Professor Charlotte Croft's research explores the influence of social media to challenge professional stereotypes and gain political influence in nursing.
As part of an ongoing research project focused on social media activity before, during and after COVID-19, they investigate whether nurses’ increased visibility has resulted in better working conditions and influence in healthcare.
The preliminary results suggest that while a more accurate social percepttion of nursing was achieved at the pandemic’s most critical times, the effect was short lived and generated limited political leverage.
The authors argue spotlight visibility, leading to political (in)visibility, may be more damaging and restrictive to evolving forms of professionalism than stereotypical invisibility.
In the context of a long-standing NHS workforce crisis, the research provides important insights on the power of social media to develop political influence over more powerful actors.
Nurses: A fundamental but “invisible” piece of the healthcare system
Nurses are the largest professional group in global health systems and a key resource in the drive for high quality care, cost improvement and service innovation.
However, the UK is struggling to maintain adequate staffing levels despite government efforts, (ie NHS Long Term Workforce Plan1), as waiting lists grow faster than the workforce.
The NHS has undergone a recruitment and retention crisis since the late noughties, exacerbated by the scrapping of nursing bursaries in 2017, Brexit and the coronavirus pandemic.
In nursing, this translates to more than 43,000 vacant roles in England, a scenario deepened by a staggering 35% decline in student nursing applications for 2025.
Despite the increasing technical skills and academic education required, nursing has been traditionally perceived as a “girl’s job” with professionals often seen as passive angels, sex objects or unskilled handmaids.
Outdated stereotypes have contributed to the “invisibility” of their skills and exclusion from organising processes by political leaders who devalue the non-medical, caring work central to nursing.
As a result, nurses have struggled to secure an influential role in the organisation of care beyond their professional jurisdiction.
But the unique circumstances of the pandemic, refocused public and political attention on nurses, who were applauded (literally and figuratively)2 and celebrated on social media.
Exploring social media’s potential to change models of professionalism
Charlotte is exploring the potential of social media to change models of occupational professionalism, by analysing over 1,300 UK posts from nurses and the general public between 2018-20243.
The goal is to better understand the impact of the evolving social media rhetoric on nurses’ role in the organisation of healthcare, ie moving from controlled to organising professionalism4.
Although still ongoing, the analysis suggests four stages of professional (in)visibility before, during and after the acute phase of COVID-19.
COVID-19: An opportunity to dismantle stereotypes and gain political power
Prior to the pandemic, nursing was in a state of stereotypical invisibility (2018-2020), with the profession characterised as feminised, dirty and underpaid work, performed by “angels”.
Nurses on social media stressed the need to defy these misrepresentations reinforced by media and political rhetoric, as they undermined their ability to construct a professional identity aligned with a demanding role.
However, the pandemic led a period of spotlight visibility (2020-2021), which brought two key changes.
Firstly, an increased social recognition of nursing work, demonstrated through public clapping, social media images, the return of retired nurses and new staff joining the workforce.
COVID-19 gave nurses an unprecedented opportunity to communicate their pivotal role in managing the crisis, the highly skilled nature of their job and the physical, mental and emotional pressures associated to it.
Secondly, enhanced organising professionalism, with nurses turning to social media to point out the government’s shortcomings in healthcare planning during – and before – the emergency.
Social media also gave nurses a platform to reject the new “hero” stereotype, as it normalised their horrific working conditions, including inadequate/insufficient personal protective equipment (PPE) - eg masks, visors, hazmat suits, aprons, etc - low pay, and overwhelming COVID-19 deaths among healthcare professionals.
For example, nurses shared PPE images to highlight the physical struggles of working in such conditions (eg swelling, sweating, dehydration, difficulty to see and breathe, etc), but also used them to lambast the government for the lack of equipment.
The short-lived effect of spotlight visibility on political influence
Their strengthened professional identity allowed nurses to use social media to leverage increased political influence and position themselves as healthcare leaders alongside doctors, managers and politicians.
On the one hand, they became a reputable voice in promoting social responsibility, by aligning themselves with government messages, including #StayAtHomeSaveLives, #StayAtHome and #StopTheSpread.
On the other hand, nurses used social media to fight government decisions to exclude them from the public sector pay rise and their refusal to pay student nurses who worked through the pandemic.
This materialised in trending conversations around the #NHSWorkersSayNO and #IamProvidingAService hashtags, which gained significant traction outside the profession.
While a public outcry forced the government to honour the payment contracts for students, nurses were unsuccessful in securing better pay and working conditions.
In a period coined by the authors as sanctioned invisibility (late 2021), nurses started to lose political and social influence when the government challenged the skilled nature of their job.
As a result, hostility against nursing work returned to social media and became exacerbated after a series of strikes, which negatively skewed public perceptions.
Social media conversations went back to diminishing the value of nursing, suggesting they could be easily replaced by international workers willing to work for less.
At the same time, nurses reduced social media activity due to concerns of their posts being used to undermine or penalise them.
While this could be seen as a return to ‘stereotypically invisibility’, the ongoing data analysis does not indicate the situation is straightforward.
Instead, the authors argue nursing has entered a novel period of political (in)visibility (2022 onwards), where politicians alter their rhetoric depending on their interests.
Political parties simultaneously render nursing work invisible to avoid challenging conversations about wages and working conditions, while they promote images of nurses in the pandemic to support their agenda.
Examples like referring to the altruistic heroism of healthcare workers in the pandemic to deflect questions about pay rises, illustrate how nursing may have reached a stage of being paradoxically (in)visible.
Learning how to use social media to improve the future of nursing
While increased visibility of nursing via social media temporarily resulted in a return of retired staff and more student applications during COVID-19, the effect was brief.
If anything, research now suggests COVID-19 exacerbated a pre-existing workforce crisis, with recruitment and retention dwindling in the face of poor public understanding or political respect for nursing work.
Although the research is still not completed, Charlotte’s analysis illustrates how this shift in public perception has played out on social media.
It provides valuable insights from a range of different audiences, with potential for future impact on nursing education and developing strategies to use social media to gain political influence.
The study also sets out a research agenda to explore how under-represented professional groups may communicate, perpetuate or change perceptions of their profession through social media.
1 The NHS Long Term Workforce Plan, published on 30 June 2023, sets out how the NHS will address existing and future workforce challenges by recruiting and retaining thousands more staff over a 15-year period, and working in new ways to improve staff experience and patient care.
2 The ‘Clap for Carers’ campaign was initiated in the UK during the first wave of the pandemic. Every Thursday at 8pm people would stand outside their door and clap to show appreciation for NHS workers.
3 The dataset included publicly available X (previously Twitter) and Instagram post, plus nursing blogs, assessed via thematic analysis, a qualitative method commonly used in social sciences., where data is closely examined to identify common themes, topics, ideas and patterns of meaning that come up repeatedly.
4 ‘Controlled professionalism’ refers to occupational models where professionals are controlled by top-down processes, encouraging them to behave in organisationally desirable ways. Conversely, in models of ‘organising professionalism’, professionals embed managerial processes in their work, to establish connections across multiple domains to jointly tackle complex issues. This concept goes beyond controlled professionalism, as staff become involved in organisational decisions to buffer the profession from managerial intrusion.
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Professor of Organisation Studies and Head of the Work, Organisation and Management Group
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