For oncology practitioners today, it's impossible to ignore the virtual tidal wave of information that patients and practitioners are sharing via social media outlets like Twitter, Facebook, and LinkedIn-dramatically reshaping the landscape of healthcare.
Joni Watson, MBA, MSN, RN, OCN
For oncology practitioners today, it’s impossible to ignore the virtual tidal wave of information that patients and practitioners are sharing via social media outlets like Twitter, Facebook, and LinkedIn—dramatically reshaping the landscape of healthcare.
Newly diagnosed patients routinely turn to the Internet for information on their cancer, and more than 40% of consumers say that information found via social media affects the way they deal with their health.1 Many will join online patient communities specific to their diagnosis, where they can find support and resources—not just for themselves, but for their caregivers as well. The information and perspectives gleaned from these interactions may well become fodder for the next clinic visit. Add in to the mix, the finding that nearly onethird of healthcare professionals say they use social media for professional networking.2
It’s a lot to keep track of. Oncology nurses— already experts at multitasking—may well wonder where they fit in and reasonably ask “What’s in it for me?”
Plenty, according to Carol Bush, BS, RN, a nurse navigator at the University of Kansas Cancer Center in Kansas City. For her, what started as a way to stay in touch with her children, has blossomed into an active social media voice in the oncology nurse community.
Initially, Bush thought Twitter was more about celebrities, but when a “Tweet-up” was announced at the Oncology Nursing Society (ONS) Annual Congress about 4 years ago, she decided to see what it was all about. The experience inspired her to “step out and take the risk,” she said. She began attracting oncology nurses to her Twitter feed, including those practicing in the palliative care setting and some physicians as well.
“When I started, my son was my only follower,” Bush noted. “Now I have almost 300, and I think that shows how as you engage in social media, you can connect with other likeminded professionals.” She added that she now uses Twitter as her professional brand, connecting with colleagues to share information.
Bush said that she follows people who attend conferences she is interested in to access the information and resources that are shared at the meeting; in turn, she tweets from the conferences she attends. She found it especially surprising and gratifying when, after tweeting key points and posting a link from a meeting, she heard from an oncologist in France who picked up the information and posted it in a weekly digest of cancer resources.
Joni Watson, MBA, MSN, RN, OCN, Director of Medical Oncology at Hillcrest Baptist Medical Center in Waco, Texas, traveled a similar path to becoming a social media influencer for the oncology nursing community. Several years ago, she served as a panelist at a nonprofit advocacy conference as part of her work with the Texas Nurses Association’s Nurse Oncology Education Program. Texas has about 360,000 nurses, she pointed out, and they all need to be aware of oncology guidelines for screening, detection, treatment, and survivorship: “Every nurse is an oncology nurse from my perspective,” said Watson, “because we all play a role in the continuum of care.”
Having learned about Twitter as part of that panel, Watson began to start using it and quickly embraced the social media platform. “I was able to connect with all sorts of people from all over the globe, and that was what really attracted me to it.” She connected not only with Bush, but with other oncology nurses on Twitter and with nurse bloggers.
About a year after that experience, Watson, like Bush, brought her Twitter savvy to the 2009 ONS Congress in San Antonio. She was one of only a handful of attendees using the Congress hashtag (Sidebar), but it allowed her to connect with several of her peers and forge longstanding professional relationships and friendships throughout the country—connections she has maintained to this day via Twitter and Facebook, as well as in person when opportunities present themselves.
Watson’s tweeting at the ONS Congress caught the eye of the editor of ONS Connect, who asked her to blog for the publication. Although she had never blogged before, she found that she really liked it, and her twice-monthly posts quickly became every week. Watson soon realized she had perspectives she wanted to share with nurses beyond oncology, and she started her own blogging website: Nursetopia.net, a platform where she shares thoughts and inspiring messages for the wider nurse community.
Hashtags are a way of organizing tweets, allowing users to find information more easily on a particular topic of interest. When the # symbol is used before a keyword or phrase without spaces, (eg, #MultipleMyeloma), this allows users to locate information more easily in their Twitter searches and extend the reach of their own messages so others can find them.
Interested in news out of a professional conference such as the ONS Annual Congress even though you can’t attend yourself? Follow messages from the conference organizers and your peers attending the meeting (and tweeting, of course!) by searching the event’s hashtag (eg, #ONS2013), and you will find any other tweets which have been tagged with the conference’s hashtag.
Finally, hashtags offer a way for you to jump on a healthcare Twitter chat, for example:
These are just some of the oncology Twitter chats— places where you can ask a question, post a comment, or simply “lurk” (monitor the discussion for information). If you can’t jump on the chat in real time, you can search the hashtag later and review the tweets.
For more information on regularly scheduled and special chats in oncology and other healthcare topics, visit the website
Here, you can also see what’s trending in healthcare social media and identify many disease- and conference-specific hashtags.
Watson also blogs for TheOnc, a gated community of oncology nurses and cancer team members. TheOnc’s LinkedIn group currently has 2341 members who exchange thoughts on such topics as compassion fatigue, pose questions about practice issues (eg, “How do you cope with the ‘thankless’ patient?’), and review job openings across the country. ONS also hosts a LinkedIn group which currently has nearly 6000 members.
She is also a member of Pinterest, a content sharing service that allows members to “pin” images, videos, and other content to themed boards. Watson said that she uses this platform more for personal content sharing, but she maintains two boards where she can post items she believes would interest the larger professional nursing community.
All of this engagement, Watson explained, “has given me the opportunity to connect with so many professionals and survivors as well.”
Twitter, especially, she said, “is a fabulous platform to share information, to connect, and to educate.” Because healthcare professionals use it, she continued, in addition to advocacy groups and survivors, “it brings a richness of relationships.” Watson said that she has certainly learned about new resources through the platform, adding that it is a great way to share best practices and float questions to the larger oncology network.
Another value added is participating in or monitoring the conversations in oncology and healthcare-related twitter chats, such as the Breast Cancer Social Media chat (#BCSM), where nurses are welcome to post or simply listen in to get a sense of what is on their patients’ minds, helping clinicians to ask the right questions during the next patient visit.
Bush concurs. Patients are looking for information about their illness. “They are just calling out for help, and I can connect them with resources and to evidence-based, reputable information.”
As exciting as all of these possibilities are, they can also be daunting amidst so many demands on the oncology practitioner’s time. Certainly on the plus side, social media is flexible—allowing users to participate in a range of professional activities at no cost and to stay current on research and practice developments at times and places that are convenient to them.2
“Twitter and social media in general is what you make of it,” said Watson. And, she stressed, nurses, “who are very good at guilting themselves,” should certainly never feel guilty for not tending daily to their social media accounts.
Social media, she continued, is like a fire hydrant. “There is no way you can drink all that information and soak it all in. I’ve had to give myself permission not to read everything in every stream,” she continued.
There are platforms, such as TweetDeck and HootSuite, which allow users to organize their tweets into streams, so that they can follow more specific Twitter accounts and topics. With these tools, for example, users can follow oncology nurses in one stream. “There have been some relationships that I wanted to cultivate early on and hang on to every juicy bit of information,” said Watson, and this functionality has allowed her to do that.
Watson offered another tip to help with managing a Twitter account: If she spots an item of interest but doesn’t have the time to look at it at the moment, she will tag it as a “favorite” or email the link to herself to read later.
In the end, she advised, “it’s your network. Don’t ever be afraid to ‘unfollow’ someone. You make your network what you want it to be—make it useful and meaningful to you.” She suggested that nurses put their passions in their bios and to use hashtags, “so that others can find you and so you can connect with people who will bring value to your network.”
She added that her engagement with the different platforms changes, depending on the work she is involved in at the time. Recently she has found LinkedIn quite useful, with the additions of the “Like” button and the ability to comment on articles and view the content easily on mobile devices.
Nurses who remain uncomfortable with engaging in the world of social media on a professional level may just want to dip a toe into the water at first or reach out to their professional organizations for advice (Box). They may, like Watson and Bush, find that once they do test the waters, they really like the experience and will begin tweeting from their own Twitter account, use hashtags, and/ or decide to join one of the oncology nursing— focused LinkedIn groups.
“There can be a lot of valuable information in taking small sips,” noted Watson.
Whether using these social media platforms a little or a lot, oncology nurses can acquire even more insight into what might be worrying their patients, which, for varying reasons, patients may be reluctant to share in the clinic. Social media also offers nurses the opportunity to showcase their critical role in delivering evidence-based cancer care.2
“One of my passions,” Bush concluded, “is to encourage oncology nurses in particular to engage in social media.” Given what we all know about oncology nursing, her perspective makes a lot of sense: “We have such a broad spectrum of knowledge and know how to connect people.”
Carol Bush, BS, RN, and two of her Oncology Nursing Society (ONS) colleagues were recently awarded an ONS special project grant to pilot webinar and coaching programs to assist oncology nurses in becoming more comfortable engaging with social media.
“I’m a naturally social person, so it was a natural fit for me—almost like networking on steroids,” she explained, but for others, the prospect may be intimidating, Bush learned in conversations with colleagues at conferences she attended. There was a need for more information and guidance on getting started.
Building on the ONS special interest group (SIG) model, the project leaders are collaborating with the Nurse Navigator and Survivorship SIGs on a LinkedIn project taking place this fall. Among the topics to be tested are LinkedIn 101, which will feature advice on how to build a profile and the top 10 ways to make it successful. Another topic is how an oncology nurse can build up a network and increase interactions.
“The plan is to take the lessons learned from this pilot and expand it out,” said Bush, and that those trained through the project will become social media “champions.”