Facebook, Twitter, and LinkedIn, Oh My!

Making senseand good useof social media.

o you have an account onFacebook, Twitter, orLinkedIn but wonder what all the fuss is about and hardly ever log in? Have you gotten e-mails from friends and colleagues inviting you to join them on these networks but arent sure what they are or why youd want to spend time on them? If so, read on, because you may be missing out on a convenient and exciting way to collaborate with friends and colleagues. On a more serious note, institutions are startingto implement social media policies, and its important to understand their contents. Therefore, from several angles, nurses will be well served by having a basic understanding of what social me dia is, how it works, and how to get started. This introductory column will be followed by acolumn addressing nursing- specific uses and abuses of social media. The last iNurse column ad dressed using RSS feeds to consume static content (see RSS forthe Uninitiated, November 2010). Using social media, in con trast, means that you can not only consume online content, but also contribute to it and in ter act with others, collaborating in constantly evolving ways. The ad vent of in teractive online me dia has profoundly changed the landscape ofpersonal and professional in ter action; for example, nurses used to have to attend con ferences or go to meetings to discuss evidencebased practice or bounce ideas off each other, but now they can
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do so via Facebook groups or Twitter discussions in near real time. Facebook, Twitter, and LinkedIn are the most commonly used social media networks, with more than 500 million, 175 million, and 90 million active users, re spec tively, as of January 2011.1-3 Other networks not discussed here because of their smaller or extremely targeted user bases in clude Bebo, Xanga, MySpace, and Ning.
FACEBOOK

Facebook, at www.facebook. com, is the most popular and best-known social media platform. As mentioned, Facebook has reached more than half a billion active users, and half of those actually use the site daily.1 On Face book, users can post status updates and photos, vid eos, and links viewable by their friends, friends of friends, or anyone on the Internet. Brands, products, and even ideas can also have Facebook pages or be liked. Most items (both posts and pages) on Facebook contain a Like link be low them (see Figure 1). Clicking

Figure 1.

Image of a like button.

it in dicates that you express agree ment with or appreciation for theitem, and others viewing the item see who has liked it. In

fact, Face book has introduced the capa bility for Facebook users to like pages, articles, photos, and so on all over the Web, thus injecting Facebook into, potentially, every online experience that any user has. Clicking an icon sim ilar to the one shown in Figure 1 on an ex ternal Web page makes note of your like on your own Facebook account, turn ing your like into a newsfeed item (a newsfeed is Facebooks constantly updated collection of your and your friends activity). In this way, you can easily pass along items of interest to your Facebook friends. Facebook requires account hold ers to use their real names, an important distinction that first separated it from older social me dia and networking sites such as America Online and from Twitter, which is discussed later in this col umn. Once you have an ac count (follow the steps at www. facebook.com), Facebook allows you to search for friends in a number of ways, including by name, e-mail address, workplace, or schools attended. Friends are people you have granted permission to see your personal in formation, and on Facebook this is a two-way interaction (meaning that you both have to agree that you know each other). Facebook will quickly begin to suggest other users as friends on the basis of mu tual friends, workplaces, and places ofeducation. You may be tempted to quickly add everyone youve ever met and to fill out reams of personal data
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By Megen Duffy, BA, BSN, RN

(Facebook profiles include fields for everything from contact in formation to favorite quotations), but its worthwhile to first read up on the sites privacy settings.4, 5 Facebook has been criticized for its complicated privacy settings and policies by both mainstream and technology journalists (for an overview, see Boyd and Hargittai6), but the settings are manageable with a bit of at tention. Whether youre new to Face book or a veteran, spend some time exploring your privacy settings. The options change frequently. The payoff is having the ability to log in to Facebook and see your friends new baby, your childrens day-to-day lives, and the Web sites and links that your peers find interesting or professionally relevant. If you arent on Facebook, join ing can open a new world to youone with advantages (keeping up with family and friends) and disadvantages (privacy concerns and spending more time atthe computer). Also, remember that you cansee content from profes sional organizations on Facebook; for ex ample, if you type American Journal of Nursing into the search bar at the top of your Facebook home page when youre logged in, you will see a link tothe AJN Facebook page. Click it, and then click the Like link when the page loads. AJNs Facebook page will now show up in your newsfeed onyour home page, and you canalso read others commentary and add your own on the AJN page. In this way, Facebook is becoming one of the most convenient ways to stay current on announcements from professional organizations and collaborate with other nurses almost instantly. Facebook doesnt limit you to using it at a desktop computer.
ajn@wolterskluwer.com

Itoffers applications that let you use it from many mobile phones and from a mobile interface for almost any phone that has Internet access. For Facebook on the go, search Google or Bing for your mobile phone model and Facebook ap plication to see whats available.
TWITTER

Twitter (http://twitter.com) had 175 million registered users as ofSeptember 20103 and reached 20 billion tweets (up to 140character user posts) in July 2010.7 GigaOM reported on the new serv ice Twitter, which started out as Twttr, in 2006, saying Twttr has married Short Code Messaging, SMStext messaging with a way to create social groups.8 The basics are that users post 140-character messages (slightly shorter than a cell phone text

message) to update other users about their thoughts and actions. Like Facebook, Twitter lets users post links to photos, videos, blog posts, and anything else with a URL (uniform resource locator, orWeb address). The privacy settings are all or nothing (your tweets are hidden from every oneexcept people you choose ortheyre totally public). Twitter doesnt force the use ofreal names, in contradistinction to Facebook, and there is nofriends concept (users have followers, meaning people who read their tweets, and follow other users, meaning they read those users tweets, but a re cip rocal relationship isnt forced). Unlike on Facebook, Twitter posts are not organized formally (tweets appear chronologically and arent threaded according to to pic). This lack of organi za tion, com bined with the short and
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transient nature of tweets, can confuse or bore new users un til theyve twittered for a while. In fact, a run ning joke inthe Twitterverse in volves cheese sandwich tweets meaning that some people overshare by tweetingabout everything they do, in cluding what theyre eating (Having acheese sandwich for lunch, for example). Still, Twitter has caught on, and caught on big. A casual glance through media outlets shows that businesses are increasingly including their Twitter user nameswhich are easily spot tedby looking for the @ in front ofthe nameon business cards, in TV commercials and magazines, and on Web sites. For ex ample, AJNs Twitter user name is@AmJNurs (its page is found athttp://twitter.com/AmJNurs). Users can follow not only peo plethey know (or would like toknow), but also businesses, magazines, and blogs, to get their regu larupdates. Again, Twitter differs from Facebook in that you can follow whomever you want as long as the account isnt protected (private). Therefore, onTwitter you can follow ce lebrities (perhaps you want to know if Brit ney Spears is eating acheese sandwich) who dont follow youback or agree to friend you. But if youre a regular person and not a celebrity or a business, why tweet (or twitterusers con tinue to debate the appro priate word)? Mostly because itsfun and provides an oppor tunity tomeet people who share your in terests. Facebook limits you topeo ple you already know, but Twit ter helps you find friends you dont know yet. Many nurses tweet, as do knitters, photographers, stay-at-home moms, gardeners, computer geeksyou name it. And because Twitter
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users can post lists of other users they recommend following based on common interests (see http:// listorious.coma Twitter listcurating sitefor a comprehensive directory), finding people tofollow is simple. Convinced? Get an account athttp://twitter.com. The Sign Up button is difficult to miss. Theoptions for Twitter are simplecompared with those for Face book: You have to choose whether to let everyone or only people you choose see your tweets and whether Twitter should send you e-mails when youreceive new followers. You can also direct Twitter to text your phone when you receive a direct message (DM), which isaprivate tweet seen by only thetwo people involved (DMs

ca pabilities, and anomalies that they arebe yond the scope of this in tro duc tion. The Twitter Help Center page at http://support. twitter.com/groups/31-twitterbasics links to explanations of the most useful concepts for un derstanding whats happening on Twitter and how to perform its basic functions. Like Facebook, Twitter use isnt limited to its Web site. Many (prob ably hundreds of) thirdparty applications exist for Twitteron almost any platform you can think of, in cluding smartphones. Twitter apps are so popular that new ones come out daily, so the best way to find a third-party application to tweet from is to search for them on Google or Bing and try a few out.

Twitter differs from Facebook in that you can follow whomever you want as long as theaccount isnt protected (private).
do re quire reciprocal following). You can also pick a background for your page. Other than that, ac count creation is uncomplicated. After youre all signed up and logged in to Twitter, youll see a box with the caption Whats hap pening? above it on your home page. You can type anything you want. Anyone who is following you will see it, and the up dates of anyone you fol lowwill appear on this page. Add users to follow by following Twitters suggestions orsites such as Listorious, and before you know it you may be hooked. Twitter began as a simple service, but over the years users have added to it, and now it has so many twists, turns, features,
LINKEDIN

The last social media network this column will discuss is LinkedIn (www.linkedin.com), which had 90 million active users as of January 2011.2 On it, users can post their rsums, educational and work histories, accomplishments, and professional activities with the goal of connecting with or remaining connected with colleagues. Twitter and Facebook can be productively used for busi ness and professional development, but these things are LinkedIns sole purposethus my short treatment of it in this column. To create a LinkedIn account, go to www.linkedin.com and click Join LinkedIn Today. Fill in all the information. LinkedIn requests
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different information than Facebook and Twitter do because its emphasis is totally professional. The more detail you provide, the more benefit you can derive from the service.

PERSONAL AND PROFESSIONAL USEOFSOCIAL MEDIA

A full treatment of the implications of disclosure in social me dianecessitates its own column (to follow), but a preliminary

Social media sites have a huge potential for improving our access to current information, particularly in areas of nursing we might not encounter daily.
LinkedIn generally starts to suggest contacts for you as soon as youve given it a workplace ortwo. If you see someone you know among the suggestions, click the name and select Add to your net work. LinkedIn will ask you to select how you know this person (colleague? friend?) and then will send her or him your request. Once the connection is confirmed, the two of youwill be reciprocal contacts (this is like Facebook and unlike Twitter). Like Facebook and Twitter, LinkedIn contains the ubiqui tousstatus update box (look for the blue Share button) on your accounts home page. You can share a link with the Attach a link button under the box. On LinkedIn, most people share links that are related to their professions, and commentary about the links (or status updates) appears, Facebook-like, right under the link. As with Facebook and Twitter, you can take LinkedIn with you on your mobile phone. Applications exist for use with the iPhone, BlackBerry, and Palm, and a mo bile Web interface is offered for other cell phones with Internet access. See www.linkedin.com/ static?key=mobile to download an application or learn how to use the mobile Web interface.
ajn@wolterskluwer.com

men tion of some issues is relevant in this introduction to so cial media for nurses. Social media sites have a huge potential for improving our practice by increasing ournet working sources and improving access to current information, particularly in areas of nursing we might not encounter daily (for example, I follow an infusion nurse on Twitter who regularly adds to my knowledge of iv skills). They can also add toour quality of life by introducing usto other nurses in our field, some times validating our experiences and feelings (for example, when Iwas a new nurse I re ceived many tips from Twitter nurses about how to manage my time inthe real world). However, nurses are bound bythe Health Insurance Portability and Accountability Acts Privacy Rule and basic professionalism online just as they are anywhere else. On LinkedIn, you are obviously stating your relationship with your institution, but on Twitter and Facebook consider doing so carefully; once you state where you work, you can be considered a representative of that institution. These is sues are only now beginning to be formally addressed and studied, but using a little common sense will go a long way.

Social media is inescapable. References to it now appear in print and over-the-air media, as well as online. E-mail in-boxes fill with invitations to join people on Facebook, Twitter, and LinkedIn. Each network offers a different approach to social media, and after reading this column readers will, it is hoped, be able to make educated decisions about which (if any) networks to join, whom toconnect with, and how to protect their privacy. This column is, however, only an introduction, and readers are strongly urged toread the recommended materials on privacy settings and ba sicfeatures. And stay tuned for the next iNurse column, which will discuss in depth how nurses can use or abuse social me dia.t
Megen Duffy is an RN in an ED in the Midwest. Her blog, Not Nurse Ratched, can be found at http://notratched.net.

REFERENCES

1. Facebook.com. Press room. Statistics.

2011. http://www.facebook.com/press/ info.php?statistics. 2. LinkedIn.com. Frequently asked ques tions. 2011. http://press.linkedin. com/faq. 3. Twitter.com. About Twitter. 2011. http://twitter.com/about. 4. Calderon SI. How to protect your pri vacy with Facebooks new privacy set tings in 17 easy steps. Inside Facebook. com. 2010. http://www.insidefacebook. com/2010/01/19/how-to-protect-yourprivacy-with-facebook%E2%80%99s- new-privacy-settings-in-17-easy-steps. 5. Richmond R. A guide to Facebooks new privacy settings. New York Times. 2010. http://gadgetwise.blogs.nytimes. com/2010/05/27/5-steps-to-reset-yourfacebook-privacy-settings. 6. Boyd D, Hargittai E. Facebook privacy settings: who cares? Bridgman, MI: First Monday; 2010. 7. Ostrow A. Twitter hits 20 billion tweets. Mashable.com. 2010. http:// mashable.com/2010/07/31/twitterhits-20-billion-tweets. 8. Malik O. Silicon Valleys all Twttr. Gigaom.com. 2006. http://gigaom. com/2006/07/15/valleys-all-twttr.

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