Tag Archives: ACMHN

A Conversation about Documentation in Consultation Liaison

De-identified info from the ACMHN Consultation Liaison Nurse Network www.acmhn.org/home-clsig

PPT slide from the report given at the Australian College of Mental Health Nurses Consultation Liaison Special Interest Group Annual General Meeting on 5th June 2008.

Question from regional Queensland 06/02/18

My team serves two digital masters: CIMHA (the mental health only file/application) and ieMR (the electronic general hospital file/application).

Our flesh + blood masters have now suggested that we should stop documenting in ieMR.

I think that’s dangerous.

However, I  want to see if there’s any CL service(s) that does NOT document in the hospital file.

If so, how does it work? Do you spend a lot of time in coroner’s court?

Response from Melbourne 06/02/18

I can’t imagine not documenting in hospital/clinical file – what part of consultation are they missing?

Sorry – this is a redundant reply to your question but can’t not respond.

Response from Melbourne 06/02/18

I agree it is dangerous and wrong. If we don’t write in the hospital file, how do our referees know what we advise, how else do we educate them? The nurses would often tell me that they loved reading my notes as it helped them make sense of what was going on. Definitely fight it. Do the other consult teams to the hospital have a separate file? I doubt it.

Response from regional Northern Territory 06/02/18

The other justification is documenting a diagnosis for clinical coding, which may or may not be relevant to activity based funding depending on where you are working.

The issue we have found in the NT with printing notes from an electronic system and placing them in the paper file, is the mental health notes often go missing, are filed incorrectly or do not even make it to medical records after discharge, meaning our input, suggestions and recommendations don’t make it into discharge summaries or correspondence for future presentations. Hence why we also handwrite in the file.

Response from Perth 06/02/18

I agree with you – I think it is dangerous to say the least.

We currently primarily document in the general hospital file (as these patients are admitted under general medical teams) as the teams who refer to us are asking for advice, suggestions or assistance with these patients.  We do not admit these patients to MH and have no beds.  If we assess that the patient requires a MH admission only then do we refer and  complete the required MH documents (which would go with the patient to MH).  We are however, required to enter our patient contacts in to the statewide MH database in order to generate statistics for our service.

Response from regional New South Wales 06/02/18

I am lucky as we do not use the local MH electronic documentation system. Our patient files are still paper based. I would be concerned about the medicolegal aspects of not having your notes available to the general hospital staff.

Response from Adelaide 06/02/18

We use both systems (MH Community AND hospital EPAS).

Hospital is where we work; therefore MH record gets ‘cut and pastes’ for ongoing CMHT requirements (if at all)

Response from Brisbane 06/02/18

Given our clients/customers are the treating medical/surgical team it’s imperative we write all our notes within the clinical chart. At this hospital all clinical notes are uploaded into iEMR once the patient is discharged; this means our notes can be accessible by anyone with access to this system. As yet we don’t directly input notes into iEMR but I think over the years this will change.

Because our notes are also useful to MHS we either write directly into CIMHA, print off the note and put it in the clinical chart or print off the note we’ve written in the clinical chart and then upload this into CIMHA.

If a patient is clearly delirious with no mental health history we don’t usually upload anything into CIMHA, we just write in the clinical chart.

It’s helpful for the referring teams to be able to ALL aspects of a patient’s care during in-patient stays, including MH input as when the patient is next admitted it gives them a more holistic view of the patient and encourages them to think more about how their MH problems may impact on their admission.

Response from Brisbane 06/02/18

I write in the hospital chart Progress Notes and then scan and upload to CIMHA the electronic MH record.  The reason I do this is because CIMHA printouts get filed under correspondence and not chronologically in the Progress Notes of the patient chart.  I often have the debate with MH clinicians who see a patient in ED or a general ward on the weekend, come back and write an excellent entry on CIMHA but the receiving medical team has absolutely no idea that the patient has been seen, what the outcome was nor any plan for ongoing review.

My concerns are:

how are any risk issues handed over to the medical areas? If an adverse event like a suicide/attempt happened would the coroner think notes on a database not accessible from the current treatment are or team or the current record be seen as satisfactory?

the medical team who owns the patients care within the care structure and has asked for the MH input gets no report, feedback nor result from their request,

how do any recommendation get carried over?

I would also ask how MH would feel if cardiology came to review someone in the MH unit and returned to cardiology, noted their review on a bespoke cardiac notation system and not the record within MH and left it at that, if that would be seen as satisfactory practice and care.

I suspect the scope to debate this would be well achieved through the accreditation standards, documentation and/or handover, would this pass the accreditors?

Response from regional New South Wales 07/02/18

I agree with the observation made regarding fact that the treating team caring for the person must be aware of all essential clinical details and interactions that all clinical services are providing to the person.

For services that maintain separate mental health and medical records it is essential that the clinicians responsible for that episode of care (i.e. the inpatient staff) have ready access to the clinical record in the location they would be presumed to be consulting. I would strongly suggest this means mental health consultation notes should be entered into the ward medical record and a copy be provided to add to the mental health record.

I have been aware of MH clinicians and managers occasionally expressing anxiety about non-specialist health staff accessing mental health documentation for fear that clinicians will inappropriately access and use such information. All health employees in Australia are bound by a code of conduct which strictly prohibits the inappropriate access to and use of privileged information from a clinical record – the consequences of breaching this element of the code of conduct can be quite serious. One of the benefits we have in our health service in NSW is that the majority of our services are now recording in common electronic files (EMR), meaning the issue of which file to record a clinical intervention in is not an issue, and any time a clinician accesses those records a digital finger print is left on the file. This means any time a clinician accesses a file without just cause there is evidence that a breach of confidentiality has occurred.

Response from regional New South Wales 07/02/18

It is interesting this discussion has arisen now as it has been the hot potato topic of our area and specifically my role in recent months.

Prior to the review I had been documenting in the clinical file AND our electronic community record CHIME, double dipping if you please, and very time consuming.

It is now the case that I write in the clinical notes, but I will also in addition complete a form based comprehensive mental health assessment for those patients who are being referred to the MHS. That form is scanned and emailed to an email address specifically set up for each CMHT, it is then added to the electronic file, the original assessment form remains with the patients hospital file as correspondence.

Response from regional Queensland 07/02/18

CLP writes notes in CIMHA and places them in the medical record in the relevant admission or community section of the medical note. This seems to flow smoothly here and has the advantage that if the consumer is discharged to a rural area the CLP notes are available to general hospital staff in the viewer. We use the CLP templates  which are in CIMHA.

The community mental health teams no longer write notes in medical records. Their notes are all recorded in CIMHA and no hard copy is placed on the medical record.

Response from Melbourne 07/02/18

We used to have two separate files but now have EMR and record directly on to the medical file under mental health (there is a function to put it “behind the glass”) so you can record more sensitive information if necessary. Someone has to “break the glass to look at it”.  We’ve had this system now for about 18 months and it has cut down our paper work enormously.

Anyone we refer within our region to the community can be accessed through their own service on EMR and we link our referral to the UR of the patient.

If they are referred to another service (outside our region) we print out and fax our assessment to them from EMR.  Everyone we see is recorded on CMI (demographics, clinician, contacts, diagnosis, advance statement etc but we don’t record assessments or impressions there.)

So just for those in Victoria, so you know, once they hit the adult system you will be able to see their registration date etc and can always make contact for more info.

Response from Sydney-based, covers many NSW Local Health Districts (LHDs) 07/02/18

This thread is particularly useful, thank you!

The clients/patients we see via telehealth, have an open encounter/MRN/electronic Medical Record (eMR) – including community/inpatient – in the referring/responsible LHD, and we need to create a new encounter/MRN/eMR in my LHD. I then extract notes from eMR, create a letter of feedback (impression and recommendations) which I email same day, with request that the MH Clinician at the other end upload the feedback into their local eMR, then to maintain privacy, delete the email and attachment from their inbox and deleted folders.

Uploaded files/feedback appear in ‘correspondence’ which as pointed out in this thread, need to be hunted for. Getting the feedback into the eMR also relies on the receiving Clinician to access their email and process it.

Many of the women we see are at high risk of relapse or first episode psychosis around the time of childbirth so Maternity Services would benefit from seeing our notes.

I have taken initial steps toward a pilot project whereby we may be able to write directly in the eMR in the other, usually rural LHD.

Response from Melbourne 07/02/18

We document in the hospital paper file in the episode of care.

Simple.

It works for us but we are getting an electronic medical record “soon”

Response from Sydney 09/02/18

Our system here is all eMR and went this way last year with MH going this way before the major hospital. So anyone can see anything from D&A, MH, general inpatient and community services. There are just a couple systems that work differently (oncology – which includes our psych oncology outpatient) and maternity.

It has made life so much easier to be able to see recent interactions and it has also stopped the need to fax assessments etc as it can be seen.

Like others, if it is an individual who is from outside our area health, we fax it and give verbal handover.

Prior to this, we only ever wrote in the medical file as they are the services that we work with. We use to fax to same AHS but no longer do this 🙂

I would be very worried for all the reasons that others have stated in relation to medico-legal issues as well.

Response from regional Queensland 09/02/18

Thanks to everyone for your generous and thoughtful responses.

I had been given the impression that there was something peculiar about my stubbornness on the matter. The reassurance and wisdom of the CL Nurse community is very much appreciated.

Attached is a deidentified version of our conversation about documentation in consultation liaison.

The title will make for a good rap refrain.

I’ve left-out names of people and hospitals/districts, and the side-conversation re timeliness (no offence meant; hopefully none taken).

I didn’t ask the question to gather data for a conference presentation, but I might use the attached for something more academic than a funky rap refrain.

If you’d rather your info be excluded please contact me directly (off-list).

The Mental Health Consultation Liaison Nurse Network started-off in 2002 as a Yahoo email list. More info: http://www.acmhn.org/index.php/home-clsig

End

Many thanks to all those who participated in the email discussion. I’m reminded of our old flyer for the email network which was headed by this catchphrase:

Consultation Liaison Nurses.
Isolated Geographically. Connected Electronically.

I’m leaving the transcript of the conversation here for three reasons:

  1. There may be others who battling the same/similar issues. This page is googleable, so may be of assistance.
  2. The conversation isn’t about nuclear missile launch codes. There’s no need to keep it secret or hidden away from the world.
  3. I, and others who are interested, will be able to find the conversations (ie: qualitative data) quickly and easily PRN.

To find out more about the Australian College of Mental Health Nurses Consultation Liaison Special Interest Group and/or the email network, go to: www.acmhn.org/index.php/home-clsig

As always, your comments and feedback are welcome in the space below.

Paul McNamara, 20th February 2018

Short URL: meta4RN.com/documentation

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

Why on earth would a Mental Health Nurse bother with Twitter? (my #ACMHN2016 presentation)

This post is a companian piece to my oral presentation at the Australian College of Mental Health Nurses 42nd International Mental Health Nursing Conference, 25 – 27 October 2016, Adelaide Convention Centre (the conference hashtag is #ACMHN2016). The function of the online version is to be a collection point to list references.

The Prezi is intended as an oral presentation, so I do not intend to include a full description of the content here.

Regular visitors to meta4RN.com will recognise some familiar themes. Let’s not call it self-plagarism (such an ugly term), I would rather think of it as a new, funky remix of a favourite old song. Due to this remixing of old content I’ve included previous meta4RN.com blog posts on the reference list (which, in turn, makes the reference list look stupidly self-referential).

abstracts

Anyway, with that embarrassing disclosure, here is the abstract and list of references  for the Prezi “Why on earth would a Mental Health Nurse bother with Twitter?

Abstract

Have you ever heard someone say something like, “Twitter doesn’t interest me – I don’t care what Justin Bieber had for breakfast”? Those people speak that way because they don’t understand the difference between personal, official and professional use of Twitter or social media more generally. Data will be presented about nurses using Twitter in a constructive, professional way, with the aim of allaying the fears of those in the pre-contemplation phase, and encouraging those in the contemplation and action phases. In recognition of nursing being a predominantly female profession, a feminist argument will be introduced that aligns the use of social media with empowerment. It will be argued that Twitter can enable and ennoble mental health nurses to engage with people beyond the “walled gardens” of our work silos, our profession, and our conference. Participants will be encouraged to have their mobile phone/tablet/laptop turned on and in use during the presentation, in the hope that we will have a shared conversation on the subject. Why on earth would a mental health nurse bother with Twitter? Answers and challenges will be available to those who attend this presentation and/or follow the conference hashtag #ACMHN2016.

References

Australian College of Nursing (n.d.) Social media guidelines for nurses. Retreived from http://www.rcna.org.au/WCM/…for_nurses.pdf

Australian Health Practitioner Regulation Agency. (2014, March 17). Social media policy. Retrieved from http://www.ahpra.gov.au/News/2014-02-13-revised-guidelines-code-and-policy.aspx

Casella, E., Mills, J., & Usher, K. (2014). Social media and nursing practice: Changing the balance between the social and technical aspects of work. Collegian, 21(2), 121–126. doi:10.1016/j.colegn.2014.03.005

Citizen Kane DVD cover. (n.d.). Retrieved from http://www.currentfilm.com/dvdreviews4/citizenkanedvd.html

Facebook. (2015). Facebook logo. Retrieved from https://www.facebookbrand.com/

Ferguson, C., Inglis, S. C., Newton, P. J., Cripps, P. J. S., Macdonald, P. S., & Davidson, P. M. (2014).  Social media: A tool to spread information: A case study analysis of Twitter conversation at the Cardiac Society of Australia & New Zealand 61st Annual Scientific Meeting 2013. Collegian, 21(2), 89–93. doi:10.1016/j.colegn.2014.03.002

Fox, C.S., Bonaca, M.P., Ryan, J.J., Massaro, J.M., Barry, K. & Loscalzo, J. (2015). A randomized trial of social media from Circulation. Circulation. 131(1), pp 28-33

Gallagher, R., Psaroulis, T., Ferguson, C., Neubeck, L. & Gallagher, P. 2016, ‘Social media practices on Twitter: maximising the impact of cardiac associations’, British Journal of Cardiac Nursing, vol. 11, no. 10, pp. 481-487.

Instagram. (2015). Instagram logo. Retrieved from https://help.instagram.com/304689166306603

Li, C. (2015). Charlene Li photo. Retrieved from http://www.charleneli.com/about-charlene/reviewer-resources/

lifeinthefastlane. (2013). #FOAMed logo. Retrieved from http://lifeinthefastlane.com/foam/

McNamara, P., & Meijome, X. M. (2015). Twitter Para Enfermeras (Spanish/Español). Retrieved 11 March 2015, from http://www.ausmed.com.au/es/twitter-para-enfermeras/

McNamara, P. (2014). A Nurse’s Guide to Twitter. Retrieved from http://www.ausmed.com.au/twitter-for-nurses/

McNamara, P. (2014, May 3) Luddites I have known. Retrieved from http://meta4RN.com/luddites

McNamara, P. (2013) Behave online as you would in real life (letter to the editor), TQN: The Queensland Nurse, June 2013, Volume 32, Number 3, Page 4.

McNamara, P. (2013, October 25) Professional use of Twitter and healthcare social media. Retrieved from http://meta4RN.com/NPD100

McNamara, P. (2013, October 23) A Twitter workshop in tweets. Retrieved from http://meta4RN.com/tweets

McNamara, P. (2013, October 1) Professional use of Twitter. Retrieved from http://meta4RN.com/poster

McNamara, P. (2013, July 21) Follow Friday and other twitterisms. Retrieved from http://meta4RN.com/FF

McNamara, P. (2013, June 7) Omnipresent and always available: A mental health nurse on Twitter. Retrieved from http://meta4RN.com/twit

McNamara, P. (2013, January 20) Social media for nurses: my ten-step, slightly ranty, version. Retrieved from http://meta4RN.com/rant1

McNamara, P. (2016, October 15) Learn about Obesity (and Twitter) via Nurses Tweeting at a Conference. Retrieved from  https://meta4RN.com/obesity

Moorley, C., & Chinn, T. (2014). Using social media for continuous professional development. Journal of Advanced Nursing, 71(4), 713–717. doi:10.1111/jan.12504

New South Wales Nurses and Midwives Association [nswnma]. (2014, July 30). Women now have unmediated access to public conversation via social media for 1st time in history @JaneCaro #NSWNMAconf14 #destroythejoint [Tweet]. Retrieved from https://twitter.com/nswnma/status/494313737575096321

New South Wales nurses and Midwives’ Association. (2014). NSW Nurses & Midwives Association logo. Retrieved from http://housingstressed.org.au/wp-content/uploads/2011/08/NSWNMA.png

Nickson, C. P., & Cadogan, M. D. (2014). Free Open Access Medical education (FOAM) for the emergency physician. Emergency Medicine Australasia, 26(1), 76–83. doi:10.1111/1742-6723.12191

Nursing and Midwifery Board of Australia (2010, September 9) Information sheet on social media. Retrieved from http://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD10%2F3224&dbid=AP&chksum=qhog9%2FUCgKdssFmA0XnBlA%3D%3D

Tonia, T., Van Oyen, H., Berger, A., Schindler, C. & Künzli, N. (2016). International Journal of Public Health. 61(4), pp 513-520. doi:10.1007/s00038-016-0831-y

Twitter. (2015). Twitter logo. Retrieved from https://about.twitter.com/press/brand-assets

Wall Media. (2015). Jane Caro photo. Retrieved from http://wallmedia.com.au/jane-caro/

Wilson, R., Ranse, J., Cashin, A., & McNamara, P. (2014). Nurses and Twitter: The good, the bad, and the reluctant. Collegian, 21(2), 111–119. doi:10.1016/j.colegn.2013.09.003

WordPress. (2015). WordPress logo. Retrieved from https://wordpress.org/about/logos/

Wozniak, H., Uys, P., & Mahoney, M. J. (2012). Digital communication in a networked world. In J. Higgs, R. Ajjawi, L. McAllister, F. Trede, & S. Loftus (Eds.), Communication in the health sciences (3rd ed., pp. 150–162). South Melbourne, Australia: Oxford University Press.

YouTube. (2015). YouTube logo. Retrieved from https://www.youtube.com/yt/brand/downloads.html

Citations

If there’s anything here of use, you can either cite this web page as:

McNamara, P.  (2016, 21 October) Why on earth would a Mental Health Nurse bother with Twitter? Retrieved from http://meta4RN.com/ACMHN2016

or, if you’re pulling info direct from the abstract, use the more academic-sounding citation that’s in the IJMHN (the ACMHN journal):

McNamara, P. (2014) Why on earth would a Mental Health Nurse bother with Twitter? (presentation, ACMHN’s 42nd International Mental Health Nursing Conference Nurses striving to tackle disparity in health care 25 – 27 October 2016, Adelaide Convention Centre). International Journal of Mental Health Nursing, Vol 25, Issue S1, Pg 34. doi: 10.1111/inm.12771

End 

That’s it. As always your comments are welcome.

Paul McNamara, 21st October 2016

What can Mental Health Nurses learn from the Amazing Story of a Catholic Patron Saint? (my #ACMHN2016 conference poster)

Welcome to the online companion to my poster presentation at the Australian College of Mental Health Nurses 42nd International Mental Health Nursing Conference, 25 – 27 October 2016, Adelaide Convention Centre.

If you have 6 minutes to spare, please watch the YouTube version:

“What can mental health nurses learn from the amazing story of a catholic patron saint?” was initially submitted as an #ACMHN2016 oral presentation, but accepted as a conference poster. So, instead of updating and reworking the YouTube presentation (as I had planned), I started again. I’m not sure that the poster meets the brief (well, abstract) as well as an oral presentation would have, but anyway…

Abstract

Mental health nursing has a long tradition of story-telling as a tool for developing relationships, undertaking mental state assessment and informing clinical practice. This presentation aims to add to mental health nursing’s discourse about “how we do business”, and add another layer of cultural diversity to our narrative and identity. A review of the literature regarding a catholic patron saint called Dymphna has been undertaken. This will be summarised and presented in a manner in keeping with philosopher Alain de Botton’s proposal that religious teachings should not be trusted to the religious alone – they can be re-purposed and re-mixed to inform atheists too. The historical and mystical story of a 7th century European teenage martyr and saint will be aligned to 21st century Australian language and values. Dymphna’s tale takes unexpected twists and turns which will raise questions about Australia’s appetite for innovative models of mental health care, and whether more could be done to promote mental health nursing as a profession and an identity. This presentation will appeal to those interested in consumer-focused mental health care, innovative alternatives to mainstream care, celebrating mental health nursing, and amazing stories.

amazingstoryposter2

References

Catholic Online (n.d.) St. Dymphna. Retrieved from www.catholic.org/saints/saint.php?saint_id=222

Catholic Saints Info (2016, 27 July) Saint Dymphna. Retrieved from catholicsaints.info/saint-dymphna

de Botton, A. (2011, July) Alain de Botton: Atheism 2.0 [Video file] Retrieved from www.ted.com/talks/alain_de_botton_atheism_2_0

Franciscan Mission Associates. (n.d.) The Story of St. Dymphna. Retrieved from franciscanmissionassoc.org/prayer-requests/devotional-saints/st-dymphna/story/ 

Goldstein, J.L. & Godemont, M.M.L. (2003) The Legend and Lessons of Geel, Belgium: A 1500-Year-Old Legend, a 21st-Century Model. Community Mental Health Journal. 39: 441. doi: 10.1023/A:1025813003347

Ireland’s Eye (n.d.) Saint Dymphna. Retrieved from www.irelandseye.com/irish/people/saints/dympna.shtm

Jay, M. (2014, 9 January) The Geel question. Retrieved from aeon.co/essays/geel-where-the-mentally-ill-are-welcomed-home

Kirsch, J.P. (1909). St. Dymphna. In The Catholic Encyclopedia. New York: Robert Appleton Company. Retrieved from New Advent: www.newadvent.org/cathen/05221b.htm

McNamara, P. (2013, 14 May) Dymphna: The Amazing Story of a Catholic Patron Saint. Retrieved from meta4RN.com/dymphna

McNamara, P. (2013, 20 May) Should May 15th be International Mental Health Nurse Day? Retrieved from meta4RN.com/may15

Novena (n.d.) Feast of St. Dympna. Retrieved from novena.com/2013/05/15/feast-of-st-dymphna/

Openbaar Psychiatrisch Zorgcentrum (OPZ) – Geel website www.opzgeel.be/en/home/htm/intro.asp

Rabenstein, K.I. (1998) Saint of the day. Retrieved from www.saintpatrickdc.org/ss/0515.shtml

Wikipedia (2016, 21 September) Dymphna. Retrieved from en.wikipedia.org/wiki/Dymphna

Image References

In an effort to engage conference delegates in the story of Dymphna, the poster has been made in a colourful quasi-comic style. At time of writing this (a fortnight before the conference starts),  I feel a bit anxious that someone will misinterpret the effort to visually engage people as trivialising the subject. This is a bit of a worry, because Dymphna’s story includes nasty stuff, not the least of which includes threatened incest, family violence and two people being beheaded. Even Donald Trump would know that these are not topics to be trivialised.

Although I don’t treat Dymphna’s story with the same reverence as The Pope, I do hold the stories I learnt as a catholic schoolboy with a nostalgic affection. My telling of Dymphna’s story is through the prism of a happily-lapsed-catholic, and with the words of Kirsch [see reference list above] ringing in my ears: “This narrative is without any historical foundation, being merely a variation of the story of the king who wanted to marry his own daughter, a motif which appears frequently in popular legends.” Dymphna’s amazing story is a centuries-old remix of a made-up myth. It’s not the news.

Le martyre de sainte Dymphne et de saint Gerbert (Martyrdom of St Dymphna and St Gerebernus), Seghers Gérard (1591-1651) http://www.photo.rmn.fr/archive/09-524783-2C6NU09M4JRG.html

Le martyre de sainte Dymphne et de saint Gerbert (Martyrdom of St Dymphna and St Gerebernus), Seghers Gérard (1591-1651) http://www.photo.rmn.fr/archive/09-524783-2C6NU09M4JRG.html

Openbaar Psychiatrisch Zorgcentrum (OPZ) – Geel http://www.opzgeel.be/en/home/htm/intro.asp

Openbaar Psychiatrisch Zorgcentrum (OPZ) – Geel http://www.opzgeel.be/en/home/htm/intro.asp

The Technical Stuff

The poster was made using Apple Pages running on a 2011 iMac.

The poster was made for non-commercial reasons, and full attribution has been given to the authors/works used to inform/illustrate the poster. I expect the same in return, so “What can mental health nurses learn from the amazing story of a catholic patron saint?” by Paul McNamara is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Creative Commons License

There’s a description of how the video was made here: meta4RN.com/Dymphna 

Citations

You can either cite this web page as:

McNamara, P.  (2016, 11 October) What can mental health nurses learn from the amazing story of a catholic patron saint? Retrieved from http://meta4RN.com/amazing

or, if you’re pulling info direct from the abstract, use the more academic-sounding citation that’s in the IJMHN (the ACMHN journal):

McNamara, P. (2016) What can mental health nurses learn from the amazing story of a catholic patron saint? (poster, ACMHN’s 42nd International Mental Health Nursing Conference Nurses striving to tackle disparity in health care 25 – 27 October 2016, Adelaide Convention Centre). International Journal of Mental Health Nursing, Vol 25, Issue S1, Pg 34. doi: 10.1111/inm.12771

End

I’ll leave a copy of the PDF here (amazingstoryposter2) just in case I need it one day. Things are much easier to find/share when they’re online.

Previous visitors to my website will know that I’ve covered the Dymphna story previously back in 2013. It’s not self-plagiarising if it’s referenced, is it? It’s more like a funky new remix. 🙂

If you’re at the conference, please say howdy if you see me skulking about, and/or share this web page or your pics of the poster using the #ACMHN2016 hashtag.

As always, your comments are welcome below.

Paul McNamara, 11th October 2016.

 

Nurses with Cred

Last week, after a fair bit of a nudge, Australia’s federal government made the National Review of Mental Health Programs and Services available. This infographic from the report caught my eye:

That nursing is the largest single component of Australia’s mental health workforce isn’t a surprise. What is a bit unsettling is that the big bubble with 19,048 in it is mislabeled as “Total mental health nurses”.

That’s not true.

Working in mental health does not make you a mental health nurse, in the same way as driving through Bathurst does not make you a racing car driver. Just because you have a basic licence and you are in the right setting, it doesn’t mean you have the skills to perform safely at a high standard. It doesn’t mean you have cred.

As per AHPRA’s Nursing and Midwifery Board there is no registration category for a specialist mental health nurse, there are only these types of registration:

  1. Registered nurse
  2. Enrolled nurse
  3. Midwife

Compare this with types of registration listed by AHPRA’s Medical Board (sub-speciality fields and full range of speciality titles not included):

  1. Addiction medicine
  2. Anaesthesia
  3. Dermatology
  4. Emergency medicine
  5. General practice
  6. Intensive care medicine
  7. Medical administration
  8. Obstetrics and gynaecology
  9. Occupational and environmental medicine
  10. Ophthalmology
  11. Paediatrics and child health
  12. Pain medicine
  13. Palliative medicine
  14. Pathology
  15. Physician
  16. Psychiatry
  17. Public health medicine
  18. Radiation oncology
  19. Radiology
  20. Rehabilitation medicine
  21. Sexual health medicine
  22. Sport and exercise medicine
  23. Surgery

Medicine and nursing do not correlate on every detail of specialisation, but still… why such a big disparity between the two in terms of registration? Australians have rated Nurses as the most ethical and honest profession each year for 21 years in a row (1994-2015) [source], but I wonder if the public is aware of a problem with nursing specialities not being given the similar recognition as medical specialities.

Midwives have made their speciality distinctly different in the eyes of the public and other health professionals. I am sure it is a comfort for many expectant parents to know that the person guiding you through pregnancy, labour, childbirth and early parenthood is a qualified specialist and is acknowledged and registered as such.

However, people receiving support/treatment for a mental health condition will not necessarily have a specialist mental health nurse providing that service. It’s quite the opposite of midwifery – the nurse providing care may have no specialised qualifications in mental health. I wonder how service users and the people who love them feel about that.

I’ve been a medical, surgical and high-dependency/ICU nurse, and have worked closely with Midwives. I can tell you with confidence that mental health nursing is as different from general nursing as midwifery is. There are some transferable skills, of course, but midwifery, general nursing and mental health nursing each have a completely different model of care, and a very different way of working with people.

It’s not all doom and gloom though: the Australian College of Mental Health Nurses (ACMHN) have a process to credential suitably qualified and experienced mental health nurses.  In the absence of AHPRA being able to discriminate the difference between a general nurse and a mental health nurse, ACMHN are essentially saying, “Leave it to us. We will tell you who is a mental health nurse and who is not.” To be credentialed by the ACMHN, applicants must demonstrate that they:

  1. Hold a current licence to practice as a registered nurse within Australia
  2. Hold a recognised specialist / post-graduate mental health nursing qualification
  3. Have had at least 12 months experience since completing specialist / postgraduate qualification OR have three years experience as a registered nurse working in mental health
  4. Have been practicing within the last three years
  5. Have acquired minimum continuing professional development points for education and practice
  6. Are supported by two professional referees
  7. Have completed a professional declaration agreeing to uphold the standards of the profession. [source]

QHcredential_Page_27There’s more good news: Queensland Health has set targets to work towards a fully qualified, fully credentialed mental health nursing workforce. I wonder if other state health departments are thinking about implementing a similar strategy. It might be important: a program staffed entirely by Credentialed Mental Health Nurses was described as “one of the most innovative services ever funded” [source].

Credentialing + Ability = Credibility.

Credentialed Mental Health Nurses have Cred.

One last thing. It is encouraging that mental health is not the only nursing speciality in Australia that is setting the standard, for saying, “We the specialist nurses will tell you who is a specialist nurse and who is not”.  Under the Credentialing for Nurses initiative, currently there are six specialty nursing organisations working collaboratively to develop consistent, evidence based, recognition for specialist nurses:

  1. Australian College of Operating Room Nurses
  2. Australian College of Children and Young People’s Nurses
  3. Australian College of Mental Health Nurses
  4. College of Emergency Nursing Australasia
  5. Gastroenterological Nurses College of Australia
  6. Palliative Care Nurses Australia

Every speciality area of nursing,  every healthcare organisation, and every patient needs the same thing: Nurses with Cred.

End

That’s it, as always your comments are welcome.

Paul McNamara, 28th April 2015

Short URL: http://meta4RN.com/cred

References

Australian College of Mental Health Nurses, 2015: Credentialing for Practice Program

Corderoy, Amy. (2015, 25th April). Innovative mental health program falling victim to funding freeze. Sydney Morning Herald

Credentialing for Nurses

National Mental Health Commission, 2014: The National Review of Mental Health Programmes and Services. Sydney: NMHC

Roy Morgan Research. (2015, 28th April). Roy Morgan Image of Professions Survey 2015: Nurses still easily most highly regarded. Finding No. 6188

 

 

A Mental Health Nurse in the General Hospital

MHCBelow is a copy of the blog post I was invited to submit at My Health Career. The website is targeted at high school and university students considering or pursuing a career in health, guidance officers, career development professionals, and others working in or with the health care sector.

To see the post where it was first published online, and/or to have a look around at the My Health Career website, please visit www.myhealthcareer.com.au/nursing/mental-health-nurse-paul-mcnamara

.

A Mental Health Nurse in the General Hospital

Paul trying not to look too much like a goob.

Paul trying not to look too much like a goob.

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 meta4RN.com

There is an odd little sub-speciality of mental health services called “consultation liaison psychiatry”. This waffly, jargon-ridden mouthful of syllables is usually abbreviated to “CL”. What is CL? Easy – just think of it as “general hospital mental health”.

I’m a mental health nurse on a CL team. The only ward in the hospital I don’t visit is the mental health unit (the mental health unit already has heaps of mental health nurses – they don’t need me there). It’s the rest of the hospital I serve: the surgical wards, the medical wards and the maternity unit.

General hospital patients are more at risk of experiencing mental health problems than the general public – being sick is stressful. It works the other way around too: people who experience long-term mental health difficulties are more at risk of becoming physically unwell – being under lasting emotional stress can take a toll on the body.

Nurses, doctors, social workers and other allied health practitioners will phone CL when they have concerns about the mental health of a patient. Sometimes all that is required is a bit of information and clarification about medication or follow-up services available in the community – we do that over the phone. More often, we are asked to meet with the patient and determine what, if any, mental health matters can be sorted-out while they are in hospital.

The most common mental health problems experienced in the community are anxiety and depression – it’s the same in the general hospital – a lot of the people I meet with are experiencing either or both of these conditions. There are other mental health problems like eating disorders and deliberate self harm that sometimes require input from both the medical/surgical team and the mental health team concurrently. Helping-out with planning and providing support and care of these patients is a pretty big part of my job.

Sometimes it’s not the person in the pyjamas (the patient) who needs our support – sometimes it’s the communication, the systems and the clinical staff who benefit most from CL input. This can be in the form of structured education sessions or, more typically, in the form of supporting discussion, reflection and problem-solving on how best to meet the needs of the patient within the limited resources available in the hospital. In this aspect of the job, a CL nurse will try to help the clinicians involved step-back from the busyness and pressures of the hospital ward and take “a balcony view” of what is happening. By taking ourselves out of the chaos of a busy shift and calmly looking back at things with a bit of distance, sometimes we can see how we can “do business” in hospitals a little more constructively.

We also spend a lot of time “undiagnosing” (this is a “neologism” – a made-up word – I heard recently via Sydney psychiatrist Dr Anne Wand). The people we “undiagnose” the most are those who are experiencing grief. There can be a lot of grief in general hospitals, but we try to be careful not to confuse the emotions of grief (sadness, anger, temporary despair etc) with a psychiatric disorder. Grief emotions are often really uncomfortable but they are part of what makes us who we are. We don’t want to “psychiatricise” or “psychologise” the human condition. Grief is not something to be simply fixed; grief is a part of life – a difficult part of life – that is usually successfully navigated without psychiatric input. Support from loved ones and/or social workers and/or specific counselling services can help.

So, that’s an overview of what it is to be a mental health nurse in a general hospital. It’s a varied role where we spend nearly as much time with the general hospital nurses, midwives, allied health staff and doctors as we do with the hospital patients. The role involves direct clinical care, collaborating with colleagues and providing education. For more information on the speciality please visit my website or the consultation liaison nurses special interest group section of the Australian College of Mental Health Nurses website.

END

Print Version (PDF): CLnurse

Thanks to Amanda Griffiths of My Health Career for inviting me to submit this overview of consultation liaison nursing.

As always, your comments are welcome.

Paul McNamara, 2nd May 2014

 

A Twitter Workshop in Tweets

Monday at the Australian College of Mental Health Nurses (ACMHN) 39th International Mental Health Nursing Conference, we conducted a workshop on Engaging with Social Media. There were three workshop facilitators: Clare Butterfield from Canberra, Communications & Publications Officer (see @ACMHN on Twitter), Paul McNamara (me), Clinical Nurse Consultant from Cairns (see @meta4RN on Twitter) and, our special guest co-facilitator Emily Mignacca (see @emilymignacca on Twitter) graduating student nurse who commences as a RN specialising in mental health early in 2014.

Rather than use a PowerPoint or other traditional presentation method, I wrote the core content of the workshop as a series of Tweets. In real time as the hands-on part of the workshop was in action, we sent the Tweets out from the @ACMHN Twitter account. The Twitter feed on this page twubs.com/ACMHN2013 was projected onto a screen so workshop participants could see the @ACMHN tweets, their own tweets using the conference hashtag and, perhaps most importantly, the comments and interaction from other Twitter users who used #ACMHN2013. It was a successful strategy – I’ll certainly use it again for future workshops on using Twitter.

You are welcome to use all or part of A Twitter Workshop in Tweets below provided you abide by the Creative Commons Licence below. This licence lets others distribute, remix and build upon the work, but only if it is for non-commercial purposes, they credit the original creator and source – Paul McNamara (2013) A Twitter Workshop in Tweets http://meta4RN/tweets – and they license their derivative works under the same terms. You are also welcome to contact me to facilitate/co-facilitate your health care social media workshop.  My email is meta4RN [at symbol] gmail.com

1. Pre-workshop info/publicity

Engaging with Social Media – Clare Butterfield and Paul McNamara Monday 21st October 2013 12:30-2:30pm

Social media allows Collaboration and Partnerships in Mental Health Nursing to transcend time and place: time through collaborative, asynchronous communication; place by being connected to the world’s online clinical communities. This hands-on workshop aims to act as a launching-pad for those who want to turbo-charge the conference theme.

The workshop will be in two parts: The first, briefest part, will introduce four examples of professional use of social media, using Twitter as the primary example. This part of the workshop intends to show participants the value of engaging with social media.

The emphasis will be the second part of the workshop. This will be a hands-on session that will assist participants gain confidence in using Twitter. This part of the workshop intends to equip participants with skills in engaging with social media in a professional capacity. Wifi will be available. Participants are asked to bring:

  • a mobile internet device (eg: smartphone, tablet or laptop computer);
  • knowledge (ie: the relevant passwords) on how to download apps onto your mobile device;
  • for those who already have an established Twitter account, the knowledge (ie: the relevant passwords) on how to access it;
  • a spirit of curiosity and fun!

To reinforce the learning acquired in the workshop, follow-up “skill checks” will be scheduled during conference breaks on Tuesday and Wednesday. Please come along – the workshop facilitators expect it to be a dynamic, fun, enlightening masterclass in engaging with social media.

Emily Mignacca was invited to join in co-facilitating the workshop just a couple of weeks before the workshop. Although Emily missed-out on being named in the pre-conference publicity, her participation on the day was vital. Emily worked hard and did a good job supporting people who were more than twice her age pick-up some of the skills and enthusiasm she has in using social media professionally. You could do worse than follow @emilymignacca on Twitter.

twitter

Below is a list of my pre-composed, pre-ordered tweets for the workshop. There were minor adjustments, inclusions and exclusion made as we went along, but mostly we just sent them out verbatim.

2. #ACMHN2013 Twitter Workshop in Tweets

Creative Commons License
A Twitter Workshop in Tweets by Paul McNamara is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.
Based on a work at http://meta4RN/tweets.

Before

Please RT to show Twitter’s potential/reach to participants in today’s #ACMHN2013 Engaging with Social Media Workshop

Starting soon: #ACMHN2013 Engaging with Social Media Workshop. Info: http://acmhnconferences.acmhn.org/speakers/ (near bottom: scroll down) #HCSMANZ

No PowerPoint slides at the Engaging with Social Media Workshop. We’re Tweeting the content using this hashtag #ACMHN2013

Warning: HEAPS of #ACMHN2013 Social Media Workshop tweets next 2 hours
To join: http://twubs.com/ACMHN2013
To mute: http://roniweiss.com/2011/05/03/muting-hashtags/

Start

#ACMHN2013 Facilitator 1 of 3: Clare Butterfield @ACMHN Communications and Publications Officer with – Face of ACMHN’s Twitter

#ACMHN2013 Facilitator 2 of 3: Emily Mignacca @emilymignacca GenY/Millennial, Almost-Mental Health Nurse – Future of @ACMHN

#ACMHN2013 Facilitator 3 of 3: Paul McNamara @meta4RN clinical nurse consultant + educator – Fellow of @ACMHN

First-up, a hard-sell on some professional uses of Twitter. For those playing-along at home see http://meta4RN.com/poster #ACMHN2013

What is Twitter’s potential/reach? Here’s a demonstration we prepared earlier https://twitter.com/meta4rn/status/392021423943716866 #ACMHN2013

Here are the results: http://www.symplur.com/healthcare-hashtags/acmhn2013/analytics/?hashtag=acmhn2013&fdate=10%2F17%2F2013&shour=9&smin=0&tdate=10%2F21%2F2013&thour=9&tmin=0&ssec=00&tsec=00&img=1 #ACMHN2013

Enough chin-wagging. Let’s start doing! Go to https://twitter.com/signup to start an account #ACMHN2013

Make a choice now: is this an official, personal or professional twitter account? Mental health nurses know about boundaries, right? #ACMHN2013

Need clarification on official, personal + professional? This Qld Gov site is clear + succinct: http://www.qld.gov.au/web/social-media/policy-guidelines/guidelines/official-use.html#ACMHN2013

On your professional twitter account you’re not representing an organisation, but are primarily talking about work-related stuff #ACMHN2013

Choose a short name (aka “handle”) eg: instead of @BartholomewBonython maybe @BartB #ACMHN2013

Bad news for people without exotic names: @JohnSmith @JSmith + @SmithJ are all taken ;-/ #ACMHN2013

Short names and concise tweets are good. Twitter = Brevity Central #ACMHN2013

Struggling deciding on a name? Get creative! Example: a nerdy mental health nurse might be @MHnerse #ACMHN2013

Or… a graduating student nurse might be @SN2RN #ACMHN2013

Don’t use your workplace name/initials unless you’re 100% sure you’re representing your employer rather than your professional self #ACMHN2013

That’s why I’m @meta4RN rather than @QueenslandHealthRN – there’s a BIG difference in implications/expectations #ACMHN2013

Think about how you’ll describe yourself in your Twitter bio. Do you need to name your employer? It might be easier if you don’t. #ACMHN2013

Twitter bios accommodate a bit of personality along with a description of you/your interests #ACMHN2013

Re bio: maybe better not to say “lost virginity to a rockstar”, but “enthusiastically supporting musicians” would be OK 🙂 #ACMHN2013

Professional doesn’t have to be boring #ACMHN2013

Still nervous re the name/bio thing? You’ll get away with being anonymous, but why? On the run? Witness protection program? #ACMHN2013

And a pic. You’ll need a pic. Eggs repel followers. #truefact #ACMHN2013

Your pic doesn’t have to be a photo. There are avatars available online PRN. eg: http://www.twittergallery.com/?p=1985 #ACMHN2013

DON’T BE AN EGG! #ACMHN2013

Right. When you’re ready, announce your arrival to the Twitterverse. No pressure: channel Neil Armstrong. #ACMHN2013

Oh, and use the conference hashtag so we can see your tweet on the #ACMHN2013 screen

Next up you’ll want to start following some people, otherwise your Twitter feed will be bare, and you will get sad, lonely and bored 😦 #ACMHN2013

Who to follow? We can start with each other – a learn as we go thing #ACMHN2013

Twitter is not like Facebook. It is perfectly acceptable, not at all stalker-ish, to follow a complete stranger. #ACMHN2013

#ACMHN2013 Also, if you want to see who else is active in health care social media in Aus/NZ sus-out this hashtag: #HCSMANZ

#ACMHN2013 @nurse_w_glasses is a rockstar amongst social-media-mental-health-nurses: well worth following.

While we’re looking at who to follow, sus out the #WeNurses + #OzNurses hashtags – anyone/anything of interest? #ACMHN2013

If so, you may want to follow that person and/or retweet (ie: share) their tweet. #ACMHN2013

RT = ReTweet
MT = Modified Tweet
HT = HatTip/HeardThrough
More about Twitterisms here http://meta4RN.com/FF #ACMHN2013

Now, about hashtags… don’t be intimidated. You can use Twitter happily with never using one in your whole life #ACMHN2013 BUT…

Hashtags pull disparate conversations and people together. Like at this mental health nursing conference, for instance #ACMHN2013

Eg: even if you had the most incisive political tweet ever created, QandA viewers wouldn’t know about it without the #QandA hashtag #ACMHN2013

The hashtag thing can be fiddly at first. For the #ACMHN2013 conference this site makes it REALLY easy: http://twubs.com/ACMHN2013

Create your own hashtags, BUT learn from the Susan Boyle album launch hashtag: #susanalbumparty can be read 2 ways 🙂 #ACMHN2013

So, what to Tweet about? Anything that you think is relevant to people who may share all or some of your interests #ACMHN2013

Remember: the conventions of professional communication are long-established: letters, email etc. Why change it on Twitter? #ACMHN2013

Now, let’s pause and have a look at the @acn_tweet / RCNA (2011) Social Media Guidelines for Nurses http://www.rcna.org.au/WCM/Images/RCNA_website/Files%20for%20upload%20and%20link/rcna_social_media_guidelines_for_nurses.pdf #ACMHN2013

While we’re at it, let’s have a look at the @NurMidBoardAust guidelines too http://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD10%2F3224&dbid=AP&chksum=qhog9%2FUCgKdssFmA0XnBlA%3D%3D #ACMHN2013

Any surprises or comments about the social media guidelines? #ACMHN2013

#ACMHN2013 The guidelines are pretty common-sense stuff. Maybe this flowchart is all we need

SoMeFlowchart

On a mobile device? Install an app, eg: Twitter https://about.twitter.com/download #ACMHN2013

On a mobile device? Install an app, eg: HootSuite https://hootsuite.com/features/mobile-apps #ACMHN2013

On a mobile device? Install an app, eg: Tapbot http://tapbots.com/software/tweetbot/ #ACMHN2013

Probably the easiest way to learn Twitter is to follow people who have already learned Twitter. Stick with it – it’ll click in. #ACMHN2013

Do unto others. #TwitterTips #ACMHN2013

#TwitterTips #ACMHN2013 Be careful mixing personal and professional. Boundaries are important.

#TwitterTips #ACMHN2013 You already know about confidentiality; if you’re doing confidentiality wrong online it will definitely get spotted.

#TwitterTips #ACMHN2013 Naturally, you would NEVER give individual or detailed clinical advice on Twitter.

#TwitterTips #ACMHN2013 Generalised info is fine, eg: Getting great feedback from consumers about the @mindhealthc site http://www.mindhealthconnect.org.au

#TwitterTips #ACMHN2013 Try not to act like a dickhead. Also, don’t use words like “dickhead” – it’s unprofessional. #TwitterTips #ACMHN2013

#TwitterTips #ACMHN2013 Apologise if you do/say something stupid. BTW sorry for saying “dickhead” before.

#TwitterTips #ACMHN2013 Twitter spam is especially good at playing on the insecurities of newbies, so be vigilant + don’t click dodgy links.

#TwitterTips #ACMHN2013 Spam example 1:
This person is saying horrible things about you www.dodgylink.com DON’T CLICK!

#TwitterTips #ACMHN2013 Spam example 2:
This photo of you! LOL www.dodgylink.com DON’T CLICK!

#TwitterTips #ACMHN2013 Mostly you won’t Tweet from/about your workplace… you’ll have your work to do.

#TwitterTips #ACMHN2013 There may be an occasional exception to the workplace rule, eg: Gammin Hospital Christmas decorations are fabulous!

#TwitterTips #ACMHN2013 Would your patients or boss be offended by that photo? Yes = Delete. No = Tweet.

Finish

#TwitterTips #ACMHN2013 RT @charleneli: Twitter is not a technology. It’s a conversation. And it’s happening with or without you.

#TwitterTips #ACMHN2013 No need to worry about forgetting today’s workshop, it’s all here: http://meta4RN/tweets

#TwitterTips #ACMHN2013 Connect. Be generous. Have fun.

Creative Commons License
A Twitter Workshop in Tweets by Paul McNamara is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.
Based on a work at http://meta4RN/tweets.

As always, your comments and feedback is welcome. Please use the comment facility below.

Paul McNamara, 23rd October 2013