social media and nursing essay

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• v.39(7); 2014 Jul

Social Media and Health Care Professionals: Benefits, Risks, and Best Practices

Health care professionals can use a variety of social media tools to improve or enhance networking, education, and other activities. However, these tools also present some potential risks, such as unreliable information and violations of patients’ privacy rights.

INTRODUCTION

Many social media tools are available for health care professionals (HCPs), including social networking platforms, blogs, microblogs, wikis, media-sharing sites, and virtual reality and gaming environments. 1 – 8 These tools can be used to improve or enhance professional networking and education, organizational promotion, patient care, patient education, and public health programs. 3 , 5 – 10 However, they also present potential risks to patients and HCPs regarding the distribution of poor-quality information, damage to professional image, breaches of patient privacy, violation of personal–professional boundaries, and licensing or legal issues. 2 – 4 , 8 , 10 – 17 Many health care institutions and professional organizations have issued guidelines to prevent these risks. 3 , 4 , 7 , 10 , 17 , 18

WHAT ARE SOCIAL MEDIA?

The definition of “social media” is broad and constantly evolving. The term generally refers to Internet-based tools that allow individuals and communities to gather and communicate; to share information, ideas, personal messages, images, and other content; and, in some cases, to collaborate with other users in real time. 2 – 6 Social media are also referred to as “Web 2.0” or “social networking.” 5

Social media sites provide a variety of features that serve different purposes for the individual user. 19 They may include blogs, social networks, video- and photo-sharing sites, wikis, or a myriad of other media, which can be grouped by purpose, serving functions such as: 4 , 7 , 8

• Social networking (Facebook, MySpace, Google Plus, Twitter)
• Professional networking (LinkedIn)
• Media sharing (YouTube, Flickr)
• Content production (blogs [Tumblr, Blogger] and microblogs [Twitter])
• Knowledge/information aggregation (Wikipedia)
• Virtual reality and gaming environments (Second Life)

Participation in social media by the general public has increased sharply over the past nine years. 5 , 11 In the U.S., the proportion of adults using social media has increased from 8% to 72% since 2005. 5 , 11 The use of social media is prevalent across all ages and professions and is pervasive around the world. 2 , 8 In 2012, Facebook users exceeded one billion people worldwide, a number that represents one-seventh of the world’s population. 2 , 8 In addition, each day 100 million active Twitter users send more than 65 million tweets, and two billion videos are viewed on YouTube. 2 Social media have been linked to highly significant political events, such as the Arab Spring revolution, as well as to widespread societal trends, including the shortening of individuals’ attention spans and the decline of print news media. 5

PARTICIPATION IN SOCIAL MEDIA BY HEALTH CARE PROFESSIONALS

Social media provide HCPs with tools to share information, to debate health care policy and practice issues, to promote health behaviors, to engage with the public, and to educate and interact with patients, caregivers, students, and colleagues. 6 , 11 , 14 , 16 HCPs can use social media to potentially improve health outcomes, develop a professional network, increase personal awareness of news and discoveries, motivate patients, and provide health information to the community. 8 , 11

Physicians most often join online communities where they can read news articles, listen to experts, research medical developments, consult colleagues regarding patient issues, and network. 9 There they can share cases and ideas, discuss practice management challenges, make referrals, disseminate their research, market their practices, or engage in health advocacy. 14 , 15 A growing minority of physicians also uses social media to communicate directly with patients to augment clinical care. 9 , 15

A survey of more than 4,000 physicians conducted by the social media site QuantiaMD found that more than 90% of physicians use some form of social media for personal activities, whereas only 65% use these sites for professional reasons. 9 , 14 Nearly a third of physicians have reported participating in social networks. 8 However, both personal and professional use of social media by physicians is increasing. 3 , 9 , 15

Unlike physicians, pharmacists have been relatively slow to adopt social media. 1 Much of the growth in the professional use of social media among this group appears to involve pharmacist-specific social networks. 1 Surveys have shown that many pharmacists use Facebook. 1 Although this use is most often for personal communications, more than 90 pages on Facebook are related to the pharmacy profession, such as the Pharmacists Interest Page, the American Pharmacists Association, and the Cynical Pharmacist. 1 Only 10% of pharmacists use Twitter, and a search for “pharmacist” on LinkedIn identified 274,981 profiles. 1

SOCIAL MEDIA SITES FOR HEALTH CARE PROFESSIONALS

Social networking sites.

As social networking has evolved, medically focused professional communities have been established. 14 These networks are often private and protected from nonmembers, such as the lay public and even members of other health professions. 1 Funding sources for these sites vary, with financial support often being provided by professional associations, advertising or data sales, research funding, and pharmaceutical companies. 17

Sermo is a “physician-only” social networking community that verifies the credentials of new members during registration. 15 Physicians representing 68 specialties in all 50 states gather on this site to network, to discuss treatment options, and to query peers for expert advice. 15 As of April 2014, Sermo boasted a U.S. membership of 260,000 physicians, most of whom use pseudonyms for anonymity. Sermo consists primarily of a large message board on which physicians create topics for discussion. 14 It also provides a rating system by which doctors rank posts on the site on the basis of perceived credibility. 15

Doximity is a newer “physician-only” social networking community that offers text and images that are compliant with the Health Insurance Portability and Accountability Act (HIPAA), which allows point-of-care information crowdsourcing. 15 As of 2013, more than 100,000 physicians and students were members. Doximity uses a national database to create “placeholder” accounts with demographic and contact information for all U.S. physicians. Therefore, although only 12% of U.S. physicians are active members of Doximity, nearly 100% can be messaged through the network. 14

The Medical Directors Forum ( www.medicaldirectorsforum.skipta.com ) is a social networking site for medical directors that provides a verified, secure, closed-loop environment for peer-to-peer interaction. The resources on this site include a comprehensive library, discussion groups, calendar postings, and alerts. The site also provides dedicated group pages for medical directors working in a wide range of sectors, including: hospital, veterans affairs, Medicare, group practice, employer, behavioral health, managed care, correctional facility, and long-term care. 20

Other physician networking sites include QuantiaMD ( www.quantiamd.com ), Doctors’ Hangout ( www.doctorshangout.com ), and Doc2Doc ( doc2doc.bmj.com ). 17 Many of these sites require doctors to submit their credentials to a site gatekeeper, recreating the intimacy of a “physicians’ lounge” in an online environment. 17

The nonprofit Student Doctor Network is a popular social community site for undergraduate and practicing physicians, dentists, and veterinarians in the U.S. and Canada. 5 It claims more than 40,000 active members and 1.5 million unique monthly visitors. 5 The forums on Student Doctor Network focus on clinical career topics, do not support detailed user profiles or “friending,” and encourage anonymity. 5

Social networking sites are also available for pharmacists. These sites include ASHP Connect ( www.connect.ashp.org ), which is sponsored by the American Society of Health-System Pharmacists; PharmQD ( www.pharmqd.com ); and The Pharmacist Society ( www.pharmacistsociety.com ). 1 , 6 Professional networking forums for nurses include the American Nurses Association’s ANANurseSpace ( www.ananursespace.org ), NursingLink ( www.nursinglink.com ), and SocialRN ( www.twitter.com/socialRN ). 17

In addition, HCPs can easily connect with each other via “general purpose” online social networks, such as Facebook, Twitter, and LinkedIn. 8 Facebook is the most popular social media site in the U.S., while LinkedIn is the most popular professional networking site. 1 , 11 , 17

The “blog,” a term formed by truncating “Web log,” is the oldest and most established form of social media, which has been used in medicine since as early as 2004. 17 Blogs can reach wide audiences, especially if one writes content that is of significant interest. 14 Posts that garner enough interest can be shared and viewed again and again by readers (referred to as “going viral”). 14 Content that goes viral can establish a reputation or an online presence. 14

Blogs can also provide the opportunity to publish large amounts of information in a variety of media (text, video, and audio) in an open forum. 14 Most blogging platforms allow readers to respond to published content by posting their own comments. 14 This enables an ongoing dialogue between the blogger and his or her audience. 14 Examples of widely used free “long-form” blogging platforms include Tumblr ( www.tumblr.com ), WordPress ( www.wordpress.org ), and Blogger ( www.blogger.com ). 14

Some physicians use blogs to communicate with other HCPs or the public. 14 For example, the Clinical Cases blog ( www.clinicalcases.org ) features case studies in a wide range of medical specialties. 17 This blog also includes a special section on admission note templates, procedure guides, and related material. 17 Blogs are becoming more popular among pharmacists, but approximately two-thirds of these blogs are written anonymously. 1

Microblogs provide the most dynamic and concise form of information exchange via social media. 17 This format allows users to post a large number of brief messages or updates over a short period. 17 Numerous microblogging platforms exist; however, Twitter is the most prominent. 17 On Twitter, users publish messages (called “tweets”) that consist of a maximum of 140 characters. 17 Tweets can be supplemented with hyperlinks to other online media, such as videos or websites. 17 Tweets can also include “hashtags,” a form of information indexing that allows people to search for tweets that are related to a particular discussion or topic. 17 Hashtags followed by HCPs include #HCSM (for Health Care Social Media), #MDChat, and #Health20. 17

There are more than 140 reported uses for Twitter in health care. 17 The Penn State College of Medicine has used Twitter to facilitate discussions between students and instructors, to conduct course evaluations, to solicit class responses, and to monitor students’ progress. 17 A Twitter Journal Club also provides advance posts about papers and questions to be discussed, along with a hashtag, so that students, doctors, and anyone interested in the subject can interact. 17 Twitter has also been used at medical conferences to discuss and enhance speaker presentations by posting real-time comments from the audience. 17 Some physicians have used Twitter to develop a large following, enabling them to reach a broad audience and potentially even affect health policy decisions. 14

Wikis are public forum websites featuring text and multimedia content that can be edited by users. 17 “Wiki” is a Hawaiian word meaning “quick,” which refers to the speed with which information on a wiki can be accessed, added, edited, or deleted. 17

Surprisingly, Wikipedia is the most commonly used wiki in the medical community. 17 It is often used as a reference by clinicians, despite its known shortcomings, such as errors and narrow breadth of information. 5 One study found that 35% of 1,056 pharmacists used Wikipedia, although only 19% trusted it. 5 In another survey of more than 1,000 pharmacists, one in five respondents said they trusted Wikipedia, but only one in four knew that anyone could edit the site. 1 One reason for the popularity of Wikipedia is its prominence in Google searches. 5 A study found that 70% of 35 junior physicians used Wikipedia to find medical information during a week-long period, with 93% citing ease of use as their primary motivation. 5

As the accuracy and completeness of Wikipedia are often debated, the drug information on that site was compared with a validated and trusted information source, the Medscape Drug Reference. 17 This analysis found that Wikipedia included approximately 76% of the content found in Medscape and had very few factual errors (most were errors of omission). 17 In contrast, other studies have found that Wikipedia includes factual errors and has a lack of depth compared to traditionally edited, peer-reviewed, evidence-based information sources. 1 , 21

Other wiki projects emulate Wikipedia in that they crowd-source medical content. However, to maintain editorial credibility, they also verify the credentials of contributors. 5 RxWiki ( www.rxwiki.com ) allows only pharmacists to add or edit drug information. 1 This was also the model for Medpedia (an initiative from Harvard University, Stanford University, the University of Michigan, and the University of California at Berkeley), which verified authors’ credentials before allowing them to generate content. 17 However, when most articles posted on “author verified” wikis were compared with open initiatives, such as Wikipedia, they were found to be shorter, to be of equal or lesser quality, and to include fewer references. 17 Wikipedia was also found to promote quality and accuracy more actively over a period of 90 days because of crowdsourcing, compared with Medpedia, which had a comparatively restrictive editorial process. 17

Media-Sharing Sites

Media-sharing sites, such as YouTube, offer a large selection of social media tools that are optimized for viewing, sharing, and embedding digital media content on the Web. 17 They also provide features that are typically found on other types of social media sites, such as profiles, connections, comments, and private messaging. 17 Most media-sharing sites are easy to use, provide free basic accounts, and are accessible from both desktop and mobile devices. 17

In medicine, media-sharing sites can be important resources for education, community building, marketing, and branding. 17 Among the most notable media-sharing sites for HCPs is The Doctors’ Channel ( www.thedoctorschannel.com ), which hosts videos featuring medical news, continuing medical education, and health care-related entertainment. 17

Virtual Reality and Gaming Environments

Multi-User Virtual Environments (MUVEs) are three-dimensional environments that allow users to interact with each other through a virtual representation of themselves (known as an avatar). 17 The application of MUVEs in health care is growing rapidly. They are increasingly being used for patient education, for the simulation of epidemiology and mass prophylaxis, for psychotherapy, for surgery, and for research. 17 However, the fact that MUVEs are often perceived as computer games rather than as serious clinical tools may impede their adoption by health care institutions. 17

MUVEs can be classified as general-purpose or health care–specific. 17 The most well-known general-purpose MUVE is Second Life. This general-purpose environment, however, is often used for health care education. 17 One study found 68 health-related virtual locations on Second Life. 17 These included the Centers for Disease Control and Prevention (CDC) education center, which aims to influence the real-life decision-making abilities of visitors. 17 Health care–specific MUVEs are typically used for one purpose, such as medical education (e.g., CliniSpace [ www.clinispace.com ]), surgical simulation (e.g., OpenSim [ www.opensimulator.org ]), or psychiatric treatment (e.g., InWorld Solutions [ www.inworldsolutions.net ]). 17

USES FOR SOCIAL MEDIA IN HEALTH CARE

Professional networking.

The most popular social media sites for physicians are those where they can participate in online communities, listen to experts, and network and communicate with colleagues regarding patient issues. 9 The use of social media by pharmacists also frequently focuses on communication with colleagues. 1 The social-networking platforms used for professional networking are often solely accessible and specifically cater to people within these professions. 12 Besides clinical topics, discussions on these sites address diverse subjects, such as ethics, politics, biostatistics, practice management, career strategies, and even dating in a medical environment. 17 They can also provide a supportive environment for HCPs who subspecialize. 8

Another example of professional networking among HCPs is crowdsourcing, which involves harnessing the knowledge and skills of a community to solve problems or to gather information and opinions. 7 , 15 Social media can also be used to connect HCPs in third-world countries with specialists in more medically advanced locations. 12 For example, surgical procedures can be streamed via the Internet and questions can be asked via Twitter in real time. 12 Thus, social media provide a new communication channel for HCPs to network professionally to share and exchange medical information in ways and at a pace that was never before possible. 7

Professional Education

The communication capabilities provided by social media are also being used to improve clinical education. 5 The high usage rate of social media by 18- to 29-year-olds has motivated the adaptation of clinical curricula to reflect the changing habits and culture of incoming students. 1 , 5 Many studies have described the use of social media tools to enhance clinical students’ understanding of communication, professionalism, and ethics. 2 Universities are also using social media to recruit students, to increase access to academic libraries, and to create virtual classrooms and office hours, as well as other unique learning experiences. 2

Social media are also being widely implemented in undergraduate pharmacy curricula. 1 One-third of pharmacy programs have reported using Twitter in some capacity. 1 A 2011 survey also found that 38% of pharmacy faculty members use Facebook for teaching, with half reporting that they plan to use social media in the future. 1 In one example, an instructor in a geriatric pharmacotherapy course at the University of Rhode Island used Facebook to encourage class discussions and to connect students with senior citizens who had volunteered to participate in the course. 1 This experience improved student perceptions of older adults and also introduced the senior citizens to Facebook. 1 At Auburn University, instructors established Twitter handles so that pharmacy students could participate in class discussions anonymously. 1 By semester’s end, 81% of students felt Twitter had let them express opinions they wouldn’t have shared otherwise, although 71% thought that Twitter had been distracting. 1

Online social media platforms have also influenced the educational experience for nurses, with one survey reporting that 53% of nursing schools are now using these tools. 2 For example, Twitter has been used to enhance the clinical decision-making skills of nursing students in critical care situations. 2 The students viewed videos of clinical scenarios and tweeted their observations on the patient’s condition for instructor feedback. 2 Other uses of Twitter in nursing education include posting a live stream of student insights during class, or creating a class hashtag so that resources such as videos, websites, articles, and photographs could be shared. 2 Media sharing sites such as YouTube can also be used in the classroom to stimulate discussion, to illustrate a point, or to reinforce a concept. 2 Students can view a video and then respond to questions that promote clinical reasoning. 2

The incorporation of social media into clinical education has met with mixed reviews, however. 5 Courses that incorporate such tools have generally been positively received, but in some cases, students have reported feeling that the use of Facebook for teaching purposes is an intrusion into their social lives. 5 Balancing the enhanced communication opportunities provided by social media with the downside of increased distraction in an educational environment is also a challenge. 5 Unfortunately, standards guiding the appropriate use of social media tools in education are in their infancy. 2

Organizational Promotion

Health care organizations, including hospitals, health systems, professional societies, pharmaceutical companies, patient advocacy groups, and pharmacy benefit companies, are using social media for many purposes. 6 , 7 Uses include communicating with the community and patients; enhancing organizational visibility; marketing products and services; establishing a venue for acquiring news about activities, promotions, and fund-raising; providing a channel for patient resources and education; and providing customer service and support. 4 , 8 , 9 , 14 It has been estimated that 70% of U.S. health care organizations use social media, with Facebook, Twitter, and YouTube being the most popular. 2 , 9 Blogs are also used by many medical centers and hospitals. 17

Studies have shown that this use of social media can greatly enhance the image and visibility of a medical center or hospital. In one study, 57% of consumers said that a hospital’s social media presence would strongly influence their choice regarding where to go for services. 2 A strong social media presence was also interpreted by 81% of consumers as being an indication that a hospital offers cutting-edge technologies. 2 In another study, 12.5% of surveyed health care organizations reported having successfully attracted new patients through the use of social media. 9

The rate of social media adoption by nonprofit health care organizations is also increasing. 9 The Mayo Clinic became an international leader in such efforts when it established the Social Media Health Network ( http://socialmedia.mayoclinic.org ) in 2010. In its mission statement for the network, the clinic said it sought to provide an “authentic voice for patients and health care professionals, building relationships through the revolutionary power of social media.” 9 To that end, this initiative has created a presence on Facebook, YouTube, and Twitter. 8 , 9 It also provides a vast library of blog posts, podcasts, conferences, and webinars to engage various community stakeholders. 8 , 9 The Mayo Clinic and other educational health care institutions have also used blogs to foster peer-to-peer learning and to implement new protocols. 17 Many universities also have a branded YouTube channel, where videos can be shared through the university’s social media site. 2

Social media also allow pharmacies to communicate with large groups of customers simultaneously, to conduct surveys, and to enable patients to feel that they are part of a pharmacy community. 18 Many pharmacies use social media to reach out to followers about products, services, discounts, newsworthy events, and health information. 18 Several large pharmacies and insurers have piloted programs that provide prescription refill and appointment reminders via social-media text messaging. 10

Patient Care

Although there has been a reluctance among HCPs to use social media for direct patient care, this practice is slowly being accepted by clinicians and health care facilities. 3 , 7 For example, Georgia Health Sciences University has provided patients with access to a platform called WebView, which allows the patients to reach their doctors to ask questions or to request prescription refills. 3

Recent studies have found that physicians have begun to develop an interest in interacting with patients online. 9 Some physicians are using social media, including Twitter and Facebook, to enhance communication with patients. 3 Approximately 60% of physicians were found to favor interacting with patients through social media for the purpose of providing patient education and health monitoring, and for encouraging behavioral changes and drug adherence, with the hope that these efforts will lead to “better education, increased compliance, and better outcomes.” 9 However, other studies have shown that considerable resistance still exists to using social media to interact with patients. 7 In a survey of approximately 480 practicing and student physicians, 68% felt it was ethically problematic to interact with patients on social networks for either personal or professional reasons. 7

Evidence indicates that electronic communication with patients can improve their care and health outcomes. 9 , 10 Studies have shown that supplemental electronic communication emphasizes physicians’ advice and improves adherence for patients with chronic diseases. 10 It may also improve patient satisfaction by increasing the time spent communicating with and having questions answered by their physicians. 10 A survey of patients at an outpatient family practice clinic found that 56% wanted their HCPs to use social media for reminders, for scheduling appointments, for diagnostic test results, for prescription notifications, and for answering general questions. 15 Patients who did not use social media said they would start if they knew they could connect with their health care provider. 15

Patient Education

Social media can also improve patients’ access to health care information and other educational resources. 12 In the U.S., eight in 10 Internet users search for health information online, and 74% of these people use social media. 5 , 19 Through social media, patients can join virtual communities, participate in research, receive financial or moral support, set goals, and track personal progress. 4 , 19

Physicians are also using social media to promote patient health care education. 7 They tweet, make blog posts, record videos, and participate in disease-specific discussion forums focused on patient education. 7 , 15 Such forums provide an important opportunity for physicians to distribute evidence-based information to counter inaccurate material on the Internet. 7 In some social media forums, the public is provided with an opportunity to participate in these discussions. 7

Unlike other health advice that a patient might encounter online, physicians could use social media to develop messaging that may be more likely to resonate with and be acted on by patients. 8 Some physicians believe that social media would be particularly beneficial for patients with chronic, rare, or fatal diseases; with questions about maternal or infant care; or with personal health-related goals, such as weight management. 9 The distribution of credible information has been proved to motivate observable behavioral changes within social networks. 8 Research has begun to show that interventions based on social media can positively affect weight loss, tobacco cessation, risky sexual behaviors, and physical activity. 8 , 9

Patients are also using social media to connect with others affected by similar conditions. 9 For example, the social networking site PatientsLikeMe ( www.patientslikeme.com ) provides a venue for patients to access information, suggestions, and support from other people who have the same disease or condition. 12 Facebook groups also frequently focus on specific medical conditions. 19 These groups actively engage in peer-to-peer support as well as fund-raising efforts for affiliated organizations and individuals. 17

Public Health Programs

Social media have created vast global networks that can quickly spread information and mobilize large numbers of people to facilitate greater progress toward public health goals. 8 Social media can therefore be a powerful tool for public education and advocacy regarding public health issues. 10 Some states’ public health departments are using Twitter and other social media for these purposes. 9

Other public health organizations use keyword content from Twitter and other social networks, in combination with location-tracking technologies, to respond rapidly to disasters and to monitor the health and welfare of populations. 8 The CDC maintains an active presence on Twitter and Facebook to track “tweets” that might indicate a flu outbreak and to share updates about such incidents. 8 The CDC has also used social media to locate and monitor sources and suspected cases of Legionnaire’s disease. 9

Organizations such as the Red Cross track Twitter posts during natural disasters, such as hurricanes and earthquakes, to gather information about where the greatest needs are. 8 , 14 Citizen-report blogs have also been monitored by hospitals for information about potential mass casualty events. 17 When used in this way, real-time social media sites provide greater agility and enhanced preparedness for responses to disasters and public health emergencies. 8 Social media sites also provide disaster and emergency response personnel with a means to rapidly share and access important information provided by agencies such as the CDC and the U.S. Preventive Services Task Force. 3

The widespread use of social media can also influence public health behaviors and goals through social reinforcement. 8 Because human beings are a highly social species, they are often influenced by their friends, as well as by friends of friends. 8 One example of the powerful effect of social media was seen after Facebook decided to allow users to post their organ-donor status in their profile. 8 According to Donate Life America, the week after this feature was introduced, online state organ-donor registries experienced a 23-fold surge in donor pledges that was presumably due to this social-networking effect. 8

THE DANGERS OF SOCIAL MEDIA

Poor quality of information.

The main limitation of health information found on social media and other online sources is a lack of quality and reliability. 16 Authors of medical information found on social media sites are often unknown or are identified by limited information. 13 , 16 In addition, the medical information may be unreferenced, incomplete, or informal. 13 While evidence-based medicine de-emphasizes anecdotal reports, social media tend to emphasize them, relying on individual patient stories for collective medical knowledge. 1 Similar problems exist with traditional online media; however, the interactive nature of social media magnifies these issues, since any user can upload content to a site. 16 Social media users may also be vulnerable to both hidden and overt conflicts of interest that they may be incapable of interpreting. 13

Measures are available that may be useful in addressing this problem. HCPs can guide patients to credible peer-reviewed websites where the information is subject to quality control. 10 The World Health Organization is leading a request to the Internet Corporation for Assigned Names and Numbers to establish a new domain suffix that would be used solely for validated health information. 17 The issuance of this domain suffix would be strictly regulated, and the content of websites with these addresses would be monitored to assure compliance with strict quality criteria. 19 These domain addresses would be prioritized by search engines when providing results in response to health-related inquiries. 17

Damage to Professional Image

A major risk associated with the use of social media is the posting of unprofessional content that can reflect unfavorably on HCPs, students, and affiliated institutions. 2 Social media convey information about a person’s personality, values, and priorities, and the first impression generated by this content can be lasting. 11 Perceptions may be based on any of the information featured in a social media profile, such as photos, nicknames, posts, and comments liked or shared, as well as the friends, causes, organizations, games, and media that a person follows. 11

Behavior that could be construed as unprofessional includes violations of patient privacy; the use of profanity or discriminatory language; images of sexual suggestiveness or intoxication; and negative comments about patients, an employer, or a school. 2 Such public missteps by HCPs have been documented, including physicians taking digital photographs during surgery, posing with weapons or alcohol, and posting “tweets” that are harmful to an individual or the profession. 10 The airing of frustrations, or “venting,” regarding patients also occurs in online forums and is not recommended. 10

Information gathered from social media can also be used to make decisions regarding admission to medical or professional programs, selection for residencies, or employment. 2 Employers and residency programs now search Facebook and other social networking sites before hiring applicants. 3 A Microsoft survey found that 79% of employers view online information regarding prospective employees, and only 7% of job candidates were aware of this possibility. 2 , 12 By making public posts, a person has willingly made information available for anyone to view for any purpose. 2 For some, it logically follows that candidates who don’t use discretion in deciding what content to post online may also be incapable of exercising sound professional judgment. 2

It is not unusual for social media users to be connected to overlapping networks of friends, family, and colleagues. 11 Some users try to keep their personal and professional images separate by creating different accounts. 2 , 11 , 18 This may be difficult to implement in practice because personal and professional contacts often overlap. 11 However, most social networking sites now provide privacy settings that allow individuals to customize both their profile content and who can view it. 11 , 19 Ideally, account and privacy settings should be set in a way that enables one’s network to expand while limiting the exposure of information to people outside of the network. 11 Any settings made available by the social media site that allow users to label different relationships so that only appropriate information is shared with certain groups or individuals should also be used. 11 HCPs should conduct periodic searches for their own names or other identifying information to ensure that their social media presence projects a professional image. 2

Breaches of Patient Privacy

Concerns regarding the use of social media by HCPs frequently center on the potential for negative repercussions resulting from the breach of patient confidentiality. 5 Such infractions may expose HCPs and health care entities to liability under federal HIPAA and state privacy laws. 4 , 15

HIPAA, as modified by the Health Information Technology for Economic and Clinical Health (HITECH) act, governs the permitted use and disclosure of patient information by covered entities, including HCPs and hospitals. 4 The HITECH act details privacy-breach notification requirements and expands various mandates to include business associates. 4 Section 13410(d) addresses civil and criminal penalties for violations that are based on the nature of the violation, as well as resultant harm. 4 Although the use of social media isn’t specifically referenced, these tools can certainly present risks under HIPAA and HITECH. 4 An HCP may breach federal HIPAA/HITECH or state privacy laws in a number of ways when posting information, comments, photos, or videos concerning a patient to a social networking site. 4 Whether communicating with or about patients on social media, breaches of patient confidentiality can result in legal action against an HCP and potentially his or her employer. 4 However, it is important to note that HIPAA does not restrict the distribution of medical information that has been “de-identified.” 14

In 2003, the Department of Health and Human Services (HHS) issued the HIPAA Privacy Rule, which provides the first federal privacy standards for the protection of patient information to be followed by “covered entities,” such as HCPs, hospitals, and health plans. 15 The HIPAA Privacy Rule levies heavy fines and potential criminal charges on the unauthorized disclosure of individually identifiable health information by covered entities in oral, paper, or electronic form. 15 The HIPAA Privacy Rule also includes a “safeguards standard” that requires covered entities to reasonably protect patients’ health information from unauthorized disclosure by using physical, administrative, and technical safeguards. 15 The safeguard standards are somewhat flexible for entities of different sizes and resources. 15 For instance, communication between a patient and an HCP using unencrypted email might be permissible, as long as other reasonable safeguards are followed. 15

To comply with the HIPAA Privacy Rule, clinical vignettes posted on social media concerning patients must have all personal identifying information and any revealing references removed. 10 This “de-identification” can be accomplished by changing or omitting key patient details (e.g., names, insurance or Social Security numbers, date of birth, and photos), by avoiding the description of rare medical problems, and by not including specific time frames or locations without the patient’s consent. 10 , 14 , 15 , 17 However, despite these precautions, there have still been many well-publicized inadvertent breaches of the HIPAA Privacy Rule involving social media. 15 Protecting a person’s identity when writing about patients is often more difficult than might be expected. 15 A study of medical blogs written by HCPs found that individual patients were described in 42% of the 271 samples studied. 15 Of these samples, 17% were found to include enough information for patients to identify themselves or their providers, and three included recognizable photographs of the patients. 15

The patient’s consent is a critical issue to consider when using social media. 4 An HCP or health care organization might determine whether patient permission is needed by considering the place of publication. 14 The use of specific HIPAA-compliant messaging systems, such as that provided within Doximity, may be theoretically safe even for patient-identifying information, assuming that the recipient has medical justification for receiving such information. 14 However, it is ultimately up to the individual HCP, the practice, or the organization to decide when they will seek patient consent before posting de-identified case details online. 14

Violation of the Patient–HCP Boundary

HCPs who interact with their patients on social media may be violating the patient–HCP boundary even if patients initiate the online communication. 10 A recent study found that patients often extend online “friend” requests to their physicians on Facebook. 10 However, very few physicians reciprocate or respond, since it is generally thought to be ill-advised for an HCP to interact with a patient through a general social media forum such as Facebook. 4 , 8 In addition, organizational policy statements often discourage personal online communication between HCPs and patients. 10

HCPs should therefore become familiar with the privacy settings and terms of agreements for the social media platforms to which they subscribe so that they can maintain strict privacy settings on their personal accounts. 10 Rather than “friending” or communicating with a patient on social media, HCPs can suggest that the patient set up a website that is specifically designed for posts regarding medical events, so that the HCP can follow the updates in a more professional manner. 2 For example, CaringBridge ( www.caringbridge.org ) is a nonprofit website that is designed to create a social media presence for patients on a protected, user-friendly venue. 2 Patients can use their CaringBridge profile for the purpose of interactively communicating with concerned followers during a health event. 2

Physicians may also violate a patient’s personal boundary through the inappropriate use of information found online or on social media. 10 Since social media can provide a wealth of information about a patient, it can be used in a positive way to aid clinical care. 15 This practice, known as “patient-targeted Googling,” has been described in many medical settings. 10 Anecdotal reports have highlighted some benefits to this practice (for example, using information found on social media to identify an amnesic emergency patient or intervening when a patient is blogging about suicide). 10 However, the potential for the blurring of professional and personal boundaries exists, since this practice can also be spurred by inappropriate curiosity, voyeurism, and habit. 10 , 15

An HCP may observe posts or photos on social media sites that depict patients participating in risk-taking or health-averse behaviors. 10 Digitally investigating the personal behaviors of patients, such as whether they have quit smoking or are maintaining a healthy diet, could threaten the trust needed for a strong patient–physician relationship. 10 Therefore, in such instances, an HCP should consider the source of this information and use clinical judgment to determine whether and how to reveal this discovery during patient management. 10

Licensing Issues

The use of social media can also adversely affect an HCP’s credentials and licensure. 4 State medical boards have the authority to discipline physicians, including imposing restrictions or suspending or revoking licenses. 3 , 10 These penalties can be meted out for unprofessional behavior, such as the inappropriate use of social media, sexual misconduct, breaches of patient privacy, the abuse of prescribing privileges, and the misrepresentation of credentials. 3 , 10

U.S. licensing authorities have reported numerous professional violations by HCPs on social media that resulted in disciplinary action. 3 For example, an emergency medicine physician was reprimanded by the Rhode Island State Board for “unprofessional conduct” and was fined after making comments on Facebook about a patient. 3 The physician did not mention the patient’s name in the post; however, sufficient information was included that allowed others within the community to identify the patient. 3 , 4 Misrepresentation of credentials is one of the most common online violations reported to state medical boards. 15 Physicians should be familiar with the requirements of state medical boards regarding online communications to ensure they do not commit any violations that might jeopardize their license. 10

Nursing boards have also disciplined nurses for violations involving online disclosure of patients’ personal health information and have imposed sanctions ranging from letters of concern to license suspensions. 12 The posting of unprofessional content on social media by HCP students is also fairly common. 3 One survey found that 60% of medical school deans reported incidents in which students had posted inappropriate content online, including patient information, inappropriate language, depictions of intoxication, and sexually explicit material. 3

Legal Issues

The widespread use of social media has introduced new legal complexities. 2 A number of constitutional rights can be applied to the use of social media, such as freedom of speech, freedom from search and seizure, and the right to privacy; however, these rights can be successfully challenged. 2

In 2009, a U.S. District Court upheld the expulsion of a nursing student for violating the school’s honor code by making obscene remarks about the race, sex, and religion of patients under her care. 2 The court concluded that the school’s honor code and confidentiality agreement signed by each nursing student governed the standards of acceptable behavior, dismissing the student’s claim that her right to freedom of speech had been violated. 2 A similar ruling was made in a case in which a student posted pictures of herself as a drunken pirate on MySpace. 2

Legal cases should never be discussed on social media because most current case law dictates that such information is “discoverable,” although this may depend on the purpose for which the information is sought. 2 , 14 Even if it is posted anonymously, various investigative methods may potentially be used to directly link legal information to a specific person or incident. 14 The Facebook policy for the use of data informs users that “we may access, preserve, and share your information in response to a legal request” both within and outside of U.S. jurisdiction. 15 The policy also states that information may be shared for a number of reasons, including to aid investigations, to prevent fraud or illegal activity, and to protect Facebook, the user, or anyone else. 15 Information posted on social media can also be used to portray—rightly or wrongly—an image of an individual’s character in lawsuits. 15

HCPs can also expose themselves to lawsuits if they respond to a question sent via social media by providing medical advice. It has been suggested that a legally sound approach in response to requests for such advice would be to send a standard response form that: 1) informs the inquirer that the HCP does not answer online questions; 2) supplies offline contact information so that an appointment can be made, if desired; and 3) identifies a source for emergency services if the inquirer cannot wait for an appointment. 15 In circumstances where a patient–HCP relationship already exists, informed consent should be obtained prior to online discussions between the HCP and the patient regarding medical care. 15 A careful explanation regarding the risks of online communication, expected response times, and the handling of emergencies should be included. 15 The informed consent and any online interactions should be documented in the patient’s chart. 15

PROFESSIONAL GUIDELINES FOR THE USE OF SOCIAL MEDIA

Social media guidelines issued by health care institutions.

Social media pose many risks for health care organizations that could potentially affect the safety and security of patient information, patient consent, employment practices, physician credentialing and licensure, the violation of HCP–patient boundaries, and other ethical issues. 4 Therefore, it would be beneficial for health care organizations to establish employee guidelines regarding the appropriate use of social media. 3 , 18 A list of points that might be addressed in organizational social media policies is presented in Table 1 . Consequences regarding policy violations should also be defined. 9

Concepts for Health Care Organizations’ Social Media Policies 4

Health care institutions should address the risks posed by the use of social media in their employee policies. 19 Policies should encompass discrimination, harassment, wrongful termination, leaking of confidential or proprietary information, damage to the organization’s reputation, and productivity as well as other issues. 7 , 19 A health care organization may also consider establishing policies that involve disciplinary actions in response to employees’ use of the Internet, cellphones, or tablets during working hours. 4 The establishment of such policies could diminish a number of concerns regarding the online posting of pictures or other patient information that could violate federal or state privacy laws or could distract from patient care. 4

Many institutional policies also prohibit the use of work email addresses on social media, reflecting a concern for security and the importance of separating personal and professional activities. 7 The use of institutional graphics or logos on employees’ personal social media pages may also be prohibited. 7 Potential conflicts of interest are also a concern. 7 Most policies prohibit arrangements that involve the exchange of money for online postings or other activities, and require full disclosure with disclaimers if such a relationship exists. 7

Several health care institutions have policies that require a signed HIPAA authorization before any patient-specific information may be posted on social media. 7 Other institutions, particularly medical schools, have expanded this concept to include consent from research subjects and volunteers. 7 It is good practice for faculty at educational institutions to inform students about potential consequences for violating this and other social media guidelines, since such infractions may not only expose the student to academic or professional disciplinary actions but can also violate state and federal laws, resulting in civil and criminal penalties. 2

Additional information regarding social media guidelines can be found in the online database at http://socialmediagovernance.com/policies . 7 , 17 This resource includes 247 social media policies, many for health care institutions or professional societies, such as the Mayo Clinic, Kaiser Permanente, and the American Nurses Association. 17

Social Media Guidelines for HCPs Issued by Professional Organizations

Many health care professional societies have issued guidelines for the use of social media. In 2012, the ASHP released a statement regarding the use of social media by pharmacists. 6 The ASHP advised pharmacists to provide clinical advice only in adherence with professional standards (i.e., when a complete history is known); to recognize when a patient’s needs would be better met by other means of communication; to provide timely and accurate information when appropriate; to rebut any misleading information; to protect patient privacy; and to maintain the pharmacist’s reputation during anonymous or personal use of social media. 1 The ASHP also recommended that hospitals or health systems that allow the use of social media establish best practices in the form of policies and procedures that balance the benefits of social media with the potential risks and liabilities of such media. 6

In 2010, the American Medical Association (AMA) released official guidelines for the ethical use of social media by physicians. 19 These guidelines emphasize the need to maintain patient confidentiality; to be cognizant of privacy settings; to maintain appropriate patient–physician boundaries; to provide accurate and truthful information; to act with collegiality; to avoid anonymity; to declare conflicts of interest; and to maintain separate personal and professional profiles. 4 , 8 , 9 , 19 The AMA’s policy also recommends that members be aware that privacy settings may not provide complete protection and that anything posted on the Internet may be permanently available online. 19

The Federation of State Medical Boards (FASB) published a guidance document on the appropriate use of social media in medical practice in 2011. 14 This document emphasizes protection of patient privacy and confidentiality; professionalism and transparency; the avoidance of dispensing medical advice online; and the caveat that once information is placed online, it can be distributed interminably. 14

The National Council of State Boards of Nursing (NCSBN) also issued its White Paper: A Nurse’s Guide to the Use of Social Media in 2011. This document includes practical guidelines for governing the appropriate use of social media in the health care environment by nurses. 2 A summary of concepts included in most professional guidelines is presented in Table 2 .

Common Guidelines for the Use of Social Media by HCPs 7 , 15

When used wisely and prudently, social media sites and platforms offer the potential to promote individual and public health, as well as professional development and advancement. 11 However, when used carelessly, the dangers these technologies pose to HCPs are formidable. 8 Guidelines issued by health care organizations and professional societies provide sound and useful principles that HCPs should follow to avoid pitfalls. 15

Glossary 7 , 17

• Research article
• Open access
• Published: 24 May 2022

Exploring nurses' experiences of social media and in-person educational interventions for professional development: a qualitative study

• Seyedeh-Somayeh Kazemi 1 ,
• Sedigheh-Sadat Tavafian 1 ,
• Alireza Hidarnia 1 &
• Ali Montazeri 2 , 3  

BMC Nursing volume  21 , Article number:  126 ( 2022 ) Cite this article

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Nurses play an important role in health promotion, prevention strategies, and care. Therefore, nurses need to obtain and update their knowledge and skills via appropriate strategies. This study aimed to explore nurses’ experiences of receiving social media and in-person education to integrate the findings into practice.

This was a qualitative study using the directed content analysis approach. A sample of nurses with previous experiences of receiving social media and in-person education participated in the study. They were asked to express their experiences and indicate their preferences. The data were collected based on individual semi-structured interviews.

In total 15 participants took part in the study with a mean age of 40.6 ± 8.93 years and work experiences of 15.3 ± 9.21 years. During the process of content analysis, three main themes emerged: Approaches to nursing education and its adoption in the health system, Achieving effectiveness and efficiency in nursing education, and Health care policy and facilitating pathways for nursing education. Participants indicated several barriers to attending an educational program, including motivation, workload, time and place, and hospital politics.

Overall the findings suggest that regardless of any methods of education nurses cannot actively engage in the educational interventions while on duty. However, the findings suggest that nurses believe that the social media approach might be superior in reducing barriers and making the educational interventions work better.

Peer Review reports

As the most important part of the health system employing a comprehensive health approach, nurses significantly affect the effectiveness of the healthcare system and play an important role in the promotion of health, prevention of diseases, and treatment and care [ 1 ]. This issue is in favor of individuals, societies, and populations in the healthcare center. The importance of the role of nurses in investments in the healthcare area and the improvement of economic growth of communities is undeniable [ 2 ]. Thus, focusing on developing the professional knowledge and skills of the nursing workforce is very important.

Professional development that involves training during working hours or beyond is an important issue for nursing personnel [ 3 ]. Approximately 90% of the universal health care is provided by nurses [ 4 , 5 ], so the professional development of nurses can be useful in patient care, the efficiency of organizations, and the promotion of nurses [ 6 ]. As such implementing educational programs for nursing personnel during working hours or out-of-hours are essential. Different strategies have been employed to implement professional development through educational programs using electronic (mobile, message, website), and in-person (lectures, role-playing) education methods.

An education method comprises the principles and methods used to enable learning in the learner. For a particular education method to be appropriate and efficient, it has to be relevant to the characteristics of the learner and the type of learning it is supposed to bring about [ 7 ]. Researchers of face-to-face or in-person education argued that effective action requires more than learning new tools and techniques, and must also include exploration of the theories and values which underpin facilitation practice [ 8 ]. The focus should also be on the personal qualities and attendance that facilitators bring to the group [ 8 , 9 ]. Some studies have shown that educational programs based on social media might be more helpful compared to other forms of education [ 10 , 11 ].

Rapid and innovative advances in participative Internet communications referred to as “social media,” offer opportunities for modifying health behavior. People of all demographics are adopting these technologies whether on their computers or through mobile devices and they are increasingly using these social media for health-related issues. Although social media have considerable potential as tools for health promotion and education, these media, like traditional health promotion media, require careful application and may not always achieve their desired outcomes [ 12 ]. Some studies show social media intervention has been successful in the management of low back pain [ 13 , 14 , 15 ], Type 2 Diabetes [ 16 ], self-efficacy [ 17 ]. Social media can support nurses in numerous ways on a personal level. Moorehead et al. highlighted several such as, increased number of interactions with others, shared and custom health content, access and availability of health information, and peer and social support [ 18 ].

Social media includes different online tools and some have been used in health promotion, such as Web Logs, Websites, Message boards, Short message services, Social networking sites, etc. [ 12 ]. As technology is rapidly changing, so is pedagogy within nursing education. In recent years, using the flexibility of the Internet provides a good opportunity to extend scientific content and enhance learning in general [ 19 ]. A qualitative study on the consequences and factors affecting work-related low back pain in nurses found that nurses could not attend the educational program continuously based on a variety of causes, such as a heavy workload, lack of time, or lack of staff [ 20 ]. It seems nursing personnel is among those who could benefit from social media including website, app given that they have growing educational needs and skills and at the same time they are dealing with overloading tasks scheduling [ 21 ].

The PRECEDE–PROCEED model is often used in health education and health promotion. This model is a cost–benefit evaluation framework proposed in 1974 by Lawrence W. Green that can help health program planners, policymakers, and other evaluators, analyze situations and design health programs efficiently [ 22 ]. Based on the study by Green and Kreuter, analyzing situations and designing and implementing educational programs efficiently can be classified in enabling factors and administrative and policy diagnoses. Enabling factors are those characteristics of the environment that facilitate action and any skill or resource required to attain specific behavior [ 23 ]. They include programs, services, availability and accessibility of resources, or new skills required to enable behavior change. The administrative and policy diagnosis phase focuses on the administrative and organizational concerns that must be addressed before program implementation. This includes assessment of resources, development, and allocation of budgets, looking at organizational barriers, and coordination of the program with other departments, including external organizations and the community [ 24 ].

In this study, we intend to explain the advantages and disadvantages of the two educational approaches. In other words, we construed and explained the presentation of educational content or intervention via two approaches of in-person and social media from the perspective of nurses based on PRECEDE model. As well, we construed the governing policies in our country hospital in facilitating the provision of education through two approaches.

Because education plays an important role in nurses’ career advancement, the present study aimed to identify and explore nurses’ experiences of two approaches of education (social media such as website, App, and in-person education) using a qualitative method.

The study sought to answer the following questions:

Which educational approach do nurses prefer? Why?

Which educational approach is more appropriate and effective?

Which approach is in line with hospital policies?

Study design

As part of a trial [ 25 ], a qualitative study was conducted to explore nurses' experiences of social media and in-person education approaches. The study used the directed content analysis approach. The goal of a directed content analysis approach is to validate or extend conceptually a theoretical framework or theory [ 26 ]. Existing theory or research can help focus the research question and it can help researchers begin by identifying key concepts or variables as initial coding categories. This approach was employed by Hsieh and Shannon in 2005 [ 27 ]. Content analysis using the directed approach employs a more structured process than in a conventional approach [ 28 ]. As such it is appropriate to use existing theories or prior investigations about the phenomenon under study.

Participants

Participants included nurses working at relevant hospitals. Inclusion criteria were: at least one year of work experience in nursing, previous experience of receiving social media, and in-person education. The study was approved by Tarbiat Modares University of Ethics Committee for Health Research Ethics (IR. TUM. REC. 2017/545), and all participants provided written consent. As well as, the researcher reminded commitment to ethics in research, such as secrecy, preservation of anonymity, permission to leave the study, and interruption of the interview if desired.

Data collection

The data were collected based on individual semi-structured interviews [ 29 , 30 ]. The Interviewees in this study were nursing personnel. The recruitment of participants for the interviews was based on purposive sampling. Decisions regarding the number of individual interviews were determined by data saturation [ 31 ]. The original interviews were conducted by the main researcher (SSK) between August 2017 and March 2018 and lasted between 35 to 50 min. All the interviews were conducted in a private room. In the first, the researcher explained the study goals and reasons for doing the research to the participants. To ensure consistency, each interview followed the same semi-structured format, using an interview schedule consisting of open questions, all interviews were recorded and transcribed. The interview guide consisted of open-ended questions based on subcategories of the enabling, administrative, and policy factors of PRECEDE model to allow respondents to fully explain their own experiences. The questions such as "What do you think about social media and in-person education approaches?/ Which approach is in line with hospital policies?" Likewise, they were asked to express their experiences and indicate their preferences.

Data analysis

The study used the directed content analysis approach. The data analysis process was carried out simultaneously by collecting data [ 32 ]. Semi-structured interviews were tape-recorded, transcribed verbatim, the transcript read several times, and parts of the text highlighted, that were relevant to the study goals. The highlighted passages were broken up into semantic units. Then investigators identified meaning-units from each transcript and performed initial coding according to the participants' phrases. Any text that could not be categorized with the initial coding scheme was given a new code. Initial codes were identified by at least two co-investigators, and codes were then categorized according to similarities and differences [ 31 ]. An initial analysis created 20 excerpts (sections of text). The data were independently coded by another researcher with in-depth knowledge to explore consistency. The second researcher also created 22 extracts. Transcripts, codes, and categories were read several times by various members of the research group to exhaust identifiable major themes. During this process, data were reduced from text to codes and categories. Based on the type and breadth of a category, researchers identified subcategories with subsequent analysis. When the coding assignments were done for both researchers, have reviewed the three assigned codes from expected outcomes, such as presentation and adoption of education, effectiveness, and efficiency of education, policymaking, and facilitators for education. All coding steps for interview passages were also managed using the MAXQDA 10 editing software.

The evaluation criteria for establishing the trustworthiness of qualitative data were also considered [ 28 ]. There was constant comparison within and across categories and across interviews where each code or category was checked against the rest of the data to establish and refine categories that reflected the nuances of the data [ 33 ].

Credibility is the equivalent of internal validity in quantitative research and is concerned with the aspect of truth-value. One of the strategies to ensure credibility is member checking [ 34 , 35 ]. All transcripts of the interviews were sent to the participants for feedback. Further, halfway through the study period, a meeting was held with those who had participated in the interviews, they corrected the ‘wrong’ interpretation.

Dependability, related to reliability in quantitative terms, occurs when another researcher can follow the decision trail used by the researcher [ 36 ]. The text of the interviews, the relevant codes, and the emerged themes were sent to two researchers outside the study who were familiar with qualitative research. Outside researchers examined the research process and the data analysis to ensure the findings were consistent and could be repetitive. Then their complimentary comments were used in the analysis of the data. Further, at a meeting, we discussed the interpretation and presentation of the research findings of uncomplimentary until achieved a common result. As well, we used peers to participate in the analysis process to enhance the original findings.

Confirmability that the findings were based on participants’ responses and there were not any potential bias or personal motivations of the researcher [ 34 ]. We have tried to use the participants’ narratives and words rather than potential researcher biases. To establish confirmability, the researcher provided an audit trail, which highlighted every step of data analysis that was made to provide a rationale for the decisions made. This helped establish that the research study’s findings accurately portrayed participants’ responses.

Characteristics of the participants

The original data collection comprised a series of interviews with a sample of 15 project participants. Most were female ( n  = 11) and their age ranged from 27 to 52 years old (40.6 ± 8.9). They have been employed as a nurse for at least one year (15.33 ± 9.2 years). Participants included nurses working in hospitals affiliated with Mazandaran University of Medical Sciences. The characteristics of participants are presented in Table 1 .

Themes, categories, sub-categories

The study obtained 3 themes, 9 categories, and 22 sub-categories (Tables 2 , 3 ).

Approaches to nursing education and its adoption in the health system.

Nurses acknowledged that most of the time, in-person education is not provided by an education specialist. So, this theme was derived from performing the program by the staff working in the hospitals, such as the educational supervisor, head nurse, or different sectors' nurses. In this case participant 4 (head nurse, age range 50–60) said:

“ Some of the time, education is provided by the staff or nurses. The supervisor teaches head nurses and the head nurse educates sector nurses in the form of a category education to the category. Since different departments need to have internal education, some education will be provided by nurses of the same department as a conference. But due to the bustling ward and a large number of patients, not all colleagues can attend the training at the same time. If education is implemented through the app or social media, then there is no need to provide education by nurses or other staff. ”

Achieving effectiveness and efficiency in nursing education : refers to whether or not a specific set of resources has a positive effect on achievement and, if so, how large this effect is. This main theme was extracted from three sub-categories as follows:

- Skill Learning: The effect of education on increasing knowledge, practice, and skill was identified, and the role of practical education in promoting behavior skills was emphasized. In this regard, participant 3 (nurse, age range 20–30) said:

“The system thinks in-person education is better than social media. Because in-person education can provide practical examples, nurses can ask questions and issues related to the subject of education. Also, pre-test and post-tests are taken in an in-person education, and the nurse's performance is evaluated. While the system can be designed for education via social media in such a way that contains educational videos practical examples in the form of videos, photos, animations, etc. And the educational supervisor monitor how many percentages of the staff used the program and training. As well, evaluate our knowledge and performance through the website."

- Interactivity in education: Interactivity in learning is viewed as a socio-constructivist process and can be communicated among content and participants [ 37 ]. Most participants had referred to interactivity in In-person education because In-person education can prepare an adequate situation to ask questions and stimulate communication between participants. Since nurses have received educational content via CD or pdf files sometimes, they thought education via social media is one-way and interactive communication is not possible. So participants emphasized two-way communication in education and its interactive social media. Participant 15 (nurse, age range 40–50) said:

“When staff gets together, it is very good. Because they can be exchanging ideas. Also, there are a lot of questions for each of us, and maybe at that moment don't work the memory to ask. Persons can be actively participation in education and do some practical work. But I think in interactive social media, we can talk and express our opinions."

- Remembrance for restoring of information:

One of the nurses' concerns was the oblivion of the content learned over time. Most participants believed that an appropriate education program should be repeated over time, otherwise it will be forgotten. In this regard, participant 1 (nurse, age range 50–60) said:

"One of the disadvantages of in-person education is receiving little information and content and it only is at one time and the information learned does not repeat over time. Thus, the content learned will be forgotten. But I think one of the benefits of education through the app or social media is receiving a lot of information and content at different times, and also reminding and repeating the content. If we forget about it over time, we can refer to the app."

Health care policy and facilitating pathways for nursing education.

This theme was extracted from five sub-categories as follows:

- The importance of motivation in education:

Considering that educational programs are part of hospital accreditation measures, lack of motivation, and disinterest by nurses, also lack of support and reward by managers prevent nurses from participating in face-to-face education. Thus, these factors lead to not attending the class on time, leaving the class out earlier, lack of taking notes, and not paying attention to education. Participant 5 (nurse, age range 30–40) on the role of material and spiritual motivation said:

"If the education program is out of work hours, nurses don't like in-person education and prefer to receive training virtually. Because the time of education will not be considered as a part of our overtime hours. The encouragement certificate for work promotion was not considered. While the certificate can have a positive impact on the annual performance appraisal."

- The time limit for easy educational access:

Getting easier to access education and having no time limits are basic nurses’ rights. But based on the analysis obtaining in-person education and its access was less possible for nurses. In this regard, participant 9 (nurse, age range 20–30) said:

“When only one date is set for an educational program, maybe we can't attend. For example, perhaps there were many patients at the same time and there aren't many nurses in the sector. Certainly, we cannot participate in education. It is better to set a few dates for an education topic so that nurses can participate in different dates or send via social media. In this way, we can read the contents when the unit is not crowded or at rest time. "

Participant 11 (nurse, age range 30–40) said:

"I think the advantage of social media is most people can access this type of education and share information. We can use this program whenever we want, and we don't have to go to the hospital from home. There is no time and space limit. Even at rest, at work and home, at any time of day, we can use this type of education. We can also have access to a lot of educational content."

- Lack of staff: Most participants referred to the lack of staff in different sectors. They said these factors lead to working pressure. Working pressure and high workloads are seen as the main barriers to attending in-person education programs. Therefore, nurses didn't have enough time to attend in-person education and expressed their tendency to use educational programs based on social media. In this case, participant 2 (nurse, age range 30–40) said:

"We are faced with a lack of staff. So that one person should work instead of two or three persons. Thus, the load of our work is very high, and we have to tolerate a lot of pressure."

- Lack of funding for education:

Data analysis found one of the barriers to in-person education is the cost of education implementation. Thus, one of the most important concerns of education executives is the financing of education costs (such as the payment of the educator, catering fees, educational equipment, and adequate space for education). Participant 6 (nurse, age range 30–40) said:

"One of our educational problems is a lack of funds. The hospital's operating personnel says you should find a sponsor for the educational program. In-person education is economically not desirable because of the commute and payment to the educator. But education through social media is just an app that's installed on the mobile phone and does not require commuting, educator fees, or catering, even it has not needed a place for education."

- Program Failure over time:

The data showed some factors that lead to program failures over time. Such as lack of suitable education space, lack of proper education, no having trainer or educator. In this regard, participant 13 (nurse, age range 30–40) said:

"Perhaps faculty members educated their students in the hospital and not at college or maybe there was a retraining class. So the educational supervisor will coordinate with the unit of education a few days before the education. But, sometimes the education program maybe to be canceled due to a lack of appropriate location or space."

Regarding the decisive role of the educational method in nursing education, this study aimed to explore nurses' experiences of the education methods context based on the in-person and social media methods through a qualitative study. The findings from this survey indicated due to the nature of the nurses' work, the educational methods and easy access to education can be a considerable role in nurses' education, particularly in promoting professional and occupational skills.

One of the main themes extracted was "Approaches to nursing education and its adoption in the health system" i.e. the educational program performed by the hospital staff. This theme illustrated the provision of the educational program by the staff, as there was no specialist educator personnel to run the program. This was due to a lack of financial support for a specialist educator. The effectiveness and success of the education process depend on the educator's professional skills. Occasionally, education is provided by an educational supervisor, or nurses such as series education, which is only as a task, although some education may be successful. Geravandi et.al study finding showed that education was effective by the clinical supervisor [ 38 ].

Nursing education plays a major role in fostering the mind to think in clinical practices, different situations, and the establishment of communication between events, decision making, and conceptualization to promoting community health [ 39 ]. Nurses reported training as an effective factor in their ability to gain knowledge, skills, and self-efficacy in different areas. For instance, a study showed the effect of education to promote nurses' ability on patient care improvement and increase the quality of health care [ 10 ].

Nurses emphasized interactive education. Nurses in in-person education can ask questions, receive answers, and there is a relationship between the educator and learner. Nurses showed their tendency to use interactive social media. That means they could write their question if they could not understand the content or can comment on website/app content. The use of online courses also provides a good opportunity for expanding scientific content and increasing the depth of learning because of the flexibility provided. A study concluded that e-learning can be considered as a supportive and complementary method in nursing education [ 40 ]. Indeed, using social media for sharing information and connecting with their colleague, also for peer support, peer learning, and participation engagement seem effective and beneficial.

Participants also had comments on barriers and facilitators of education. Nurses acknowledged that they could not access the content if they did not attend the training. They believed they could access information and educational content using a social media method at any time, anywhere. This supports a study by Thiele which showed access to more information, taking responsibility for learning by learners, and access to educational content at any time by nursing students were achieved [ 41 ]. This finding is also consistent with Buckley et al. results who theorized that the facility of access to educational content in the Web-based method leads to increased satisfaction of learners [ 42 ]. Nurses can use a variety of social media programs to advance their personal and professional goals. 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 [ 43 , 44 ].

Another side, the data depicted a lack of motivation as one of the barriers to training participation and can lead to not paying attention to educational content, and also leaving the class before the education finished. In similar studies, inadequate motivation for education, lack of support, and encouragement for nurses to participate in education are mentioned [ 45 , 46 ]. Thus, based on policymaking, managers are recommended to motivate nurses to attend in education, such as financial support, reward.

High workload, shortage of personnel, and lack of proportionality of the number of patients to the nurse in different units impede attending in-person education. Other studies also pointed to the high amount of work and work pressure on colleagues for attending continuing education as a barrier [ 40 , 47 ]. As well, the data indicated inadequate financial support of the organization or lack of funding for education to create a suitable platform for education, in particular, in-person education. So that hospitals should run educational programs following the Ministry of Health instructions. However, the cost of education and the necessary preconditions for the implementation of education are not provided. This issue has always been one of the most important problems for education executives. In similar studies, inadequate funding by the organization was a major barrier to nurses' attendance in professional education [ 45 , 48 ]. While nurses believed that directors' support from nursing staff would have a key role in their productivity. Furthermore, nurses represent education social media is appropriate because of increased quality of learning, ease of access to a high level of information at a limited time, reduced costs and also, family conditions, fatigue due to long work hours, and a lack of adequate human resources.

Limitations, implications, and perspectives

The main limitation of our study is related to data collection. Some nurses were reluctant to participate in the study because of their high workload and lack of time. To overcome this limitation, the researcher asked nurses to choose the time of the interview according to their working conditions. Other limitations of this qualitative research include the following:

The interview process was time-consuming.

It was not possible to reach all the participants.

The interview required the consent and willingness of the respondent, the patience and perseverance of the interviewer.

Sometimes, participants were reluctant to express explicit opinions.

Despite its limitations, our study has had several characteristics of value. Firstly, our results provided a platform from the nurses' standpoint to evaluate educational approaches. As well as, it is recommended policymakers assess resources, development, and allocation of budgets, organizational barriers, and coordination of the program according to target groups.

This study provided some advantages and barriers of the two educational methods from the nurses’ perspective. The choice of educational methods in nursing education is very important. Currently, despite inadequate motivation, insufficient support, and much workload, nurses are not motivated enough to attend in-person education. Therefore, it is necessary to establish a suitable framework for the implementation of the education process for nursing personnel. Indeed, it seems that applying educational methods based on interactive social media might be helpful.

Availability of data and materials

The data will be available from the corresponding author on request.

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Acknowledgements

This paper was originated from the first investigator’s Ph.D. thesis at the Department of Health Education and Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. The authors thank the staff of hospitals of Mazandaran University of Medical Sciences especially nurses. As well, the research team needs to be honored and thankful to Claire E Hiller (School of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia) who contributed to the writing and editing of the paper.

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Seyedeh-Somayeh Kazemi, Sedigheh-Sadat Tavafian & Alireza Hidarnia

Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran

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Faculty of Humanity Sciences, University of Sciences & Culture, ACECR, Tehran, Iran

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SSK was the main investigator, collected and analyzed the data, and wrote the first draft. SST supervised the study and contributed to the writing process. AH helped in the design and contributed to the writing process. AM was the study advisor and contributed to providing the final draft. All authors read and approved the final manuscript.

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Kazemi, SS., Tavafian, SS., Hidarnia, A. et al. Exploring nurses' experiences of social media and in-person educational interventions for professional development: a qualitative study. BMC Nurs 21 , 126 (2022). https://doi.org/10.1186/s12912-022-00903-4

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Social Media in Nursing Practice

Introduction, first main point, second main point.

It is evident that social media became one of the most powerful instruments used by numerous specialists from a variety of professions (Hood, 2014). People use social networks to find out about the latest news and exchange information. It is interesting how the current state of the social media network allows nurses to connect with their patients (Henderson & Dahnke, 2015). This is rather important because this opportunity highlights the ability to achieve positive outcomes by merely connecting with the patient online.

Holistic nursing practice became accessible to the development and popularization of social networks. On a bigger scale, it allowed the nurses to expand their knowledge on a number of pivotal subjects and develop their professional skills (Henderson & Dahnke, 2015). The use of social media can be considered profitable, but nurses should take into consideration the patient’s confidentiality before engaging in this activity.

The impact of social networks on how the nursing practice is perceived is visible. The nurses obtained a novel way to deliver critical information to their patients. Nonetheless, the nurses should be aware of the constantly changing nursing environment and the standards of the nursing practice so as to apply their knowledge of social networks properly (Henderson & Dahnke, 2015).

The unwillingness of the nurses to learn the basics of social networking may lead to serious complexities. The patients will be exposed to the vast amounts of information that can be identified as inappropriate and unreliable (Henderson & Dahnke, 2015). This will make the patients more vulnerable to external factors and increase the probability of misinformation.

The nurses are responsible for providing their patients with accurate information concerning their diagnoses, lifestyle changes, and other imperative data. This can be explained by the role of the nurses which consists of helping the patients to preserve their well-being (Henderson & Dahnke, 2015). Therefore, the nurses have to avoid incorrect information and guarantee that their patients receive the best care possible.

Regardless of the benefits of social networks, they possess a number of serious disadvantages that should be mitigated by the nurse. First, the nurse should certify the patient’s confidentiality and follow the ethical considerations of nursing practice (Henderson & Dahnke, 2015). There is little chance to convey critical information concerning the patient’s diagnosis if he or she does not trust the nurse.

The nurses should treat their patients with compassion and not disclose any of the information regarding the case. It is vital to minimize the risk of exposing the patients to the public and triggering in them any emotional pain (Henderson & Dahnke, 2015). The use of social media limits the nurses in terms of their behavior and requires them to be professional and understanding at all times.

The nurses should be careful when accessing social media and distinguish between their nursing practice and personal use of social networks. The core objective of the nursing practice is to guarantee positive health outcomes. The nurses are required to make sure that their patients receive the best care and are not impacted by the adverse influence of erroneous evidence (Henderson & Dahnke, 2015).

Irrespective of all the debates concerning the use of social media, the real problem consists of the overall knowledge concerning the use of technology in nursing practice. The patients’ confidentiality and the integrity of the nursing practice are never safe. Nonetheless, social media is an influential tool, and it can impact health outcomes and nursing practice if used properly.

Respectively, the nurses are required to expand their knowledge on the subject so as to provide their patients with high-quality care both online and offline. By using social media correctly, the nurses will be able to provide assistance while not compromising the ethical considerations of the nursing practice. To end with, social media may be firmly considered to be the future of the nursing practice.

Henderson, M., & Dahnke, M. D. (2015). The ethical use of social media in nursing practice. MEDSURG Nursing , 24 (1), 62-64.

Hood, L. J. (2014). Leddy & Pepper’s conceptual bases of professional nursing (8th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

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Best Topics and Ideas for Social Media and Nursing

Social media has become an integral part of our lives, and its effects cannot be ignored, particularly in nursing. It has transformed how healthcare workers relate with their colleagues and patients. It has also provided opportunities for more nursing research and policy development. Thus, both nurses and nursing students need to understand the different topics of social media and nursing.

The following article lists different topics on social media and nursing developed by our online nursing writers .

Social Media and Nursing Essay Topics Argumentative

Argumentative essays on social media and nursing require you to evaluate the given topic, review credible evidence, and take a stance. Generally, these types of essays call for an extensive review of relevant materials. The following are some argumentative essay topics you can use:

• Provide a critical analysis of social media in nursing practice.
• Is targeted recruitment via social media effective?
• Explain the influence of social media on the nurse-patient relationship.
• What role does social media play in nursing education and training?
• The use of social media in nursing research.
• Impact of social media on the mental health of nursing professionals.
• Provide a critical review of social media and its impact on the nursing workforce.
• Show the effectiveness of social media in patient education and engagement.
• Compare the benefits and drawbacks of social media in nursing practice.
• Social media and nursing leadership and management.
• Impact of social media on nursing communication and collaboration.
• The use of social media in policy making.
• How social media affects nursing recruitment and retention.
• A discussion of social media guidelines for students in clinical rotation and nurses in their practice
• The impact of social media on nursing education and professional development.
• Social media and nursing practice: a discussion of patient privacy
• Does social media help in nursing disaster preparedness and response? Explain.
• Show the comparison of social media use among nurses and nursing students of different generations.
• What do you think about cosmetic surgery in health insurance?

Related: Nursing Debate Topics.

Social Media and Nursing Essay Topics for Expository Essays

When asked to write an expository essay, the expectation is to investigate an idea, review the evidence, and concisely set an argument. The following topics in social media and nursing can help you get started.

• Discuss the history of social media in nursing practice.
• Using Self-Determination Theory (SDT), explain how social media influences nurses' behavior.
• Provide a comprehensive overview of social media platforms used in nursing.
• What are the benefits and drawbacks of social media in nursing education?
• Social media and nursing research dissemination.
• Social media and nursing advocacy.
• Use Social Cognitive Theory (SCT) to show how social media shapes nurses’ behaviors.
• Does social media impact patient engagement in nursing practice?
• Does social media impact nursing communication and collaboration?
• Social media analytics and nursing research.
• How social media is affecting the future of nursing practice.
• Before and after social media: the case of modern nursing.

Social Media and Nursing Essay Topics for Narrative Essays

Narrative essay topics about social media and nursing require you to share your experiences. You must get personal and creative about your experiences. Some of the topics in this genre include:

• My social media experience in clinical rotations as a student and nursing practice.
• How does Facebook help me connect with my patients?
• How social media has influenced my nursing education journey.
• A day in the life of nurses who incorporate social media during their practice.
• My journey in nursing research dissemination using social media tools
• The impact of social media on my nursing leadership and management skills.
• How social media tools helped me cope with nursing burnout.
• A patient's perspective on social media use in nursing care.
• A personal reflection on the ethical dilemmas faced by nurses using social media in nursing.
• A discussion of how social media helped improve my nursing communication skills.
• The role of social media in helping me navigate a nursing crisis.
• How is social media used for mentorship and professional development?
• A reflection on the benefits and drawbacks I experienced using social media in nursing practice.
• My journey in advocacy and policy-making.
• Nursing job satisfaction and career growth.
• A personal account of social media use in nursing disaster preparedness and response.
• How social media helped me connect with patient's family during end-of-life care.
• A nurse's perspective on how nursing practice.
• A personal reflection on the role of social media in nursing.

Related: Writing a reflection nursing essay.

Descriptive Social Media and Nursing Essay Topics

Descriptive essay topics are those that ask you to describe something. It is important to provide a vivid and detailed description for readers to see what you are discussing. The following topics can help you develop a descriptive essay on social media and nursing.

• The analysis of social media use in nursing practice.
• Describe the characteristics of effective social media use in nursing education.
• Provide a clear description of the types of social media platforms useful in nursing research.
• Social media activity by international students
• Explain the characteristics of effective social media use in mentorship and professional development.
• Describe the role description of the role of social media in nursing leadership and management.
• Social media and patient engagement in nursing care: A descriptive study.
• A descriptive analysis of the guidelines for using social media
• Friendships and social networking for nurses.
• Social media on nursing research dissemination: A descriptive study.
• Social media use in nursing education for patient safety.
• The characteristics of effective social media use in nursing communication with patients.
• Use of social media in nursing advocacy for underserved populations.
• Social media on nursing mentorship and professional development: A descriptive study.

Persuasive Social Media and Nursing Essay Topics

Persuasive essays are those that are meant to persuade readers about your arguments. Some of the persuasive topics about social media and nursing include:

• Social media use should be mandatory for all nurses and students.
• Healthcare facilities should have social media policies that support nursing practice.
• Nurses should be required to undergo training on the appropriate use of social media in nursing practice.
• The use of social media is a mandatory component of nursing continuing education.
• Nurses should be encouraged to share their nursing experiences and insights with social media tools.
• Social media use must be incorporated into nursing research methodologies.
• Social media should be relevant as a tool to advocate for patient safety and better healthcare policies.
• Explain how social media impacts nurses' body image
• Show the link between social media and anxiety among nurses and nursing students
• Healthcare facilities should encourage using social media among their employees to promote diversity and inclusivity in nursing practice.
• Discuss why all nursing schools should incorporate social media literacy courses for their students.
• Social media should be a tool that helps nurses promote mental health and wellbeing among their colleagues.
• Healthcare facilities should have social media accounts for nursing recruitment and retention efforts.
• Nursing conferences should prioritize social media use for engagement and promotion of knowledge sharing.
• Benefits of social media use for nurses to promote evidence-based practice and patient-centered care.
• Healthcare workers should use social media to engage with the public and promote nursing advocacy efforts.
• Social media use must be encouraged to help promote nursing quality improvement initiatives.
• Nurses should be encouraged to use social media to promote cultural competence and understanding in nursing practice.
• Nursing schools should incorporate social media use into their nursing simulation training.
• Nurses should use social media to promote nursing mentorship and professional development.
• Hospitals and clinics should use social media to promote patient satisfaction and quality of care.
• Nursing organizations should use social media to promote nursing leadership and management skills.
• Social media as a tool for the promotion of healthcare access and equity.
• Social media uses in nursing communication and collaboration strategies.
• Social media is an encouragement to promote public health and disease prevention.
• How can nursing schools use social media to engage students and alumni better?
• Social media use in the promotion of nursing innovation and creativity.

Related article: Persuasive speech topics for nursing and medicine.

Trending topics on social media and nursing

Choosing a trending topic can help you connect with readers interested in pursuing popular topics on social media and nursing topics. If you are looking for a trending topic, the following list can help.

• Explain the impact of TikTok on nursing education and patient care.
• Explain how Instagram helps promote mental health and well-being among nursing professionals.
• How does Twitter help in nursing research dissemination and knowledge sharing?
• How has social media been instrumental in nursing recruitment and retention during the COVID-19 pandemic?
• Does LinkedIn help promote nursing leadership and management development?
• Facebook and nursing patient education and engagement.
• How does Instagram help in nursing advocacy and policy-making during the Black Lives Matter movement?
• How can social media help nursing skills training and education?
• Social media influencers in promoting nursing professionalism and ethics.
• Social media and its impact during natural disasters.
• The role of TikTok and Instagram in promoting diversity and inclusivity in nursing practice.
• The impact of LinkedIn and YouTube on nursing education during remote learning.
• How has social media helped in promoting public health and disease prevention?
• Twitter use and nursing innovation and evidence-based practice.
• Social media’s role in nursing research during the COVID-19 pandemic.
• Nursing advocacy for underserved populations: the role of social media.
• How has LinkedIn helped in nursing career development and job searching?
• How did social media help in nursing communication and collaboration during the COVID-19 pandemic?
• YouTube’s role in nursing simulation training and education.

Nursing Ethics and social media

Social media has become increasingly prevalent in nurses' personal and professional lives. Therefore, it's important to understand how nursing ethics can guide nurses navigating the platform to avoid risks such as breaching patient confidentiality or privacy violations.

• Discuss the ethical implications of social media use in nursing practice.
• Privacy and confidentiality issues in social media use among nurses.
• How social media affects nursing professionalism and ethics.
• Review social media guidelines for ethical nursing practice.
• Explain the ethical considerations of social media use in nursing research.
• What is the role of social media in nursing advocacy and ethical decision-making?
• What are the ethical implications of social media use in nursing education and training?
• Does social media influence nursing patient-provider relationships and trust?
• Explain the ethical considerations of social media use in nursing disaster preparedness and response.
• Social media use in nursing patient consent and informed decision-making.
• Ethical considerations for using social media in nursing recruitment and retention efforts.
• What social media affects nursing communication and collaboration ethics.
• What are the ethical implications of using social media in nursing career development and networking?
• Nursing ethical codes and social media use guidelines.
• Ethical considerations of social media tools in nursing advocacy for social justice.
• What’s the link between nursing mental health and wellness ethics?
• Discuss the ethical implications of social media influencers and sponsored content in nursing.
• Explain how social media can help promote cultural competence and understanding in nursing.
• Ethical considerations of social media use in nursing patient education and engagement.
• Social media and nursing end-of-life care ethics: Discuss the link between the two.

Related Readings:

• Carper's ways of knowing and nursing practice.
• Kholberg Heinz Ethical Dilemma.
• Ethical Dilemmas in Nursing.

Cause and Effects Topic on Social Media and Nursing

Understanding the cause-and-effect relationship between social media and nursing can help nurses and nursing students know how to use it effectively. The following are some cause-and-effect essay topics on social media.

• Cause and effect: social media and nurses’ self-esteem and body image.
• Cause and effect: social media and relationship satisfaction and stability.
• Cause and effect: social media and political engagement and activism in nursing practice.
• The effect of social media on social skills and socialization.
• The impact of social media on job search and employment opportunities.
• The effect of social media on physical health and fitness.
• Social media effects on self-discipline and self-control.
• Social media impact on creativity and productivity.
• Social media and family dynamics.
• Social media effects on stress levels and anxiety.
• Social media’s influence on cultural norms and values.
• What is the effect of social media on nurse’s addiction and substance abuse?
• How does social media impact nurses' language skills and literacy?
• Show the effects of social media on political polarization and division.

Negative effects of social media on nurses and nursing students

While social media is good, research shows it has many negative effects. According to the Research by Massey University PhD graduates, nurses experience cyberbullying from their colleagues, patients, and families. But cyberbullying is not the only negative aspect of social media; there are a ton of effects of social media on both nurses and nursing students. The following are topics for essays on the negative effects of social media on nurses and nursing students that can help shed light on the matter.

• Show how social media tools affect nursing students’ academic performance.
• Explain how social media is effectively used to manipulate public opinion, affect elections, and promote social division within the healthcare industry.
• Has social media encouraged racism in healthcare?
• Show the negative impact of social media on nursing student professionalism and ethics.
• Discuss the impact of social media on nursing students' mental health and wellbeing.
• How social media impacts nursing student clinical skills and patient care.
• Nurses and social media addiction.
• Explain how social media influence nursing student communication and collaboration skills.
• Is the use of social media by nurses a threat to patient care?
• Nursing student privacy and confidentiality.
• Explain how nursing students suffer from stress levels and burnout due to social media.
• Nursing student time management and productivity.
• The effect of social media on interpersonal communication skills in nursing students.
• Does social media negatively affect nursing students' critical thinking and decision-making? Discuss.
• Social media: the leading cause of social isolation.
• How nurses suffer from FOMO, “Fear of Missing Out.”
• Explain how social media affects student engagement and motivation.
• How social media is negatively impacting nursing student relationships and socialization.
• Is there a connection between social media and social justice and activism?
• Discuss how social media leads to informational overload for nursing students.
• Social media effects on personal and professional branding.
• Show how social media negatively affects nurses' clinical judgment and patient safety.
• Do social media negatively influence a nurse's cultural competence and understanding?
• Social media impact on nursing students' sleep patterns and quality.

Final Words on Social Media Nursing Topics and Ideas

Choosing a good topic for a nursing essay can be daunting when you have no idea where to begin. Hopefully, the above list can help you decide what topic to focus on for your essay about social media and nursing.

The quality of your essay will depend on your choice of topic and how well you write it. If you need help writing an exemplary essay on social media and nursing, our writers can help.

We have qualified nursing assignment writers who can write assignments at any nursing educational level (BSN, MSN, or DNP). Our nursing paper writers have handled different nursing papers, including capstone papers , and we can help with yours, too. Try us now for high-quality essays.

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Nursing Social Media Do's and Don'ts

Social media guidelines for nurses.

• Nurses Can Get Fired for Being Insensitiv
• Accidentally Releasing Patient Info
• Why You Need to Be Careful

by Carlton G. Brown, PhD, RN, AOCN, NEA-BC, FAAN

Over the last several years, the world has witnessed the explosion of social media and other electronic communication like Facebook, Twitter, Pinterest, and Instagram. Nurses often use social media platforms to discuss issues around patients, healthcare, and to promote their own profession.

However, these same sites have been used inappropriately by nurses who have found themselves in significant legal problems both for the organizations in which they work, but also for their own registered nurse licensure.

As a nurse, it's important to know what you can and cannot post on social media. Here’s how to stay out of hot water when sharing about your career on your favorite social platform.

Brittney Wilson, RN, BSN, also known as The Nerdy Nurse, is an award-winning author and national speaker on social media issues, bullying, and informatics. She has rules for how nurses can keep out of trouble while using social media but also using social media effectively and positively.

These rules nurses should use while utilizing social media include:

Social Media Do's for Nurses

• Nurses can talk about themselves, the nursing profession, their families, hobbies, and interest
• Nurses should aim to uplift the nursing profession in their posts
• Become keenly aware of your employer’s social media policies
• Realize that nothing online is ever really anonymous

Social Media Don'ts for Nurses

• Never talk about patients or identifiable coworkers
• Avoid identifying your employer on your social media profiles
• Don’t post anything online that you wouldn’t say in front of your boss or human resources
• Don’t post online that you are at work as this could put you and your home at risk
• Don’t use the employer’s internet to post on social media sites--just don’t post to social media while at work
• Don’t identify your employer on your personal profiles
• Don’t do anything you would be embarrassed to say to your mother, your clergy, your boss, or a potential employer
• Don’t do anything that could degrade or embarrass your profession

Nurses Can (And Do) Get Fired for Being Insensitive on Social Media

Posting patients by name or providing enough information that patients might be identified can get you in a lot of trouble. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) gives patients rights over their health information and sets rules and limits on who can look at and receive patients health information. It is illegal and fineable for nurses and other healthcare professionals to purposely or accidentally release information about patients.

Take the 2014 case of an RN in New York City who was fired by her employer for posting a picture on Instagram depicting a chaotic emergency room following the care of a man who was hit by a subway train. While the RN never mentioned the patient's name or other information, it isn’t every day that a person is hit by a subway and thus a connection could have been made between the Instagram picture and news report involving a specific patient. The nurse was not fired by her employer for a HIPAA violation or break in hospital policy. But she was fired for being insensitive.

In a recent case, OB nurses from Emory got fired for sharing their patient "icks" on social media.  When Emory found out about the viral videos mocking patients, they quickly fired the nurses who were involved. 

What Happens if You Accidentally Release Patient Information on Social Media?

Releasing patient information is a serious problem for nurses. Nurses who accidentally release patient information can be fined anywhere from $100 to $50,000 civil fine. In addition to civil fines, nurses can also find themselves in trouble in relation to licensure problems.

One only needs to search the words “social media” and “nurse,” to read the numerous stories where nurses have been let go for writing or posting comments and photos about patients or hospitals.

Why You Need to Be Careful About What You Post on Social as a Nurse

No nurse is immune to penalties resulting from inappropriate social media sharing. In many instances, nurses make HIPAA violations or even post insensitive comments about a patient, hospital, or situation innocently.

Yet, the consequences of a violation of patient privacy or insensitivity to an employer or co-workers are very real and even detrimental to offending nurses both financially and for their licensure.

But beyond penalties themselves, remember that you are a representative of your profession. Give the world a positive impression of your beloved career.

Plus, get exclusive access to discounts for nurses, stay informed on the latest nurse news, and learn how to take the next steps in your career.

By clicking “Join Now”, you agree to receive email newsletters and special offers from Nurse.org. We will not sell or distribute your email address to any third party, and you may unsubscribe at any time by using the unsubscribe link, found at the bottom of every email.

Social media in nursing and midwifery education: A mixed study systematic review

Affiliations.

• 1 School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK.
• 2 University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.
• 3 School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK.
• 4 Arthur Labatt Family School of Nursing, Western University, London, ON, Canada.
• PMID: 30019486
• DOI: 10.1111/jan.13799

Aim: To synthesize evidence on the effectiveness of social media in nursing and midwifery education.

Background: Social media are being explored to see if these online tools can support teaching, learning, and assessment.

Design: A mixed study systematic review.

Data sources: A systematic search of PubMed, MEDLINE, CINAHL, Scopus, and ERIC was run in January 2016. An updated search was run in June 2017. No date limits were applied.

Methods: Titles, abstracts, and full papers were screened against inclusion criteria by two independent reviewers, who extracted and quality assessed data. Synthesis followed a sequential explanatory approach.

Results: Twelve studies were included. Social media seemed to support students to acquire new knowledge and skills. The learning process centred on the interactive nature of the platforms which allow information to be dynamically shared and discussed in near real time. The characteristics of social media enabled social support and a more student-centred setting, which appeared to enhance collaborative learning, although information quality was sometimes problematic. Learning via social media was underpinned by how well the educational interventions were organized, digital literacy and e-Professionalism of students and faculty, the accessibility of the online applications, and personal motivation.

Conclusion: This review provides the first rigorous synthesis of social media in nursing and midwifery education. A new Social Media Learning Model was conceptualized to aid our understanding of learning via this technology. Knowledge gaps are identified and recommendations on how to capitalize on social media to improve learning in higher and continuing education provided.

Keywords: education; learning; midwifery; nurse; nursing; social media; social networking; systematic review; technology.

© 2018 John Wiley & Sons Ltd.

Publication types

• Systematic Review
• Clinical Competence
• Education, Nursing / organization & administration*
• Faculty, Nursing / psychology
• Midwifery / education*
• Online Social Networking*
• Students, Nursing / psychology*

Grants and funding

• Sigma Theta Tau International
• National League for Nursing

Social Media Use in the Nursing Profession Essay

Inappropriate posts and conversations, nurses’ responsibility to uphold standard of conduct, areas of social media activity that could be improved.

Social media has played an important role in the nursing profession as it creates a platform on which nurses can share their professional experiences (Westrick, 2016). However, the same platforms can be the sources of problematic issues for the professionals should the content they put out pose a risk to patients or is misinterpreted by the public (Ross et al., 2017). For example, I once had a conversation on Facebook I which I discussed how to use pain relieving tablets, where I stated that such medication may make one relax and therefore reduce physical suffering.

The post was inappropriately interpreted by some of followers who thought that it advocated for use of psychedelics to relieve pain. This post could be considered inappropriate based on the professional standard for nursing as it would have been viewed as representation of the employer and the nursing body at large. In addition, such statement can be considered non-professional due to disclosing medical information to the public who could wrongly use the information shared (Westrick, 2016). It could also mean that the opinion that was posted on the social media represent the position of my employer and the profession at large, thus causing more harm not only to the individuals involved but also to other parties such as the employer.

Nurses have a responsibility to uphold the standard of conduct both at professional and personal levels because it helps to ensure that the nursing profession maintains competent practices. According Jackon et al. (2018), the competency level of a nurse is illustrated not only by the professional performance but also by personal responsibility which can be evaluated by the level of professionalism on the social media space.

Personal conduct, especially that demonstrated on social media, can be considered unethical if it poses a threat to the private information of a patient, uses abusive, offensive and derogatory language, or reflects complains about places of employment (De Gagne et al., 2018). For example, if a nurse posts a comment of social media with a photograph of a patient, it violates the HIPAA privacy rule. Upholding professional conduct at personal level and social media ensures that the nurses represent their employers and institutions positively. It is therefore necessary to ensure that nurses understand how their personal preference may affect the attitude towards their profession.

Social media platforms can be used as a space that promotes values that are helpful to all users. Importantly, nurses can apply informational technologies to show their engagement (Westrick, 2016). For example, posting details on the methods that can be relied by home care givers to take care of patients can reflect compassion, one of the central Christian values. In addition, online platforms can be used to emphasize the value of creativity; for instance, nurses can post fitness programs that promote healthy living.

The areas of social media that could be improved could include interaction with followers by positively influencing their lives. This means close focus on the content posted to ensure that the details available on the social media indicate high level of professionalism and good behavior, while at the same time promoting values helpful to the followers and the host. The posts should therefore, ensure that they encourage personal development by providing reliable information in reference to health and promote wellbeing by emphasizing such aspects as healthy eating and exercise, since nurses have the relevant scientific knowledge and skills on such issues.

De Gagne, J. C., Yamane, S. S., Conklin, J. L., Chang, J., & Kang, H. S. (2018). Social media use and cybercivility guidelines in US nursing schools: A review of websites . Journal of Professional Nursing , 34 (1), 35-41. Web.

Jackson, J., Gettings, S. & Metcalf, A. (2018). “The power of Twitter”: Using social media at a conference with nursing students . Nurse Education Today, 68, 188-191. Web.

Ross, J. G., & Myers, S. M. (2017). The current use of social media in undergraduate nursing education: a review of the literature . CIN: Computers, Informatics, Nursing , 35 (7), 338-344. Web.

Westrick, S. J. (2016). Nursing students’ use of electronic and social media: Law, ethics, and e-professionalism. Nursing Education Perspectives , 37 (1), 16-22.

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1. IvyPanda . "Social Media Use in the Nursing Profession." May 19, 2022. https://ivypanda.com/essays/social-media-use-in-the-nursing-profession/.

Bibliography

IvyPanda . "Social Media Use in the Nursing Profession." May 19, 2022. https://ivypanda.com/essays/social-media-use-in-the-nursing-profession/.

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An NPR editor who wrote a critical essay on the company has resigned after being suspended

FILE - The headquarters for National Public Radio (NPR) stands on North Capitol Street on April 15, 2013, in Washington. A National Public Radio editor who wrote an essay criticizing his employer for promoting liberal reviews resigned on Wednesday, April 17, 2024, a day after it was revealed that he had been suspended. (AP Photo/Charles Dharapak, File)

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NEW YORK (AP) — A National Public Radio editor who wrote an essay criticizing his employer for promoting liberal views resigned on Wednesday, attacking NPR’s new CEO on the way out.

Uri Berliner, a senior editor on NPR’s business desk, posted his resignation letter on X, formerly Twitter, a day after it was revealed that he had been suspended for five days for violating company rules about outside work done without permission.

“I cannot work in a newsroom where I am disparaged by a new CEO whose divisive views confirm the very problems” written about in his essay, Berliner said in his resignation letter.

Katherine Maher, a former tech executive appointed in January as NPR’s chief executive, has been criticized by conservative activists for social media messages that disparaged former President Donald Trump. The messages predated her hiring at NPR.

NPR’s public relations chief said the organization does not comment on individual personnel matters.

The suspension and subsequent resignation highlight the delicate balance that many U.S. news organizations and their editorial employees face. On one hand, as journalists striving to produce unbiased news, they’re not supposed to comment on contentious public issues; on the other, many journalists consider it their duty to critique their own organizations’ approaches to journalism when needed.

In his essay , written for the online Free Press site, Berliner said NPR is dominated by liberals and no longer has an open-minded spirit. He traced the change to coverage of Trump’s presidency.

“There’s an unspoken consensus about the stories we should pursue and how they should be framed,” he wrote. “It’s frictionless — one story after another about instances of supposed racism, transphobia, signs of the climate apocalypse, Israel doing something bad and the dire threat of Republican policies. It’s almost like an assembly line.”

He said he’d brought up his concerns internally and no changes had been made, making him “a visible wrong-thinker at a place I love.”

In the essay’s wake, NPR top editorial executive, Edith Chapin, said leadership strongly disagreed with Berliner’s assessment of the outlet’s journalism and the way it went about its work.

It’s not clear what Berliner was referring to when he talked about disparagement by Maher. In a lengthy memo to staff members last week, she wrote: “Asking a question about whether we’re living up to our mission should always be fair game: after all, journalism is nothing if not hard questions. Questioning whether our people are serving their mission with integrity, based on little more than the recognition of their identity, is profoundly disrespectful, hurtful and demeaning.”

Conservative activist Christopher Rufo revealed some of Maher’s past tweets after the essay was published. In one tweet, dated January 2018, Maher wrote that “Donald Trump is a racist.” A post just before the 2020 election pictured her in a Biden campaign hat.

In response, an NPR spokeswoman said Maher, years before she joined the radio network, was exercising her right to express herself. She is not involved in editorial decisions at NPR, the network said.

The issue is an example of what can happen when business executives, instead of journalists, are appointed to roles overseeing news organizations: they find themselves scrutinized for signs of bias in ways they hadn’t been before. Recently, NBC Universal News Group Chairman Cesar Conde has been criticized for service on paid corporate boards.

Maher is the former head of the Wikimedia Foundation. NPR’s own story about the 40-year-old executive’s appointment in January noted that she “has never worked directly in journalism or at a news organization.”

In his resignation letter, Berliner said that he did not support any efforts to strip NPR of public funding. “I respect the integrity of my colleagues and wish for NPR to thrive and do important journalism,” he wrote.

David Bauder writes about media for The Associated Press. Follow him at http://twitter.com/dbauder

An ISU nursing student was shown in a racist video about Beyoncé. Here's what happened next.

Indiana State University students protested on campus on Monday over the administration's response to a student video containing racist comments against the Black community.

According to the Indiana Statesman , Indiana State University's campus newspaper, the discriminatory remarks were originally posted to Yik Yak. The student was identified by some on social media platforms as a nursing student at the university.

Why did students protest at Indiana State University?

The comments were made in response to Beyoncé's country album, "Cowboy Carter," released on March 29. The identified student took issue with a Black artist releasing a country album, saying her ancestors were "pickin' okay, they wasn't plantin'," in a reference to the Southern slave trade.

The campus protesters marched from 1-5 p.m. on the former Lincoln Quad with four main demands. These included repercussions for the student’s behavior and future incidents, a statement denouncing the video, a zero-tolerance policy regarding hate speech on campus and amendments to the university’s Code of Conduct to oppose hate speech and implement repercussions for future incidents.

How did Indiana State respond to the video?

Nadia Lomax, one of the students involved in the protest, said the goal was to make sure silence isn't an option when faced with hate speech. “We’re here to make sure something like this doesn’t get swept under the rug again. The damage that occurs because of that (the lack of university response) is that students are told silence is OK and that they don’t matter,” Lomax said to the Statesman.

ISU president Deborah Curtis issued a statement on April 10 saying , "The student's comments in the video in no way represent the ideals and goals of Indiana State University. We are appalled by the sentiments expressed in the video and condemn those comments in the strongest terms."

How can racism affect health care?

Such attitudes coming from a prospective nurse are particularly concerning to those who realize how health care professionals can impact lives and contribute to shortened lifespans.

Racism, both structural and interpersonal — is a fundamental cause of health inequities, health disparities and disease, with the impacts being severe, according to the Centers for Disease Control and Prevention (CDC).

It’s among the contributors to disparities in maternal health between Black and white women, according to the CDC . Black women are three times more likely to die from pregnancy-related causes than white women. 

More than 80% of those deaths are preventable, the CDC says, with the delivery of respectful, quality care a factor.

The video and protests came ahead of Black Maternal Health Week, running April 11-17 to improve conditions around pregnancy-related health.

One woman, about to get her doctorate, commented on the issue on TikTok. "Black women have been screaming about how they get treated in the health care field for generations. The fact that she's so openly and blatantly racist while also learning to practice medicine is so scary."

"Our country has one of the highest death rates for Black women, especially Black women giving birth. To see a health care professional or somebody who is striving to be a health care professional and take care of people have this attitude, I am terrified that someone like her is going to be working in the health care profession and that we're going to have to see that person treating patients," said TikTok user @erinonthecape.

IndyStar reporter Cheryl V. Jackson contributed to this story.

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NPR in Turmoil After It Is Accused of Liberal Bias

An essay from an editor at the broadcaster has generated a firestorm of criticism about the network on social media, especially among conservatives.

By Benjamin Mullin and Katie Robertson

NPR is facing both internal tumult and a fusillade of attacks by prominent conservatives this week after a senior editor publicly claimed the broadcaster had allowed liberal bias to affect its coverage, risking its trust with audiences.

Uri Berliner, a senior business editor who has worked at NPR for 25 years, wrote in an essay published Tuesday by The Free Press, a popular Substack publication, that “people at every level of NPR have comfortably coalesced around the progressive worldview.”

Mr. Berliner, a Peabody Award-winning journalist, castigated NPR for what he said was a litany of journalistic missteps around coverage of several major news events, including the origins of Covid-19 and the war in Gaza. He also said the internal culture at NPR had placed race and identity as “paramount in nearly every aspect of the workplace.”

Mr. Berliner’s essay has ignited a firestorm of criticism of NPR on social media, especially among conservatives who have long accused the network of political bias in its reporting. Former President Donald J. Trump took to his social media platform, Truth Social, to argue that NPR’s government funding should be rescinded, an argument he has made in the past.

NPR has forcefully pushed back on Mr. Berliner’s accusations and the criticism.

“We’re proud to stand behind the exceptional work that our desks and shows do to cover a wide range of challenging stories,” Edith Chapin, the organization’s editor in chief, said in an email to staff on Tuesday. “We believe that inclusion — among our staff, with our sourcing, and in our overall coverage — is critical to telling the nuanced stories of this country and our world.” Some other NPR journalists also criticized the essay publicly, including Eric Deggans, its TV critic, who faulted Mr. Berliner for not giving NPR an opportunity to comment on the piece.

In an interview on Thursday, Mr. Berliner expressed no regrets about publishing the essay, saying he loved NPR and hoped to make it better by airing criticisms that have gone unheeded by leaders for years. He called NPR a “national trust” that people rely on for fair reporting and superb storytelling.

“I decided to go out and publish it in hopes that something would change, and that we get a broader conversation going about how the news is covered,” Mr. Berliner said.

He said he had not been disciplined by managers, though he said he had received a note from his supervisor reminding him that NPR requires employees to clear speaking appearances and media requests with standards and media relations. He said he didn’t run his remarks to The New York Times by network spokespeople.

When the hosts of NPR’s biggest shows, including “Morning Edition” and “All Things Considered,” convened on Wednesday afternoon for a long-scheduled meet-and-greet with the network’s new chief executive, Katherine Maher , conversation soon turned to Mr. Berliner’s essay, according to two people with knowledge of the meeting. During the lunch, Ms. Chapin told the hosts that she didn’t want Mr. Berliner to become a “martyr,” the people said.

Mr. Berliner’s essay also sent critical Slack messages whizzing through some of the same employee affinity groups focused on racial and sexual identity that he cited in his essay. In one group, several staff members disputed Mr. Berliner’s points about a lack of ideological diversity and said efforts to recruit more people of color would make NPR’s journalism better.

On Wednesday, staff members from “Morning Edition” convened to discuss the fallout from Mr. Berliner’s essay. During the meeting, an NPR producer took issue with Mr. Berliner’s argument for why NPR’s listenership has fallen off, describing a variety of factors that have contributed to the change.

Mr. Berliner’s remarks prompted vehement pushback from several news executives. Tony Cavin, NPR’s managing editor of standards and practices, said in an interview that he rejected all of Mr. Berliner’s claims of unfairness, adding that his remarks would probably make it harder for NPR journalists to do their jobs.

“The next time one of our people calls up a Republican congressman or something and tries to get an answer from them, they may well say, ‘Oh, I read these stories, you guys aren’t fair, so I’m not going to talk to you,’” Mr. Cavin said.

Some journalists have defended Mr. Berliner’s essay. Jeffrey A. Dvorkin, NPR’s former ombudsman, said Mr. Berliner was “not wrong” on social media. Chuck Holmes, a former managing editor at NPR, called Mr. Berliner’s essay “brave” on Facebook.

Mr. Berliner’s criticism was the latest salvo within NPR, which is no stranger to internal division. In October, Mr. Berliner took part in a lengthy debate over whether NPR should defer to language proposed by the Arab and Middle Eastern Journalists Association while covering the conflict in Gaza.

“We don’t need to rely on an advocacy group’s guidance,” Mr. Berliner wrote, according to a copy of the email exchange viewed by The Times. “Our job is to seek out the facts and report them.” The debate didn’t change NPR’s language guidance, which is made by editors who weren’t part of the discussion. And in a statement on Thursday, the Arab and Middle Eastern Journalists Association said it is a professional association for journalists, not a political advocacy group.

Mr. Berliner’s public criticism has highlighted broader concerns within NPR about the public broadcaster’s mission amid continued financial struggles. Last year, NPR cut 10 percent of its staff and canceled four podcasts, including the popular “Invisibilia,” as it tried to make up for a $30 million budget shortfall. Listeners have drifted away from traditional radio to podcasts, and the advertising market has been unsteady.

In his essay, Mr. Berliner laid some of the blame at the feet of NPR’s former chief executive, John Lansing, who said he was retiring at the end of last year after four years in the role. He was replaced by Ms. Maher, who started on March 25.

During a meeting with employees in her first week, Ms. Maher was asked what she thought about decisions to give a platform to political figures like Ronna McDaniel, the former Republican Party chair whose position as a political analyst at NBC News became untenable after an on-air revolt from hosts who criticized her efforts to undermine the 2020 election.

“I think that this conversation has been one that does not have an easy answer,” Ms. Maher responded.

Benjamin Mullin reports on the major companies behind news and entertainment. Contact Ben securely on Signal at +1 530-961-3223 or email at [email protected] . More about Benjamin Mullin

Katie Robertson covers the media industry for The Times. Email:  [email protected]   More about Katie Robertson

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NPR editor Uri Berliner resigns after bombshell expose reveals network’s pervasive left-wing bias

U ri Berliner, the veteran editor and reporter for National Public Radio who was suspended without pay after publishing a lengthy essay denouncing the outlet’s liberal bias, has resigned from the broadcaster.

“I am resigning from NPR, a great American institution where I have worked for 25 years,” Berliner wrote on his X social media account on Wednesday.

“I respect the integrity of my colleagues and wish for NPR to thrive and do important journalism.”

Berliner wrote that he “cannot work in a newsroom where I am disparaged by a new CEO whose divisive views confirm the very problems at NPR I cite in my Free Press essay.”

Berliner was referring to Katherine Maher, the chief executive at NPR who has come under fire for a series of “woke” social media posts in which she criticized Hillary Clinton for using the term “boy” and “girl” because it was “erasing language for non-binary people.”

Maher also appeared to justify looting In 2020 during the Black Lives Matter protests, saying it was “hard to be mad” about the destruction. In 2018, she wrote a post denouncing then-President Donald Trump as a “racist” before deleting it.

On Tuesday, NPR spokeswoman Isabel Lara said in a statement that Maher “was not working in journalism at the time and was exercising her First Amendment right to express herself like any other American citizen.”

Berliner, a Peabody Award-winning journalist, called out journalistic blind spots around major news events, including the origins of COVID-19, the war in Gaza and the Hunter Biden laptop, in an essay published last Tuesday on Bari Weiss’ online news site the Free Press.

In Berliner’s essay — titled “I’ve Been at NPR for 25 years. Here’s How We Lost America’s Trust” — Berliner said that among editorial staff at NPR’s Washington, DC, headquarters,  he counted 87 registered Democrats and no Republicans.

He wrote that he presented these findings to his colleagues at a May 2021 all-hands editorial staff meeting.

“When I suggested we had a diversity problem with a score of 87 Democrats and zero Republicans, the response wasn’t hostile,” Berliner wrote. “It was worse. It was met with profound indifference.”

Maher, who took up the role as CEO of NPR in late March, responded to Berliner’s essay by claiming that the veteran journalist was being “profoundly disrespectful, hurtful, and demeaning” to his colleagues.

She accused Berliner of “questioning whether our people are serving our mission with integrity … based on little more than the recognition of their identity.”

Berliner also called out his bosses at NPR for their refusal to seriously cover the laptop story — which was exclusively broken by The Post.

The laptop contained emails showing that the son of President Biden was engaged in influence-peddling overseas — though NPR and other media outlets declined to aggressively cover the story in the run-up to the 2020 presidential election.

According to Berliner, senior editors at NPR feared that devoting airtime to the story would help Trump’s re-election chances just weeks before voters cast their ballots.

Berliner wrote that NPR had deteriorated into “an openly polemical news outlet serving a niche audience.”

“The laptop was newsworthy,” Berliner wrote. “But the timeless journalistic instinct of following a hot story lead was being squelched.”

Berliner also accused NPR of giving disproportionately more attention to allegations that Trump was colluding with the Russian government to win the 2016 presidential election — only to devote far less resources to Robert Mueller’s findings that there was insufficient evidence to bring criminal charges.

After the contents of the laptop proved to be authentic, NPR “could have fessed up to our misjudgment,” Berliner wrote.

“But, like Russia collusion [allegations against Trump that were debunked], we didn’t make the hard choice of transparency.”

Berliner also called out NPR for pushing other left-leaning causes, such as subjecting staffers to “unconscious bias training sessions” in the wake of the May 2020 death of George Floyd.

Employees were ordered to “start talking about race,” he said.

NPR journalists were also told to “keep up to date with current language and style guidance from journalism affinity groups” that were based on racial and ethnic identity, including “Marginalized Genders and Intersex People of Color” (MGIPOC), “NPR Noir” (black employees at NPR) and “Women, Gender-Expansive, and Transgender People in Technology Throughout Public Media.”

According to Berliner, if an NPR journalist’s language “differs from the diktats of those groups,” a “DEI Accountability Committee” would settle the dispute.