Tag Archives: nursing

The Art of Mental Health

art

Sigmund Freud is purported to have said, “Everywhere I go I find that a poet has been there before me.” Not every nursing speciality has this advantage of being informed and sustained by artists. Can those of us interested in supporting mental health consumers and carers look to art to improve our understanding and empathy of the experiences of others? 

I have created a Prezi as a seed for others to use art as an adjunct to our other sources of learning (courses, colleagues, peer-reviewed journals, text books etc). Please see the Prezi by following the link here.

The examples I have collated in the Prezi are listed below, and credit is given to the sources that were used in the Prezi.

Veronica by Elvis Costello is a beautiful song and film clip, that improves our understanding and empathy of nursing the person with dementia. The YouTube video is here: youtu.be/zifeVbK8b-g The lyrics were sourced from this website: www.azlyrics.com/lyrics/elviscostello/veronica.html I’ve written about this previously: meta4RN.com/dementia and have self-plagarised. Again. 

Dog by Andy Bull (with vocal support from Lisa Mitchell) is a fantastic song that captures some of the difficulties of the experience of depression. In the Prezi I used this YouTube link youtu.be/bBOe660BYjI and the lyrics were sourced via www.songlyrics.com/andy-bull/dog-lyrics

Dog is a poignant, wonderful song. Listen to it here:

I had a black dog, his name was depression is written, illustrated and narrated by Matthew Johnstone. It is a very accessible way think about depression and would resonate with a broad age group, I think. Here is the YouTube video used in the Prezi:

To improve understanding and empathy for the family/carers of those who experience schizophrenia I use a song called Neighbourhoods #2 (Laika). This takes a bit of explanation. First though, lets get the credits out of the way. The lyrics were sourced here: www.azlyrics.com/lyrics/arcadefire/neighborhood2laika.html The YouTube video linked in the Prezi is from here: youtu.be/8Wq917ucGaE

Laika - First dog in Space by Belgian artist Paul Gosselin. Source: http://cultured.com/image/4063/Laika_First_dog_in_Space/#fav

“Laika – First Dog in Space” by Belgian artist Paul Gosselin. Source: http://cultured.com/image/4063/Laika_First_dog_in_Space/#fav

Laika by Arcade Fire may not have been written about mental illness at all. However, as with all art, interpretation is an individual experience. I have had a few years experience as a community mental health nurse. In that role I provided direct care and support to the person experiencing mental health problems (nearly all of my clients at the time had schizophrenia) and, when family were still around, support for them too.

Much of the word imagery of Laika fits with that experience. Carers often described their frustration at the lack of insight and empathy that their family member seemed to have. Carers would oscillate between deep concern and desperate frustration about their family member. More than a few times carers expressed a nihilistic outlook – an almost complete lack of hope. The line “Our mother should’ve just named you Laika” expresses that poignantly: Laika was the name of a stray dog in Moscow who became the first living creature to orbit earth. She was never expected to return to earth safely, and died a few hours after launch. Families I have worked with have, at times, expressed that level of despair about their family member.

I also like how Laika’s story has been taken-up by the art community. I love the Arcade Fire song, and my favourite visual representation of Laika – First Dog in Space is the painting above by Belgian artist Paul Gosselin.

The last piece of art I used in the Prezi was The Scream by Edvard Munch. The source of the picture is here: www.ibiblio.org/wm/paint/auth/munch/munch.scream.jpg I’ve read that this picture has been associated with other health problems including  trigeminal neuralgia, psychosis and depersonalisation. To my eye, The Scream looks like acute anxiety and/or a panic attack. It serves as a graphic visual reminder that the first step is to assist the person to contain their distress, to be and feel safe. It shows distress that must feel overwhelming and rallies us to help: let’s think “safety first” kids.

So, that’s it for this little weekend project: if you haven’t visited the Prezi yet please do so now: The Art of Mental Health

What songs, poems, books, music and visual art will inform and sustain your clinical practice?

Paul McNamara, 7th December 2014

art

A Nurse’s Guide to Twitter

Today Ausmed Nursing Education launched the web page “A Nurse’s Guide to Twitter”. I was very pleased when Will Egan from Ausmed asked me submit the content. Now that I’ve seen how great it looks online I’m very very pleased.

The web page looks really cool.

Check it out for yourself via www.ausmed.com.au/twitter-for-nurses or the short URL aus.md/tfn

I’m writing this blog post purely to link to Ausmed page. Yes, that’s right: this web page is about another web page. There’s that meta part of meta4RN again. :-)

While I’m at it, I want to make an acknowledgement. The process of writing for Ausmed was great. Not only did they pay for the article to be written (a first for me), but they asked for my approval to all the edits that were made (another first for me – I’ve never had that courtesy extended by other publications). To top it off, the Ausmed team made my humble text look great! Aesthetics = accessibility. A big thanks to Will Egan specifically, and the Ausmed team generally.

Ausmed_Education-Logo

That’s it. Please go have a look at aus.md/tfn now!

Paul McNamara, 21st November 2014

Short URL: meta4RN.com/ausmed

 

Movies, Myths, Mistakes

The Cairns Post, 14th August 2003:

my say 1 140803As if schizophrenia isn’t enough of a burden to those who have it, they also have to put up with the myths and misunderstandings that accompany it, and the discrimination that follows.

So, let’s try to get some of the facts about schizophrenia right.

Probably the most common myth is that schizophrenia means split personality. Comparisons to Jekyll and Hyde are commonplace, but utterly wrong.

In Latin schizophrenia means split mind. This refers to the split between perceiving the world in the way most of us do and perceiving it in other ways.

To illustrate, someone with schizophrenia may interpret everyday events as having significance beyond their intent.

In health, our jargon terms for these sorts of symptoms are delusional beliefs and/or ideas of reference.

my say 2 140803In the film Angel Baby the main character sought special meaning from a game show. I have met plenty of people with schizophrenia and haven’t heard anything quite like that, but then I don’t have to make a living by entertaining people either.

I think what the movie-makers were doing was jazzing-up and stylising the experience of perceiving the everyday in another way.

Speaking of jazzing-up and stylising, A Beautiful Mind certainly did a good job with making paranoia look exciting (it’s not).

Perhaps because movies are visual, this film gave the impression the main character was experiencing his paranoia as a visual experience.

Some people with schizophrenia do have paranoid beliefs and delusions when they are unwell. Nobody I’ve met has described this visually, although quite a few have spoken about hearing things, usually voices,.

It seems these auditory hallucinations are an intrusive and exaggerated version of what all of us experience when we have those little conversations with ourselves throughout the day.

From what I’ve heard, most people’s idea of what a mental health ward looks and functions like comes straight out of One Flew Over The Cuckoo’s Nest.

Anyone who has been inside our local mental health unit at CBH will be able to tell you that it is a modern, light-filled place where there’s direct access to fresh air from just about every room.

In my opinion, the layout and design is the best of all the wards in the hospital.

Finally there’s the violence myth. Hollywood has created a perception that schizophrenia means danger.

I don’t associate violence with schizophrenia at all. I know that on occasions tragic things have happened, but this is rare.

I’ve met dozens of people with schizophrenia who would not  hurt a fly.

I guess if you’re making movies you’re not interested in a story about an ordinary-looking person doing everyday stuff in a pretty average way, other than taking medications to control uninvited symptoms.

Final Notes

Back in 2003 a journalist from The Cairns Post invited me to submit this article for the My Say column (a daily feature presenting the views of a cross-section of the community). The article’s reference to man’s inhumanity to man is in the context of current events at the time – it was published during the second week of the war in Iraq.

As I was identified as an employee of a local hospital, at the time of publication the content of the article had to be approved by the hospital’s media department. The media department approved the article without changes to content.

In 2003 I used some phrases that I find a bit jarring now. I was tempted to correct it in this 2014 version, but decided it was more authentic to leave the original unaltered.

Anyway, I stumbled across the very-low-resolution JPG version of the article today and thought it might be worth reprising. Stigmatising representations of schizophrenia still pop-up in Hollywood, – this is a tiny, inadequate bit of counter-balance.

As always, your feedback is welcome in the comments section below.

Paul McNamara, 26th October 2014

Short URL:  meta4RN.com/movies

Originally:
McNamara, Paul (2003). Movies, myths, mistakes. The Cairns Post, 14 Aug 2003, pg 13.

Humanity to Man

The Cairns Post, 29th March 2003:

cairns post column 290303Man’s inhumanity towards man has been getting plenty of coverage lately – it might be time a good time to be reminded of men who demonstrate humanity.

Not quite 10 percent of nurses are male (please don’t call us male nurses – we’re nurses, but happen to be male).

Like our female colleagues, we’re spread across all aspects of health. Blokes nursing in Cairns include Stephen in Intensive Care; Adrian and Denis who work with elderly people; Bill the midwife; Andrew in orthopaedics; Colin who runs a medical ward; Sean who visits new parents and their babies in their homes; Greg and Clif who work with people battling mental health problems; Andy does mostly policy and administrative stuff; Steve and Scott on the local crisis team, and Nick who has spent a fair bit of time nursing out bush and is currently back in town.

There’s plenty of blokes nursing locally not mentioned (sorry fellas), but you get the picture – we pop up everywhere.

So, why nursing? I won’t presume to speak for other nurses of either gender, but I can tell you what I like about the profession – I like being useful.

It’s a peculiar privilege being a nurse. Peculiar because, for all its different guises and specialities, the basic job description is the same – try to be useful to people. It’s a privilege because nursing offers an amazing level of responsibility and intimacy.

It might sound more convincing if it wasn’t coming from a bald bloke with a bit of a beer gut, but nursing is a nurturing profession. The nature of our relationships with patients is therapeutic, but first and foremost it’s a human relationship.

We often have the privilege of being with people at very important stages of their lives, and we get the opportunity to show that nurses can be professional, skilled and caring.

I’m sure it’s not unique to nursing, and it’s certainly not unique to nurses who are male, but let’s not forget that there are daily demonstrations of man’s humanity towards man.

Final Notes

Back in 2003 a journalist from The Cairns Post invited me to submit an article for the My Say column (a daily feature presenting the views of a cross-section of the community). The article’s reference to man’s inhumanity to man is in the context of current events at the time – it was published during the second week of the war in Iraq.

As I was identified as an employee of a local hospital, at the time of publication the content of the article had to be approved by the hospital’s media department. The media department approved the article without changes to content.

In 2003 I should have used the phrase “man’s humanity towards mankind” instead of “man’s humanity towards man”. Sorry. I was tempted to correct it in this 2014 version, but decided it was more authentic to leave the original unaltered.

Anyway, I stumbled across the very-low-resolution JPG version of the article today and thought it might be worth reprising. Man’s inhumanity towards mankind is still dominating the mainstream media. This is a tiny, inadequate bit of counter-balance.

As always, your feedback is welcome in the comments section below.

Paul McNamara, 26th October 2014

Short URL:  meta4RN.com/men

Originally:
McNamara, Paul (2003). Humanity to man. The Cairns Post, 29 Mar 2003, pg 19.

 

Defending Mental Health in Nursing Education

NHS

The Guardian (UK ed), 29 Sep 2014

There was an article in The Guardian (UK edition) recently where a nurse described how ill-equipped they felt to support patients experiencing mental health difficulties. The article included the startling information that, “My nursing course, which I think was excellent, contained no more than three days structured education on caring for patients with mental health problems.”

Umm. That wasn’t an excellent nursing course. That’s a crap nursing course.

Look, us Aussies like to tease the Brits about their weather and cricket team every chance we get, but I’m not accustomed to criticising their nursing courses. The truth is, I do not know enough about nursing courses in the UK to hold any strong opinions about how good or bad they are.

That said, I wonder what the general public would think of hospitals being staffed by nurses who had undertaken, as reported, a three year nursing course that includes only three days of teaching in mental health. I am glad that doesn’t happen in Australia.

Dumbing Down is Dumb

Since July 2000 most of my work has been about supporting mental health care in the general health settings as Consultation Liaison CNC (more about that here) and as Perinatal Mental Health CNC (more about that here). These roles have direct clinical input, but also have a lot to do with supporting general nurses and midwives to feel more confident and become more skilled at providing direct clinical care to people experiencing mental health difficulties. It’s inevitable that they’ll need these skills – a significant proportion of people who access general hospitals and/or maternity services also experience symptoms of depression, anxiety etc. Dumbing-down mental health education for general nurses and midwives is dumb.

elistIn August 2012 a Mental Health First Aid (MHFA) instructor proposed using MHFA as inservice education for hospital-based nurses. I mounted my high horse to defend the depth and quality of nursing education sprouting the opinion that MHFA is not suitable training for RNs. My rant went along the lines of it’s great training for many community and professional groups, but it’s inadequate for those working in health role. Undergraduate nursing programs have more than the 12 contact hours that MHFA offers, and we should re-awaken/build-on that education. Nurses in particular need to know a bit about:

  • symptom detection
  • meanings/implications of diagnostic groups
  • medication effects and side-effects
  • the biopsychosocial model of mental health
  • social determinants of health
  • risk assessment/management
  • emotional intelligence and therapeutic use of self

confpresTo give MHFA their due, they have never claimed their training to be an alternative to formal nursing education (others have). MHFA does a good job at informing first responders, but does not address mental health in a manner suitable for a frontline clinician. There is a community expectation that nurses and midwives will have a depth of understanding of mental health beyond that of the general community, beyond basic fist aid.

This conversation started off as a discussion in the workplace, then became a topic of discussion on the Australian College of Mental Health Nurses e-lists, then morphed into a conference presentation and, more recently, was articulated as this journal article:

Happell, B., Wilson, R> & McNamara, P. (2014) Undergraduate mental health nursing education in Australia: More than Mental Health First Aid. Collegian (2014), http://dx.doi.org/10.1016/j.colegn.2014.07.003

Happell, B., Wilson, R. and McNamara, P. (2014) Undergraduate mental health nursing education in Australia: More than Mental Health First Aid. Collegian (2014), http://dx.doi.org/10.1016/j.colegn.2014.07.003

Anyway, I guess there are two points to this blog post:

One: Quality Control
Let’s make sure that we continue to defend the quality and depth of undergraduate nursing and midwifery training in Australia. We must never let it slip like the UK example of just three days training in three years. That is woefully inadequate.

Two: Speak Up 
If you’re a nurse or midwife with strong opinions about a subject, it doesn’t hurt to discuss these opinions online. As per this example, a discussion held online morphed into a conference presentation and a journal article. For me, anyway, the difference between it being a rant and a paper was the interest and input from a couple of Nursing Academics: Brenda Happell (@IHSSRDir on Twitter) and Rhonda Wilson (@RhondaWilsonMHN on Twitter).

References

Happell, B., Wilson, R. L. & McNamara, P. (2013). Beyond bandaids: Defending the depth and detail of mental health in nursing education. Paper presented at the Australian College of Mental Health Nurses 39th International Mental Health Nursing Conference Perth, Western Australia, Australia. Abstract in International Journal of Mental Health Nursing, Vol 22, Issue Supplement S1, pp 11-12 http://onlinelibrary.wiley.com/doi/10.1111/inm.2013.22.issue-s1/issuetoc

Happell, B., Wilson, R. L. & McNamara, P. (2014) Undergraduate mental health nursing education in Australia: More than Mental Health First Aid. Collegian (In Press) http://dx.doi.org/10.1016/j.colegn.2014.07.003

End

Thanks for reading this far. As always, your feedback is welcome in the comments section below.

Paul McNamara, 21st October 2014

Short URL: meta4RN.com/defend

Free Open Access Mental Health Education for General Nurses and Midwives #FOANed

If you’re a nurse or midwife, and own an internet-enabled device you have unprecedented access to information.

Information + motivation = education.

Borrowing from the very successful #FOAMed initiative, recently there has been a flurry of activity regarding Free Open Access Nursing Education (aka #FOANed).  That is:

Free
Open
Access
Nurse
education

The #FOANed hashtag makes it’s easy to share info and resources via social media. If you’re cruising Twitter, Facebook, Google+ or even Instagram, have a look for the #FOANed hashtag.

Still not sure what the #FOANed hashtag is all about? Perhaps it’s just easier to see for yourself via this Storify (click here).

Mental Health #FOANed

Anyway, in the spirit of #FOANed, here are four suggestions for free open access nursing education re mental health for general nurses and midwives (click on each picture for more info):

1. Physical and Mental Health Care via Australian College of Mental Health Nurses:

2. Mental Health Liaison in General Hospitals via New South Wales Health:

inkysmudge.com.au/eSimulation/mhl.html

inkysmudge.com.au/eSimulation/mhl.html

3. Perinatal Mental Health Training for Midwives via Monash University:

perinatal.med.monash.edu.au

perinatal.med.monash.edu.au

4. MIND Essentials via Queensland Health:

Obviously, this is not an exhaustive list of the mental health #FOANed available online, but hopefully it’s enough to get you started if you’re looking for some CPD/info.

Please feel free to add your suggestions for other free open access nursing education re mental health in the comments section below.

Paul McNamara, 20th October 2014

Short URL: meta4RN.com/FOANed

These words have been in my head and they needed to come out (a blog post about suicide)

Trigger Alert – this blog contains info re suicide which may be unsettling for some people.

Guest Post: Stevie Jacobs has contributed this guest post to meta4RN.com

StevieJacobsStevie Jacobs is the pen name of a newly-minted Enrolled Nurse. The person behind Stevie is smart, experienced in life and has some awesome insight into the world of the student and new graduate nurse.

You can follow Stevie Jacobs on Twitter: @SJWritesHere

Stevie has contributed to other nurse blogs, including the excellent site Injectable Orange, by Jesse Spurr.

These words have been in my head and they needed to come out
(a blog post about suicide)

I am ‘Pro choice’.

I am a patient advocate.

I am a person advocate.

I support euthanasia.

I am pretty much of the opinion that if you have all the facts, figures and feelings figured out then you can go ahead and do pretty-much whatever you like. Even if it’s ‘bad’ for you. I can provide you with action plans and phone numbers and personal support, however ultimately, the choice my friend, is yours.

So when someone wants to kill themselves/suicide/take their own life (however you want to put it) what does my head feel about that? I’m not talking about obligations as a Health Care Professional, I’m talking about obligations as a human being. I can provide you with an ear to bend, a shoulder to lean on, I can find you professional help if you want, I can tell you that I don’t think you’re in a safe space and I want to get more support. For both of us. I can do all that. What I am stuck with is that if euthanasia is assisted suicide and I’m OK with that (OK meaning I won’t physically stop you nor judge you), does that mean I am ‘OK ‘ with someone’s suicide? Both have the same ending:, the removal of pain through the death of a person. I don’t know how my heart or my head feel about that.

Robin Williams was 63. That’s a long time to be living in pain. Yes, there are medications and therapies and support groups, but what if that starts to feel just all too much? That living is just all too much, a bit like ‘diabetic burnout’, where the person with diabetes basically gets fed up with ‘managing’ their diabetes and becomes unwell. That can happen with all chronic diseases. That can happen with mental health issues. Yes, some people have a depressive episode, it’s self-limiting and then they never have another one. Wonderful. For others, it just keeps on coming back, more painful than before.

To someone who is experiencing suicidal thoughts, suicide I can seem to be a rational method of pain relief. It’s the ultimate pain reliever for the person experiencing the thoughts.

For those left behind it can be devastating.

I can’t make up my mind. Do I have the ‘right’ to stop someone from suicide? I’m on the fence. The boundaries get blurred. I’ve experienced anxiety & depression, I’ve experienced suicidal thoughts & been ‘suicidally depressed’, I’ve had a family member suicide and I’ve known someone I followed on Twitter suicide. Which is a really fucking weird experience, quite frankly. Grief for someone who you ‘know’, but don’t ‘know’. 101 ‘What ifs?’. I could ‘see’ that something wasn’t right, but aside from checking in and offering an ear what else could I do? I’m at peace with those choices now, no longer haunted by ‘what ifs’. I’m sure that is not the same for their family and friends. I realised that what has stayed in my head is a photo of themselves they posted shortly before it happened. It’s their eyes. Their eyes haunt me. I can see something in their eyes I’ve seen time and time again. In my face. In the faces of others. I know those eyes so well. However good your mask is it’s in the eyes.

So, what to do? Who am I to tell anyone what to do? There isn’t really a clear answer. I think it’s really important to keep checking in on people: RU OK? I have RUOKed a few people and I will keep doing it. If it’s a ‘No’, and they express some ideas that worry you, it’s OK to ask “Do you have a plan?” If it’s a ‘Yes’, what then? Especially if you just don’t believe them. That’s trickier ground to navigate. I’m no expert on this. There are links at the end of this from people who are.

RU OK? It’s just a simple question. A simple, lifesaving question. I was on another planet from OK, and someone who barely knew me asked me that question.

It was like a thunderbolt.

It made me stop and think and choose to get help to make living less painful. Choosing to get help is hard. Getting help can be harder. What’s even harder is acknowledging that choosing to live is a conscious effort. It’s an effort. Accepting that medications and therapy and exercise and diet changes and avoiding triggers are now part of your life is an effort.

In time I hope that life will once again become effortless, but it might not.

Finally, after years of effort, I now think I am OK with that.

.

Post Script 1:

I wrote the above post a little while back. Normally when I have said all I have to say on a subject it doesn’t pop back in to my head. This post did. If I am honest, I have only scratched the surface. I have more to say. The way I write usually is like a good vomit on a night out: it all comes out in one go and it’s done and dusted and you’re up and dancing again. The other way I write is a bit more like a gastro bug: on and off with a bit of dry retching when you just can’t get it out. Then you’re done and you feel better.

Paul told me the ‘meta’ point of meta4RN is ‘talk about what you’re talking about’. So I guess that’s what I’m doing here. Rereading the above, reflecting on it and trying to work out quite what it is that I still feel I want to say.

We need to talk about mental health. We need to talk about suicide. We need to do it in a safe, appropriate and open way, but we do need to talk about it. Talking about it is hard. Talking about it can be terrifying for anyone. Talking about it when you’re a health professional is really damn hard. There are so many ‘what ifs’. What if they ‘lock me up’? What if they don’t? What if they think I’m not fit to practice? What if I lose my job? What if my colleagues find out? What if I have to be treated in the same hospital that I work in? What if…

I want to talk about how it feels to have suicidal thoughts. I want to talk about how it feels to be suicidally depressed. I’m not sure how to do that. I know that there are media guidelines for discussing suicide. As someone who is trying to describe a ‘lived experience’, I decided the best way for me to write was to let it all come out uncensored, and then give it to Paul to edit it using some of those guidelines and make it ‘safe’. I am in a safe enough space now to be brutally honest about how those suicidal thoughts feel, and far away enough from those thoughts to be able to talk about them without feeling ‘triggered’.

I can only speak for myself. For me there is a distinction between having suicidal thoughts and being ‘suicidal’ or ‘suicidally depressed’, as I have referred to it in the past. The thing about ‘suicidal thoughts’ is that the longer you have them the more rational they seem. For me suicidal thoughts are more of a hypothetical notion; it’s not something I am going to carry out. It’s an icy calm IF. IF things don’t get better, IF that was to happen, IF there isn’t another way out, IF the pain becomes unbearable, IF.

I know exactly how I would kill myself. I know exactly how I would spend the jackpot from a lottery win. I know exactly what I would get done if I had free access to plastic surgery. It’s all hypothetical.

It’s hypothetical. Until it’s not. Until I am suicidally depressed. Until I am in pain. Until the self-loathing I carry around with me every day takes over. Until I truly believe that the people in my life would be better off without me. Until I can’t see any way out aside from that way. And that place is not icy calm. It’s a messy, clinging on to something, anything to get through hour after hour, painful, emotional swamp. I feel emotionally swamped. I can’t think in a straight line. I can’t sleep. I can’t eat. The anxiety eats at my stomach. The panic attacks feel like I am dying of a heart attack. The after effects of which last for days. And nothing, nothing stops the pain. That’s how suicidal feels like for me. I know, however, that it is not what it looks like to other people. People see what they want to see. Even people who are trained to see more. I am brilliant at hiding it. I know how to put on my mask and polish up my armour. It is exhausting.

There are cracks in my armour, sometimes the mask slips. My fellow walking wounded can see though them, but for the most part the people I see every day wouldn’t know. I can make people feel so good about themselves. I can make people cry with laughter. Then, the second I am alone, the pain floods over me and I can barely breathe. I keep coming back to pain. It’s about pain. Not control, nor attention seeking, nor escape; in that moment it is about wanting that pain in my heart to stop. To. Stop.

It’s a horrendous place to live to be honest. It’s a half life. I had to choose to live better. To live for me. To get help – medications, counselling, CBT, exercise, diet. It’s a conscious choice. And what helped me make that choice was being asked ‘RU OK?’

.

Post Script 2:

So, turns out it’s not a verbal gastro bug. It’s verbal C.Diff. The words just keep coming out.

I think I need to make it clear that I am talking about a period of over 10 years. I need to make it clear that I am talking about the past. I might write ‘I know’, but I suppose really it is ‘I knew’. Deciding to share this is a decision that has been easy, but it is a decision that I have made because these words have been in my head and they needed to come out. There are more things I could say, about specific attempts, specific feelings. However, I don’t want to share them. I think that’s OK.

I need to make it clear that I support ‘RUOK’ & WHO suicide prevention strategies. I need to make it clear that if you judge me negatively based on what I have written or if it changes your opinion of me, then that’s your thing, not mine. I’m not asking for agreement or understanding, but I do ask for kindness.

I was asked recently what the best thing in my life is right now. Aside from Nursing, the answer is the people in it. I know that my people love me, and accept ‘me’, and that’s enough.

Black Dog Institute Healthy Living Study is a program to help those experiencing suicidal thoughts manage them: http://www.blackdoginstitute.org.au/public/research/participateinourresearch/index.cfm

Black Dog Institute Healthy Living Study is a program to help those experiencing suicidal thoughts manage them: http://www.blackdoginstitute.org.au/public/research/participateinourresearch/index.cfm

End.

Short URL:  meta4RN.com/guest02

Many thanks to Stevie Jacobs for sharing this gutsy piece of writing. Your sensitive, constructive feedback is welcomed in the comments section below.

It’s also important to acknowledge that talking and thinking about suicide can be distressing. People in Australia can access support via:

Lifeline – 13 11 14

Suicide Call Back Service – 1300 659 467

MindHealthConnect www.mindhealthconnect.org.au

phone_hotline-40Outside of Australia and not sure where to get support? Google usually displays a red telephone icon and your country’s suicide support phone number when searching for a suicide-related topic.

This guest blog post has a companion piece, which I have imaginatively called “A Blog About A Blog About Suicide” – the link is here: meta4RN.com/mindframe

Paul McNamara, 23rd September 2014