising online is becoming more targeted to an individual’s browsing activity and social media use. For example, it is possible that those shopping for larger clothing or using dieting websites might have weight loss ads appear on social media websites more frequently. This targeted advertising could negatively impact self-perception or self-worth. Other areas of emerging concern are addictive and bullying behaviors, which may impact sleep, productivity, and overall mental health.

Workplace: Ensuring Professionalism Translates to Social Media

Nurses need to know and adhere to published professional guidelines for use of social media... Social media in the workplace is also not without its negative consequences. One of the most commonly discussed issues is violation of patient privacy (Spector & Kappel, 2012). Violations of patient privacy are a serious concern for nurses, as these represent a violation of professional standards, and can result in termination or suspension. Privacy concerns are paramount for nurses, as self-regulating healthcare professionals (College of Nurses of Ontario, 2009). A breach of privacy, or the failure to report another nurse’s breach of privacy, constitutes the most common ethical violations of nurses using social media (Spector & Kappel, 2012). Lachman (2013) notes that many nurses are ignorant to the privacy settings of their social media accounts, and do not know or appreciate the far reaching nature of posts on social media. It is important to consider how social media may negatively impact health, such as the mental anguish associated with a professional ethical violation, if used inappropriately and without consideration. Nurses need to know and adhere to published professional guidelines for use of social media (Spector & Kappel, 2012) and to understand settings and policies associated with whatever media they use.

There have also been examples of social media used as a tool for cyberbullying in the workplace. This is concerning as there are reports of frequent lateral violence within the nursing profession (Lachman, 2014). Cyberbullying is dangerous because it is pervasive and can happen anywhere there is internet access. Nurses could be victims of cyberbullying, by direct deformation or attack via social media tools. Nurses can also be impacted indirectly by being excluded from workplace social media programs. Other cyberbullying risks are associated with cellphone use. As most cell phones can record pictures and videos, there is a risk that images can be shared via social media to bully colleagues (Hall & Lewis, 2014). Nurses and nurse managers need to be aware of the risks for bullying and social media, and actively promote positive use of social media tools. Consequences for misuse of social media in the workplace should be clearly delineated in an appropriate organizational policy.

Social Media to Foster Healthy Organizational Culture

There are many ways that social media can play a positive role at an organizational level. An example at The Ottawa Hospital (TOH) is the nursing social media campaign, TOH Nurses, aimed at clinical nurses working at this hospital (TOH Nurses, 2014). This campaign uses a variety of social media tools to create a positive workplace culture and professional self-image amongst its nurses. TOH Nurses shares information with nurses about events, educational opportunities, and wellness programs at the hospital. However, social media is more than a newsletter broadcast. TOH Nurses allows these nurses to ask questions and provide feedback to the corporate office in real time. It also provides a means of recognizing nurses; pictures that are shared through Facebook® and Instagram® allow each nurse to be the face of TOH Nurses for a day. Spreading positive images and recognition of clinical nurses through photographs is meant to be a key component to increase engagement of the nurses in this facility. This example demonstrates how a social media campaign can play an important role for branding at a hospital, recruiting nurses, and role modeling to other healthcare professionals and the general public, which hopefully creates a healthier workplace environment.

As social media continues to become a tool that can help impact the workplace environment, it has potential to influence organizational commitment and the sense of community amongst nurses. This can positively impact the local professional culture of nurses; such a positive culture has been found to influence both nurse satisfaction and patient safety (Liang & Lin, 2007). Gonzalez, Leidner, Riemenschneider, and Koch (2013) examined the many ways social media can be utilized for this purpose. They asserted that social media can be used to connect newly hired nurses with organizational resources, and further information on the nursing role and organizational policies. Additionally, nurses can find employment related educational material via social media, including videos and wikis. This encourages self-directed learning, and can help both new and existing nurses grasp their roles and feel more confident. Gonzalez et al. (2013) noted that, from a socialization perspective, nurses can feel more connected to their peers through social media. For example, a new nurse being “friended” (connecting to people you know through an online social networking site) by a colleague can help start to build relationships and a support network at the organization.

Social Media and Consumers of Healthcare Delivery

Social media can provide an avenue for timely and accurate information and support individuals to adapt and self-manage their health. Social media can provide an avenue for timely and accurate information and support individuals to adapt and self-manage their health. Since nurses deal with both the health of patients, and their own health, it is especially important that they take steps to become wise consumers of Internet-based healthcare information, including that found in avenues of social media. Two areas important to consumers of healthcare delivery in the context of social media are the ability to make patient connections (with peers and/or providers) and the importance of obtaining trustworthy information.

Patient connections. Social media is changing the ways that patients interact with healthcare providers, and also with the healthcare system. Gone are the days when individuals passively received health information and interventions, assuming that a provider held all the answers. It is increasingly common for patients to find resources and/or seek out additional information. Websites such as PatientsLikeMe® (2014) enable people to connect with others dealing with a similar diagnosis. This website also allows patients to contact healthcare providers, track personal data, and share their stories. Establishing effective patient connections among peers and/or providers via social media sites may contribute to health by leading to emotional support and helping patients maintain relationships with providers.

Trustworthy information. With the internet offering potentially hazardous false information, it is important that patients receive correct information from a source they can trust. Credible health information is important for public health, and can assist in outbreaks as it did with H1N1, or with disease prevention (McNab, 2009). Reliable sources such as Health Canada (2014) or the Centers for Disease Control (n.d.) can provide healthcare professionals and the public with information they can trust, and can help counter inaccurate and potentially harmful health information from other sources (Greysen, Kind, & Chretien, 2010).

There are a host of resources that promote self-care and provide credible health information online. However, there are also sources of dubious quality that may be providing inaccurate information to people who lack the education to recognize good from bad (Silversides & Sullivan, 2012). The most startling example of this is anti-vaccination campaigns (adherents are referred to as “anti-vaxers”). Following the (now refuted) claims that vaccines could cause autism, anti-vaxers began using social media to share information about the perceived harmful nature of vaccines, and encouraged parents not to vaccinate their children. The fallout of this effort has been very detrimental. There have been outbreaks of preventable diseases across North America, and some areas have seen a resurgence of previously eradicated diseases, such as measles (Maki & Barton, 2014). It is important for nurses to remember they may need to review evidence with patients and recommend credible resources to promote health.

Selected Best Practices for Healthy Social Media Use

As social media use evolves and becomes more integrated into health related apps, nurses need to stay informed of the changing landscape. Nurses can build their understanding of social media and maximize the positive impact it can have on their own health. It is also important that nurses are informed when using social media, to mitigate the risks of participation. As discussed above, there are many ways nurses can effectively use social media, both individually and in the workplace, but social media can also have potentially negative effects on both emotional and physical health. Below are selected best practices to consider for using social media at both the individual and organizational levels.

Individual: Monitor the Impact of Social Media on Health

Be intentional. Nurses are educated to monitor the impact of clinical interventions on patients. This can be translated to using social media. When nurses think about social media, with a mindset that evaluates outcomes, it shifts the focus toward consequences of using social media. It is important that nurses take time to proactively develop a strategic and intentional approach to social media use. Contemplation of the desired outcomes prior to using social media can provide a useful guide when evaluating the impact of this technology.

Use reflective practice and analytics. Reflective practice is a commonly used method for lifelong learning, which can be applied to social media. Reflective practice is the use of an active intentional approach to explore experiences in order to learn (Mann, Gordon & MacLeod, 2009). It is a simple and powerful way nurses can monitor how they are affected by their use of social media. Asking questions about how social media is personally meaningful, distracting, relaxing, energizing, stressful, or supportive can provide great insight. Doing this on a regular basis can help nurses reinforce positive participation in social media. Nurses can evaluate how much time is spent using a particular service and whether or not to close an account.

Social media accounts have built in measures, commonly referred to as analytics, related to the service. For example, SlideShare allows you to upload presentation slides and informs users how many times a particular presentation was viewed and downloaded. Social networks provide measures such as how many professional contacts or friends have been added. These analytics can be used to gather some quantitative data that can be incorporated into a nurse’s reflective practice. This feedback can be used to critically appraise social media use and outcomes.

Consider health related apps. Social media sites that have health measures can provide direct feedback regarding health-related goals. There are many fitness-related apps and services that can track various measures, develop a program, provide reminders, and reinforce the adoption of healthy behaviours. Personal tracking devices can measure criteria such as total daily steps or hours and quality of sleep (e.g. Fitbit® trackers, Jawbone’s Up®). The social features of these tools enable individuals to share their goals, progress, and accountability with others. Services like MyFitnessPal® allow make it easier to monitor calories and track weight loss. These types of apps make it easier to see how behaviours are affecting health. Other social media apps like RunKeeper® can mix social features of goal setting as well as provide programming. Increasingly, social media services are trying to provide advice to help users reach fitness targets. When nurses have particular health goals these apps can make easier to track, adapt, and reach personal milestones.

Workplace: Measure the Impact of Social Media on the Work Environment

Use organizational reflective practice and analytics. When an organization uses social media to positively impact others, measuring and reflecting upon the impact of a program is even more critical. Resources of all types (e.g., time, money) should be used judiciously. Often, social media is perceived as low or no cost; however, effective use of social media requires an investment of time to participate, develop skills, and monitor activities. Any workplace or group of nurses using social media should spend time planning proactively. This can include reflecting on goals and discussing possible outcome measures to evaluate the initiative, using analytics. Figure 1 provides several examples of analytics to consider.

Figure 1. Examples of Social Media Analytics


  • Views are the number of times someone views particular content.
  • Exact measurement may vary depending on the service used. For example, a website can track visitors, a video sharing service (e.g., YouTube) can measure how many times a video is played and a photo-sharing service (e.g., Flickr) can measure how many times a photograph was viewed.
  • This measure provides feedback about the amount of people that are aware of content or possibly the effectiveness of offered activities.


  • Engagement is the number of viewers/participants that perform an action related to the content.
  • Examples of engagement are clicking a button to indicate positive (e.g. like or thumbs up) or negative (e.g. vote down, thumbs down) response; sharing on another individual’s social media account (e.g. retweet, sharing, embedding); or providing narrative feedback through a comment section.
  • This measure can indicate the quality or reaction of the viewer to the content. The stronger the reaction (positive/negative) the more likely users are to share with others.


  • Participation is the number of unique individuals that are connected to the individual, group or initiative.
  • Measures of participation have various terms across sites (e.g., “Likes” on Facebook®, “Followers” on Twitter®, “Subscribers” to an email list).
  • This measure can be helpful to indicate the number of individuals interested in learning when new content is published.

Source: The Change Foundation, 2011

Analytics provided by a social media service can provide very useful feedback (see Figure 2 for an example of analytics used for TOH Nurses). This is similar to how nurses use measures such as vital signs in clinical practice. When evaluating analytics, it is important to consider measures in context. Is there an increase in the amount of views for a short time after a presentation was made? What content seems to have more engagement from participants? Using analytics can help to determine which activities contribute to the success of a project and which might not be effective/needed.

Figure 2. TOH Nurses Facebook® Analytics Provide Insight Into Participation

Source: Facebook, n.d.

Seek feedback. Social media makes it easier to ask for direct feedback. Questions can be posted or shared to survey engaged users. This allows for improvement and learning from the audience, rather than a one-way dialogue. For example, if a healthcare organization has a goal to support employees to reduce smoking, it is important to ask how nurses want to be recognized, supported, and encouraged in a smoking cessation program.

Workplace planners that offer health initiatives should be open to adapting and unexpected forms of feedback. When projects are in a developmental phase, this can be especially helpful because at this stage, analytics may not provide a full picture. For example, a video that is played once will increase the viewed count by one, regardless of whether it was watched by an individual, by a group in a classroom, or by an entire convention audience. An email about the positive or negative impact of a social media program should not be discounted solely because it was not part of the planned evaluation. Best practices suggest evaluation with a variety of feedback collection options and time points.

Using Social Media Carefully: Additional Considerations

Whenever nurses use social media they need to consider the implications. Nurses know that as professionals their actions (public and private) can be held accountable to professional standards. This does not mean that nurses should fear anything that may have a risk; it means nurses need to apply critical thinking and judgment proactively.

Individual: Professional Filters, Standards, Privacy Settings is important for nurses to take a proactive approach to social media, emphasizing appropriate use... Nurses are educated about professional standards throughout their careers. This education provides the foundation required to apply “professional filters,” such as considering the laws, professional regulation, employer agreements, professional recommendations and personal standards related to using social media (Fraser, 2011). As a regulated health profession, with a higher standard of public trust, it is important for nurses to take a proactive approach to social media, emphasizing appropriate use (Spector & Kappel, 2012). Taking time to consider the professional practice implications of social media can help nurses to identify how to maximize positive health benefits for patients and themselves, and reduce risk.

In addition to privacy concerns, it is important for nurses to consider what information is shared with third party services (Hader & Brown, 2010). When signing up for social media services, there is a legal disclaimer that explains what the company may or may not do with information and expectations for use of the service. For example, a company may reserve the ability to make changes to privacy settings and the way that information is shared. Thinking about what is being stored “privately” should be something that nurses pause to consider. In the case of fitness and wellness apps, it is reasonable to consider information such as your weight, fitness activity, or nutritional status could be shared. These considerations broaden for services such as addiction support or other sensitive health-related information.

There are hidden costs for services that are free, such as email from Google or a profile on Facebook®. These services require that the user grants the company permission to use personal information at their discretion, such as to sell advertising. This is not always unreasonable, but nurses should take time to understand what underlying expectations, uses and future actions of a social media service may be. It is much easier to decide not to use a social media service than to delete information that has been shared (Chretien, Greysen, Chretien, & Kind, 2009).

Individual nurses using social media should remember there are still other sources for health information offline. Individual nurses using social media should remember there are still other sources for health information offline. The Health on the Net Foundation’s (n.d) Code of Conduct for medical and health website states that websites and services should be complementary to existing healthcare provider and professional relationships. Nurses, and anyone else, may use social media to support their health, but this should not replace seeking professional advice. This is especially true for more complex health issues, such as chronic disease, mental health, and addictions. Depending on the issue or challenge nurses face it is prudent to seek different types of support from an employer, professional association, union, or other professionals as required. While social media provides additional tools that may positively impact health, it is important to have appropriate input from credible organizations and/or professionals.

Nurses that are using social media may also witness negative behaviour or content that makes them feel uncomfortable. It is important to consider how nurses respond and take action. The American Medical Association's (2011) opinion on social media suggests that if a provider sees unprofessional content that it should be reported to the individual who generated the content to address, and then reported to the proper authorities, if appropriate remedies are not taken. To support this obligation and facilitate positive online communities, social media sites often have reporting policies and links. Figure 3 illustrates an example of how users can report a specific issue with content shared by another user on Facebook®.

Figure 3. Flagging Inappropriate Content on a Social Media Website

Using these mechanisms can help ensure other professionals use online services appropriate, can prevent harm, and promote a positive online community (Facebook, n.d.). 

Workplace: Setting Boundaries to Manage Risk and Opportunities

Organizations should have a social media policy in place. Organizations should have a social media policy in place (Greysen et al., 2010). This is important for shaping acceptable social media use by the organization and its employees. Policies create clear expectations and guidelines that nurses can follow. Policies also establish appropriate processes to handle violations of organization policies or misconduct. Clear policies are crucial for any organization using social media, as lack of clarity may cause anxiety for nurses or lack of nurse participation in positive initiatives because of fears about using social media in the workplace. Also, a nurse may post inappropriate content online, due to lack of awareness about an organization’s social media policies.

Nurses can and should contribute to shaping organizational policy and strategic use related to social media. Nurses can and should contribute to shaping organizational policy and strategic use related to social media. They are educated in health monitoring, intervention, and evaluation of patient care. Nurses can also help to identify the needs and wants of their peers in terms of information, education, and communication to support health goals. Nurses who are involved in developing social media usage at their organizations can also help to engage and encourage peers to use technology, thus becoming teachers and advocates for technology in their areas (Barton, 2011). This can significantly contribute to developing successful social media initiatives, and also creating leadership opportunities for nurses.

Future Directions for Practice and Research

There are many ways that use of social media can grow in nursing practice. As health-based social media sites expand, nurses should consider how they can measure individual and group outcomes. In many organizations, there are wellness initiatives targeted at nurses. Healthy eating, physical activity programs, and transportation groups are commonly part of corporate initiatives. These programs often rely on self-reported measures of health and/or general satisfaction surveys at infrequent intervals or at program end. Social media services allow for active feedback throughout a program and can integrate direct measures of health. For example, Fitbit® provides a social platform that integrates daily activity, eating, and sleeping patterns with a social platform, with data that can be viewed in real time.

Figure 4. Corporate Wellness Dashboard (Fitbit, n.d.)

Nurses can move from measuring individual level health data to tracking the health of a group, and the data is easier to collect and closer to real-time. Regardless of the interventions, the more data that can be gathered from an initiative, the more insight into its positive, negative, and perhaps unexpected consequences.

In addition to promoting their own health, nurses can use social media across all domains of the profession to expand nursing knowledge and facilitate best practices. Individual nurses can use social media to connect with colleagues, access information, contribute to online discussions, and celebrate many aspects of the nursing profession. At an organizational level, social media can be used to promote engagement, recognize nurses, facilitate communication, and recruit new employees. When nurses are mindful of the ethical standards and potential pitfalls of social media, they will be able to use the technology to its maximum benefit.

There is little research on the direct implications of social media for nurses’ health, and also for its impact on patients. Much of the literature that currently exists on nursing social media is editorial in nature. Nurse researchers have the opportunity to evaluate the impact of social media, so that the impact of these technologies is better measured and understood. Qualitative and quantitative research can enable the nursing profession to use social media tools more effectively for positive individual and patient level outcomes.


Social media has revolutionized communication technology and allows for people to connect in unprecedented ways. Social media has revolutionized communication technology and allows for people to connect in unprecedented ways. Nurses use social media to communicate at the individual level, and sometimes to track health-related milestones. The nursing profession uses social media across all domains of practice, allowing nurses to connect with colleagues and share information. Social media can also be used on an organizational level for engagement, and to communicate with nurses. There are risks to using social media, which can be mitigated through reflective practice. Social media use will continue to evolve, through innovative use and research. Social media has changed the world, and nurses can use this change to create the maximum benefit for themselves, their patients, and their profession.


Jennifer Jackson, BScN Hon, RN

Jennifer Jackson is a Registered Nurse with a background in critical care and a passion for nursing empowerment. She is currently a Masters of Nursing student at Athabasca University in Athabasca, Alberta and is researching the role of resilience for critical care nurses. She works at The Ottawa Hospital in Ontario, Canada within the Nursing Professional Practice Department. She spearheaded the launch of the Facebook® group “TOH Nurses” social media campaign, one of the world’s first integrated social media platforms for clinical nurses working in a hospital setting.

Robert Fraser, MN, RN

Rob Fraser is a Registered Nurse, published author, researcher, and consultant with an interest in the impact of digital tools and social media on health and healthcare. He wrote “The Nurse’s Social Media Advantage,” published by Sigma Theta Tau International in 2011. The book won an American Journal of Nursing “Book of the Year” award. Rob currently works as a consultant, and maintains a clinical practice on a General Internal Medicine unit at Toronto General Hospital.

Peter Ash, B.Mgmt

Peter Ash is a Project Manager at University Health Network in Toronto, Canada. Peter’s work involves designing and managing innovation projects for point of care staff, specifically in the areas of healthy work environments and workforce planning. Additionally, Peter has a market research background having worked in the private sector for several years. Peter is currently pursuing a Master of Business Administration.


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© 2014 OJIN: The Online Journal of Issues in Nursing
Article published September 30, 2014

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