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Nurs608 - Philosophical foundations

Social Media and Its Influence on Patients

Question: What does the current evidence say about the influence of social media on patients' decisions? What are examples of effective use of social media to translate evidence into behaviour change?

A decade ago, it was surveyed that 78% of American’s had used social media to search health information for either themselves or a family member (Patrick et al., 2022). They go on to discuss that access to health information has increased for several reasons, including quicker access to health information as wait times to see a medical professional have also increased. People are looking for instant information. The concern Patrick et al. (2022) expressed in relation to people searching for this information comes from peoples lack of understanding the social media algorithm and the tailoring of content to their interests. The problem herein is a significant amount of content delivered is not evidenced based and can lead to all sorts of misinformation. Patrick et al. (2002) stated an analysis of 126,000 stories on twitter found that the false stories were 70% more likely to be shared due to how the content is portrayed for increased engagement. If we want to look at a specific example, the amount of misinformation and anti-vaccination rhetoric circulated during the COVID-19 pandemic is a prime example of how social media influences people. From misinformation about SARS-CoV2 virus, its transmission and treatments, to conspiracy theories of how the pandemic started, flooded social platforms. The WHO called it an infodemic. People are often influenced by family and social circles in the healthcare decisions they make and information they share online. Groups can be created with other like minded individuals and information shared within these groups are tailored to their beliefs, furthering the spread of misinformation.

In saying that, there is also effective use of social media in relation to health care, including health promotion and public awareness to any public health concerns from local health units or healthcare facilities. It’s important to remember when we discuss health information found online with our patients, we educate what to look for in relation to evidenced based information, such as verified healthcare information sites or how to validate something like a blog or social media content creators credibility. We also need to ensure any media we share online is from a valid, evidence based resource.

The social media groups discussed above can also be beneficial for human connection when it comes to something such as a diagnoses with a rare disease (Patrick et al., 2022). Patients and families have the ability to connect with others facing similar difficulties and not feel so alone in their journey. They can share stories and hardships and feel support from all over the world.

Ultimately as we evolve in the tech world and now with AI, nurses will continue to be presented with more challenges regarding misinformation patients and families are consuming.

Reference

Patrick, M., Venkatesh, R.D., Stukus, D.R. (2021). Social media and its impact on health care. Annals of Allergy, Asthma & Immunology 128(2), 139-45. https://doi.org/10.1016/j.anai.2021.09.014

I am Your Nurse.

For me, the poem by Beth Perry RN, PhD, identifies that the interactions nurses have with their patients drives their nursing process. Nurses have a special unique connection with each patient and while we provide the patient care, we learn from our patients as well. We deeply connect and empathize with our patients in difficult moments. Each of those individual experiences and interactions shape our future nursing practices; "You teach me... You touch my soul" (Perry, 2009, p. 24).

Being in the IPAC world, the verse I would add below highlights and the important aspect of patient safety and infection control. We listen to patients concerns regarding their infections or potential for communicable diseases. As nurses we ensure we physically protect our patients from transmission of communicable diseases and hospital acquired infections through the examples here such as hand washing, wearing PPE, disinfecting line access, and the like. We listen to the fears and concerns from our patients, in this verse I related to infection concerns, which helps us understand our patient and guide how we teach and provide care to each patient individually.

Original poem by Beth Perry RN, PhD. (2009). I have added my own verse in italics.

I am Your Nurse

I ease your pain.

I bathe your skin.

I make your bed.

I help you dress.

I meet your needs.

You heal me.

I am your nurse.

I feed you meals.

I give you rest.

I tend your wounds.

I sense your suffering.

I answer your questions.

You teach me.

I am your nurse.

I know your pain.

I share your loneliness.

I feel your despair.

I taste your joy.

I sense your spirit.

You touch my soul.

I am your nurse.

I wash my hands.

I wear my gloves.

I scrub the hub.
I hear your fears.

I will protect you.

You guide me.

And sometimes,

for just a moment,

I am you,

and you are me,

and we are one.

Together,

we go beyond the limits

of ordinary experience,

to live the extraordinary.

Reference:
Perry, B. (2009). More moments in time: Images of exemplary nursing. Edmonton, AB. AU Press., p. 24. [e-book link]

My Nursing Core Values

The word cloud above demonstrates a few additional core nursing values I have. Hands holding onto each other, symbolizing nurses and patients working together to create the best health outcomes.

Nursing's Metaparadigm

While I can agree the 4 elements of Fawcett’s 1984 nursing metaparadigm - nursing, health, environment and person - can still guide nursing practice, I believe these concepts are far too broad given the complexities of human health today. I also agree that as the profession of nursing evolves, so should the metaparadigm. Fawcett (1984) said herself that while it was time to accept the four concepts of nursing, it was also time to refine the concepts within the metaparadigm. While the adding technology could be considered valid given innovative technological advances, I question if it truly needs to be an included concept on its own within the metaparadigm. Yes, technology can aid in our work a great deal, however, technology is merely a tool in practice. There are various interpretations of what technology would mean within practice and I question what Johnson et al. (2023) referred to when they suggest incorporating technology into the metaparadigm. Does this mean technology influences the patient and their environment, or the use of technology, such as AI, within the healthcare system itself?

Watson (2025) discussed the critiques of Fawcett’s metaparadigm are often lacking the concept of caring, while modern definitions of a nurse and nursing include the concept of caring. Watson (2025) states “[caring] is a serious moral, ethical, epistemic, ontological, epistemological, methodological, pedagogical, praxis and policy structure as central to an evolved mature metaparadigm...”. In reading Littzen, Langley and Grant (2020), I feel the introduction of the prismatic midparadigm of nursing to be much more relevant to the nursing profession today. The additional tiers and centre of vulnerability, offer a more inclusive approach to all aspects of nursing care between many different roles of the nursing profession, knowledge development and application within nursing practice. I view the concept of caring, although not directly stated within the model, is encompassed within the tiers surrounding vulnerability under compassion, collaboration and equity. It may not be the perfect metaparadigm, but it’s well on its way to a more modern concept of nursing practice, especially given more diverse roles within the profession of nursing itself.

For myself, the concept of the nursing paradigm has a similar meaning to those stated by my classmates. Health encompasses the person, from a physical, mental, emotional well-being standpoint. The environment is the conditions in which a person lives, their surroundings, support system and external influences on their health and wellness. The person is who they are, their values, morals, beliefs and diverseness that makes them who they are. Finally, nursing is the person caring for them, building a therapeutic relationship to understand and bring everything together for a positive health experience, success in healing or a dignified death, advocating, being the constant through a vulnerable experience; the art and the science of nursing.

References

Fawcett, J. (1984). The metaparadigm of nursing: Present status and future refinements. Image: The Journal of Nursing Scholarship, 16(3),84-87.

Johnson, E., Carrington, J. M. (2023). Revisiting the nursing metaparadigm: Acknowledging technology as foundational to progressing nursing knowledge. Nursing Inquiry, 30, e12502.

Littzen, C.O, Langley, C.A., Grant, C.A. (2020). The Prismatic Midparadigm of Nursing. Nursing Science Quarterly, 33(1), 41- 45. https://doi.org/10.1177/0894318419881806

Watson, J. (2025). Opinion Paper: What is Nursing Science?: Ontological – Epistemological Disciplinary Questions. Advances in Nursing Science 48(4), 316-318.

Technology in nursing: How is it changing practice?

Reading the article by Glaucer cited below, the question was posed: What is your experience with the way technology is changing nursing theory and practice?

I have mixed emotions surrounding the implementation of technology within nursing and healthcare in general. There has been a fundamental shift in the use of technology since I was in nursing school 20 years ago. There has been a shift from paper to electronic medical records and now the inclusion of artificial intelligence (AI) for physician dictation. While I believe it creates improvements in documentation, record keeping and assists in dictation, I hesitate to support all AI efforts proposed.

The difficulties with AI is that it doesn’t take into consideration the person holistically and looks at an individual based on numbers and algorithms. Human connection and making people feel respected and important is an essence of caring in nursing practice. There is valid fear in technology overtaking the profession and becoming a barrier, but it needs to focus on assisting with the mundane tasks, such as supply delivery, allowing more time for nurses to foster human connection and listening to our patients. As Glauser (2017) discusses her conversation with Richard Booth, nurses should utilize technology in a way that can assist them in their day to day tasks, and have a say in those that can be automated versus the ones that cannot be. Glauser (2017) states “[m]ore nurse involvement in technological development will benefit nurses as well” (p. 25).

As for the application of TAVIE discussed in this article, I again have some conflicting views when it comes to pre-made generalized video education. While these can be great for patients to have instant access to health coaching and education, I do believe these resources are a better tool if used as an additional resource for continued education or a refresh, once the initial education has been provided by the nurse or health care provider. This discussion here does focus on using TAVIE as an integrated complement to education which I can support.

For the future, we need to continue to look at, and educate, digital literacy of the nurse and the people we care for. Technology is moving a lot faster than humans can keep up with and nurses must be technologically agile.

Reference

Glauser, W. (2017). Artificial intelligence, automation and the future of nursing: Technological change is already shaking up the profession. What is your relationship with technology going to be? Canadian Nurse, 113(3), 24-26.

Environmental Sustainability and IPAC

How can nursing knowledge in your speciality be re-imagined today and in the future?

Shifting towards other nursing knowledge from an IPAC lens, a significant discussion within the IPAC over the last few years is a focus toward attempting to be more environmentally sustainable within the confinements of infection prevention. With strict infection control practices, it is usually counterproductive towards sustainability (Roberts, as cited by Dhillon et al., 2015). A significant amount of waste produced with single use/disposable PPE, single use devices, and disinfectant wipes to name a few. Some ways IPAC is looking into being more sustainable while maintaining infection control standards includes biofriendly cleaning products/wipes, reusable gowns. I was at an IPAC conference in 2023 where a member from BC had a presentation that discussed recycling PPE, specifically masks and gloves. Through some quick research today, I saw that Vitacore has a PPE recycling program. Something I believe should be explored more.

An additional article by Alruwaili et al. (2023) discusses some sustainable strategies from lessons learned during the COVID-19 pandemic including more green designs, air quality and ventilation for cleaner air while using less energy, proper waste management, energy and water conservation and choosing more sustainable products. A large part of success for a more sustainable healthcare environment is the commitment from leadership to overcoming barriers and fostering the culture shift. Included in that is the staff commitment to becoming more sustainable and advocating for a change.

While the relationship between infection control and environmental sustainability is a balance, it is important for the long term health of the planet to try and leverage a more green approach within the confines of infection prevention. Something I feel that has become a priority across many facilities and hopefully continues to be explored.

Reference

Alruwaili, R., Alsadaan, N., Alruwaili, A. N., & Alrumayh, A. G. (2023). Unveiling the symbiosis of environmental sustainability and infection control in healthcare settings: A systematic review. Sustainability, 15(22), 15728. https://doi.org/10.3390/su152215728

Dhillon, V. S., & Kaur, D. (2015). Green hospital and climate change: Their Interrelationship and the way forward. Journal of Clinical and Diagnostic Research, 9(12), LE01–LE5. https://doi.org/10.7860/JCDR/2015/13693.6942