Monthly Archives: November 2019

Complimentary Criticism

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This week I attended the Aboriginal and Torres Strait Islander Cultural Practice Program –  a one day workshop facilitated by Stan Savo. Stan is a Cultural Capability & Workforce Advisor and he does his job terrifically well. He’s an engaging, upbeat and authentic bloke, who delivered many pearls of wisdom on the day. This blog post is about just one of them.

Passive vs Active Communication

Stan spoke about it not being uncommon for Aboriginal and Torres Strait Islander people, especially those who are from a rural/remote area and find themselves in a big hospital, to be disinclined to openly disagree with staff, or to nod or passively agree just to get an uncomfortable conversation over and done with.

Although it sounds counter-intuitive at first, Stan said it’s not necessarily a bad sign if an Aboriginal/Torres Strait Islander person expresses frustration or anger with you. He said something like, “If they are growling at you maybe it’s because they think you can do better, and they want you to know. Maybe it’s a good thing.”

Rupture and Repair

It was timely information for me. An Aboriginal man I’ve been working with was really angry with me the day before the workshop. He was a bit sweary (it wasn’t abuse, it was lalochezia) and clearly frustrated, but he was making sense. He said I should have seen him more promptly than I did after he had let a nurse on the ward know he was having an increase in psychiatric symptoms. I apologised, and we shook hands at the end of the session, but he was still cranky with me. I was worried that I had buggered-up our therapeutic relationship. Rapport and trust take time and effort to establish, but can be lost quickly and easily.

I saw him again yesterday, and we chatted for nearly an hour. Our conversation was half about clinical stuff, and half about non-clinical stuff (“non-clinical conversation” also known as “yarning” in Aboriginal/Torres Strait Islander terms, or “phatic chat” in whitefella way). In keeping with the rupture-and-repair nature of relationships, our therapeutic relationship had a rupture on Tuesday and was repaired on Friday. Just as Stan Savo said, being growled at isn’t necessarily a bad thing.

White Middle-Class Reframe

How does a white middle class nurse like me feel OK about being growled at? It feels bad, and sometimes a little scary, when someone gets angry with you. Here comes a white middle-class reframe (it’s probably the whitest thing you will read today):

I like restaurants. A lot.

If I go to a new restaurant and the food/service is a bit underwhelming, I pay the bill, leave, never go back again, and if anyone asks about the restaurant I’ll probably tell them not to bother.

However, if it’s one of my favourite Cairns restaurants, it’s a different matter.

For example, I’ve probably been to Mondo about a million times in the last 20-something years. On a couple of those million occasions my favourite dish (Sizzling Mexican Fajitas!) has been not up to scratch. On both occasions I let the wait staff and kitchen staff know that today’s fajitas were not at the usual standard. It’s a bit uncomfortable, but it’s important. I care about Mondo’s Sizzling Mexican Fajitas being good. Even if it’s a rare occasion, if they’re not good I want to make sure that staff know that there’s been a slip-up. It’s a bit awkward, but in reality – even though I’m not on their payroll – I’m helping helping the Mondo quality assurance program.

I don’t complain about dud meals in restaurants I don’t care about. I just don’t go there anymore.

I do complain about dud meals in restaurants I care about. I want to go back, so offering an honest critique is an investment in their quality.

Complimentary Criticism

Here’s the thing:

Criticism can be complimentary, in both senses of the word: it’s free and it’s an expression of approval. Approval, as in, “I know you can do better, and I’m encouraging you to do so.”

If someone is growling at us, let’s resist the reflex to get defensive or hurt, and listen for helpful suggestions. This is especially important in the tricky business of crossing cultural barriers, where often we don’t even know what we don’t know.

One Last Thing

Stan Savo’s workshop was full of pearls of wisdom. This blog post has honed-in on just one of them. However, I know it wasn’t Stan’s closing message. This was:

End

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

Paul McNamara, 23 November 2019

Short URL meta4RN.com/cc

Recommended Reading

Geia, L., Hayes, B. & Usher, K. (2013) Yarning/Aboriginal storytelling: Towards an understanding of an Indigenous perspective and its implications for research practice, Contemporary Nurse, 46:1, 13-17, DOI: 10.5172/conu.2013.46.1.13

Queensland Health (2014) Aboriginal and Torres Strait Islander patient care guideline https://www.health.qld.gov.au/__data/assets/pdf_file/0022/157333/patient_care_guidelines.pdf 

Queensland Health (2015) Sad News, Sorry Business: Guidelines for caring for Aboriginal and Torres Strait Islander people through death and dying (version 2) https://www.health.qld.gov.au/__data/assets/pdf_file/0023/151736/sorry_business.pdf

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Digital Professionalism📱vs The Dinosaurs 🦕

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In a famous reddit exchange from about 7 years ago, this question was asked:

If someone from the 1950s suddenly appeared today, what would be the most difficult thing to explain to them about life today? 

Nuseramed replied: 

I possess a device, in my pocket, that is capable of accessing the entirety of information known to man. 

I use it to look at pictures of cats and get in arguments with strangers.

The response went viral.

The iPhone revolutionised how we use mobile phones. Although there were internet-connected phones years before the iPhone came along, it wasn’t until the iPhone was released (2007 in the US + Europe, 2008 in Australasia) that it started to become normal to access the internet while on the run, not just at a desk. Furthermore, the explosion of apps that followed the iPhone release made it clear that making phone calls and sending text messages were the least fun things you could do with a mobile phone. 

Which brings me to the point of this post. Smartphones don’t have to be used for looking at cat videos and getting into arguments with strangers. Smartphones can be a terrific asset to nursing work, but there’s sometimes a weird reluctance from nursing’s leaders to encourage or even permit their use. This reluctance was noted in a recent Journal of Advanced Nursing editorial:

I could wave my hands around and talk about why nurses should embrace, not avoid, using smartphones. It might be a bit abstract though.

We could ask more people to google “mHealth” so they can see their there’s a whole field of study about using smartphones in health care.

Instead, let’s just list a dozen real-life examples of how clinicians use smartphones at work:

  1.  

Google translate does not replace using an interpreter, but for occasional words or phrases it’s terrific, especially if you use the Voice or Conversation functions. 

Overcoming communication barriers often relies on creative solutions. If you can break the ice/engage the person using content you can access on your phone you absolutely would, wouldn’t you? 

In Australia the medication bible is MIMS. Having MIMS on your phone = being able to check on medication info quickly and easily wherever you are. There’s a free 7 day trial, then they’ll charge you $ome monie$ (I’m assuming/hoping it’s tax deductible for nurses, doctors and pharmacists). 

Mindfulness/stress-management can be much easier if there’s a framework and tools to guide you. The free and credible SmilingMind app does just that. 

Google maps is great for this sort of thing.

Calculating BMIs is a tad tricky with pen and paper. The Mediquations app does it for you. 

  1.  

Screening tools like the Edinburgh PND Scale don’t have to be paper-based. This one is on the Mediquations app. It calculates the score automagically, and the whole thing can be emailed to cut and paste into the electronic medical record, so the woman can track her changes/progress, and/or shared with others on the clinical team. 

In the last couple of years there has been a push towards making sure that people who experience suicidal thoughts have a safety plan. Some organisations have created forms for this sort of thing. That might be OK for the organisation, but how handy is it for the person? For most individuals it would be MUCH more handy having a shareable safety plan on your mobile phone. If you haven’t done so already, sus-out BeyondNow.

  1.  

I used to struggle with CPD documentation. With an app you can do it in real time, and readily access it PRN. I used to use the C4N app, but it was a bit clunky. The free Ausmed one is better. There are probably other CPD evidence-based record apps. Wouldn’t it be nice if ANMF and/or AHPRA provided their fee-payers with a free, easy-to-use, and fit-for-purpose CPD app? 

A previous blog post called “Phatic Chat: embiggening small talk” introduced this example of how Google maps can help bridge cultural and language barriers by demonstrating interest, openness and respect. 

  1.  

I must have been away the day they told us about Klienfelter’s syndrome in nursing school. This app makes me sound much smarter than I really am. 

  1.  

Accessing info online (eg https://www.nmsupport.org.au) is a legitimate way for nurses to improve the safety of their practice and to support each other. Why on earth would nursing’s leaders want to restrict ready information access? 

Score

That’s the end of the list of a dozen real-life examples of how clinicians use their smartphone at work. Here’s the score: 

Digital Professionalism📱= 12
The Dinosaurs 🦕 = 0

Snippily Sarcastic Suggestion

Does your nurse manager, nurse educator, university lecturer or clinical facilitator need to know about this stuff? 

Here 👉 [click link to open] 👈 is a PDF version of this blog post that you can print and mail or fax to them. After all, we wouldn’t want to risk using a modern digital technology like email, would we? 🙄 

End

Do you have other examples of Digital Professionalism? Please feel free to add them in the comments section below. 

Thanks for visiting. 

Paul McNamara, 2 November 2019

Short URL: meta4RN.com/mHealth

APA citation:  McNamara, P. (2019, November 2). Digital Professionalism📱vs The Dinosaurs 🦕 [Blog post]. Retrieved from https://meta4RN.com/mHealth

The 12 tweets used above are collated here: wakelet.com/@metaRN

References 

O’Connor, S. , Chu, C. H., Thilo, F. , Lee, J. J., Mather, C. and Topaz, M. (2019), Professionalism in a digital and mobile world: A way forward for nursing. Journal of Advanced Nursing. doi:10.1111/jan.14224

Rolls, K., Massey, D. & Elliott, R. (2019). Social media for researchers – beyond cat videos, over sharing, and narcissism. Australian Critical Care, Volume 32, Issue 5, 351 – 352 doi:10.1016/j.aucc.2019.07.004

Addit 12 July 2020

Many thanks to Dr Siobhan O’Connor et al for acknowledging this blog post (dinosaur emoji and all) in their recently published paper, namely:

O’Connor, S., Daly, C., MacArthur, J., Borglinde, G. & Booth, R. (2020) Podcasting in nursing and midwifery education: An integrative review. Nurse Education in Practice. https://doi.org/10.1016/j.nepr.2020.102827

 

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