Author Archives: Paul McNamara

About Paul McNamara

Nurse, educator & social media enthusiast. Loves AFL (Go Adelaide!), hates cotton wool. More info at meta4RN.com

The Hearing-Voices/Car-Driving Metaphor

A while ago I met a lady who had a fantastic way of describing and understanding her experience of auditory hallucinations/psychosis. It goes a bit like this:

My body’s a car. I’m the driver.

In the back seat are the voices. They’re like naughty kids, always chatting away amongst themselves. Often they’re taunting me. 

Usually I can just ignore them and get on with driving the car.

However, every now and then the voices get real loud.

It’s distracting. Driving becomes difficult and that’s when I’m most likely to drive badly or, if I’m unable to concentrate properly, I could even crash the car. 

It’s pretty scary, but I usually don’t have to come into hospital at that point. I just need more support to get control back, and maybe a change to my medication. 

The worst time for me is when the voices get so distracting that I can’t focus on driving at all. I turn to the voices in the back seat and try to get them to shut up. But they’re like naughty kids yelling and jumping around the car, and I can’t get them to stop. 

I take my seatbelt off and turn to face them, then somehow – I don’t even notice it happening – one of the voices will slip into the driver’s seat and take over control of driving the car.

Thats when it gets REALLY dangerous.

I’m not out of control – it’s worse than that – I have lost control entirely. I haven’t even got my hands on the steering wheel anymore, and I can’t reach the brakes. 

That’s when I need to come into hospital.

At the time I met this lady she was make a tentative recovery from one of these acute episodes of psychosis. On admission she had been experiencing command auditory hallucinations, paranoid delusions, racing thoughts and suicidal ideation.

When we met the intensity of these symptoms was settling. The lady’s articulate insight helped us both communicate effectively when she had a relapse in symptoms. To keep her safe we needed to stop her from leaving the hospital, and provide an increased level of supervision/support. To get a shared understanding of this I was able to return to the lady’s metaphor:

I’m worried that you’re at risk of losing control of the car again. What I’m planning to do is take the keys away for now, and hand them back to you when you’re safe to drive again. 

That’s a good way to think about using the Mental Health Act – it’s a mechanism to decrease risk/stop people from a foreseeable crash if they’ve lost the capacity to drive. 

However, the real story here is about the intelligence, insight and articulate communication of a young woman who experiences symptoms of psychosis.

An impressive person, and a fantastic metaphor. 

Hopefully other people will be able to make use of this lady’s metaphor as a way to understand psychosis/hearing voices. 

car
End

Thanks for visiting. As always your comments/feedback is welcome below.

Paul McNamara, 20th February 2017.

Short URL: https://meta4RN.com/car

The problem is the date, not the day

Back in the olden days only birds tweeted.

In 1994 we didn’t have social media with which to share, Like or Tweet about every outrage du jour. Those were the days when if you had a strong opinion about something in the news, the only way for an ordinary person to join the public conversation was thus:

  1. Find a piece of nice paper
  2. Succinctly write your thoughts on an issue
  3. Find an envelope
  4. Buy a stamp
  5. Mail your letter off to the local newspaper
  6. Then wait to see whether it is published as a Letter to The Editor.

Crazy, right?

Who would bother?

tiserdate

.

tiser1

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tiser2

I want to reprise that old Letter to the editor here for two reasons:

1. The Headline is Wrong

The Editor of the Advertiser put the wrong headline on my letter: It should have read “Inappropriate date”, not “Inappropriate day”. It’s totally appropriate to have a day to celebrate being Australian and to celebrate prominent, successful Australians (e.g.: Nurses on the Australia Day Honours List). Of course it’s ridiculous to hang onto January 26th. It’s inevitable that the date will change when Australians get around to electing a progressive government again.

The problem is the date, not the day.

Let’s not throw the baby out with the bathwater.

We can celebrate the people on the Australia Day Honours List without celebrating the date.

2. Long Weekends are Good

When i wrote the letter in 1994 it was the first time that the Australia Day public holiday was tied to January 26th. Before then it used to be the closest Monday. I was doing shift work at the time (12 hour shifts, 2 on/2 off @ Glenside Hospital, Adelaide), so wasn’t directly affected by long weekends. Nevertheless, I still knew a good thing when I saw it: consecutive days off work are a great way celebrate our good fortune of being Australian.

When we consciously de-couple ourselves from the current date, let’s re-couple our national day to a weekend. What a great way to celebrate Australia’s most valuable assets – our environment, climate and accent on leisure.

icea

End

As alway, your comments/feedback are welcome. Please use the comments section below.

Paul McNamara, 26 January 2017

Short URL: meta4RN.com/ChangeTheDate 

Twitter Hashtag: #ChangeTheDate

Nurses on the 2017 Australia Day Honours List

Extracting information from gg.gov.au/australia-day-2017-honours-list, below are the Nurses named on the 2017 Australia Day Honours List.

Emeritus Professor MaryAnn Bin-Sallik AO
Officer (AO) in the General Division of the Order of Australia
Darwin, Northern Territory
For distinguished service to tertiary education as an academic, author and administrator, particularly in the area of Indigenous studies and culture, and as a role model and mentor.

Service includes:
Pro Vice-Chancellor, Aboriginal and Torres Strait Islander Leadership, Western Sydney University, 2015 and Board of Trustees, since 2016.
Dean, College of Indigenous Education and Research, University of South Australia, 1998-2001.
Head of the School, Aboriginal Studies and Teacher Education, University of South Australia,1990
Senior Lecturer in Aboriginal Studies, South Australian College of Advanced Education,1989-1990.
Coordinator, Aboriginal Taskforce, South Australian Institute of Technology, 1980-1985.
Chair, Vice Chancellor’s Indigenous Advisory Council, Charles Darwin University, 2013-2015.
Dean, Faculty of Aboriginal and Torres Strait Islander Studies, Northern Territory University and Ranger Chair in Aboriginal Studies and Director, Centre for Indigenous Natural and Cultural Resources.

Served in the nursing profession for 17 years before moving into higher education.

Member, Ethics Council, National Congress of Australia’s First Peoples, 2013-2015
Director, Power and Water Corporation Board, Northern Territory, 2014-2015
Director, Kormilda Christian College Board, Darwin, 2005-2015.

Commonwealth Government Committees include:
Review of Aboriginal Employment and Training.
National Aboriginal Employment Development.
National Committee Against Discrimination in Employment and Occupation.

Member of numerous councils including:
National Population Council.
Council of the Institute of Aboriginal Studies (now AIATSIS).
Co-Commissioner, Human Rights Commissions Enquiry into the Forced Removal of Aboriginal and Torres Strait Islander Children.

Author:
Aboriginal Women by Degrees, ‘The journey of 13 Indigenous women on their road to achievement’, (University of Queensland Press, 2000).

Awards and recognition includes:
Life Time Achievement Award, National Aboriginal & Torres Strait Islander Observance Day, Darwin, 2015.
Emeritus Professorship, ‘for services to Indigenous Higher Education in Australia’, Charles Darwin University, 2008.
Centenary of Federation Medal, for contributions to Indigenous Higher Education in Australia, 2001.
Medal, ‘for contributions made to the Museum’, National Museum of Australia, 2001.
Chancellor’s Medal, ‘recognition as first Indigenous person to work in the Higher Education Sector’, Flinders University, South Australia,1994.
Aboriginal Overseas Study Award, Commonwealth Department of Education, 1985

More info about MaryAnn Bin-Sallik:
www.sbs.com.au/nitv/article/2016/07/04/naidoc-2016-female-elder-year-mary-ann-bin-sallik

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Ms Gillian Mary Biscoe AM

Member (AM) in the General Division of the Order of Australia
Sandy Bay, Tasmania
For significant service to the community through leadership and advisory roles with state, national and international public health organisations.

Service includes:
Consultant and Executive Director, The Bellettes Bay Company, since 1996.
Advisor and Consultant, World Health Organization (WHO), since 1989.
Executive Associate, JTA International, 2005-2013.
Secretary, Tasmanian Department of Community and Health Services, 1993-1996.
Secretary, ACT Health and Chief Executive of the Canberra Hospital, 1991-1993.
Deputy Director General, New Zealand Department of Health, 1988-1990.
Assistant Secretary,Commonwealth Department of Health, mid 1980s-1988 and
Executive Director, Royal Canberra Hospital, 1988.
Deputy Director of Nursing, Royal Hobart Hospital, 1970s.
Chair and/or Member of national and international committees including:
WHO Medical Workforce Development Committee.
The Australian Ministerial Advisory Committee on Health.
The Australian National Health and Medical Research Council.
WHO (WPRO) Technical Advisory Group, Universal Health Coverage, since 2016.
Board Member, Tasmanian Leaders Inc, since 2005 and co-designer and co-facilitator,
Tasmanian Leaders Program, since 2005 and Honorary Alumni.

Awards and recognition includes:
Recipient, Sidney Sax Medal, Australian Hospitals and Health Association, 2010.

More info about Gillian Biscoe:
community.newsarticles.net.au/Health/2010-Sidney-Sax-Medal-Awarded.htm

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Ms Elizabeth Anne Bowell OAM 
Medal (OAM) of the Order of Australia in the General Division
South Golden Beach, New South Wales
For service to nursing, and to international natural disaster health care assistance.

Service includes:
International Health Delegate, Australian Red Cross, since 2004, including 23 international missions:
Nepal Earthquake, Nepal, 2015.
Ebola outbreak, Liberia, 2014.
South Sudan, 2014.
Typhoon Haiyan Response, Philippines, 2013.
Vanuatu, numerous visits, 2012 and 2013.
Sierra Leone, 2012.
Nepal, 2011.
Solomon Islands, 2011.
Papua New Guinea, 2010.
Haiti Earthquake, Haiti, 2010.
Solomon Islands, 8 visits, 2008-2012 and Team Leader, Solomon Islands Flood Emergency, 2008.
Tana River Floods Emergency Response Team, Kenya, 2006.
Yogyakarta Earthquake, Indonesia, 2006.
Public Health Coordinator, Indian Ocean Tsunami Response, Indonesia, 2005-2006.

National Director of Education, Emergency Care Program, Council of Remote Area Nurses of Australia – CRANAPlus, since 2005 and Remote Emergency Care (REC) Coordinator, 2003-2005 and Remote Emergency Care Facilitator, since 2000.

Co-Director, Extreme Health, current.

Awards and recognition includes:
Recipient, for courage and devotion to victims of armed conflict or natural disaster,
Florence Nightingale Medal, International Committee of the Red Cross, 2015.
Recipient, for outstanding contribution to remote health, Aurora Award, CRANAPlus, 2007.
Recipient, Meritorious Award, Australian Red Cross, 2006.

More info about Elizabeth Boswell:
www.abc.net.au/news/2017-01-26/australia-day-honour-list-recipients-recognised/8213226

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Ms Denele Valli Crozier AM
Member (AM) in the General Division of the Order of Australia
New South Wales
For significant service to the community, particularly to women’s health, and to social
welfare and legal assistance organisations.

Service includes:
Chief Executive Officer, Women’s Health New South Wales, since 2001.
Administrator, Redfern Legal Centre, 1994-2001.
Administrator, Women’s Health, Information, Resource, Crisis Centres Association, 1987-1994.
Nurse, Community Health Worker and Educator, Liverpool Women’s Health Centre, circa 1980s.
Registered Psychiatric Nurse, Rozelle Hospital, 1960s-1970s.
National Treasurer, Australian Women’s Health Network, since 2011 and National
Board Member, since 2003.
Vice-President, NSW Council of Social Service (NCOSS), 2015-2016 and Treasurer, 2011-2015 and Board Member and Member, since 2007 and Chair, NCOSS Health Policy Advice Group, since 2009.
Chairperson, Women’s Legal Services NSW, since 2012.
Member, NSW Premier’s Expert Advisory Council for Women, 2010.
Member, NSW Premier’s Council for Preventing Violence Against Women, 2008.
Inaugural President, Social and Community Services Division, Australian Service Union, 1988-1993 and Member, 1984-2016 and Member, NSW and ACT Branch, ‘for over 30 years’.
Member, Non-Government Organisation Advisory Committee, NSW Health, 2003-2016.
Member, Non-Government/Government Women’s Health Group, 2003-2016.
Member, Female Genital Mutilation Advisory Committee, 2003-2016.
Member, Women’s Health and Resources Foundation, 1982-2016.
Member, South West Women’s Child Sexual Assault Resource Centre, 1984-1985.
Member, Women Against Incest 1982-1983.

More info about Denele Crozier:
www.abc.net.au/news/2013-10-23/regional-abortion/5039522?pfmredir=sm

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Ms Noela Isobel Davies OAM
Medal (OAM) of the Order of Australia in the General Division
Doomadgee, Queensland
For service to nursing, and to international humanitarian healthcare programs.

Service includes:
Humanitarian Aid Worker (Nurse), International Red Cross, 1999-2005.
Has served in Northern Kenya, South Sudan, Darfur, East Timor, Northern Liberia,  Somali/AFAR, Ethiopia, Afghanistan and Kyrgyzstan.

Member, Field Assessment Coordination Team, Tacloban, Philippines, 2012-2014.

Humanitarian Observer, Australian Red Cross. Northern Territory Department of Health:
Rheumatic Heart Disease Public Health Nurse Coordinator, Centre for Disease Control.

Queensland Department of Health:
Clinical Nurse Consultant, Remote Generalist Complex Care, (Nurse Navigator), Doomadgee Community Health, North Queensland, since 2016.

Director of Nursing, Birdsville Health Centre, 2015-2016.
Awards and recognition includes:
Recipient, Florence Nightingale Medal, International Red Cross, 2011

More info about Noela Davies:
www.northweststar.com.au/story/4421287/ex-isa-nurse-gets-oam/

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Lieutenant Colonel Nicholas Andrew Duff
Conspicuous Service Cross (CSC)
Queensland
For outstanding devotion to duty to clinical training and preparedness of health services personnel as the Deputy Director of Clinical Services, 2nd General Health Battalion, from 2012 to 2015.

Lieutenant Colonel Duff has orchestrated high quality clinical training, benchmarked clinical readiness and improved the career progression for Army nursing. Through outstanding devotion to duty, professionalism and skilful management he has made a crucial contribution to improving clinical governance and significantly enhanced Army’s deployable health capability.

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Ms Kerryn Eileen Ernst
Public Service medal (PSM)
Page, Australian Capital Territory
For outstanding public service to community health in the Australian Capital Territory.

Ms Ernst qualified as a registered nurse in 1998 and since that time has completed a graduate
certificate in Oncological Nursing, gained accreditation as a Breast Care Nurse with the Cancer
Council of Victoria, and completed a Master of Nurse Practitioner and a Master in Palliative Care.

Since 2009 she has been a metastatic McGrath Breast Care Nurse employed by ACT Health
providing support to more than 1,000 families who are faced with the devastating news that their breast cancer is metastatic.

In her role she provides education and support in relation to treatment options and translates
medical language and specialist information for patients. She assist people to navigate the
complex landscape of treatment, disease progression and prognosis and also recognises that care needs to be holistic and looks for ways to support people both physically and emotionally.

She is a staunch advocate for the importance of educating Australians about breast cancer and
has shown a commitment to the education of other nursing professionals by presenting at
conferences and workshops.

Ms Ernst consistently goes above and beyond to provide the best level of support and care
to her patients and their families and has had a positive impact on the lives of many in the Canberra region.

More info about Kerryn Ernst:
www.canberratimes.com.au/act-news/canberra-life/inspiring-breast-cancer-nursing-stories-from-the-mcgrath-foundation-20150915-gjn6aw.html

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Mrs Heather Emily Hewett MBE OAM
Medal (OAM) of the Order of Australia in the General Division
Horsham, Victoria
For service to the Indigenous community of the Northern Territory.

Service includes:

Translation, to Maung, Gospel of Mark, a project of the Northern Regional Council of the Uniting Aboriginal and Islander Christian Congress and the Uniting Church in Australia Northern SYNOD, 2009-2016.

Co-authored Maung Grammar with the noted linguist Arthur Capell, ‘Texts and Vocabulary’ (published in 1974).

Assistant, Bilingual education program, Nungalinya College, introduced to the school in 1972.

Started recording the Maung alphabet with the elders, included linguistic analysis, bible translation, translation and discussion of educational material including electoral information and land rights legislation, 1966-1974.

Nursing sister, appointed to the Methodist Overseas Mission at Warruwi, 1957-1979.

Awards and recognition includes:
Recipient, The Order of the British Empire – Member (Civil), 1978, for services to Aboriginal linguistics, health and religion.

More info about Heather Hewett:
www.mailtimes.com.au/story/4427205/connection-language-and-honours-for-heather/

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Professor Catherine Therese Turner AM
Member (AM) in the General Division of the Order of Australia
Brisbane, Queensland
For significant service to nursing through research into nurse practice and population health, and to professional organisations.

Service includes:

The University of Queensland:
Professor, School of Nursing, Midwifery and Social Work, current.
Head, School of Nursing and Midwifery, 2008-2014.
Director of Research and Deputy Head of School, 2007.
Associate Professor, Coordinator of Research and Higher Degrees, 2004-2006.
Project Officer, Development of an undergraduate nursing degree, Faculty of Health Sciences, 2002-2003.
Senior Lecturer, Division of Epidemiology and Social Medicine, School of Population
Health, 2001-2003.
Visiting Fellow, Boston College, Maine, United States of America, 2000.

Australian Catholic University:
Assistant Head, School of Nursing, 1999.
Head, Department of Nursing Practice, 1995-1998.
Lecturer in Nursing, 1992-1994.

Clinical Teacher, Rural Placements, University of Canberra, 1991-1992
Nurse Educator, Royal Brisbane Hospital, 1988-1990.

Assistant Commissioner Nursing, Health Quality and Complaints Commission, 2011-2014.
Board of Directors, Mater Education Ltd, since 2016.
Board of Directors, Mater Health Services, 2008-2016.
Executive, Council of Deans Australia and New Zealand, Nursing and Midwifery, 2012-2014.

Awards and recognition includes:
Career Development Award, Population Health, National Health and Medical Research Council, 2007-2011.
Distinguished Alumni Award, Flinders University, 2008.
Fulbright Fellow, Channing Laboratory, Harvard University, 2006-2007.
Excellence in Teaching Award, The University of Queensland, 2005.
International Research Collaboration Travel Award, The University of Queensland, 2003.

More info about Catherine Turner:
nmsw.uq.edu.au/profile/584/catherine-turner

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Mrs Julianne Mary Whyte OAM
Medal (OAM) of the Order of Australia in the General Division
Lowesdale, New South Wales
For service to community health through palliative care programs.

Service includes:

Founder and Chief Executive Officer, Amaranth Foundation, since 2009 (provides therapeutic
and psychosocial support for people coping with advanced chronic and terminal illness).

Palliative Care Project Officer; Riverina Division of General Practice, 2006-2011.

Palliative Care Clinical Support Leader and Project Officer; Intereach NSW Pty Ltd, 2006-2009.

Care Support Officer; Greater Southern Area Health Service, 2003-2006.

Registered Nurse and Chronic Care Coordinator; Murrumbidgee Health District, 1980-2006.

Research Fellow, Charles Sturt University, Wagga Wagga, since 2014  (Listen Acknowledge
Respond Project – a translational research project to up-skill the allied health workforce in End of Life Palliative Care).

Executive position, Oncology Social Work Australia, 2009-2011.

General Committee Member, Palliative Care New South Wales, 2008-2009.

General Member, Palliative Care Australia, ongoing.

More info about Julianne Whyte:
palliativecare.org.au/palliative-matters/10-minutes-with-julianne-whyte/

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Closing Notes

Please let me know via the comments section below if I missed any nurses or midwives. I’m happy to correct any oversights (not fully caffeinated yet).

Not all of Nurses on the 2017 Australia Day Honours List remain in a nursing-specific role. Nevertheless, they are included here because one does not simply leave nursing.
It’s like the Mafia.
You know too much.
🙂

Although MaryAnn Bin-Sallik's award was received outside of a nursing context, her 17 years of nursing experience =  valid inclusion criteria IMHO.

That’s it. Thanks for visiting.

Paul McNamara, 26 January 2017

Short URL meta4RN.com/honours17

Blatant Self-Promotion

Ever written an article about yourself as an act of blatant self promotion?

I have. Here it is:

ijmhn-photo

Paul McNamara, photograph by Vera Fitzgerald

Cairns Nurse on Journal Editorial Board

Cairns CNC Paul McNamara has recently been appointed to the editorial board of the International Journal of Mental Health Nursing (IJMHN). IJMHN is now in its 26th volume, and has built a solid reputation over the last quarter century. The journal’s impact factor of 1.943 is a great achievement.

Paul was specifically invited to join the board to help develop and drive a social media strategy for IJMHN. “I’ve been very active in using social media in a professional sense for the last few years, and have presented at conferences and published about health professionals using social media.”, says Paul. “I guess that’s what caught the attention of the IJMHN Editor in Chief.”

“Twitter is my favourite platform for work-related social media. I think it will be the best fit for IJMHN. Twitter allows information to be shared with the whole world. If it’s good enough for the Pope, the US President and the Australian Prime Minister, maybe it’s good enough for mental health nurses too.”, joked Paul. “Twitter is where the influencers are. As US marketing guru Charlene Li said, ‘Twitter is not a technology. It’s a conversation. And it’s happening with or without you.’ It’s a professional trait of Mental Health Nurses to want to be part of the conversation.” When asked about other social media platforms, Paul said, “We’ll keep an eye on what develops: nothing is static on the internet. Facebook is too big to ignore, so we’ll certainly have a look at smartening-up IJMHN’s presence there too.”

Traditionally the success or failure of a journal article was measured by citations. The only way authors/researchers knew if their work was being read was when other authors referenced their paper. Now that IJMHN is purely an online publication (with an iPhone/iPad app), there is another metric that can be used – how often the article is shared on social media.

Social media can help drive visibility and brand awareness of the journal, and raise awareness of Mental Health Nursing’s work and contributions. For the first time in history, nurses have unmediated access to the public conversation via social media. “Social media provides a terrific opportunity for all health professionals to share and acquire information. It’s a fun way to do professional development.”, Paul said. “It’s also a good way to let people know who we are and what we do.” When asked for a recommendation about using social media, Paul said, “Just be aware that some of your patients, some of your colleagues, and some of your managers will Google your name. Make sure you’re in control of what they’ll find. Don’t be afraid. Be intentional. Make your digital footprint your CV.”

Paul’s professional digital footprint is built around the homophone “meta4RN”, which can be read as either “metaphor RN” or “meta for RN” – try Google or go to meta4RN.com to see what it’s all about.

And follow @meta4RN and @IJMHN on Twitter!

End

This blatant piece of self-promotion could possibly also be included in a newsletter/magazine, but it’s one of those publications that’s organisation/member-specific. That means only a certain group of people will see it, and it will remain unknown to those not part of the organisation. A bit secretive, eh?

Maybe a modern reworking of the biblical “don’t hide you light under a bushel” thing could be, “don’t just do stuff – blog about it!”

Or maybe not.

As always your comments/feedback is welcome below.

Paul McNamara, 9th January 2017.

Short URL: https://meta4RN.com/IJMHN

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
www.ausmed.com.au/course/cairns-nurses-conference

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 http://meta4RN.com

ausmed16

End

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

Short URL: https://meta4RN.com/Ausmed16

 

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 http://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD16%2f21646&dbid=AP&chksum=t4OGdyru9MwpHjKdC5SBeA%3d%3d

Source: Nursing and Midwifery Board of Australia Registrant Data, Reporting period: 1 April – 30 June 2016, pg. 8 http://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD16%2f21646&dbid=AP&chksum=t4OGdyru9MwpHjKdC5SBeA%3d%3d

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!

End

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: https://www.facebook.com/meta4RN/posts/1353685884664226:0

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

Paul McNamara, 4 December 2016

Short URL https://meta4RN.com/letter

Hand Hygiene and Mindful Moments

Nurses and other health professionals are expected to attend to hand hygiene about eleventy seven times a day. The WHO and HHA recommend 5 moments for hand hygiene: before touching a patient, before clean/aseptic procedures, after body fluid exposure/risk, after touching a patient, and after touching patient surroundings. 57.4% of Australia’s nurses/midwives are hospital/ward-based [source], they’re doing A LOT of hand hygiene. 

On top of that, while they’re going about their business and busyness, ward-based nurses are interrupted 10 times an hour [source]. Yep, every 6 minutes there’s something or somebody distracting us from our tasks and thoughts. Dangerously disorderly much? Hopefully that doesn’t happen to neurosurgeons, commercial airline pilots, tattoo artists or Batman.
Especially Batman. 

batman

Pro-Tip: most of us can not do this at work. Only respond to distractions with face-slapping if you are Batman.

So, here’s the idea: if you’re going to do hand hygiene dozens of times a day anyway, don’t just do it for your patients: do it for yourself too. We’re not cold callous reptilian clinicians, we’re educated warm-blooded mammals who do emotional labour. We need to nurture ourselves if we are to safely continue to nurture others.

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5 moments for hand hygiene & head hygiene!

Turn the 5 moments of hand hygiene into mindful moments. Make the 5 moments for hand hygiene 5 moments for head hygiene too. Yes, clean hands save lives – let’s not forget that clear heads save lives too!

Come up with a process/script that works for you, maybe something a bit like this: 

Mindful Moment (The 30-Second Handrub Version) 

  1. Step towards the pump bottle with intent. This is my mindful moment. I’m taking a brief break. 
  2. Squirt enough to squish. 
  3. The rub is slippery at first. Frictionless fingers feel fine.
  4. Feel the product texture and temperature. The rub is cooler than the air. The rub is cooler than my fingers. It feels nice. 
  5. Start with cleaning. The first half of my hand hygiene routine is about rubbing stuff off. Let the stuff I want to get rid of float away. 
  6. Move on to restoration, healing. The second half of my hand hygiene routine is about rubbing in resilience and health. Let the stuff that sustains me seep into my skin. 
  7. Check in on the breathing. The slower and deeper the better. If the breathing or the brain are running too fast, slow down and repeat steps 5 and 6. 
  8. There’s no rush. Slowly scan the surroundings. With any luck someone from infection control is watching. 
  9. Smile.
  10. Breathing slowly, its time let the air rinse off the residue. 
  11. One more slow breath. Its time to get back to work. 

Mindful Minute (The 60-Second Handwash Version)

  1. Step towards the sink with intent. This is my mindful minute. I’m taking a brief break. 
  2. Let the water flow.
  3. Feel the water flowing over both hands. The water’s warmer than the air. The water’s warmer than my fingers. It feels nice. 
  4. Add soap. It’s slippery. Frictionless fingers feel fine.
  5. Start with cleaning. The first half of your hand hygiene routine is about washing stuff away. Let the stuff you need to get rid of flow down the drain. Let it flow away. 
  6. Move on to restoration, healing. The second half of my hand hygiene routine is about rubbing in resilience and health. Let the stuff that sustains me seep into my skin. 
  7. Check in on the breathing. The slower and deeper the better. If the breathing or the brain are running too fast, slow down and repeat steps 5 and 6. 
  8. There’s no rush. Slowly scan the surroundings. With any luck someone from infection control is watching. 
  9. Smile.
  10. Breathing slowly, its time rinse both hands. 
  11. Breathing slowly, its time to thoroughly dry both hands together. 
  12. Throw the towel in the bin.
  13. One more slow breath. Its time to get back to work. 
poster2

Clean hands save lives. Clear heads save lives too!

Acknowledgements & Context

This is not my original idea. I first stumbled across the idea of combining hand hygiene with head hygiene via Ian Miller‘s November 2013 blog post “mindfulness during handwashing”: http://thenursepath.com/2013/11/18/mindfulnurse-day-8/. I’ve been using the idea myself and suggesting it to colleagues and students ever since. When I left the clinical environment for a few months, I found myself really missing intentionally punctuating my day with mindful moments. Since returning to clinical practice I’ve come to appreciate the strategy even more than I did when I first started using it 3 years ago.

So why am I blogging about it too? Why now? Well, on Monday I attended the Australasian College for Infection Prevention and Control 2016 conference to chat about Twitter [link to that presentation here. Also, check-out the #ACIPC16 hashtag here and here]. Luckily I was there for the opening plenary sessions, and was pleasantly surprised at the emotional/psychological literacy that was being displayed and advocated for. The opening presentations by Peter Collignon, Mary Dixon Woods and Didier Pittet all went to some lengths to emphasise the importance of emotional intelligence, constructive communication and building relationships. It was really impressive stuff; giving the hand hygiene and mindful moments idea a remix is my way to give recognition/thanks to the #ACIPC16 conference delegates and organisers.

How to win friends and influence people: https://twitter.com/emrsa15/status/800495292642508801

How to win friends and influence people: https://twitter.com/emrsa15/status/800495292642508801

Just so you know, a quick google search reveals that others have also thought of using hand hygiene as a mindful moment, eg this paper:

Gilmartin, Heather. (2016) Use hand cleaning to prompt mindfulness in clinic: A regular prompt for reflection could reduce distraction. BMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.i13 (Published 04 January 2016)

and this video:

There are others too. Do you think using hand hygiene as a mindful moment could become mainstream?

5mindfulmoments

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That’s it. As always your comments are welcome via the space below.

May you hands be clean and your head be clear! 🙂 

Paul McNamara, 26 November 2016

Short URL: http://meta4RN.com/hygiene