How Twitter can boost your nursing mojo

As Revalidation bites, we’re all on the look out for ways to fill those 35 hours of CPD, especially the 20 hours of participatory learning.  Did you know that taking part in professional conversations on Twitter can be used?  If you’ve never considered the professional benefits of social media, you may think Twitter is all about cats:

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Aww, he’s so cute.

And there is no denying that cats own the internet.

But there is so much more to Twitter for nurses and health professionals, something which the NMC recognise.  We even have our own dedicated community space in the form of @WeNurses and the We Communities.  But before we go any further, let’s remind ourselves of the key elements of ‘Participatory Learning’ for Revalidation:

“To meet the participatory learning requirement, you simply have to undertake activity that involves interaction with one or more other professionals. This can be in a physical environment or a virtual one – you don’t have to be in the same room as the people you undertake the activity with.”

I clarified with the NMC (via Twitter, of course) that professional Twitter chats could be included:

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OK, so now we know we can use Twitter to support CPD.  But why bother?  There are plenty of other ways to get your hours in, aren’t there?   If you’re unfamiliar with the platform, it may be difficult to see how this global conversation and cat gallery can have anything to offer nurses.

I spoke to Teresa Chinn MBE, founder of the WeNurses community and asked her why she first took to twitter.

I started WeNurses because I was an isolated agency nurse and wanted to reach out and discuss nursing issues and best practice with a few other nurses.  Social media gives nurses a world of expertise and opportunities in the palm of their hand.”

With nearly 48,000 followers, WeNurses has spawned similar communities across the board of healthcare professionals, including paramedics, pharmacists, midwives and many more.  Hosting regular twitter ‘chats’, it offers an unprecedented opportunity to discuss a broad range of clinical issues with peers.

There are benefits to twitter beyond Revalidation, as Teresa points out:

Social media is immensely valuable for nurses not only for what it can offer us in terms of CPD, learning and support but also with how it helps us to shape our digital identities as individuals and as a profession.”  

But what is a digital identity and why does it matter?  Consider the recent junior doctors strike.  Junior doctors presented a professional, vast, visible, united front on social media. Everything that we respect and admire in our medical colleagues was encapsulated in their digital identity.  Twitter is a public platform for us to showcase our professional identity and demonstrate to the world that we are a credible, educated, compassionate, dedicated, connected workforce.     

Like anything new, twitter may seem scary and deter those who are unfamiliar with it, something Teresa recognises:

“Sometimes its about showing [nurses] the possibilities and how it can help them in terms of learning or CPD.  Sometimes its about allaying fears around connecting in such a wide open space as a nurse and talking those through.”

For the new generation of nurses, the majority of whom will be ‘digital natives’, social media is likely to be a far less daunting professional space.  Indeed, they will play a fundamental role in shaping nurses digital identity.

Second year student nurse, Zoe Butler is a blogger and active member of the WeNurses twitter community.  I asked her how social media had benefited her professionally:

“Twitter has vastly increased my ability to network, develop and learn with not only fellow students, but also health professionals who I would not have had the opportunity to meet.”

Zoe talked of the opportunity to discuss clinical issues, challenging her practice and perceptions, stating this has “allowed me to be a more confident and considerate practitioner.”  Her engagement in social media has led to opportunities in her professional life which she argues she simply would not have been exposed to otherwise.

As Zoe points out however, it’s essential that we abide by the NMC Code and our employers social media policy when taking to social media.  A recent investigation by the Nursing Standard found that twenty nurses had faced Fitness to Practice proceedings between 2012 and 2015 for improper conduct on social media.  Social media platforms are public spaces, regardless of our privacy settings.

As Zoe points out though,

“If we portray a positive message that shows care, compassion and a love of nursing, this surely is allowing patients to see how passionate we are about their health and well-being.”

It is fantastic to hear the next generation of nurses speak with such passion about our profession, something Teresa echoed when i asked her how to engage nurse colleagues with twitter:

 “It can be hard at times to get nurses to see the value, however I have always gone with the mantra that if I can show just one nurse the difference it can make to them then I would have made a difference.”  

Spoken like a true nurse.

So, are you ready to take the plunge and boost your nursing mojo?  The WeCommunities site has a fantastic ‘Twitterversity’ for everyone; from absolute beginner to advanced tweeter.  Find it here.

©Jo Higman

Storytelling: the schizophrenia illness narrative.

In my previous post I introduced the value of illness narratives.  Here I’ll be using Eleanor Longden’s TEDTalk to demonstrate the power of narrative in schizophrenia.

Schizophrenia can be a devastating illness with catastrophic consequences.  Whilst there have been few advances in medical treatments, the growth of the recovery model is now helping people to manage their symptoms and build a meaningful life.

It was once thought that people who have been through the more distressing aspects of the illness may be unable to form a coherent account of their experiences.  That notion is now being widely rejected.  Indeed, it’s becoming apparent that in trying to make sense of the fallout from schizophrenia, constructing a narrative can actually form part of the recovery process (Roe & Davidson).  In her TEDTalk, Eleanor presents her story with eloquence, taking the listener on an engaging journey.

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In his work around stigma, Goffman referred to the concept of a ‘spoiled identity.’ Given the stigma surrounding schizophrenia one could argue that the diagnosis has the potential to create a spoiled identity.

Hyden however argues that illness narratives provide an opportunity for individuals to counteract this.  As Benwell & Stokoe suggest, “the practice of narration involves the ‘doing’ of identity.”

Eleanor constructs an identity that will be reasonably familiar to her audience. She is a graduate, and a highly successful one at that, with the “highest degree in psychology” and the “highest masters” the university has ever awarded. Her delivery is articulate, with moments of self-deprecating humour.  At one point she describes herself as a ‘madwoman’ and jokes that arming herself with picnic ware was ‘strategic.’

This has the potential to achieve several outcomes. First of all, her academic accomplishments suggest she is the intellectual equal of her audience. Secondly, by poking fun at herself, she is minimising the opportunity for anyone else to do so. She recognises the bizarre nature of her symptoms, occasionally with humour, effectively robbing her audience of the capacity to pass judgment.

the chaos of her illness is firmly in the past

The distressing aspects of Eleanor’s illness are clearly presented in the past tense, in the context of periods of acute illness: “It was then that I…” and “It was at this point…” There is a definite switch to the present tense, when Eleanor signals that the chaos of her illness is firmly in the past: “I’m now very proud to be a part of Intervoice.” This fits neatly into Toolan’s suggestion that “our preference is often for the sequence of connected events to take shape around a state or period of turbulence or crisis, subsequently resolved.”

society continues to marginalise and stigmatise those with a diagnosis of schizophrenia

Schneider argues, “If we do not present ourselves in terms of reasonably familiar histories and identities, we are likely to be regarded as, at best, eccentric and, at worst, mentally ill.” Eleanor would appear to have skilfully avoided the latter by presenting herself as an eloquent, engaging professional, working with a global organisation to bring about social change. This sits very comfortably with the TED ethos which claims to promote “the power of ideas to change attitudes, lives and, ultimately, the world.”

Interestingly, she does appear to invoke rather a socialist identity throughout her story. She refers to fellow voice hearers, as ‘comrades’ and quotes Hugo Chavez, former Venezuelan president and socialist. She refers to solidarity and oppression, words which are associated with the socialist movement, battling the hegemony of the ruling elite.  

The ruling elite in this case may be psychiatry itself, or a society which continues to marginalise and stigmatise those with a diagnosis of schizophrenia. As Schneider argues, if individuals wish to contest the pejorative nature of this diagnosis, they can either contest their membership to this category, or they can contest the definition of it.  Eleanor does not contest her identity as someone with a diagnosis of schizophrenia; rather, through her narrative she challenges us to reconsider our preconceptions about the illness.

©Jo Higman

Storytelling: illness narratives in mental health

Telling stories is an intrinsic aspect of being human, helping to shape the culture and values of the society we live in (Hyden, 1997).  It is, according to the Society for Storytellingthe very first way of communicating life experiences.”

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Brown et al suggest personal narratives help us to construct and re-examine our identities within our cultural and social context.  They are, according to Schneider, “artful constructions that draw on both our life experiences and on culturally available discourses to cast our lives and ourselves in particular ways.” 

As a nurse, I’m particularly interested in illness narratives; those stories we tell when we experience disease, trauma or periods of ill health.  Whether a bout of the flu or a life-changing diagnosis, we often like to share it with others, which can be part of the recovery process.  Roe & Davidson suggest narratives can help individuals to make sense of their experience and to restore their sense of self and agency at a time when power and control over one’s life may be compromised.

This opportunity to construct a narrative account of illness experience not only allows the individual to regain ownership of their stories, but may also become a fundamental aspect of the healing process.  Greenhalgh and Hurwitz highlight the importance of narrative in the clinical encounter: “Narratives of illness provide a framework for approaching a patient’s problems holistically, and may uncover diagnostic and therapeutic options.”

recovery in serious mental illness is distinctly different from the traditional idea of a clinical recovery from disease

The rise in interest in illness narratives has developed in parallel with the growth of the recovery approach in mental health, both having an emphasis on collaboration, hope and empowerment.  It is worth pointing out that recovery in serious mental illness is distinctly different from the traditional idea of a clinical recovery from disease. Rethink define recovery as, an ongoing process.  It is normal to have difficulties or setbacks along the way.

The therapeutic value of illness narratives may explain the explosion in the number of personal blogs, especially in mental health.  From perinatal mental health to depression, individuals now have a platform for telling their stories, which previously didn’t exist.

with support and encouragement, narrative offers individuals with schizophrenia the opportunity to weave back together a sense of self

Roe & Davidson argue that whilst having the opportunity to ‘re-author’ one’s life story should be considered a key aspect of recovery, it may not be so straightforward. They point out that individuals who have been through the more distressing aspects of schizophrenia, may have difficulty in constructing a coherent narrative.  Some argue that this lack of coherence may actually serve as a protective factor against the despair brought about by the illness. 

However, with support and encouragement, narrative offers individuals with schizophrenia the opportunity to weave back together a sense of self. With an illness that can cause tremendous distress and potentially deprive someone of their liberty, Roe & Davidson argue that narratives offer an opportunity for the person to become “the protagonist, the hero of her own story” 

Nowhere is this better demonstrated than in this brilliant TEDTalk by Eleanor Longden.  In my next blog post, I’ll be discussing Eleanor’s narrative in more detail, celebrating an alternative aspect of storytelling.

©Jo Higman