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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:

Working with Aboriginal and Torres Strait Islander people?
Stanley Savo recommends reading these two documents first:
1. Patient Care Guidelines https://t.co/Q9EgHLwa57
2. Sad News. Sorry Business. https://t.co/zwpnvJN3PG pic.twitter.com/6Xx9vPrZMe

— Paul McNamara (@meta4RN) November 20, 2019

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

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License

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.

Source: https://memerial.net/6067-i-possess-a-device-in-my-pocket

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:

Digital Professionalism📱vs The Dinosaurs 🦕

“… some nurse managers were unable to distinguish between private and professional use of personal mobile devices (ie smartphones) by nursing students. Hence, they preferred to prohibit this technology…” https://t.co/twofWcATZm

— Paul McNamara (@meta4RN) October 25, 2019

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:

1️⃣ Digital Professionalism 📱
0️⃣ The Dinosaurs 🦕https://t.co/8QoL7sxlRd

— Paul McNamara (@meta4RN) November 1, 2019

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.

2️⃣ Digital Professionalism 📱
0️⃣ The Dinosaurs 🦕https://t.co/dpZuY2m1Ic

— Paul McNamara (@meta4RN) November 1, 2019

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?

3️⃣ Digital Professionalism 📱
0️⃣ The Dinosaurs 🦕

“I don’t know that medication. Give me a tick to look it up.”
iMIMS app https://t.co/OWvsomlj4o pic.twitter.com/gqaAFH7tBd

— Paul McNamara (@meta4RN) November 1, 2019

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).

4️⃣ Digital Professionalism 📱
0️⃣ The Dinosaurs 🦕

“See this app? It’s free, evidence-based, helps with stress-management, and is endorsed by @beyondblue. Do you want to put it on your phone now?”
SmilingMind app https://t.co/OWvsomlj4o pic.twitter.com/qCLIcYAzfE

— Paul McNamara (@meta4RN) November 1, 2019

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.

5️⃣ Digital Professionalism 📱
0️⃣ The Dinosaurs 🦕

“Oh. You haven’t been to the community health centre before? See here? From your place take a hard left at the Smithfield roundabout. It’s a couple of hundred metres down that road on your right.” https://t.co/OWvsomlj4o pic.twitter.com/9aKQerTjKN

— Paul McNamara (@meta4RN) November 1, 2019

Google maps is great for this sort of thing.

6️⃣ Digital Professionalism 📱
0️⃣ The Dinosaurs 🦕

“Yeah, you’re right: NGs are irritating and hospital is pretty boring. The good news is your nutrition and health have improved HEAPS since admission.”
Mediquations app https://t.co/OWvsomlj4o pic.twitter.com/0ejxj3x6pM

— Paul McNamara (@meta4RN) November 1, 2019

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

7️⃣ Digital Professionalism 📱
0️⃣ The Dinosaurs 🦕

“If it’s OK with you, I’ll send a copy of today’s Edinburgh PND Scale to your Midwife and GP. Do you want a copy too?”
Mediquations app https://t.co/OWvsomlj4o pic.twitter.com/rP6psaXBF3

— Paul McNamara (@meta4RN) November 1, 2019

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.

8️⃣ Digital Professionalism 📱
0️⃣ The Dinosaurs 🦕

“Is now a good time to talk about a safety plan together? Let’s get this app on your phone. It’s free, endorsed by @beyondblue, and gives us some ideas on what sort of things to include.”
BeyondNow app https://t.co/OWvsomlj4o pic.twitter.com/qGxPKrEroj

— Paul McNamara (@meta4RN) November 1, 2019

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.

9️⃣ Digital Professionalism 📱
0️⃣ The Dinosaurs 🦕

“Yes boss. I have evidence of my self-directed learning readily available. I keep my CPD record in my pocket. 🙂”@Ausmed CPD app https://t.co/OWvsomlj4o pic.twitter.com/ak1HmvsT9I

— Paul McNamara (@meta4RN) November 1, 2019

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?

🔟 Digital Professionalism 📱
0️⃣ The Dinosaurs 🦕

“I’ve never been to Aurukun. Is it OK if you show me around town?” (phatic chat often builds rapport https://t.co/YvRI77RWBE)
Google Maps app https://t.co/OWvsomlj4o pic.twitter.com/Q6I4QqjaB4

— Paul McNamara (@meta4RN) November 1, 2019

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.

1️⃣1️⃣ Digital Professionalism 📱
0️⃣ The Dinosaurs 🦕

☎️ [phone referral] “Umm, Klinefelter’s? I’ve heard if it, but wouldn’t pretend to be an expert.”
Eponyms app https://t.co/OWvsomlj4o pic.twitter.com/8GgeebFpnF

— Paul McNamara (@meta4RN) November 1, 2019

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.

1️⃣2️⃣ Digital Professionalism 📱
0️⃣ The Dinosaurs 🦕

“One last thing before we go home. There is specialised support available for us nurses and midwives. It doesn’t matter if you’re an EN, RN or student – we all have a 24/7/365 safety-net.” https://t.co/OWvsomlj4o pic.twitter.com/WcrWuo0Cu9

— Paul McNamara (@meta4RN) November 1, 2019

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

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License

A tale of two hashtags

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Once upon a time (October 2019) two nursing conferences occurred almost back-to-back.

The 45th ACMHN International Mental Health Nursing Conference was held in Sydney from 8-10 October 2019. The conference hashtag was #ACMHN2019.

Over the week of the conference over 250 people used the hashtag on Twitter, there were 2,264 Tweets.

Source: https://www.symplur.com/healthcare-hashtags/ACMHN2019/analytics/?hashtag=ACMHN2019&fdate=10%2F5%2F2019&shour=7&smin=0&tdate=10%2F13%2F2019&thour=7&tmin=0

The 17th CENA International Conference for Emergency Nurses was held in Adelaide from 16-18 October 2019. The conference hashtag was #ICEN2019.

Over the week of the conference nearly 230 people used the hashtag on Twitter, there were 1751 Tweets.

Source: https://www.symplur.com/healthcare-hashtags/ICEN2019/analytics/?hashtag=ICEN2019&fdate=10%2F13%2F2019&shour=7&smin=0&tdate=10%2F21%2F2019&thour=7&tmin=0

Keeping Score

To be honest, I’m a little surprised. It is often pointed out that Australian Mental Health Nurses are an ageing bunch. I kind-of assumed that us old fogies would be out-Tweeted by our younger and more glamorous Emergency Nurse colleagues. Not that it matters, of course… we’re qualified, experienced and motivated specialist health professionals.

Of course we are much too mature to get caught-up in trivial competition.

Ahem.

2020 Rematch

Next year the 46th ACMHN International Mental Health Nursing Conference will be held on the Gold Coast from 14-16 October 2020 (source/more info: www.acmhn2020.com).

And, the 18th CENA International Conference for Emergency Nurses will also be held on the Gold Coast from 14-16 October 2020 (source/more info: www.icen.com.au).

So, in 2020 two specialist groups of nurses will conferencing in the same place at the same time. Game on! 🙂

Will the #ACMHN2020 or #ICEN2020 hashtag be the most used next October? Please feel free to leave your predictions, hopes or bets in the comments section below.

🙂 #ICEN2020 + #ACMHN2020 will be on the same days in the same town…
maybe my people (@ACMHN) should speak to your people (@CENAorg). After all, it’s not unusual for mental health nurses + emergency nurses to work together. FYI @timwand + @eimearmuirc https://t.co/C0WTHUG2uW

— Paul McNamara (@meta4RN) October 18, 2019

End

Thanks for visiting.

Paul McNamara, 25 October 2019

Short URL: meta4RN.com/hash

Ye Olde Yahoo CL Nurse eMail Network

1 Reply

Once upon a time (February 2002) there were a bunch of mental health consultation liaison nurses in Australia, New Zealand, and other places far, far away. They were separated geographically, but became connected via the magic of email.

Keep in mind it was 2002 – Google, Facebook, Twitter etc hadn’t made their mark back then, so starting a Yahoo email list was about as clever as we could get at the time.

In 2012-2013 our Ye Olde CL Nurse Yahoo eMail network [link] stopped being used, and we transitioned to the email platform hosted via the Australian College of Mental Health Nurses instead [link]. Anyway, today I stumbled across an old powerpoint presentation and poster re Ye Olde CL Nurse Yanoo eMail Network, and thought it would be nice to plonk them both online for nostalgic/historical purposes.

Here’s the powerpoint:

Australian & New Zealand Consultation Liaison Nurses eMail Network (2002 to 2008) from Paul McNamara

And here’s the text from the poster and a pic + PDF of the poster itself:

Consultation Liaison Nurses
Isolated Geographically. Connected Electronically.

The Mental Health Consultation Liaison Nurse Network aims to link peers for an exchange of information and ideas. Given the nature of this mental health sub-speciality, Nurses working in this field are usually pretty independent practitioners and often don’t have regular contact with peers who share CL Nurse experiences and interests

The email network originally spluttered to life in February 2002 and has gained momentum over subsequent years. The email network’s formation and development coincided with the formation and development of the Australian College of Mental Health Nurses (ACMHN) Consultation Liaison Special Interest Group (CLSIG). The email network is also promoted by the NSW/ACT Mental Health Consultation Liaison Nurses Association. The email network is maintained by the CLSIG, but the ACMHN and the CLSIG do not take responsibility for nor endorse opinions expressed through this network.

The email network is not moderated (ie: user’s comments are uncensored), but nuisance posts (abusive, racist, sexist, advertising etc) will not be tolerated. We take pride that the tone of the email network has been always casual, generous & supportive, and that it has attracted over 320 subscribers from at least nine countries.

No matter where you live & work, if you’re a Mental Health/Psychiatric Consultation Liaison Nurse you are very welcome to join our email network…

Here’s the PDF: 1008

One Last Thing

Just a reminder, this info is being released online in September 2019 purely for nostalgic and/or historical purposes. If you’re interested in an email network for consultation liaison nurses there is one, it’s just not the Ye Olde Yahoo one described here anymore. Instead, join the email network that is being hosted by the Australian College of Mental Health Nurses Consultation Liaison (CL) Special Interest Group (SIG): www.acmhn.org/home-clsig

End

Thanks for reading.

Paul McNamara, 27 September 2019

Short URL: meta4RN.com/email

meta4RN

The online home of Paul McNamara: Nurse. Educator. Digital Citizen.

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Complimentary Criticism

Digital Professionalism📱vs The Dinosaurs 🦕

A tale of two hashtags

Ye Olde Yahoo CL Nurse eMail Network

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