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 @CairnsHelp swing tag QR code (brochures are so last century)

In the grand old tradition of “see one, do one, teach one”, here is a two-and-a-half minute video which hopes to spark some ideas on how we share information.

The video above tells the story. No need to read below unless you’re especially curious.

Background/Elaboration

Back in 2012 I picked-up a Health Roundtable  Innovation Award in the “Improving Quality of Patient Care” stream for Deploying complex information via a QR Code. However, it wasn’t until the COVID-19 pandemic kicked-in and, in keeping with public health advice, every cafe, bar, restaurant and retail outlet required customers to check-in that QR code use became as endemic as a virus.

In April 2021 I stumbled across linktree, and thought it was a cool way to collate all my social media stuff in one place (here: linktr.ee/meta4RN).

Soon afterwards, I thought it would be a cool way to collate a list of Cairns organisations that I refer to and/or recommend when at work. The first incarnation was intentionally short, but at the recommendation of Anton Saylor – an Aboriginal & Torres Strait Islander Hospital Liaison Officer – we added a lot of agencies to the list. Anton said something like, “Brother, some of my mob have complex lives. Let’s make sure they have access to the services they need.” That’s how linktr.ee/CairnsHelp got started.

I used QR Monkey to make the QR code because it’s free, and allows a logo/text box to be inserted into the code as a label. Tina Jenkins – an Executive Support Officer – kindly made 16 laminated swing tags featuring the QR code above. With our “home made” swing tags we conducted a small trial amongst colleagues, and surveyed them after a couple of weeks [results]. With the modest survey results in hand, the idea was pitched to the executive to print swing tags so other staff and the people they support would have easy access to the CairnsHelp list. These things take a while, of course, but it was approved that we print a couple of hundred swing tags (we used lotsa printing) for a broader trial of the QR Code.

We are not limited to using the QR code/CairnsHelp link on swing tags. Richard Oldham – a Clinical Nurse Consultant with Mental Health – has suggested a trial of wall posters in waiting rooms and the like. There have been other ideas too. For instance, it’s really handy to include the https://linktr.ee/CairnsHelp link when sending an SMS or email.

I’m planning to form a small representative committee to review the CairnsHelp content before Christmas, and every 6 months thereafter, to keep the content up to date.

That’s where we’re at in October 2021. I’m still in the process of distributing the swing cards and getting the idea out there. There’s been a fair bit of interest. As much as I’d love to chat about it with people all day, my paid job is to provide clinical support and education. It’s more time efficient and sensible if I just plonk the info here on the interwebs, and pass-on the link to let people find out about it when and if it suits them. See one. Do one. Teach one.

Share & Repurpose PRN

Maybe there will be people in other services who will find the idea handy to borrow and repurpose for their area. That’s cool with me. You are free to copy and redistribute the material in any medium or format, and remix, transform, and build upon the material. I would appreciate attribution, and a similar approach to free sharing.

This info by Paul McNamara is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Based on a work at https://meta4RN.com/brochures.

Kicking Myself/A Suggestion For You

I really wished I thought of this BEFORE printing the swing tags. Frustratingly, some older/cheaper phones still struggle with QR codes, so it would be sensible to print the URL below the QR Code to quickly and easily overcome that [example].

Of Course I’m Not Representing The Organisation That Employs Me

There is a brief glimpse of my work name tag on the video. Does that mean I am representing the organisation that employs me? No. Of course not. It’s a ridiculous question to ask. It’s like asking whether I represent the views of the Pope and the Catholic church just because I used to be an altar boy. (source: McNamara, 2012, Number 13)

I am not ashamed of where I work, and I am grateful that the organisation allowed me to progress the idea. That encouragement deserves a respectful nod, which is why I left the glimpse of my work ID tag in the video.

However, I am very careful not to conflate my amateur little Saturday-morning YouTube/TikTok videos and blog post as anything to do with “official business”. You should not conflate the two either.

End

That’s it.

If you have any suggestions or feedback, please add them to the comments section below.

Thanks for watching/reading.

Paul McNamara, 23 October 2021

Short URL: meta4RN.com/brochures

Self Compassion and Post Traumatic Growth amongst Nurses in the Pandemic (Hooray for Grey Hairs!)

You may have seen that COVID-19 related content from the International Journal of Mental Health Nursing has been collated on one page, and is free to read. If not, sus it out here: IJMHN COVID-19

There’s an interesting recent addition to that list of articles by a group of nurses working at Southern Cross University and in the Northern New South Wales Local Health District. The paper reports on the stress risk and protective factors amongst 767 Australian nurses working in acute-care settings during the COVID19 pandemic.

The findings that jumped-out at me from the paper were that more experienced* nurses reported more self-compassion. Greater self-compassion resulted in:
– a reduction in pandemic-related stress
– less symptoms of depression and/or anxiety
– greater post-traumatic growth.

That’s great, right?

The findings from the Australian survey are similar to a large-scale China survey in that post-traumatic stress for nurses during COVID-19 is offset by post-traumatic growth. Understandably, the numbers in the Australian study are less pronounced than they were in the Chinese study, reflecting the difference in the two country’s experience of the COVID-19 pandemic.

Chen, R., Sun, C., Chen, J.‐J., Jen, H.‐J., Kang, X.L., Kao, C.‐C. & Chou, K.‐R. (2020), A Large‐Scale Survey on Trauma, Burnout, and Posttraumatic Growth among Nurses during the COVID‐19 Pandemic. International Journal of Mental Health Nursing.

So What?

If, like me, you’re an experienced * nurse, celebrate and share your self-compassion super-power and with other nurses. This, together with the possibility that the pandemic may cause professional/personal growth to offset the stress, is very encouraging.

If you’re new-ish to nursing, be very deliberate about building-in self-compassion to your work.

People who are attracted to nursing are usually empathetic towards the needs of others. That’s great, of course, but the downside for empaths is that sometimes we put the needs of others before our needs.

That’s the pathway to burnout, my friend.

It is sensible to be intentional about self-compassion, ie: the art of being kind to yourself, and finding a workable, realistic balance between your life experiences, thoughts and feelings. Self-compassion will not dilute your empathy. It will allow you to continue in your empathetic work better for longer.

How do you go about self-compassion?
Maybe finding yourself the right mentor(s).
Maybe just everyday stress management stuff.
Maybe getting some clinical supervision.
Maybe phoning Nurse & Midwife Support.
Maybe you should stop reading dumb nursing blogs, and go outside and do something fun instead. 🙂
Maybe a bit of each of the above.

NB*

*“experienced” is probably code word for “those with grey hairs”

References

Aggar, C., Samios, C., Penman, O., Whiteing, N., Massey, D., Rafferty, R., Bowen, K. & Stephens, A. (2021), The impact of COVID-19 pandemic-related stress experienced by Australian nurses. International Journal of Mental Health Nursing,
https://doi.org/10.1111/inm.12938

Chen, R., Sun, C., Chen, J.‐J., Jen, H.‐J., Kang, X.L., Kao, C.‐C. & Chou, K.‐R. (2020), A Large‐Scale Survey on Trauma, Burnout, and Posttraumatic Growth among Nurses during the COVID‐19 Pandemic. International Journal of Mental Health Nursing
doi.org/10.1111/inm.12796

Declaration of Interests

In the interests of transparency, there are three declarations to be made re this blog post:
1. I am the Social Media Editor of the International Journal of Mental Health Nursing.
2. I have a bias towards promoting nurse mental wellbeing, including my own.
3. What little hair I have left is very very grey.

End

That’s it. If you haven’t gone out to do something fun already, maybe stay where you are and sus-out the the Aggar et al article here, and have a browse through the other IJMHN COVID-19 papers here.

Thanks for reading. As always, your feedback is welcome via the comments section below.

Paul McNamara, 16 October 2021

Short URL meta4RN.com/grey

Never Iron Again

You’re too busy, sensible and in need of downtime to iron.

So don’t ever iron again. It’s easy:

  1. Select the slow spin speed on your washing machine
  2. Use thick clothes hangers (those spindly wire ones will not do the trick)
  3. Take the clothes straight from the washing machine onto the hanger
  4. Button-up and tidy-up the shirt so it looks neat on the hanger
  5. Leave overnight
  6. Voilà! It’s ready to wear or hang in the wardrobe.
@meta4rn

Never Iron Again. (1) Slow Spin Speed (2) Thick Hangers [not wire] (3) Straight From Machine To Hanger ✅🙂 #iron #noiron #ironic #isntitironic #freedom

♬ Rockin – Chris Alan Lee

That’s it. That’s all you need to do.

If you hear yourself saying, “Yeah, but…” you’re sabotaging yourself. Stop it. You deserve better.

If you hear yourself saying “Yeah, duh…” you’re on my side. I’ve doing the washing, and NOT doing any ironing, this way for all my adult life. You and I are allies. It amazes me that there are others who don’t know.

If you hear yourself saying, “Yeah, isn’t it great that a middle-aged white man is telling everyone what to do…” you’re right. It’s a bad habit us middle-aged white men have. In my defence, I’d just like to point out that as a nurse I’ve been educated, trained, mentored and inspired by smart women. I’m not assuming superiority here, I’m just sharing a life hack from the trenches.

Never iron again. Slow spin speed, thick hangers, and straight from the washing machine to the hanger will do the trick.

Oh my giddy aunt! I will never iron again!

End

That’s it. At first blush it may seem that this blog post is WAY off track for a nursing blog, but I reckon it belongs here. Why? Because nurses using and passing-on self care tips is in keeping with the rest of the blog. Also, mental health week is coming-up – what better way to walk the mental health talk than stop being a slave to ironing?

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

Naturally, if you know someone who irons it is you solemn duty to pass-on this info. 🙂

Paul McNamara, 5 October 2021

Beginning of the End

Yesterday I confirmed what I’ve been mulling-over for a while: I’ll retire the meta4RN blog in September 2022.

#ihatemytwittertypos

That will make a nice even ten years of nurse-blogging. I’m only a few years away from retirement, and need to start the transition. It’s time for me to use my non-work time doing more non-work stuff.

When I started the meta4RN thing I thought I’ll aim to be the most visible Australian mental health nurse on social media. I’m not sure, but I think I’ve probably achieved that. Even if I haven’t, it’s a remarkably unambitious target.

I’m amazed how many nurses – mental health nurses, in particular – self-censor themselves into silence on social media. I started the meta4RN blog in response to the prevailing “stop it or you’ll go blind” approach to social media by senior health and university people at the time. It’s incredible that nurses are the most trusted profession in Australia [source & source], are employed to go behind the curtains and help people who are having one of the worst days of their lives, but are not considered by some within our ranks not to be mature enough to go online. FFS.

I’m getting bored and tired pushing against the bricks. I’ll use the platform for the next 12 months, and then put meta4RN.com to bed. I haven’t really decided to do with the rest of the meta4RN social media portfolio yet, but I’ll work that out over the next year.

For the uninitiated, and so (hopefully) it with be swept-up by the Wayback Machine and Trove/National Library of Australia bots, below is a list of the other arms of the meta4RN social media portfolio.

Twitter @meta4RN

Facebook facebook.com/meta4RN

YouTube youtube.com/meta4RN

Instagram instagram.com/meta4RN

TikTok tiktok.com/@meta4RN

Prezi prezi.com

Wakelet wakelet.com/@metaRN

SlideShare slideshare.net/paulmcnamara

Reddit reddit.com/user/meta4RN

Tumblr meta4RN.tumblr.com

ResearchGate www.researchgate.net

Orcid orcid.org

LinkedIn www.linkedin.com/in/paulmc

LinkTree linktr.ee/meta4RN

It’s an unnecessarily over-the-top list. I’ve probably overdone the effort to demonstrate that there is an avenue for nurses to promote their profession and voice, should they – like me – get exasperated at being routinely forgotten or sidelined in the public conversation.

End of ‘Beginning of the End’

That’s it.

Just putting it out there so when I pull up stumps next year it comes as no surprise.

If you know of someone who might be interested in the not-so-lofty title of ‘most visible Australian mental health nurse on social media’ let them know that now is a good chance to pounce. 🙂

Paul McNamara, 25 September 2021

Short URL meta4RN.com/end

Share or Perish: Social media motivation for busy and important academics

You’ve done the research, you’ve written the paper, you’ve jumped through the flaming hoops of peer review, and – FINALLY – your paper has been published.

Now you want people to read it, right?

This short video aims to motivate academics to play an active part in employing social media as a tool to promote their published work, and – for those not already familiar with it – introduces Altmetric: a tool that measures and reports on the attention that academic work is attracting online.

YouTube version.

Share or Perish: Social media motivation for busy and important academics

@meta4rn

Share or Perish: Social media motivation for busy and important academics #academia #academic #socialmedia #busy #important https://meta4RN.com/busy

♬ original sound – Paul McNamara
TiTok version. Is there anything quite as sad as a middle aged man on TikTok? No. There is not.

Reference

McNamara, P. & Usher, K. (2019), Share or perish: Social media and the International Journal of Mental Health Nursing. International Journal of Mental Health Nursing, 28(4): 960-970. https://doi.org/10.1111/inm.12600

End

If there’s an academic (or anyone else, for that matter) in your life who may think they’re too busy and important for social media, please feel free to send them a link to the video/this page. 🙂

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

Paul McNamara, 14 September 2021

Short URL meta4RN.com/busy

Q: RUOK? A: Not really. I’m a nurse.

09/09/21 = RUOK Day. More about that here: www.ruok.org.au

Ask a nurse how they are and they’ll probably give a positive answer: “good thanks”, “ticketyboo” and “living the dream” are favourite reflex answers in the hospital where I work.

Scratch beneath the surface though, and the overwhelming answer to the question “Are you OK?” amongst health professionals – especially nurses – in September 2021 would be: “No. Not really.”

Nurses know we’ve been lucky to have secure employment at a time when many others have not. However – as a profession – we are tired and anxious. This is evidenced by articles in the mainstream press, posts on social media, and research published in academic, peer-reviewed, journals.

Source: https://pbfcomics.com/wp-content/uploads/2018/06/PBF-Youll_Be_OK.png

There is some stuff we can do by ourselves.

There is some stuff to manage stress that we can do by ourselves. Simple things like mindfully washing our hands, for instance. I first read about this idea via Ian Miller (aka @impactednurse and @thenursepath) in 2013. When Ian withdrew from the online space, I reprised the idea in a 2016 blog post:

Then refreshed the idea in March 2020 when the pandemic hit Australia:

And made a short video version to accompany the blog post:

The mindful handwashing idea for nurses, as I saw for myself for the first time yesterday, has now been published in a text book:

Being published in a text book makes an idea legit, right? 🙂

Anyway – if you haven’t already – try building-in something like mindful handwashing into everyday practice. Something that you can do for yourself, by yourself, while you’re at work.

On behalf of your boss, I can assure you that she/he/they does not want you to burnout – nurses have never been more valued than they are in September 2021. She/he/they needs you. If taking a couple of extra seconds to wash your hands helps you take care of yourself, your boss will be happy that you’re using that time productively.

There is some stuff that we need to do with others.

Nursing is a team sport. So is self-care.

Those familiar with meta4RN would know already that I’m likely to bang-on about clinical supervision. So as not to disappoint, here you go:

And the other thing that I want to remind readers about is Nurse & Midwife Support – a 24/7 national support service for Australian nurses and midwives providing access to confidential advice and referral.

I was chatting with one of the NMSupport staff members recently, and her only suggestion was to encourage colleagues to NOT leave it until they’re feeling overwhelmed before phoning. It seems as if many of us have the bad habit of not asking for support until we’re in crisis. Now that I think about it, phoning a week or two BEFORE the crisis is probably a better idea. 🙂

Phone NMSupport on 1800 667 877, and/or visit their website (www.nmsupport.org.au), Facebook (www.facebook.com/NMSupportAU), Insta or Twitter:

One last thing (an overt plug for a friend’s book chapter).

In case you missed the subtle plug above, please let me be more explicit about promoting the chapter by a Consultation Liaison Nurse peer and friend, Julie Sharrock. The chapter title and book title say it all:

Sharrock, J. (2021). Professional self-care. In Foster, K., Marks, P., O’Brien, A. & Raeburn, T. (Eds.). Mental health in nursing: Theory and practice for clinical settings (5th ed.). (pp. 86-105). Elsevier Australia. www.elsevierhealth.com.au/mental-health-in-nursing-9780729

I really like that this chapter in a text book by nurses for nurses acknowledges that we need to care for ourselves to care for others. Although it flies in the face of that ridiculous hero narrative, it is legitimate for nurses to seek a long-lasting, satisfying and meaningful career. Julie’s chapter speaks to that, and provides explicit information on strategies for nurses to use.

I recommend that you have a read of the evidence-based ideas for sustaining yourself and your career that the chapter contains. Perhaps your local hospital/university already has a copy of the book.

End.

That’s it. I just wanted to make a point that not all of us are OK. Unlike the caravaner below, not all of us can “Just deal with it Trish.” Well, not ALL the time, anyway.

@meta4rn

“Just deal with it Trish.” #JustDealWithItTrish Trish and Rex: stranded Victorians interviewed in an Albury caravan park, 09/09/21 #RUOKday #RUOK

♬ original sound – Paul McNamara

As always, you are very welcome to leave feedback in the comments section below.

Paul McNamara, 9 September 2021

Short URL: meta4RN.com/RUOK

Voluntary DOES Mean Voluntary; Scaremongering Means Scaremongering

Just a quick blog post to reassure those alarmed by the dodgy “voluntary should mean voluntary” scaremongering campaign. Please see the corrected version below.

Of course neither patients or health professionals will be pressured into voluntary assisted dying under the proposed Queensland voluntary assisted dying legislation. The word “voluntary” in “voluntary assisted dying” makes it pretty clear, but don’t just take my word for it.

Let’s look at some key sections from “A Legal Framework for Voluntary Assisted Dying”, published by the Queensland Law Reform Commission (QLRC) in May 2021 [PDF]. This is the document Queensland politicians will be reviewing next week, prior to casting a conscious vote.

“Voluntary assisted dying is an active and voluntary practice… It is a voluntary practice in that it is undertaken at the person’s request. More than one request is required. The decision to access the process must be made freely and without coercion.” (QLRC, May 2021, section 1.48, page 7)

“In summary, we recommend that the right to refuse to participate in voluntary assisted dying on the grounds of conscientious objection should apply to registered health practitioners (such as doctors and nurses) and to speech pathologists.” (QLRC, May 2021, section 14.96, page 437)

The proposed Queensland voluntary assisted dying law is similar to the existing legal framework for termination of pregnancy, in that neither patients or clinicians are forced into dong something they object to. The proposed Queensland voluntary assisted dying law has additional safeguards.

For example, a patient safeguard includes: “The process of request and assessment involves three separate requests that are clear and documented. The process has a waiting period of at least 9 days between the first and final request.” (QLRC, May 2021, section 8.477, page 248)

An example of a safeguard for health practitioners includes provision for “conscientious objection” (QLRC, May 2021, section 8.103, page 200) and, “The practitioner must have completed the approved training before they accept a transfer of the role of administering practitioner.” (QLRC, May 2021, section 13.187, page 412) To my way of thinking, this is a generous safeguard in that it allows health professionals who are unsure or ambivalent to simply not-get-around-to completing the training. This also safeguards the patient from enduring a clinician who is unsure of their own beliefs, or passively resistant to the patient’s wishes.

There is strong support for voluntary assisted dying (VAD) legislation in Queensland:
~77% of the public support VAD
~87% of nurses support VAD

Source: Queensland Nurses & Midwives Union (QNMU), June 2021, Submission into the Voluntary Assisted Dying Bill 2021 [PDF]

It is interesting to reflect on why nurses have a higher rate of support for voluntary assisted dying than the general public… What do nurses see and know that others don’t see and know?

It is also important to reassure the 13% of Queensland nurses and midwives who did not support voluntary assisted dying in the QNMU February 2021 survey [PDF], that they will not be pressured or compelled to participate. Just as is the case with pregnancy termination, only a very small percentage of the nursing workforce are in roles where they will be directly exposed voluntary assisted dying. Not only is there no pressure to become involved if you do not want to, you can not be involved unless you choose to complete specific voluntary assisted dying training.

Voluntary does mean voluntary. Scaremongering means scaremongering.

End

Obviously, I’m part of the 87% of Queensland nurses who support voluntary assisted dying legislation. I’ve written about it previously in July [here], and wasn’t intending to write about it again. However, the scaremongering campaign can not go unaddressed. I’m realistic. I know the Catholic church has a much bigger audience and budget than me. All I have to counter their scaremongering is integrity and social media (it’s my loudest voice).

Thanks for visiting my blog. As always, your feedback is welcome via the comments section below.

Paul McNamara, 7 September 2021

Short URL: meta4RN.com/Voluntary

Addit on 08/09/21

This makes the same argument as me, but in a more articulate manner:

Vax Facts for Nurses by Nurses

Let’s start with a quote from this ANMF zoom page:

The fast moving pace of COVID-19 science both from disease progression and treatments has been hard to keep up with. As nurses and midwives, we are well-positioned to advocate for science and safety. In this webinar, Dr Jessica Stokes-Parish (RN, PhD) and IPN Romy Blacklaw will present the safety processes, research, surveillance of adverse events (including data on safety so far) and difference between COVID-19 vaccines.

The “Vaccine Science in the Context of COVID-19” webinar was on Thursday 26 August.

ICYMI (like I did), a recording of the webinar is available for free to Australian Nursing Midwifery Federation members, including the QNMU and NSWNMA branches, until 10 September 2021.

Have a sneak peek of the content here:

Want to see more? If so, login to the ANMF continuing professional education portal 👉 catalogue.anmf.cliniciansmatrix.com 👈  by 10 September and search on the word “vaccine”. Despite missing the live event, you’ll still get a certificate in recognition of continuing profession education on completion (see example below).

What’s with the blog post? 

I have three reasons for promoting the webinar.

  1. I think the content of the webinar is worthwhile sharing. I really enjoyed learning about the COVID-19 vaccines in more depth than the info I had picked-up from work, online and in the mainstream media.
  2. Free, quality and easily accessible CPD/CPE for nurses and midwives deserves a shout-out, right? 🙂
  3. I reckon there’s a future for nurses delivering short, sharp and evidence-based information via video online. Not convinced? Have a look at the less-than-two-minute-long video clip above and see if you find it interesting/useful. I do.

Acknowledgement

Sincere thanks to the webinar presenters Jess Stokes-Parish and Romy Blacklaw, and the webinar host Australian Nursing and Midwifery Federation, for permission to use the video excerpt above, and for providing engaging and interesting CPE.

I was distracted for 15 seconds when a Harley loudly blurted past my house, and another 30 seconds by the dog chewing my thongs, so when claiming CPD hours for AHPRA will detract 0.0125 hours from the total. #fulldisclosure

End

That’s it.

You have less than 10 days to:

  1. hit this 👉 catalogue.anmf.cliniciansmatrix.com 👈 website
  2. login using your ANMF/QNMU/NSWNM membership info
  3. search the word “vaccine”
  4. and complete the free “Vaccine Science in the Context of COVID-19” CPD

Quick sticks! Don’t dilly-dally! Get a wriggle-on! 🙂

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

Paul McNamara, 1 September 2021

Short URL: meta4RN.com/VaxFacts 

Addit (to encourage Kiwis and Aussies)

CLovid Communication

This blog post aims to clarify how the clinicians on one Consultation Liaison (CL) Psychiatric Service communicate with general hospital inpatients who are being nursed in isolation during the COVID-19 pandemic.

Why? 

There has been some confusion re nomenclature of how we provide mental health assessment/support to hospitalised people in isolation . Hopefully by describing the pros and cons of the methods we’ve tried to date we’ll clear-up any misunderstandings. 

CLovid Communication options: 1. Videoconference. 2. In-Room (featuring Jelena Botha in PPE). 3. Face-To-Face through a window. 4. Phone.

1. Videoconference Review
ie: using an online videoconferencing platform that works on both the clinician’s computer and the patient’s own device

Pros:

  • No risk of infection transmission
  • When it works there is reasonably good eye contact and exchange of facial expressions and other non-verbal communications, leading to opportunities for engagement/establishing rapport 
  • Since mid-late 2020, nearly all clinicians and many (most?) consumers are familiar with videoconferencing 

Cons:

  • In my clinical practice videoconferencing for these reviews has been mostly unsuccessful. Cross-platform incompatibility and limitations to what the devices/bandwidth that hospital inpatients in isolation have access to have been problematic.
  • At our end, clinical workplaces do not provide access to the same platforms our patients typically use (eg: FaceTime, Video Chat on Facebook or WhatsApp).
  • The technology was getting in the way of the therapeutic relationship, not enhancing it.
  • For these reasons, we pretty-much gave up on trying to videoconference hospital inpatients in isolation back in April/May 2020. 

2. In-Room Review 
ie: in full PPE – face mask, goggles/face shield, gown and gloves

Pros:

  • Physical proximity is standard practice: Clinical staff and the people we care for are familiar with this 
  • Reasonably good eye contact and partial exchange of non-verbal communication, leading to opportunities for engagement/establishing rapport

Cons:

  • PPE obscures facial expressions, thereby inhibiting rapport/assessment
  • An extra clinician(s) using PPE resources
  • With no disrespect to my CLPS clinical colleagues, we’re generally not as well-drilled with donning and doffing as the specialist nursing and medical teams, creating potential risk of infection transmission

3. Face-To-Face Review 
ie: through the window/glass door panel, using phones for easy/clear auditory communication

Pros:

  • Good eye contact and exchange of facial expressions and other non-verbal communication, leading to opportunities for engagement/establishing rapport
  • No risk of infection transmission
  • Low-tech, easy to organise
  • Well received by nearly every hospitalised person in isolation that my team has seen from March 2020 to August 2021

Cons:

  • Reminds me of prison-visit scenes in American movies

4. Phone Review 
ie: speak to the person on their personal mobile or bedside phone, no visual contact

Pros:

  • No risk of infection transmission
  • Low-tech, easy to organise 
  • It’s the go-to method of communication for community mental health intake clinicians/services (ie: thought to be a good-enough tool for most triage and sub-acute presentations; may be familiar to the clinician or consumer)
  • Some people find emotional expression easier without the intimacy/intrusion of eye contact

Cons:

  • Assessment and rapport may be limited
  • Not thought to be adequate for acute or high-risk presentations

And The Winner Is…

Number 3: Face-To-Face Reviews, ie: where the clinician and person in isolation chat through the window/glass door panel, using phones for easy/clear auditory communication. 

It’s cheap, easy and effective. We use it nearly every time when there’s someone in a negative-pressure/isolation room. We’ve saved dozens, maybe hundreds, sets of PPE, and we’ve reduced the likelihood of becoming potential super-spreaders. 

Why Does It Matter?

Like just-about every other specialist mental health nurse on the planet, my clinical practice is influenced by Hildegard Peplau. Back in the 1950s dear old Aunty Hildegard had the audacity to tell nurses that, done right, the nurse-patient relationship = therapy [source]. About 60 years later neuroscience caught up with nursing theory and showed us that Peplau was right: strong relationships and strong attachments help brains heal by building new neural pathways [source]. 

A specialist mental health nurse is, amongst other things, a psychotherapist and a relationship focussed therapist [source]. A face-to-face review, even if has to be through glass, helps establish rapport and build a therapeutic relationship. 

CLovid Acknowledgements

Consultation Liaison Psychiatry Service is a bit of a mouthful, so it’s usually abbreviated to “CL”. CL = mental health in the general hospital

Back in March 2020 John Forster, a CL Nurse in Melbourne, accidentally coined the portmanteau “CLovid” by combining “CL” and “covid” as a typo. 

That’s why I’m calling this blog post “CLovid Communication”. 

Please forgive people like me who take delight in silly things like an accidental neologism. There’s been a fair bit of CLovid in the last eighteen months, and there’s more to come. Staying vigilant to the small joys and moments of lightheartedness is a survival skill. 

Thanks also to Jelena Botha, CL CNC (who arrived on my team just in time for the global pandemic 😳), for allowing me to use her PPE pic.

Further Reading

Cozolino, L. (2006/2014) The Neuroscience of Human Relationships: Attachment and the Developing Social Brain. New York, W. W. Norton & Company. [Google Books]

Hurley, J. and Lakeman, R. (2021), Making the case for clinical mental health nurses to break their silence on the healing they create: A critical discussion. International Journal of Mental Health Nursing, 30(2): 574-582. https://doi.org/10.1111/inm.12836

Peplau, H. (1952/1991) Interpersonal relations in nursing. New York: Putnam. [Google Books

Santangelo, P., Procter, N. and Fassett, D. (2018), Seeking and defining the ‘special’ in specialist mental health nursing: A theoretical construct. International Journal of Mental Health Nursing, 27(1): 267-275. https://doi.org/10.1111/inm.12317

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What have I missed from this description of CLovid communication? Please add your on-the-job experiences and lessons in the comments section below.

Paul McNamara, 14 August 2021 

Short URL meta4RN.com/CLovid

A Nurse’s Digital Identity

I am a nurse who uses social media a lot. It is my loudest voice.

If you want to see what a nurse’s digital identity looks like, grab your phone and sus-out this QR code.

My role and ambitions are mid-range. As a student nurse I thought it would be cool to be a Nurse Educator or Clinical Nurse Consultant – I’ve achieved that. I have never aspired to one of those senior management/academic gigs. The downside to that lack of ambition is the limited opportunities to set agendas that drive broad change. In fact, even getting ideas heard or considered is difficult at times.

[insert sound of trumpets going “TooDa-TooDa” here] Social media to the rescue!

And, (this is the main point of this blog post), it is OK for nurses to use social media. Actually, it’s not just OK, USING SOCIAL MEDIA IS RECOMMENDED FOR NURSES AND MIDWIVES.

Don’t believe me?

Read on.

In the ‘National Nursing and Midwifery Digital Health Capability Framework‘ there is a section specifically about being online, as below:

1.3 Digital Identity
Nurses and midwives use digital tools to develop and maintain their online identity and reputation.

This section has four parts – feel free to tweet your favourites 🙂

Digital Identity 1.3.1: Maintains a professional development record demonstrating innovation, reflecting upon skills and experience to help monitor professional identity.

You could use a free app or website for that, for example:

Or just keep it all online via the ANMF Continuing Professional Education portal

Digital Identity 1.3.2: Understands the benefits and risks of different ways of presenting oneself online, both professionally and personally while adhering to the NMBA social media policy.

The policy uses slightly more formal language (read it for yourself here), but can be accurately summarised as “Even if you’re prone to being a dickhead at times IRL, when you’re representing yourself as a nurse online don’t be a dickhead.” If you do be a dickhead online occasionally (to err is human, blah blah blah), be sure to proactively delete and/or apologise.

It is MUCH more simple to keep your private and professional social media identities separate. Create a social media portfolio using the same name on your work name badge/AHPRA registration just for work-related stuff. That’s what I’ve done here linktr.ee/meta4RN Look, I know I’ve overdone it (#tryhard), but that was intentional too. I created the meta4RN social media portfolio at a time when the “prevailing wisdom” (“prevailing ignorance”, more like it 🙄) amongst hospital and university influencers was that social media is bad. Some of these people are still impersonating Grandpa Simpson and shaking their fist at the cloud. And the internet. And social media.

Digital Identity 1.3.3: Understands that online posts can stay in the public domain and contribute to an individual’s digital footprint.

If you want an example of how online posts stay in the public domain, visit/search for The Wayback Machine or Trove (part of the National Library of Australia).

Digital Identity 1.3.4: Recognises that their professional digital footprint, where it exists, should showcase their skills, education, and professional experience.

This is where things like LinkedIn or an online Curriculum Vitae (overdue for an update) come in handy.

Don’t hide your light under a bushel. If you’re a nurse please celebrate your achievements – if we don’t, who will?

My (univited) advice to nurses and midwives is this: Don’t be afraid of social media. Be intentional.

Reference

Australian Digital Health Agency, 2020. National Nursing and Midwifery Digital Health Capability Framework. Australian Government: Sydney, NSW.
nursing-midwifery.digitalhealth.gov.au


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Thanks for visiting the meta4RN.com website/blog. Be sure to use the QR Code above or this link to see other arms of my m̶a̶g̶n̶i̶f̶i̶c̶e̶n̶t̶ m̶e̶t̶a̶4̶R̶N̶ ̶s̶o̶c̶i̶a̶l̶ ̶m̶e̶d̶i̶a̶ ̶e̶m̶p̶i̶r̶e̶ try-hard professional social media portfolio (aka professional digital identity).

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

Paul McNamara, 5 August 2021

Short URL meta4RN.com/ID