Monthly Archives: December 2012

We Nurses: Communication and Compassion

wenursesEarlier today (Cairns time) Nurses from the United Kingdom and Australia came together on Twitter to discuss issues raised by the death of a colleague. This matter has received a lot of media and social media publicity over the last two weeks. The Twitter chat was hosted by UK social media portal www.wenurses.co.uk – thanks must go to Teresa Chinn for her time and enthusiasm in bringing this chat together.

During the chat thirty-three (33) participants used the #wenurses Twitter hashtag, there were 360 Tweets, and the potential “TweetReach”/impression of the chat was well in excess of one million views (data courtesy of www.symplur.com).

The content of the Twitter chat has been curated and organised as below. This is my subjective arrangement (that is: subject to disagreement – another curator may have made different decisions about what to include/exclude). The intent of curating the content is to clearly identify the themes that emerged during the discussion, and to assist understanding by arranging the themes under subject headings. Twitter is a vibrant, immediate tool, but conversations do overlap in an asynchronous manner; consequently, comments appear to be jumbled/out-of-context if the transcript is read strictly in chronological order.

The headings and sub-headings that emerged are:

    • Preliminary Information
      • Introductions
      • Setting the Tone
  • First Issue: Communication & Confidentiality
    • Sub-Issue: Patients and Mobile Phones.
    • Sub Issue: Social Media
    • Sub-Issue: Individualising Communication & Confidentiality
    • Sub-Issue: WiFi for Hospital Patients
  • Second Issue: Compassion
    • Sub-Issue: Prank Call
    • Sub-Issue: Targeted Crisis Support
    • Sub-Issue: Clinical Supervision (aka Peer Supervision, aka Guided Reflective Practice)
    • Sub-Issue: Supportive Workplaces
    • Sub-Issue: Preventative/Early-Intervention Resources
    • Sub-Issue: The 6Cs (Care, Compassion, Competence, Communication, Courage & Commitment)
    • Sub-Issue: Integrating Defusing Emotions into Clinical Practice
  • Finishing-Up:
    • Key Learnings
    • Closing Remarks
    • Farewells

The curated version of the discussion is presented using Storify – I urge you to browse through the posts by clicking here.

WordCloud created from the full transcript of the #WeNurses Twitter chat

WordCloud created from the full transcript of the #WeNurses Twitter chat

A Comment and Two Questions

Jacintha Saldanha, a Nurse living and working in Britain, died a fortnight ago – just a few days after been inadvertently involved in an Australian radio station prank. Earlier this week her funeral was held in her home town in India.

Jacintha’s death made news headlines in the United Kingdom, India, Australia and elsewhere day after day after day; all manner of media commentators and armchair critics were asked to trot-out their opinions on the matter. As far as I saw, not many media outlets ever got around to speaking to nurses/nursing organisations about the nursing perspective.

At the same time mainstream media was giving the subject saturation coverage, social media erupted with reactions. Sometimes – far too often – responses and opinions were unhelpful and misinformed. Some very nasty and stupid stuff has been Blogged, Tweeted and Facebooked.

questionsAs mentioned in an earlier post, despite the inclination of many to point fingers, the truth is that suicide is a complex matter that should not be blamed on a single event or single interaction. Thoughts of self harm are most likely to occur when significant, long-term stress, depression, anxiety or other mental health problems are present.

Out of respect to Jacintha’s family, friends, workmates and the Coroner’s Court, we did not speculate about her life and death on today’s Twitter chat. It is note-worthy that the prank phone call received barely more than a mention in today’s Twitter chat.

Today’s Twitter chat was not about Jacintha, it was not about radio DJs, it was not about the media, it was not about the lack of understanding of suicide, and it was not about social media being used as vehicle for ignorance.

KeepCalmToday’s Twitter chat was about Nurses using social media in a constructive manner, and responding to the highly publicised death of one of our colleagues with thoughtfulness and grace.

The content of today’s Twitter chat raises two questions:

  1. Does this hour-long chat between nurses via Twitter contain more calm, practical wisdom than nearly everything else written about this sad event to date?
  2. If the answer is to question 1 is “Yes”, why didn’t the media ask nurses for an opinion on what the salient issues were?

Today on Twitter #WeNurses identified and discussed the salient nursing issues: communication and compassion.

In Closing

mindhealthThinking and talking about suicide can be distressing; be assured that there are always supports available:

In Australia

Lifeline phone 13 11 14 or visit www.mindhealthconnect.org.au

In the United Kingdom

Samaritans ph 08457 90 90 90 or visit www.samaritans.org

In other countries

The world’s most popular search engine (Google) displays a picture of a red telephone and the helpline phone number if searching for a suicide-related topic.

Paul McNamara, 21st December 2012

Questions of Compassion

This morning we woke to the sad news that a British Nurse inadvertently involved in an Australian radio station prank has, apparently, taken her life. Suicide has loomed large in my work over the years. I have lost colleagues and clients to suicide, and have had the privilege of being on-hand for those who have attempted to take their life but survived; they have been some of the most important, profound hours of my working life. I’ve also had the poignant privilege of being on hand to support those who are mourning the person that has taken their own life – sometimes this has been in the immediate aftermath, more often in the weeks, months and years that follow. The death of a loved one is always sad, but sadder still when those left can make no sense of the why questions:

  • why didn’t s/he ask me for help?
  • why didn’t I notice something?
  • why did s/he do this?
  • why can’t I stop crying?

Perhaps the outpouring of anger on social media over the last few hours has been another expression of the why questions. Although the tweets and facebook posts have used different, more emotive, words the underlying messages seem to be something along the lines of these why questions:

  • why would this happen?
  • why can’t we stop it from happening?
  • why is suicide so frighteningly inexplicable?
  • why can’t we blame something/somebody?

These why questions will mostly go unanswered, of course. The only one we can reasonably hope to address is the last one: why can’t we blame something/somebody? The answer is that suicide is a complex matter; it is not likely to be caused by a single event or single interaction. Thoughts of self harm are most likely to occur when significant, long-term stress, depression, anxiety or other mental health problems are present.

Which brings me to the three points of this post:

One. Jacintha’s death is a poignant reminder that in times of distress there are always people we can reach-out to:

Aussies via Lifeline ph 13 11 14 or www.mindhealthconnect.org.au

Brits via Samaritans ph 08457 90 90 90 or www.samaritans.org

For people in other countries, the world’s most popular search engine (Google) displays a picture of a red telephone and the helpline phone number if searching for a suicide-related topic.

Two. A few days ago in the UK, the Director of Nursing at the Department of Health and Chief Nursing Officer for England released a three year vision and strategy for nursing, midwifery and care staff called Compassion in Practice. In this document compassion is defined as how care is given through relationships based on empathy, respect and dignity - it can also be described as intelligent kindness, and is central to how people perceive their care (page 13).

In this sad time while we include Jacintha’s family, friends and workmates in our compassionate thoughts, let’s also share and encourage compassion for the radio DJs and their family, friends and workmates.

Suicide is too complex for blame. Nurses are too compassionate to blame.

Three. Only one Australian state (Victoria) has access to the Nursing and Midwifery Health Program – an independent support service specifically for nurses and midwives experiencing a mental health issue or substance use issue.

Shouldn’t this scheme be opened-up to all Australian Nurses and Midwives? Let’s nurture those who nurture.

In Closing

In the late 1990s I partnered with a Mindframe representative to speak with Cairns journalists about safe, sensitive reporting of mental health issues and suicide. While having no pretence of having a journalist’s qualifications or expertise, there’s no reason why those of us who blog shouldn’t be informed by the Mindframe guidelines to assist us to frame our posts in a sensitive, helpful way. Part of doing so is to acknowledge that talking and thinking about suicide can be distressing, and to ensure that readers are aware of supports:

In Australia

Lifeline – 13 11 14
Suicide Call Back Service – 1300 659 467
For young people 5-25 years: Kids Helpline – 1800 55 1800
For men: MensLine Australia – 1300 78 99 78
MindHealthConnect www.mindhealthconnect.org.au

In the United Kingdom

Samaritans ph 08457 90 90 90 or www.samaritans.org

For people in other countries, the world’s most popular search engine (Google) displays a picture of a red telephone and the helpline phone number if searching for a suicide-related topic.

Paul McNamara, 8th December 2012