Monthly Archives: December 2016

Mental Health and Cognitive Changes in the Older Adult

This afternoon I’m presenting at Ausmed’s Cairns Nurses’s Conference. The title of the presentation is “Mental Health and Cognitive Changes in the Older Adult”.

The only real point of this blog post is to leave a copy of the powerpoint presentation online, so that those attending the conference can revisit the slides PRN. Here it is:

And here’s the spiel from the Ausmed website

Mental Health and Cognitive Changes in the Older Adult

As we get older, the likelihood of undergoing alterations to brain function is high. This may include normal neurodegenerative changes as well as abnormal deteriorations. Separating normal from dysfunctional degeneration when screening and assessing an older adult is essential for quality nursing care planning. This session will look at:

  • What are normal age-related changes to the brain and consequent behavioural signs?
  • How are these changes different to the onset of mental health disorders such as schizophrenia, psychosis or bipolar disorder?
  • Age appropriate assessment tools for effective mental health assessment
  • Benefits of brief psychosocial interventions
  • What practical behavioural strategies may improve outcomes for a person with a mental health disorder and cognitive changes?

About the presenter:

Paul McNamara has extensive experience providing clinical and educative mental health support in general hospital and community clinical settings. He holds hospital-based, undergraduate and post-graduate qualifications, is Credentialed by the Australian College of Mental Health Nurses (ACMHN), and has been a Fellow of the ACMHN since 2007. Paul is a very active participant in health care social media, and is enthusiastic about nurses embracing “digital citizenship” – more info via his website



That’s it. Short and sweet.

I hope this is of some use/interest to those who are attending the conference, and (maybe) some people who are not able to get along.

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

Paul McNamara, 15 December 2016

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Dear Australian Student Nurses (a letter of encouragement, with data and a song)

Dear Australian Student Nurses yet to be offered a Graduate Nurse position,‬

‪Take heart. We need you.‬

Here’s the evidence:

In related news, ‪about 8.000ish new nurses graduate in Australia every year [2014 info: source].

3501 of Australia’s nurses and midwives are aged 70+. ‬

17,089 of Australia’s nurses and midwives are aged 65+.

39% of Australia’s nurses/midwives are aged 50+ (not that there’s anything wrong with that).

Source: Nursing and Midwifery Board of Australia Registrant Data, Reporting period: 1 April - 30 June 2016, pg. 8

Source: Nursing and Midwifery Board of Australia Registrant Data, Reporting period: 1 April – 30 June 2016, pg. 8

Look, I don’t really know what I’m talking about. I was in your position in 1991, and I remember it feeling daunting then. I have no real idea what it’s like to be a new grad in Australia in 2016/2017, and don’t have any detailed understanding of Graduate RN hiring processes around the country. With that disclaimer out of the way, here’s my 2 cents worth:

1. Nurses graduate in packs, but retire one by one. Today there are about 8000 freshly minted Australian RNs wondering if they’re going to get a gig. I don’t know how many of existing RNs are on the verge of retirement, but the demographic info in the table above would suggest at least 8000 will retire within the next year. Have you read the small print in the ‘Modelling Results’ chart above? The last sentence reads, “The major contributing factor to this result is that workforce exits exceed new entrants from 2016 onwards.” [page 37] Be patient. The jobs will become available.

2. If it’s practical to chase the work (ie: go rural/remote) do so. You’ll pick-up some deadly skills, and will be a better future employment prospect than someone who hasn’t worked as a RN.

3. Have you heard the cliché re not waiting for Mr/s Right, and being comfortable with Mr/s Right-Now? Same with your first few RN jobs: anything will do to get your foot in the door. Don’t knock back an unappealing gig. Quitting is quicker/easier than applying.

4. You know that other cliché “It’s not what you know, it’s who you know”?
It’s not quite accurate.
It’s who you ARE, and who knows it.
If you’re well suited to a particular speciality/hospital/ward make sure that it’s not a secret. Make sure you’re friendly with all staff, but be especially sure that the senior staff (the people with their hands on the levers) know that you’re an asset. If they know you’ll make their workplace better, they’ll be keen to grab you when the funding/positions allow.

5. This one is the important one. It’s REALLY disheartening to spend 3+ years working towards something, and then find out that that something isn’t there where you expected it to be.
The fragile self-confidence of a novice RN isn’t geared-up for a kick in guts like that.
It’s not just a disappointment, it’s an injury to the ego.
Be kind to yourself.
Don’t spend all your money at Dan Murphy’s.
Do fun stuff despite feeling crap.
The data tells us that there are RN gigs in the pipeline. Do whatever it takes to be sure that you’re ready when your opportunity arrives.

6. Expect to experience grief emotions. You probably remember the Kübler-Ross 5 stages thing, as a quick reminder: denial, anger, bargaining, depression and acceptance. Anger and depression are uncomfortable, but very understandable, emotions. Find a safe way to express them (pro-tip: resist the temptation to spray paint swear words on your university or local hospitals).

7. On bad days, have another look at the chart at the top of the page. Australia’s health system needs you!

8. Find things that help you stay optimistic. Music works for me. Just in case it works for you too, here’s a song of determination and defiance. Turn it up!


This blog post is yet another example of blatant self plagiarism doing a funky remix of previous work. It started out as a short Facebook post, which turned into a conversation. The original is here:

As always, feedback/corrections/additions are welcome in the comments section below.

Paul McNamara, 4 December 2016

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