Check out our special interview on nursing and social media with Pamela Ressler, MS, RN, HN-BC, founder of Stress Resources and lecturer in the pain research, education and policy program at Tufts University School of Medicine in Boston. She researched how social media can be a tool to help combat isolation and build communities for chronic disease patients. Here’s what she has to say.
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Jamie Davis: Hi, Pam. Welcome to Nursing Notes Live and I always start off and ask our nurse guests to share with our audience a little bit about their nursing background. Why did you want to become a nurse?
Pamela Ressler: Well, thank you for having me, Jamie. I really appreciate this opportunity to talk to other nurses out there. This may sound a little trite or silly but when I was in elementary school – and this is dating myself a bit – there was a very popular series of books called “Cherry Ames.” Cherry Ames was a nurse and she seemed to be able to do anything everywhere. I guess I kind of put this in the back of my mind for several years that nursing didn’t have to be done in a hospital. That it could be done in lots of different places and it was so flexible and I thought this was pretty cool. Again, dating myself, I thought it would be pretty cool to have a white cap and those white shoes. Fast-forward a bit, I did go directly into a bachelor’s program, a BSN program, at the University of Michigan and I entered that in the mid-‘70s, in 1975. I graduated in ’79 and moved to the Boston area where I kind of started a long and winding journey that I never really would have imagined in certainly the mid to late ‘70s my nursing career would take me. I started thinking that I would be in mother-child health especially. I really liked post-partum and nursery work. But my career took me into a more ambulatory area of general surgery, vascular surgery, and I stayed there for a number of years. My main part of my job was a lot of patient teaching, a lot of connection to our folks and lot of learning about – it was very new at that time, it was in the early ‘80s, about this thing that we now call, “Mind-body connection.” So I was in the Boston area, I started to look into work around mind-body medicine which at the time was being touted at one of the Harvard-affiliated hospitals. I learned about this, started to teach our patients in our practice, and we were able to actually use lower doses of, let’s say, the vasodilators that we had been using. So this kind of really piqued my interest in relationship teaching, this whole area of patient self-care, started to really be exciting for me. One of my children had been diagnosed at a very early age with ulcerative colitis and I became an incredible advocate for pediatric care. Then I transitioned my career more back to where I thought I might be when I graduated into working in school nursing for a few years. That was really exciting because again building that relationship really was working with kids with maybe some medical issues but more right with them than wrong with them and how do we support and nurture that ability of being well within the context of disease and that it can really be an integral part of where I felt my nursing was really important.
I formed my own company at the time called “Stress Resources,” which I still run, and the focus was really on how do we build tools and use tools of resilience, those that help healthcare providers, individuals and organizations but also how do we nurture that within our patients and communities. So through that, and as I became more well-known in that field, I was offered opportunities to teach within the College of Nursing at UMass Boston where I taught Stress Management program in undergrad nurses and also with a consultant on a federal grant called “The Nursing Scholars Program” which we were helping underserved populations, make sure they enter the nursing force with the best tools of resilience that they can possibly have. At that point, I also decided that a lot of my work really surrounded the idea of pain and suffering from a social psychological model more than the biological model. My son, while he was sick, had taught me a lot and one of those was – it was right at the edge when the internet was starting – and one of the times that he was very much without pain was when he could connect as a kid again. He was 14 and it was so important back then that we hook in with the dialup for him to connect with friends back home while he was spending days in the hospital. So I really started to see this correlation between pain and suffering, sense of isolation and patient’s family and society. So I sought out a program to get a degree and it happened to be not in the school of nursing where I was expected to go back to but actually in the medical school. It’s the only multidisciplinary pain program of its kind in the US still and it’s called the “Pain Research Education and Policy Program” at Tufts School of Medicine in the Boston area. In that program I found that I could get out of the nursing silo a little bit and I could really be a thought leader around this idea of resilience, pain and suffering. So I started to do a lot of research and with consent to the social media piece which was just beginning at the time in the mid-2000 and became one of the leading researchers around this idea of patient connection and communicating the experience of chronic pain and illness through tools of social media such as blogging. So I’m now part of the faculty also at Tufts School of Medicine but researching is always with the nursing lens. And so my research is actually framed by Margaret Newman’s Nursing Theory of Health as Expanding Consciousness and so I love to bring in nursing theory into folks that might not be as familiar with where we are. So that’s probably more than you or your listeners really wanted to hear but that’s kind of my long and winding journey in Nursing from the ‘70s till now.
Jamie: You know it’s interesting, Pam, whenever I hear nurses describe the various directions their career goes in nursing that how holistic approach towards patient care, I think, could also be applied to a holistic approach towards the way our careers progress because so often it is the skills that we bring from other disciplines, it is the life events that happen to us and around us that shape the directions of many varied directions we take in nursing and I find that always fascinating. Your example is a perfect one to point that out.
Pamela: Yes. I think I would totally agree with you. One of the things that I always tell young nurses who are starting out is don’t get yourself in that box where you think your career is going to go or how you think you should do something. Follow the passion and follow what you are well trained and going in so many directions with your nursing skills. As I went into business, it’s only my own business, I found that the nursing process was a perfect model for business. Here we’re talking about evaluating and planning and analyzing and implementing. Well, hello, that’s what we nurses are excellent at and we always have been. So don’t be scared about kind of pushing the envelope a little bit of where you think your career make out and don’t stay in one place too long in terms of that mental place.
Jamie: Speaking of expanding your horizons and not being afraid, where do you think nurses as a group stand with regard to use of technology and specifically things like social media as a vehicle to model healthcare and to provide opportunities to share communication in a positive way about health?
Pamela: Well, unfortunately, we, as a collective group of professionals in nursing, have been very slow in implementing tools of connection through social media or even using a lot of – I don’t want to say “computer” because now we’re talking smartphones and all kinds of devices – we have been a little nervous. I think there are a number of reasons why. First, we have a different way of interacting. HIPAA is certainly in our minds. Confidentiality and privacy certainly weigh in very heavily on our use of social media tools. But I would encourage nurses to kind of take a step back from that risk and fear mindset and think about what we really can do and why we want to engage in social media. When I say “social media” that doesn’t mean just posting pictures from your weekend Facebook. Social media is a tool that we can learn to use like all of the tools we use within the healthcare profession. One of the great things about social media is that it can be a two-way dialogue. It doesn’t need to be only a broadcast media. So with that, we can share with society, with global patients our knowledge. Certainly not making diagnosis, et cetera but really helping that foster the connection, the relationship that I have valued so much through my decades of nursing in a different form. So I encourage nurses to get at least a little more comfortable. We know that patients, as a group, especially those with chronic disease are engaged in social media. Peer-to-peer health has become the new word, the new phrase of the last couple of years where patients are interacting around certain issues. We need a nursing voice to be present, to be adding resources, advocating and connecting. The only way we can get there is for nurses to become more comfortable with this idea that social media is a tool that, yes, has risks but it has enormous benefits for decreasing isolation and increasing connection between us as the healthcare folks and our patients and families.
Jamie: I completely agree. It is I think a perfect role for nurses to be a curator of trusted health resources both in and among research facilities and healthcare industry but also with patient resources and forums and patient blogs are tremendous resource of those little things that make life bearable for somebody with a chronic illness.
Pamela: That’s right. And we know that isolation is a huge risk for anyone with chronic illness and not just the patient but the family. When we look for ways to reduce that sense of isolation and it’s not just the physical isolation but the social isolation, they are removed from being in the Land of the Well and how do we bridge that? How do we help patients and families regain some meaning, some purpose, some ability to feel like their voice matters and to give them a voice. And I believe that the social media isn’t the only way we can do that. But it’s certainly a tool that wasn’t in our arsenal to offer even ten years ago. As nurses, I feel not only can we be the curator but we can also be an aggregator for pulling together lots of information and then helping patients sift through that. We can be a voice of reason. We can also help foster the organic connections that can occur in a social media space. But I think our role also is to teach patients like we teach all patients safe practices, best practices and that can also be our role. But the first thing is nurses have to understand by engaging themselves what this is all about because otherwise you’re using a tool that you’ve never used yourself.
Jamie: There’s so many different platforms out there and I’m very active in many platforms as a function of the work that I do but for somebody that’s not been engaged in social media, do you think there’s a particular place they should start? Rather than trying to jump in and try to engage on for your four different platforms, is there one or two that you think are better than others to get started with?
Pamela: Yes, but I usually recommend who just kind of want to dip their toe in the water, so to speak, with social media. The first place is to engage in LinkedIn. LinkedIn has been a tried-and-true professional network for a number of years. Healthcare has not been well-represented on LinkedIn but I think it serves two purposes: first, nurses need to understand how to market themselves like other professionals have learned to do for a number of years and often learn in their undergraduate training to get a job, et cetera. Nurses never have really had to position ourselves with what our knowledge is, our resumes, et cetera, in this space. And so I think it’s important as we enter a new workplace, kind of a global workplace, that you establish your professional self and nurses have just a wealth of knowledge, of accomplishments that we often don’t give ourselves credit for. So I think it’s really important to spend a little time to develop a profile on LinkedIn. And then the next step there is to take a look at some areas of your interest. There are a lot of great discussion groups that are happening now in that healthcare space on LinkedIn that anyone can join. So it’s a great way to kind of start just understanding how the protocol works, the conversations work on these different groups. You can engage as much or as little as you would like. It’s a free platform and it’s a wonderful way to kind of get started. The second place that I usually recommend, so to kind of want to see what’s happening in the space is Twitter has become I think a wonderful professional opportunity and many people may hear that and say, “No way. I don’t want to be on Twitter.” But Twitter is not only a listening post that you can follow a trend around a certain interest or disease or trend around flu, et cetera, but there are chats, real-time chats that are happening in the Twitter space. Twitter is just a microblogging. We call it a microblogging platform. But these chats have a lot to do with how we establish ourselves as nurses as these thought-leaders change agents within healthcare. And you can find a listing of these healthcare-related chats. There’s a site called “Symplur” – symplur.com – that lists all the current healthcare conversations that they know of that are happening in the Twitter space. This is kind of an assassinating way to actually engage like you are in a room in real-time with other nurses and healthcare professionals from all over the world. And again you don’t need to engage as much as listen at first but it’s a wonderful way to also understand what’s happening in your areas of interest. Journal article links are posted frequently various conferences get posted. And it’s a wonderful way to just engage yourself a little more in not only the profession but your specific target area.
Jamie: So as we wrap up this interview, Pam, is there any particular advice that you’d offer for that nurse who wants to engage more with their community about healthcare issues in a social media way?
Pamela: I would say get in there and start listening first. Remember, don’t post anything that you wouldn’t want your mother or your boss to see and it doesn’t matter how private social media sites say they are. Assume that they are all public. Be cautious against engaging directly with patients online. That is not really the purpose and that is when I see the most problems arise around confidentiality and privacy. So you want to have a kind of a step back. You don’t want to have that one-on-one engagement necessarily but get on there and start exploring. It really is learning to use a new tool that we haven’t had in our nursing tool box before but I think it’s a perfect tool to help nurses really establish themselves as the healthcare leaders to get out of our rather narrow silos that some of us find ourselves in and to really show the world that we are change-agents, we are advocates, we have an incredible wealth of knowledge to share.
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Make sure you check out the entire February, 2014 issue of Nursing Notes, where we look at how nurses use social media and technology in their nursing practice. You can read the entire issue online at www.discovernursing.com and don’t miss the other Nursing Notes Live episode this month with a panel discussion on our topic featuring nurse Pamela Cipriano, Research Associate Professor at the University of Virginia School of Nursing and Meredith Rowe, nursing professor and endowed chair at the University of South Florida College of Nursing. You’ll find this and other episodes of Nursing Notes Live in the podcast area on iTunes.