Tag Archives: social media

That’ll do. Seeya.

Hello. Thanks for dropping by. This will be the last post on meta4RN.com

meta4RN.com attracted visitors from more than 100 countries

It is 10 years ago today when the post “Hello World!” jauntily announced the meta4RN.com launch, and the “About” page outlined the rationale and vision for this nursing blog.

Since then there have been more than 200 meta4RN.com posts published (they’re all listed here meta4RN.com/contents). Those posts have yielded more than 190,000 words – that’s the length of a PhD thesis, twice 😳. Additionally, meta4RN.com has been adorned with hundreds of images and embedded Tweets, and dozens of Prezi and SlideShare presentations, and a heap of YouTube and TikTok videos. The visual stuff is much more labour-intensive than writing.

How many hours have been poured into meta4RN.com? IDK. About a bajillion.

The decision to stop contributing to meta4RN.com today was made a year ago. It is the right decision. I plan continue working full time for another 4ish years, but not beyond that. It is sensible to transition away from doing work-related things like maintaining the meta4RN.com nursing blog, and spend more time and energy on non-work-related stuff.

I have enjoyed creating meta4RN.com. I’ll stop paying for the domain name in about a year, but the site will remain online in one form or another. I think WordPress will maintain a free version of the site with a different address (something like wordpress.meta4RN.com), but I’m not really sure. I am sure that the site is being archived by the WaybackMachine (here: web.archive.org/web/20220910010128/https://meta4rn.com/) and the National Library of Australia (here: webarchive.nla.gov.au/tep/140064).

The best thing about having a nursing blog is that it gives an ordinary working nurse an extraordinary audience. The meta4RN.com site has attracted over 190,000 views. That’s a big deal. I do lots of face-to-face education sessions, but those audience sizes are mostly around 10 at a time, and only occasionally larger than 30. Crowd sizes are a bit bigger at conferences, but even then it’s unusual to have more than 100 in a room. Is there any way to amplify your message and audience without going online?

There is context for this. Nurses have often lamented that their voice is not heard in the media, that they have been intentionally frozen out of conversations about health service planning/delivery, or that they are overlooked or ignored altogether. Social media gives Nurses an avenue to assert their voice in the public realm, but how many of us are accessing this opportunity? You have probably heard the Dalai Lama quote, “If you think you are too small to make a difference, try sleeping with a mosquito.” Nurses are the most numerous of clinicians. Try ignoring a swarm of mosquitoes. Make a buzz.

Reach & Readership

Who does meta4RN.com reach?

The primary value – to me, anyway – has been the improved access to my workmates that the blog has provided.

  • Couldn’t get to the inservice? No worries, I’ve plonked a video version and the references here: meta4RN.com/grow
  • Want to revisit what we were chatting about last week? Easy. There’s a summary here: meta4RN.com/step
  • Feeling stressed by nursing in a pandemic? Me too. Here’s how I frame it: meta4RN.com/switch
  • What you’ve achieved has been amazing. Check out the data: meta4RN.com/surfing

Obviously it’s an unofficial, “back channel” kind of access (the sort of thing that makes managers nervous), but it’s been very valuable over the years. Every inservice education session should have a webpage for easy access to references and resources, shouldn’t it? It was incredibly helpful to have had the meta4RN.com site already in place and fairly well known before the pandemic – it’s interesting to scroll through the contents page (meta4RN.com/contents) and note the increased emphasisis on posts about reflective practice and self compassion from early 2020.

Act locally. Echo globally.

For most of the meta4RN.com posts I imagined the reader as a 3rd year nursing student or early-career Registered Nurse in FNQ. The actual readership was much-more geographically far-flung.

The meta4RN.com site attracted visitors from more than 100 countries, the top 8 of which were Australia (about 47%), United States (about 28%), United Kingdom (about 9%), and Canada, New Zealand, India, Phillipines and Ireland (each between about 1 and 3%).

Top 8 countries visiting meta4RN.com

Hits & Misses


Let’s start with the hits. That is, the five posts that attracted the most hits online, and the five posts that I am most proud of.

Sample of meta4RN.com posts: 5 that attracted the most visits and 5 that I am most proud of

Interestingly, 4 of the 5 posts that attracted the most visits are instructive and/or have free, reusable templates, ie:

  • Using the Edinburgh Postnatal Depression Scale meta4RN.com/EPD
  • Example of Nursing Curriculum Vitae meta4RN.com/CV
  • Mental State Examination: Looking, Listening and Asking meta4RN.com/MSE
  • Sample Clinical Supervision Agreement meta4RN.com/sample – this page attracts most of the hits meta4RN.com gets from the United States.

The “Nurse Can’t Take Pulse. Seriously.” post was a critique of the first episode of an Australian hospital-based TV series called “Pulse”. It attracted 17,000 hits in a couple of days, which was a bit of a surprise. Typically meta4RN.com attracts about 2,000 hits a month. It was topical for about a week, then stopped being of interest, as evidenced by the paucity of hits since the year it was published.

The posts I am most proud of didn’t attract the most attention.

  • The Broken Leg/Psychosis Metaphor meta4RN.com/leg prolongs one of the many learnings I acquired from Greg Holland – the most skilled communicator/mental health nurse I have worked with
  • Emotional Aftershocks meta4RN.com/aftershocks is too long, but it was cathartic to shine a light on the remarkably common nurse experience of being exposed to violence at work
  • Lalochezia meta4RN.com/lalochezia is short, fun and is the blog post that my workmates speak of the most
  • Hand Hygiene and Mindful Moments meta4RN.com/hygiene is a pretty simple and not entirely original idea; it’s had pretty good acceptance and uptake amongst my workmates

The “Self Care/Compassion [combined]” section of the chart above is essentially the same post used in support of face-to-face education sessions (primarily, but not exclusively, for new graduate nurses). The post was repeatedly updated/refined to remain relevant. This was especially important during and after the pandemic arriving. The posts tallied together as one under the Self Care/Compassion heading are:
– 2013: Nurturing the Nurturers meta4RN.com/nurturers
– 2017: First Thyself meta4RN.com/thyself
– 2019: Self Care: Surviving emotionally taxing work environments meta4RN.com/SelfCare
– 2020: Clean Hands. Clear Head. meta4RN.com/head
– 2022: Self Compassion: surviving and thriving in emotionally taxing work environments meta4RN.com/grow
If the meta4RN.com site has any legacy at all, I hope it is recalled as a place where nurses showed care for nurses.


The posts that missed were the ones that attempted to enthuse, beguile or bully nurses into using social media more intentionally and actively. If you scroll through the contents page (here: meta4RN.com/contents) you will see that nurse social media is a reoccurring theme of meta4RN.com. Anyway, those posts did not reach much of an audience, nor have I seen any large-scale change in Australian nurses embracing social media as a way to participate in the public conversation. I think it’s a lost opportunity for the profession. Why? Scroll back up and read paragraph 8 (the one that starts, “There is context for this”).

Daggy Stuff

I didn’t update the look of the meta4RN.com website at all over its 10 years of existence. Sorry. I thought about it once, but couldn’t be bothered. It’s daggy.

Even though I articulated that “meta4RN” is a homophone that can be read as either “metaphor RN” or “meta for RN”, it didn’t really catch-on. It’s a bit daggy.

Although it was flattering to have heaps of people subscribe to the blog, I really wished they didn’t. Subscribers get the published version sent straight to their email address, which is bad for me. Why? Because I make an embarrassing amount of typos with every blog post. When I notice typos I can fix them online, but subscribers don’t get to see that. They only get to see the typo-ridden version that lands in their inbox. Daggy.

Also, email is so 20-something years ago. Who can be bothered with email anymore – it’s too daggy.

Daggy email pic source and context: https://twitter.com/meta4rn/status/1559382221470912513?s=21&t=UMeI60oWU0inenVpy4DESA

What’s Next?

I don’t know. There will be something post-meta4RN.com, but I’m not sure exactly what it will look like. It will be less work-related, and more to do with cultivating activities that will sustain me when I get around to retiring in a few years.

I’m not sure what, if anything, I’ll do with my new website: paulmc.au

I do know that paulmc.au will not be a nursing blog like meta4RN.com. I’d like to visit other Australian nursing blogs though.

I’m not sure yet what I’ll be doing with all the other meta4RN-branded social media platforms, which are listed here: meta4RN.com/links and here: linktr.ee/meta4RN


Thanks to everyone who has visited, interacted with or shared meta4RN.com over the last 10 years. Your support has been very encouraging. Thank you.

As I did 10 years ago I would like to acknowledge and thank Ian Miller as a pioneer of this space. Ian’s impactEDnurse.com blog inspired the launch of meta4RN.com.

Special thanks to my favourite human @StellaGRN for putting-up with me buggerising-about on the blog and related stuff for a decade. You’re very patient darling. Thank you.

Finally, thank you to my life-long partner Early-Waking Insomnia. I never would have found the time for meta4RN.com without you.


That’ll do.

As always, feedback is welcome via the comments section below.

Paul McNamara, 24 September 2022

Short URL: meta4RN.com/seeya

Seeya 🙂

How to be a Journal Social Media Editor

Drawing on more than 5 years of experience as Social Media Editor for the International Journal of Mental Health Nursing, I hereby present an amateurish manifesto in two parts. Feel free to ignore it.
Version 1 (copy & paste from an email I sent on 7 December 2016)
Twitter is a hungry beast. IJMHN will feed it daily with scheduled Tweets promoting its papers/authors. IJMHN will be cautious about entering into conversation with individuals, and is unlikely to retweet much at all, other than an occasional RT of ACMHN tweets. The IJMHN’s standing as a peer-reviewed journal will not be compromised. The often-too-long-to-Tweet journal article titles will stripped of most of their jargon, and rephrased in accessible language that will readily understood by most clinicians and consumers. The goal is to make Tweets engaging and shareable, in the hope that it will drive more traffic to individual papers. 
Facebook will require less active input. About once a fortnight/month will be about right. Rationale = people generally have their social life on Facebook: occasional posts from a work-related site on an individual’s feed will be tolerated, too many posts would likely be construed as intrusive risking the “Like” button being deactivated.
The advantage of SoMe is that it’s all on public view. Feedback from other members of the IJMHN Board will be invited in the New Year.

Key Performance Indicators for a Journal Social Media Editor

Version 2 (in preparation for handing-over the social media editor role at the end of 2022)

First things first. Get your head around these three ways to use social media:

Personal Use.
Personal use of social media is where you share photos of your holidays with family and friends on services like Facebook or Instagram. You may engage in conversations with friends, strangers or public figures, but you will not be representing your profession or an organisation when you do so.
Professional Use.
Professional use of social media is based on your area of expertise and interests. This use of social media is when you share information with and interact with other individuals and organisations that have the same interests. Like you do at work, you will occasionally share aspects of your personal life, but you will be boundaried and cautious re this.
Official Use.
Official use of social media is where an organisation presents their brand and shares information online. @IJMHN = the International Journal of Mental Health Nursing on Twitter, for instance. Official use of social media will have a different tone and goal to personal or professional use of social media.

A Journal Social Media Editor’s personality and opinions take a backseat when they are driving the brand and content of the journal. Your performance is as public as your social media posts. Your key performance indicators (KPIs) are not a matter of opinion, they are quantitative (see below).

Twitter is a hungry beast. Feed twice daily.

Schedule tweets so that the journal’s Twitter account is as steady and reliable as a metronome.

For the majority of my time as Journal Social Media Editor I used the free version of Hootsuite to schedule Tweets. Mid-2021 the features I was accessing for free became available only to paid Hootsuite subscribers, so I switched to Tweetdeck. Tweetdeck has been fine, but you may want to see what other platforms are out there.

The content of the Tweets achieves interest, not random timing.

As the Social Media Editor of the journal you have a regularly updated library of the journal’s content at your disposal – that’s where the interest lies.

Unless you can find a way to get paid for achieving nothing tangible, a tweet without a link to an article is a poor return on your investment of time. Your primary KPI is the Altmetric Attention Score (more about that below), everything else is aesthetics. How much time do you want to spend on aesthetics each week/month/year?  

This Tweet below is a vanity Tweet. It might provide a transient frisson of feel-goodness, but it has all the nutritional and health benefits of fairy floss. It’s a rare distraction, not a regular thing.

One Sunday each month schedule tweets using these self-explanatory hashtags: #20YearsAgo #FromTheArchives @IJMHN Volume… & #10YearsAgo #FromTheArchives @IJMHN Volume… browse the 10/20 year old issue that most-closely corresponds with the current month, and select the most interesting/controversial titles, eg:

Be open to spotting patterns/trends, and sharing insights you stumble across. There won’t be many people keeping as close an eye on IJMHN articles as you. eg:

Schedule a run of Tweets to coincide with each new bimonthly issue, eg:

Keep an eye out for international days that have social media campaigns, and align articles with them if you can. eg:

If your journal also serves as the book of abstracts for a professional society, align the journal’s tweets with the society’s conference using the conference hashtag, eg:


I took over the Social Media Editor role late in 2016. It took until July 2021 to get access to the journal’s Facebook page. That’s a ridiculous delay, but as far as KPIs go it’s not such a big deal.

Facebook posts to a public page (not a personal account) attain a smaller Altmetric Attention Score than a Tweet. It plays a part in meeeting your KPI, but only a small part.

I’ve been using Facebook as an avenue to promote new open access articles primarily. That keeps the volume of posts fairly low, which I think is an important consideration if we don’t want to alienate Facebook followers. Why? Individual’s Facebook pages are primarily used for sharing photos, stories and other aspects of their personal life. If work-related info swamps this people will tend to unfollow or mute the page. Less is more.


After being the ugly-duckling of social media for many years, in the last couple of years LinkedIn has become a platform that is worthwhile using. I say this with confidence because of looking at referral data for the meta4RN.com blog. LinkedIn never used to generate any significant traffic to meta4RN.com before 2018. Since 2020 it has become the 4th largest referral source (behind Google, Twitter and Facebook).

Use LinkedIn the same way you use Facebook. Use your time efficiently and just copy and paste the same content. If you have the time/patience to tag the authors on LinkedIn that’s fair enough, BUT it won’t help you meet your KPI. LinkedIn does not generate an Altmetric score at all.


Forget it.

Insta is a visual platform and most journal articles are visually boring. Also, Insta posts don’t carry links, nor does Insta affect the Altmetric score (your KPI). Forget instagram.

Traps to Avoid
You will receive requests from people, including people on the editorial board/related organisations, to share info on their behalf (eg: recruiting for their projects etc). Ignore them all. That’s not the Social Media Editor’s job. How could you possible pick what’s ‘worthy’ of promoting and what isn’t? Also, it does not meet any of your KPIs. Forget it.
Don’t quarantine time to do social media stuff alone. Since January 2017 every Tweet, Facebook post and LinkedIn update has been written and scheduled on my ipad while I’ve been listening to music, half-watching TV (shows my partner likes, but I don’t), or filling-in time during the ad-breaks while watch sport on TV. Scheduling a social media post is not brain science or rocket surgery, it doesn’t require your undivided attention.   
Don’t get involved in an argument you can’t hope to win. Every now and then someone will respond to your social media post negatively. That’s fine. Just let it sit there. They are not talking to you the Journal Social Media Editor, they are talking to the author(s) of the journal article. It is not for you to defend or respond.
Things to Enjoy
This is a bit sad, but I’ve trained myself to get a little dopamine hit every time I “discover” a new article via Early View. I only check when it’s a good time for me: while on holidays I might not check for a few weeks, but otherwise I’ll have a sneak-peek every day or so when I’m not doing anything else especially important.

Enjoy the articles too. Unless you’re super-geeky you’re not going to read every word of every article, but you’ll read every abstract. You’ll look for, and find, insightful quotes, interesting data, and inspiring themes. Enjoy.

Opportunities to Explore

Social media platforms come and go. It will be surprising if the platforms being used in 2022 will have the same weight and functionality that they will in five years time. Stay flexible.

Blog posts present a relatively easy 3 points on the Altmetric Attention Score. At time of writing ijmhn.com, ijmhn.org and ijmhn.net all remain available URLs. Setting up a basic website/blog takes minimal funding and expertise. Journal article authors could be invited to write a plain-language summary of the article together with a visually appealing dit of data and/or an author photo. Suggestion: if you do go down this path, make sure that the site will be compatible with embedding the Altmetric badge (for more info follow the button in the top-right corner here: wiley.altmetric.com/details/128895594). That – at time of writing – means avoiding the most-readily-available/user-friendly wordpress platform.

Something I’ve thought about, but never sought opinion/permission from the editorial board, is emailing article authors at time of publication with tips on promoting their article via social media. That’s what I had in mind when I made the video below. The video is a bit too smart-arsey in tone and amateur in production for use, I reckon, especially considering that most authors for the IJMHN are not Australian and may not understand/could be offended by the irreverence/humour.

Primary KPI
The primary key performance indicator (KPI) for the success of failure of the social media strategy is via altmetric, as articulated in this journal article. Read up on how the Altmetric Attention Score is calculated – as the journal’s social media editor you’ll probably know and care it more than anyone else in the editorial board – do what you can to share the enthusiasm. I suggest gathering and reporting on the pre- and post- data to see what impact your strategies are having.
Secondary KPIs include
The number of social media interactions
The number/relevance of current social media platforms

The popularity of specific social media platforms will rise and fall over time: is the journal keeping up?

Similar question with different wording: Is altmetric measuring data from platforms that the journal is not using? If so, that’s a good indication that the journal is not keeping up.
The annual Impact Factor ?

There is debate in the literature on whether social media interaction leads to more citations. Do a search for yourself and stay abreast of contemporary data.

To my way of thinking if you were doing a thorough literature search, whether or not an article(s) had been shared on social media wouldn’t make much of a difference. I guess that the reality is that not every literature search will be thorough, and – thorough or not – what is cited in an any given article on a topic will rarely be 100% complete. If you accept those arguments as being plausible, would it not also be plausible that an article that already attracted a lot of attention would be more likely to come to the attention of researchers/authors?

But anyway, don’t rely on my arguments about plausibility. See if you can find contemporary evidence one way or another – fair dinkum stuff with a control group and quantitative data, not the namby-pamby opinions of a bloke with a blog (me).  
So What?
Look, being a Journal Social Media Editor won’t create world peace, rid the planet of poverty and starvation, or solve climate change. However, if the research and innovations your journal publishes contribute to the world being a better place, you will play an important role in amplifying the reach and readership of that work.

I’m pretty sure I’m the only person on the editorial board of IJMHN who does not have a PhD. If you’re capable and confident with using social media in an offical way, becoming a Journal Social Media Editor can add a bit of oomph to your curriculum vitae.

The main reward for being a Journal Social Media Editor for me was the knowledge acquired from the discipline of perusing all published research in my speciality’s main journal for the last 5 years. Some of my peers are doing great work; it is inspiring to read about it as soon as it’s published. Of course there are some subjects of research that don’t excite me much, but even skim-reading those articles looking for a tweetable quote has been informative and enlightening.


Too long; didn’t read? Fair enough.

In the grand tradition of see one, do one, teach one, just have a look at these sites instead:

Twitter twitter.com/IJMHN
Facebook www.facebook.com/IJMHN
LinkedIn www.linkedin.com/company/IJMHN

What would you do different if you had your hands on those accounts? You should do that then, and see how it goes. 🙂

Further Reading (an embarrassingly self-referential, but mercifully short, reference list)

McNamara, P. (2017), Cairns Nurse on Journal Editorial Board meta4RN.com/IJMHN

McNamara, P. & Usher, K. (2019), Share or perish: Social media and the International Journal of Mental Health Nursing. International Journal of Mental Health Nursing, 28(4), pp. 960-970 doi.org/10.1111/inm.12600

McNamara, P. (2022) Mental Health Nursing making an impact meta4RN.com/impact

McNamara, P. (2022), Happy anniversary IJMHN. International Journal of Mental Health Nursing, 31(4), pp. 767-771 doi.org/10.1111/inm.13025


Feel free to ignore this amateurish manifesto. I’m only writing it as a starting point, a handover-of-sorts, to the next IJMHN Social Media Editor.
As always, your feedback is invited in the comments section below.

Paul McNamara, 22 September 2022

Short URL meta4RN.com/editor

Happy Anniversary International Journal of Mental Health Nursing

Since late 2016 I have been the Social Media Editor for the International Journal of Mental Health Nursing (IJMHN). If you’re interested in how that started, see meta4RN.com/IJMHN. The years that have followed have resulted in heaps of Tweets, Facebook posts and LinkedIn updates. As a byproduct, I’ve been keeping a closer eye on the journal than I would have otherwise, and stumbled across the fact that 2022 marks the anniversary of three important milestones in the journal’s history:

✅ 30 years as a fully refereed journal (1992)
✅ 20 years as the International Journal of Mental Health Nursing (2002)
✅ 10 years on social media (2012)

That observation has been explored and elaborated-on via my first (and probably only) editorial. Please read and share the article far and wide:

McNamara, P. (2022), Happy anniversary IJMHN. International Journal of Mental Health Nursing. https://doi.org/10.1111/inm.13025

Below are some abbreviated highlights and a video summary from the editorial.

What’s in a name?

1980 Journal of the Australian Congress of Mental Health Nurses
1990 Australian Journal of Mental Health Nursing
1994 Australian and New Zealand Journal of Mental Health Nursing
2002 International Journal of Mental Health Nursing

Figure 3. Evolution of the Journal (1980–2022). https://doi.org/10.1111/inm.13025


1980 Dennis Cowell
1982 Ron Dee
1986 Owen Sollis
1987 Linda Salomons
1988 Andrew King
1990 Michael Clinton
1999 Michael Hazelton
2004 Brenda Happell 
2015 Kim Usher

I have not attempted to discover the names of everyone who has served on the journal’s editorial board – there would many dozens (in the hundreds?) of people of who have contributed over the years. For what it’s worth, below is a May/June 2022 snapshot of the editorial board.

Online list: https://onlinelibrary.wiley.com/page/journal/14470349/homepage/editorialboard.html

Beyond the Walled Gardens

It is sensible to promote the work of IJMHN authors/researchers beyond the walled gardens of mental health nursing and academia. Below are links to the journal’s first excursions from behind the paywalls and exclusion zones that prevent people seeing the work and research of mental health nurses, and out to ‘the village square’ that is social media:

Twitter 2012 bit.ly/IJMHNTwitter
Facebook 2013 bit.ly/IJMHNfacebook
LinkedIn 2021 bit.ly/IJMHNLinkedIn

As I’ve argued previously (here and here), there’s not much value in spending weeks/months/years doing research, then pushing through the tedium of academic writing, and finally jumping through the flaming hoops of peer review only for your work to sit around unread and gathering dust. Authors and the institutions that support them should promote the paper to its greatest readership. The IJMHN has a strategy to promote mental health nursing’s research and work on social media – do you?

Figure 4. Example of Altmetric Attention Score. https://doi.org/10.1111/inm.13025

Average Number of IJMHN Articles

2000–2006 = 35 per year
2007–2017 = 62 per year
2018–2021 = 135 per year

Figure 1. Number of IJMHN Articles Published (2000=2021). https://doi.org/10.1111/inm.13025

Making an Impact

The first IJMHN Impact Factor was 1.427 (2010). At time of writing, the most recent available Impact Factor is 3.503 (2020). That’s pretty amazing – the IJMHN is the highest-ranked mental health/psychiatric nursing journal, and is rated as the 5th most cited nursing journal in the world (in a field of 124 nursing journals).

A targeted social media strategy together with the increased volume of articles coincide with the Impact Factor upward trend starting in 2017.

Time will need to pass before we know whether the most recently reported Impact Factor is an anomaly of the pandemic. I make this observation because, at time of writing, the three most cited IJMHN papers are all from 2020, and each of these highly-cited articles discuss contemporary-at-the-time COVID-19 issues (see the “Most Cited” tab here: onlinelibrary.wiley.com/journal/14470349).

Figure 2. IJMHN Impact Factor (2010–2020). https://doi.org/10.1111/inm.13025

Connecting with IJMHN

Website www.wileyonlinelibrary.com/journal/INM
Twitter twitter.com/IJMHN
Facebook www.facebook.com/IJMHN
LinkedIn www.linkedin.com/company/IJMHN


too long; didn’t read?

Watch the video – it’s less than 2 minutes long, and has a cool musical accompaniment (‘Dashed Ambitions’ by Moby, kindly provided gratis via mobygratis.com).

(video made by first making a Prezi)

End Notes

In case you missed it above, here’s the citation and link to the editorial:

McNamara, P. (2022), Happy anniversary IJMHN. International Journal of Mental Health Nursing. https://doi.org/10.1111/inm.13025

And the PDF version is here: onlinelibrary.wiley.com/doi/epdf/10.1111/inm.13025

Thanks for reading this far. I would be grateful if you share either this blog page or – preferably – the article itself. Sharing is caring 🙂

As always, feedback is welcome via the comments section below.

Paul McNamara, 29 May 2022

Short URL: meta4RN.com/happy

A Health Professional’s Guide to Twitter

(an entirely tweetable guide to Twitter for health professionals)

Have you ever heard someone say something like, “Twitter doesn’t interest me – I don’t care what Justin Bieber had for breakfast”? Those people speak that way because they don’t understand the difference between PERSONAL, OFFICIAL and PROFESSIONAL use of social media media.

Personal Use.

Personal use of social media is where you share photos of your holidays with family and friends on services like Facebook or Instagram. If you happen to be interested in what Justin Bieber had for breakfast, sus-out his Insta or Twitter feed. We won’t judge you 🙂

Official Use.

Official use of social media is where an entity like company or organisation presents their brand and shares information online. @IJMHN = the International Journal of Mental Health Nursing on Twitter, for instance.

Professional Use.

Professional use of social media is based on your area of expertise and interests. This use of social media allows you to share information with and interact with other individuals and organisations that have the same interests.

Health professional use of social media a legitimate thing to do. In fact, it is encouraged! Don’t believe me? Put “National Nursing and Midwifery Digital Health Capability Framework” into your favourite search engine and see for yourself.

National Nursing and Midwifery Digital Health Capability Framework includes section 1.3 Digital Identity: “Nurses and midwives use digital tools to develop and maintain their online identity and reputation.”
There are four subheadings to this section (see below)

Digital Identity 1.3.1: Maintains a professional development record demonstrating innovation, reflecting upon skills and experience to help monitor professional identity.

Digital Identity 1.3.2: Understands the benefits and risks of different ways of presenting oneself online, both professionally and personally while adhering to the NMBA social media policy.

Digital Identity 1.3.3: Understands that online posts can stay in the public domain and contribute to an individual’s digital footprint.

So, let’s be clear here. Unless your governing body (for me it’s Australian Health Practitioner Regulation Agency, aka @AHPRA on Twitter) says otherwise, it is fine to represent yourself as a health professional online. Just be professional 🙂

Twitter: What’s in it for Health Professionals?

“Twitter is not a technology. It’s a conversation. And it’s happening with or without you.” Charlene Li (aka @charleneli), 2009, Foreword, in S. Israel (Ed). Twitter Ville: How businesses can thrive in the new global neighborhoods. New York: Portfolio.

Is there any need for health professionals to participate in conversations with each other and/or the general public about what we do, our work and values, who we are?

To borrow, and slightly mangle, a quote from Jane Caro (aka @JaneCaro), social media allows nurses and midwives unmediated access to public conversations for the first time in history. Empowering stuff, right?

Twitter puts you within reach of over 300 million people who are active each month. There are now over 500 million tweets sent every day. There are a lot of conversations going on out there!

Obviously you’re not going to read every tweet or follow ever person, but amongst this traffic you are bound to find people who share your special interest, whether it’s clinical, educational or research. eg: interested in the history of nursing? follow the #histnurse hashtag

There isn’t much in the way of hierarchies on Twitter. You can find yourself answering a question from a student nurse in Perth one minute, and the next minute sharing information with a professor of nursing in London.

When you interact with health professionals on Twitter, it usually has a tone that’s not unlike the banter you hear at nurses stations: it’s work-related, and nearly always respectful and friendly.

If the style of interaction is not respectful and friendly, perhaps the person is not a health professional, and/or perhaps you should stop interacting with them. #toxic

Twitter @ Events.

Twitter is fantastic for taking the content of conferences beyond the walls of a conference. Nearly all health care conferences have their own Twitter hashtag for this very reason.

You can find out more about conference tweeting by searching for an @IJMHN article called “Mental health nurses’ use of Twitter for professional purposes during conference participation using #acmhn2016”

Or, if you are comfortable with a blog (no paywalls!), use the search function on meta4RN.com – I have quite a few posts about conference tweeting there.

As with conference Tweeting, if you have an education session you want to spread beyond the walls of the workshop, Twitter can allow information to be shared and amplified.

I once conducted a workshop with four people in attendance; the workshop resources (web links, mostly) shared via Twitter had an audience that was in the thousands. Twitter costs nothing, yet it gives you/your info access to an audience MUCH larger than most of us would ever have face-to-face.

I use social media knowing full well that it is my loudest voice.

Engage in a Scheduled Twitter Discussion.

There are planned Twitter discussions, that is discussions with a designated time and topic, that are known as “Twitter Chats”. The chats are a fast-faced, fun way to learn and contribute to the contest of ideas in subjects of interest.

My recommendation for a sneak-peak at what a Twitter Chat looks like is to visit/follow @WeNurses (the Twitter handle) and/or #WeNurses (the hashtag). If anyone else does health-related Twitter Chats with more consistency or passion, I haven’t come across them yet.

Twitter is a microblogging platform that restricts each Tweet to 280 characters or less. This means that scanning through each Tweet is a quick and lively way to gather and share information. Perfect for the time-poor (that’s pretty-much all of us, isn’t it?).

It’s Academic.

Twitter is not the antithesis of academia. Twitter is academia’s friend.

You’ve done the research, you’ve written the paper, you’ve jumped through the flaming hoops of peer review, and – FINALLY – your paper has been published. Now you want people to read it, right? Twitter can help with that. A lot!

You can use Twitter to share journal articles. Here is an example prepared earlier:

Even busy and important academics might be able to find two minute and thirty second to watch this https://youtu.be/57Dj1XJPgjA video that explains why social media tools like Twitter and reporting tools like @altmetric are of interest.

Share or perish: Social media and the International Journal of Mental Health Nursing. https://doi.org/10.1111/inm.12600 (McNamara and Usher, 2019)

Getting Started on Twitter.

Make a choice: will you have an official, personal or professional Twitter account? Don’t mix it up. Health professionals know about boundaries, right?

On your professional Twitter account you’re not representing an organisation, but are primarily talking about work-related stuff.

Choose a short name (aka “handle”) eg: instead of @AngelaCateMaryHelenNormandy maybe you should try @ACMHN (well, if the handle is not already taken by someone else, that is 🙂)

Bad news for people without exotic names: @JohnSmith @JSmith + @SmithJ are all taken 🙄

Short names and concise tweets are good. Twitter = Brevity Central

Struggling to decide on a name? Get creative, e.g. a nerdy mental health nurse might be @MHnerse.

If you are a Registered Nurse you will almost certainly be able to use “RN” in combination with all/part of your name to make a short, snappy handle. Same would be true for OTs, GPs, SWs, SPs, PTs, ENs, etc etc

Don’t use your workplace name/initials unless you’re 100% sure you’re representing your employer rather than your professional self.

That’s why I’m @meta4RN rather than @QueenslandHealthRN – there’s a BIG difference in implications/expectations. 😬

One last thing about the Twitter handle thing: Do NOT keep the ridiculous name and number combination that Twitter might throw-up as a suggestion. Something like @JohnSmi274983615 will not be easy to remember and it will repel followers. True.

Think about how you’ll describe yourself in your Twitter bio. Do you need to name your employer? It might be easier if you don’t.

Twitter bios accommodate a bit of personality along with a description of you/your interests.

Re bio: maybe better not to say “lost virginity to a rockstar”, but “enthusiastically supporting musicians” would be OK 🙂

Professional doesn’t have to be boring.

Still nervous re the name/bio thing? You’ll get away with being anonymous, but why? On the run? Witness protection program?

And a pic. You’ll need a pic. The Twitter default avatar repels followers. #truefact

Your pic doesn’t have to be a photo. There are avatars available online PRN.

JUST DON’T BE A WEIRD GREY LITTLE SILHOUETTE OF A MAN! #scaramouchscaramouchwillyoudothefandango


Now. When you’re ready, announce your arrival to the Twitterverse. No pressure: channel Neil Armstrong.

Next up you’ll want to start following some people, otherwise your Twitter feed will be bare, and you will feel sad, lonely and bored. 😕

Who to follow? It depends on your interests. Use the Twitter search function to search for your areas of interest.

Other ideas on who to follow: your professional college, the health journal(s) you read most, your union, your local health services, your colleagues, your heroes.

Twitter is not like Facebook. It is perfectly acceptable, not at all stalker-ish, to follow a complete stranger.

Twitter is not like Facebook. It is perfectly acceptable, not at all rude to unfollow somebody (eg: if their tweets don’t interest you)

The Mighty Hashtag

Now, about hashtags… don’t be intimidated. You can use Twitter happily with never using one, BUT…

Hashtags pull disparate conversations and people together. If you haven’t seen this in action previously, check out these hashtags on Twitter: #COVID19 #wenurses #medtwitter #wespeechies or a conference hashtag like #ACMHN2019

As an example of the power of hashtag: even if you had the most incisive political tweet ever created, @QandA viewers would not ever know about it without the #QandA hashtag.

Create your own hashtags, BUT learn from the Susan Boyle album launch hashtag: #susanalbumparty can be read 2 ways 🙂

So, what to Tweet about? Anything that you think is relevant to people who may share all or some of your interests.

Remember: the conventions of professional communication are long-established: letters, email etc. Why change it on Twitter?

Now, pause for a moment and check-out your employer’s and registering body’s social media guidelines.

Any surprises for you there? Probably the only thing that routinely surprises people is being extra careful about testimonials/advertising. Most of us find the rest of it pretty sensible and intuitive.

Twitter Tips.

The easiest way to learn Twitter is to follow people who have already learned Twitter. Then get started with your Tweets/Retweets and replies. Stick with it – it’ll click in.

Definitely download a Twitter app onto your mobile. I’m happy enough with the default app by @Twitter, but also like @HootSuite and @TweetDeck. As a newby, don’t rush for a paid app – the free ones are fine.

Be careful mixing personal and professional. Boundaries are important.

You already know about confidentiality; if you’re doing confidentiality wrong online it will definitely get spotted.

Naturally, you would NEVER give individual or detailed clinical advice on Twitter.

Generalised info is fine, e.g.: Getting great feedback from consumers about the @beyondblue app called “Beyond Now” (it’s free and evidence-based)

Try not to act like a dickhead. Also, don’t use words like “dickhead” – it’s unprofessional.

Apologise if you do/say something stupid. BTW sorry for saying “dickhead” before.

Twitter spam is especially good at playing on the insecurities of newbies, so be vigilant + don’t click dodgy links.

Spam example 1: This person is saying horrible things about you http://www.dodgylink.com DON’T CLICK!

Spam example 2: This photo of you! LOL http://www.dodgylink.com DON’T CLICK!

Mostly you won’t Tweet from/about your workplace… you’ll have your work to do.

There may be an occasional exception to the workplace rule, e.g.: How cool are these paeds ward Christmas decorations?

Would your patients or boss be offended by that Tweet or photo? Yes = Delete. No = Tweet.

Connect. Be generous. Have fun.

End Notes.

This is a reworking of a 2014 web page I wrote for Ausmed called “A Nurses Guide To Twitter”. 2014 is so old in internet terms it has been consigned to the Internet Archive (aka Wayback Machine). That webpage was, in turn, a reworking of a 2013 workshop and blog page called “A Twitter Workshop in Tweets“. Self-plagiarism? Such an ugly word! Let’s call it a funky new remix of a favourite old song.

I was keen to republish it as an alternative to doing a series of inservices and workshops. It’s more expedient for me to do stuff like this in my own time, and leave work time to do the stuff related directly to my paid role.

Also, it’s fun to make the whole thing in tweetable chunks. Please feel free to tweet/share your favourite bits.

As always, you are welcome to leave feedback in the comments section below.

Paul McNamara, 10 November 2021

Short URL: meta4RN.com/twitter

Creative Commons: Attribution-ShareAlike 2.5 Australia

A Nurse’s Digital Identity

I am a nurse who uses social media a lot. It is my loudest voice.

If you want to see what a nurse’s digital identity looks like, grab your phone and sus-out this QR code.

My role and ambitions are mid-range. As a student nurse I thought it would be cool to be a Nurse Educator or Clinical Nurse Consultant – I’ve achieved that. I have never aspired to one of those senior management/academic gigs. The downside to that lack of ambition is the limited opportunities to set agendas that drive broad change. In fact, even getting ideas heard or considered is difficult at times.

[insert sound of trumpets going “TooDa-TooDa” here] Social media to the rescue!

And, (this is the main point of this blog post), it is OK for nurses to use social media. Actually, it’s not just OK, USING SOCIAL MEDIA IS RECOMMENDED FOR NURSES AND MIDWIVES.

Don’t believe me?

Read on.

In the ‘National Nursing and Midwifery Digital Health Capability Framework‘ there is a section specifically about being online, as below:

1.3 Digital Identity
Nurses and midwives use digital tools to develop and maintain their online identity and reputation.

This section has four parts – feel free to tweet your favourites 🙂

Digital Identity 1.3.1: Maintains a professional development record demonstrating innovation, reflecting upon skills and experience to help monitor professional identity.

You could use a free app or website for that, for example:

Or just keep it all online via the ANMF Continuing Professional Education portal

Digital Identity 1.3.2: Understands the benefits and risks of different ways of presenting oneself online, both professionally and personally while adhering to the NMBA social media policy.

The policy uses slightly more formal language (read it for yourself here), but can be accurately summarised as “Even if you’re prone to being a dickhead at times IRL, when you’re representing yourself as a nurse online don’t be a dickhead.” If you do be a dickhead online occasionally (to err is human, blah blah blah), be sure to proactively delete and/or apologise.

It is MUCH more simple to keep your private and professional social media identities separate. Create a social media portfolio using the same name on your work name badge/AHPRA registration just for work-related stuff. That’s what I’ve done here linktr.ee/meta4RN Look, I know I’ve overdone it (#tryhard), but that was intentional too. I created the meta4RN social media portfolio at a time when the “prevailing wisdom” (“prevailing ignorance”, more like it 🙄) amongst hospital and university influencers was that social media is bad. Some of these people are still impersonating Grandpa Simpson and shaking their fist at the cloud. And the internet. And social media.

Digital Identity 1.3.3: Understands that online posts can stay in the public domain and contribute to an individual’s digital footprint.

If you want an example of how online posts stay in the public domain, visit/search for The Wayback Machine or Trove (part of the National Library of Australia).

Digital Identity 1.3.4: Recognises that their professional digital footprint, where it exists, should showcase their skills, education, and professional experience.

This is where things like LinkedIn or an online Curriculum Vitae (overdue for an update) come in handy.

Don’t hide your light under a bushel. If you’re a nurse please celebrate your achievements – if we don’t, who will?

My (univited) advice to nurses and midwives is this: Don’t be afraid of social media. Be intentional.


Australian Digital Health Agency, 2020. National Nursing and Midwifery Digital Health Capability Framework. Australian Government: Sydney, NSW.


Thanks for visiting the meta4RN.com website/blog. Be sure to use the QR Code above or this link to see other arms of my m̶a̶g̶n̶i̶f̶i̶c̶e̶n̶t̶ m̶e̶t̶a̶4̶R̶N̶ ̶s̶o̶c̶i̶a̶l̶ ̶m̶e̶d̶i̶a̶ ̶e̶m̶p̶i̶r̶e̶ try-hard professional social media portfolio (aka professional digital identity).

As always, your feedback is welcome via the comments section below.

Paul McNamara, 5 August 2021

Short URL meta4RN.com/ID

Share or Perish!


About a decade ago, the old academic refrain to ‘publish or perish’ was updated to ‘be cited or perish’. A couple of days ago we published a paper arguing for a new call-to-arms: ‘share or perish’.

The truth is not too many people are perishing in the academic space. However, there is a pretty good indication that publishing in a journal that has a social media strategy makes a difference.

Want evidence? Have a look at these excerpts from our paper that compares the 18 months before the appointment of a social media editor for the International Journal of Mental Health Nursing (IJMHN) with the 18 months after that appointment.

First piece of evidence is in Figure 1 (below). Data from Twitonomy collated in 6‐monthly increments shows that after appointment of an IJMHN social media editor there was a 13½‐fold increase in tweets, and a 16‐fold increase in shared URLs.

Figure 1. Twitter Activity before and after the commencement of IJMHN social media editor on 01/01/17. Data from Twitonomy collated in 6‐monthly increments.

Figure 2 (below) plots 4 different data points. 

It shows that Impressions increased from an average of 118 per day to 2839 per day. That’s a 24-fold increase on how many Twitter accounts potentially saw an @IJMHN Tweet each day. 

Retweets increased from an average 62 retweets every 6 months to over 2140 retweets every 6 months. That’s a 35-fold increase in the number of time @IJMHN Tweets were shared – a remarkable increase in audience reach.

Similarly, the ‘likes’ that @IJMHN attracted increased from 45 times every 6 months to 2083 every 6 months. That’s a 46-fold increase in people acknowledging or showing approval to @IJMHN Tweets.

Most importantly, the number of times people clicked on the link (URL) of an IJMHN paper increased markedly too. It jumped from 129 to 2960 link clicks recorded every six months – a 23‐fold increase.

Figure 2. Twitter Impact before and after the commencement of IJMHN social media editor on 01/01/17. Data from Twitter Analytics collated in 6‐monthly increments.

The final data point I’ll present here is the Altmetric Attention Score (AAS), as shown in Figure 3 (below). The AAS increased from an average of 490 to 1317 every 6 months. This equates to an 169% increase in online attention and activity for IJMHN.

Figure 3. Altmetric Attention Score and Number of Articles published before and after the commencement of IJMHN social media editor on 01/01/17. Data from Altmetric collated in 6‐monthly increments.

Closing Remarks

This simplified summary of the paper misses some of the data and the description of context, the social media strategy and the reporting method. Please see the original paper for more info [link].

Want to find out more about how some of this stuff is measured? Start here: https://wiley.altmetric.com/details/62929297

Please share the link to this blog and/or to our paper about stage one of the International Journal of Mental Health Nursing social media strategy.

Don’t forget: Share or Perish! 


McNamara, P. and Usher, K. (2019), Share or perish: Social media and the International Journal of Mental Health Nursing. International Journal of Mental Health Nursing, online from 30/06/19, volume and issue yet to be allocated [I’ll update this when it’s in an issue]
DOI: https://doi.org/10.1111/inm.12600
URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/inm.12600 


As always, feedback is welcomed via the comments section below.

Paul McNamara, 2 July 2019

Short URL: meta4RN.com/share