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The ethical boundaries of nursefluencers

Search “NurseTok” on TikTok and you’ll be flooded with endless scrub-clad boomerangs. You’ll find masked nurses dancing in supply rooms, nurses on airplanes inviting you to join them  for their next travel assignment, and nurses offering their specialty-dependent tips of the day. For virtually any nursing topic you are hoping to learn more about (or be entertained by), there’s a nurse waiting on your social feeds, ready to deliver content. 

Successful “nursefluencers”—as they are aptly referred to now—tend to their feeds with the consummate attention usually reserved for full-time jobs. The job requirements include finding your niche, posting frequently, engaging with your followers, and voicing positions on trending (and oftentimes controversial) nursing topics. Gain enough popularity and you can monetize your account by promoting products, organizations, and services through affiliate links. 

The latter aspect of nursefluencer life is the one with the most ethical gray area. Making recommendations as a medical professional comes with a heightened level of ethical responsibility that other non-medical influencers needn’t consider. When you factor in the added layer of generating income from your influencing prowess, the muddy waters of social media can darken considerably. 

In this article, we will discuss the rising popularity of the nursefluencer, their potential as both misinformation-spreaders and misinformation-fighters, the importance of following (and being) ethical creators, and finally, how to figure out the nursefluencer-life for yourself.

NurseTok, et al.

The social sites you use tend to be generation-dependent. Facebook dominates with almost 3 billion monthly users, followed by YouTube, WhatsApp, Instagram, and TikTok. All have seen a meteoric rise in the past 10-15 years alone and they each boast a healthy population of nursefluencers. 

No matter which platform you prefer, the tendency for creators to post (only) their highlight reel has begun to shift—today’s audience favors authenticity. Nurses who have worked through the past several years yearn for solidarity with the burnout and compassion fatigue they’ve experienced as a result. Influencers who manage to connect with their audience on these levels—ranging from earnest, soul-baring posts to dark humor—wield an impressive level of clout.  

Positioned at the intersection between lifestyle aesthetic and vetted health professional, nursefluencers possess a unique viewpoint on many different topics that followers are eager to consume. For a lot of nurses, that includes following their curiosity about the many different ways one can be a nurse. In this way, nursefluencers who post “day in the life” content provide a valuable window for both aspiring nurses and those looking to switch up their day jobs to peer through. 

But there is also a dark side to nursefluencer life. The rise of misinformation and its ability to spread like wildfire across social media is a real concern. Some nursefluencers participate passively—resharing information without vetting it appropriately, for instance—while others demonstrate a clear disregard for following the science on vital public health issues, like anti-vaxxers, for example.

The reasons for this dangerous trend are numerous—there are times it can be complicated to disentangle one’s personal life and opinions from one’s professional identity. But it was most apparent during the height of the COVID-19 pandemic just how dangerous and insidious these misinformation missteps could be. 

When a pandemic and social media fame collide

Even before the COVID-19 pandemic arrived in 2020, popular social platforms like Instagram were a potent breeding ground for misinformation, conspiracy theories, and hate. The algorithms used by these sites have one purpose—keeping your attention. To accomplish this, they figure out what topics you view most and then expose you to more of the same. Choose to follow one account spouting misinformation, and several accounts with similar-type content will be offered up. The trouble is, increasing exposure to misinformation potentiates the possibility of a viewer attributing its abundance to well-established fact. 

Harmful topics that trended during the pandemic were plentiful and pervasive: skepticism of masking, vaccine hesitancy, not to mention the requests for inappropriate treatment options like hydroxychloroquine. Assertive posts making bold claims capitalizing on the public’s fear and uncertainty did well. It’s no mystery why; controversial posts tend to get a lot of engagement and engagement drives exposure. Spin-off posts—many times crafted by malware bots—popped up by the thousands and amplified misinformation even further.

The politicizing of health information only added fuel to this dangerous fire. Nursefluencers are human, and as such, are prone to the biases we all have. Depending on one’s political affiliation, views on vaccine mandates, CDC recommendations, and lockdown and quarantining policies can differ wildly from an opposing partisan even when the science on these topics is clear—and despite one’s status as a health professional who has pledged to care for the public. 

Thankfully, misinformation-fighting campaigns have sprung up on social media in response in equal measure. #VerifyHealthcare, a hashtag campaign started by gastroenterologist and popular influencer Austin Chang, became so popular that it led to the creation of a new position at his hospital: Chief Medical Social Media Officer. In spaces where being a nurse can feel more like a personal brand than a profession, #VerifyHealthcare reminds practitioners to continually qualify their opinions with their education, specialty, and certifications. 

Why nursefluencer ethics matter? 

Transparency in nursefluencer content is vital. Anyone can don a pair of scrubs and sling a stethoscope around their neck and come off as authentic in their thumbnails. But when creators choose to monetize their content, they enter into an ethical landscape that must be intentionally careful. 

“Sponcon” is a term that describes sponsored content, otherwise recognizable as #ad posts. Build a big enough following and either brands will approach you, or you can seek out partnerships with them as a “brand ambassador” leveraging your audience. Product recommendations are relatively simple and clear-cut—scroll through any popular nursefluencer’s feed and you can spot them pretty readily. 

But healthcare professionals have an added layer of ethical concern when it comes to recommending supplements and other OTC products. Without FDA approval, your recommendation as a nurse can inadvertently verify something that has only murky  pseudoscience backing it. Paid endorsement of products is akin to the bygone days of pharmaceutical reps “wining and dining” medical practices —a practice not tolerated anymore for good reason.

Shilling mediocre products is cringey, but it usually won’t get you fired. Going against the clearly defined policies and procedures of your employer—not to mention the federal government—will. Which brings us to the biggest ethical concern for nursefluencers to consider: violating HIPAA. Posting any content from work is a big no-no. Relating horror stories about patients is equally forbidden. No matter how careful you try to be, a trail of breadcrumbs can be left for dedicated internet sleuths to follow more easily than you might think. 

Is nursefluencer life for you?

Nursefluencers overall provide a valuable asset for the nurse community. Raising awareness for our profession, shining a light on important healthcare topics, advancing public health campaigns, and crusading against misinformation are all great platforms to stand on. Virtual communities provide a vital respite for a burned out workforce, and connecting to those we wouldn’t otherwise interact with can provide unique networking opportunities.

If your interest is piqued, Nursedeck offers tons of resources on how to get started as a nursefluencer. Here are some of the nursefluencer topics we have covered: