Speech notes of a presentation to NZNO Southern Regional Convention at the Otago Golf Club, Balmacewan, Dunedin, 28 March 2018.

Tihei mauri ora! Te mea tuatahi, ka tū ahau ki te tautoko i ngā mihi ki te kaihanga. Firstly I stand to support the acknowledgement of the creator.
Kei te mihi hoki ahau ki ngā uri whakaheke nā Tahu-pōtiki, te tino tipuna, me ō rātou wāhi tapu katoa. I also acknowledge the descendants of Tahu-pōtiki, the great ancestor of Ngai Tahu, and all their sacred places.
Nō reira, e ngā mana e ngā reo, e ngā karangaranga maha, tēnā koutou. So to all the authorities, all voices and the many affiliations, greetings.
As I speak at meetings around the country, I often talk about my connections to this place. It was here, in Ōtepoti/Dunedin, that my ancestors arrived from Scotland back in 1849, aboard the Cornwall.
Behind me I know that Mount Cargill, Kapukataumahaka, is looking down on us, as it always has. Out there beyond the trees, I see my old high school, where I returned last year for the school centenary. And over the ridge line, I know that Ōwheo, the water of Leith, winds its way to the sea.
It’s wonderful to be back home, on my tūrangawaewae, the home where my feet belong.
The topic I’ve been asked to speak on today is, “The impact of social media on NZNO members, delegates and on NZNO’s reputation”. It’s a sensitive topic. It is also very large.
My talk will not be a definitive, or comprehensive account of the impact of social media.
As you may be aware, a review of the DHB MECA bargaining process and supporting campaigns is currently being conducted by former CTU President Ross Wilson. The terms of reference for the review direct him to “Enquire into and comment on NZNO’s… processes for communications (internal and external) including the use of social media”. We keenly await his findings, which are due to be delivered to the NZNO Board in June. After that, we will be in a better position to evaluate thoroughly the impact of social media on NZNO members, delegates and on NZNO’s reputation.
Even this time next week, I would be better placed. At the CTU Organising Conference in Auckland on Wednesday, there will be an NZNO presentation on, “Lessons learned from the major state sector industrial campaigns of 2018”. No doubt this will cover the impact of social media, as well.
In place of a definitive, or comprehensive account, what I have to offer now are just some interim personal observations, based on a few examples of social media impacts, followed by a brief introduction to NZNO’s new publication, “Social media and the nursing profession: a guide to maintain professionalism online for nurses and nursing students 2019”.
So what are we talking about, when we speak of social media?
Social media is defined in our Guideline as the “internet or web-based technologies that allow people to connect, communicate and interact in real time to share and exchange information. This may include using Facebook, Twitter, YouTube, Snapchat, Instagram, blogs, forums, dating “apps” and personal websites. The key element of social media… is the active nature of the dialogue, enabling user-generated content and images to be communicated instantly.”
It’s a truism to say that social media is rapidly evolving. It’s moving so fast, in fact, that some of the content in NZNO’s new guideline, updated during 2018 and published just last month, is already starting to become dated.
Part of this rapid evolution is a blurring of the distinction between social media and traditional news media. Online newspapers such as Stuff are increasingly integrating user-generated content, through a comments area, through reporting on social media posts, through embedding of tweets and Facebook Live videos directly in their articles and through an entire section dedicated to content submitted by readers, called “Stuff Nation”. For this reason, my talk will also touch on the impact of the news media.
Let me start with an immediate example – one that’s current, and close to home.
Here are a couple of photos taken earlier this month in Ōamaru.

You may recognise some of the people, and what the photos depict.
Last month, the Otago Daily Times obtained a copy of a confidential “proposal of change” document distributed to Ōamaru Hospital staff, which included a proposed staffing restructure. The proposed restructure would impact seriously on NZNO members. All current nursing positions would be disestablished. Those currently employed to fill the 35.3 full-time equivalent nursing roles would be forced to reapply for a reduced number of jobs, adding up to just 20.5 FTE.
Reflecting on the theme of today’s convention, “Nurses A Voice to Lead – Health for All”, the proposal for change could also impact on access to healthcare for the rural population inthe Waitaki District.
“The document has caused a large amount of negative discussion around the community”, reported the ODT on 25 February, “particularly on social media platforms, which has caused public unease. As a result, the Waitaki District Council-controlled company that owns and operates the hospital will hold community meetings.”
The photo on the lower left of the slide above comes from an ODT story about one of these meetings, where strong views were expressed about the proposal to cut nursing jobs. The one on the upper right, courtesy of Oamaru Captured, shows a march to support jobs and services. So here we see how social media is influencing practice environments and job security for NZNO members.
Then last Saturday, the ODT reported: “On Wednesday the Waitaki Community Hospital Action Group started an online petition on its Facebook page – Halt the Oamaru Hospital Proposal.”
That petition, fronted by former Ōamaru Nurse Manager Dr Janice Clayton, calls for a halt on the restructure because:
“The Waitaki Community deserves the right to ensure ongoing service provision at the Hospital now and well into the future.
The current staff deserve the right to voice openly what matters most to them moving forward with a new Model of Care.
Our elderly and young families deserve to know exactly how community-based and home-based care structures will affect them.”
In its first week, the petition has been signed by over 400 people – or around one in 30 of Ōamaru’s resident population.
So overall, I think the primary impact of social media on NZNO members and delegates in this instance has been to rapidly mobilise strong public support. It’s a good example of what’s known as “online-to-offline” activism, where the power of social media is harnessed to generate measurable effects in the community – in this case, to the benefit of NZNO members and delegates.
But this is not the only prominent example from this region over the last year. Here are two photos taken in the Octagon, on International Nurses Day 2018.

They depict one of 15 rallies held around New Zealand that day.
As reported in the ODT these rallies, too, were organised through social media: “A social media site has transformed into a nationwide nurses movement which will stage rallies across New Zealand this weekend”, says this article, which also carries an interview with Dunedin Hospital delegate Anne Daniels (pictured, on the right).
The site in question was the the “New Zealand, please hear our voice” Facebook group, created by two anonymous nurses after the first DHB offer was rejected. Within a fortnight, it had grown to 37,000 members.
The effect of this large social media-led campaign is probably impossible to quantify, in what was a period of intense and multi-faceted activity by and for NZNO members. But two weeks after these rallies, the DHBs lifted their pay offer to members from 6% over three years to 9.3–15.9% over 26 months. I think it’s undeniable that the impact on NZNO members was significant and positive.
But to say that the impact of social media hasn’t been universally positive would be an understatement.
I won’t dwell on this point, as I’m sure most of us who are on Facebook have plentiful first-hand experience of negative impacts, both on ourselves as members and on the reputation of our organisation. But I will refer to the end of year editorial in Kai Tiaki.
Co-editor Teresa O’Connor looked back on 2018 and reflected that, “Social media, notably Facebook, was used to mobilise nurses and to provide a platform for their views on the progress and eventual outcome of the [DHB MECA] negotiations. The power and influence of social media took some by surprise, but what was more of a shock was the rancour of many who took to Facebook to air their views.”
In this, O’Connor was echoing the sentiments of an earlier editorial by acting Manager, Nursing and Professional Services Hilary Graham-Smith, who wrote: “Some members (and non-members) took to social media to rain down abuse on NZNO and on individual staff. For many of us in the profession, that behaviour was the wellspring of deep sadness. What has the profession come to, we asked ourselves and each other as, day after day, the insults, name-calling, ill-informed commentary and blatant lies spewed forth from various Facebook pages.”
The abuse that was rained down via social media fell, above all, upon NZNO representatives in the DHB MECA negotiating team and campaign leadership. And I want to acknowledge in particular the impact this had on your local delegate, Robyn Hewlett.
In July last year, as the manifold impacts of the protracted bargaining started to mount, I called a special meeting of the Board to consider whether some organisational guidance from the governance leadership might be required. In the event, the meeting took place in August, just after the MECA offer was ratified.
One of the issues we discussedwas the impact of social media on NZNO negotiators. Afterwards, a statement penned by Vice-President Rosemary Minto was published on the official NZNO Facebook page.
It said: “The Board would like to wholeheartedly thank the NZNO negotiating team and supporting NZNO staff for their work on the recent MECA negotiations… The Board acknowledge the part that social media played in the process, which at times directed negative and personal attacks towards NZNO members and staff… The Nursing Council of NZ Code of Conduct and the NZNO Constitution and guideline on social media and the nursing profession should be considered by all nurses including NZNO members, before and during their engagement and discourse on social media sites.”
It is hard to say why NZNO experienced such a negative impact, where other professional groups taking large scale industrial action over the last year, such as doctors and teachers, did not.
One difference between NZNO and these other groups is that the others mounted high profile media campaigns, starting well before bargaining commenced, or set up their own officially moderated Facebook groups for union members to engage in online-to-offline activism.

Here on the left we see the primary teachers union launching its campaign, and on the right the creation of the secondary teachers union Facebook group, in each case six or more months prior to the start of their negotiations.
When NZNO did embark on our digital campaign on 26 March 2018, under the umbrella of #HealthNeedsNursing, it immediately generated strong positive effects for NZNO members and delegates, and for NZNO’s reputation. Although it did not utilise Facebook groups, #HealthNeedsNursing was a cross-platform, multi-media campaign, deploying text, images and video over Instagram, Facebook Pages, YouTube and Messenger.

This two-page infographic shows just how great the impact of our social media was. I have hard copies of the “Campaign at a Glance” document here, for you to take away.
Again showing the power of online-to-offline campaigning, note the three dozen rallies which were held around the country in April. Organised through Facebook Events as well as through workplaces, they involved thousands of NZNO members and supporters – even more than the numbers who took part in the #HearOurVoices marches. And of course there was integration with the historic DHB strike on 12 July. Overall, this social media activity certainly contributed to positive impacts on DHB members achievedthrough bargaining.
So far, I have offered observations and examples where social media has impacted on NZNO members collectively. I will conclude by looking at individual impacts.
Rosemary Minto’s statement abovementions the Nursing Council of NZ Code of Conduct.
Historically, nurses have tended torun into trouble on social media through breaches of patient confidentiality. The 2016 Annual Report from the Nursing Council, for example, notes that, “With the millennial generation so digitally connected, there has been concern at their reduced awareness of issues related to privacy and the increasing number of disciplinary cases related to social media.”
Patient confidentiality remains a primary focus of the new NZNO social media Guideline. But speaking with NZNO Professional Nurse Advisors in different parts of the country, new trends appear to be emerging.

Anecdotally, referrals to Nursing Council for individuals are now less frequentfor breaches of patient confidentiality, and more frequentfor social media breaches of these two standards – “treat colleagues with respect” and “maintain high standards of behaviour in your relationship with your employer”.
There is little in the way of hard data on this, as yet. The latest published Annual Report from the Nursing Council is now two years old. And I’m told that NZNO’s data collection systems, through the Member Support Centre, are not well set up to capture this emerging trend. Calls related to social media issues could be coded variously by MSC as an “Industrial – Disciplinary” matter, a “Professional –Media” issue, or something else.
But there appears to be one such case, here in this post in the “hear our voice” group in January.

“I’ve just received a message from a member who’s been reported to Nursing Council… due to being overtly savage online regarding their employer”.
I hope these personal observations and examples of social media impacts have helped to stimulate your thinking. I will leave you with one piece of advice. To avoid the negative impacts of social media for yourself and NZNO, and maximise the positive impacts, the best thing you can do is refresh your knowledge of these two guidelines.

Thank you.
_________
* See also:
‘To post or not to post? Social media and nursing’
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