Tag Archives: communication

Sex Essentials – The Fairy Tale

On Friday 18 May 2018 the Cairns Sexual Health Service hosted their seventh Sex Essentials education day for nurses, GPs, youth workers, allied health, Aboriginal and Torres Strait Islander health workers, educators and community workers. These annual education days are famous in FNQ and beyond for being energetic and fun. Each Sex Essentials day has a different theme, the 2018 theme was “The Fairy Tale”.

Regular visitors to meta4RN.com know that I’m a fan of taking health education beyond the classroom/conference walls by using social media. While readily acknowledging that there’s no way to capture the whole day on a web page, hopefully this collation of Tweets gives a taste of the creative, inspiring, fun and educational event that was Sex Essentials – The Fairy Tale:

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More info re #SMACC (Social Media and Critical Care) here.
More info re #FOAMed (Free Open Access Meducation) here.
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This is not an exaggeration. For example, watch this short presentation about how FNQ is home to Australia’s first Hep-C free prison here.
Vimeo

AVHEC 2017 – Darren Russell “Keynote 11 – Eliminating Hepatitis C – The Cairns Experience” from ASHM on Vimeo.

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You know what bear means, right? If not, have a quick read here.
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Sincere thanks to Max for an excellent keynote presentation, and agreeing to this Tweet being in the public domain.
Also, my mistake: that should read cisgender/cisgendered.
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URL to the How Much Do You Know? podcasts: eastsidefm.org/howmuchdoyouknow
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URL to Cairns Sexual Health Service: www.health.qld.gov.au/cairns_hinterland/html/shealth
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This session was facilitated by psychologist Suzanne Habib, and drew on the lived experience and generous wisdom of three remarkable people who shared their stories and answered our (sometimes a bit dumb) questions.
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Finishing-Up

For the sake of posterity, here are pics of the program.

Morning

Afternoon
Also for posterity, and by way of thanks to the slightly crazy, but very fun, staff of Cairns Sexual Health Service, here is the way the day started:

More info re Cairns Sexual Health Service here.

Visit the their Facebook page for more photos and info re future Sex Essentials days – health education done right.

End 

As always, comments are welcome in the section below.

Paul McNamara, 19 May 2018

Short URL: meta4RN.com/sex

#WeNurses Twitter Chat re Communication and Compassion

On 21st December 2012 (Cairns time) nurses from the United Kingdom and Australia came together on Twitter using the #WeNurses hashtag. The planned Twitter chat was used to discuss issues raised by the much-publicised death of a nursing colleague – Jacintha Saldanha.

This curated version of the Twitter chat demonstrates nurses using social media in a constructive manner, and responding to the issues surrounding Jacintha’s passing with thoughtfulness and grace. This was in sharp contrast to the shrill, insensitive and ill-informed way the matter was discussed elsewhere on social media and in mainstream media in the UK and Australia.

I’ve used sub-headings in red to structure the chat as per the themes that emerged.

WordCloud created from the full transcript of the #WeNurses Twitter chat

Preliminary Information.
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Introductions.
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Setting The Tone.
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Communication and Confidentiality.
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Mobile Phones.
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Social Media.
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Individualising Communication & Confidentiality.
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WiFi for Hospital Patients.
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Compassion.
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Prank Call.
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Targeted Crisis Support.
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Clinical Supervision (aka Peer Supervision, aka Guided Reflective Practice).
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Supportive Workplaces.
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Preventative/Early-Intervention Resources.
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The 6Cs (Care, Compassion, Competence, Communication, Courage & Commitment).
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Integrating Defusing Emotions into Clinical Practice.
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Finishing-Up: Key Learnings.
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Closing Remarks.
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Farewells.
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Explanation

These Tweets were initially compiled using a social media aggregation tool called Storify
storify.com/meta4RN/communication-and-compassion

Unfortunately, Storify is shutting-down on 16 May 2018 and all content will be deleted.

I’m using my blog as a place to mimic/save the Storify pages I created and value.

End Notes

This archive of Tweets relate directly to two blog posts I wrote at the time. If you’re interested in elaboration re the context at the time, please visit these pages:
Questions of Compassion meta4RN.com/questions-of-compassion
WeNurses: Communication and Compassion meta4RN.com/WeNurses

As always, please use the comments section below for any feedback/questions.

Paul McNamara, 3rd April 2018

Short URL: meta4RN.com/Chat

The Hearing-Voices/Car-Driving Metaphor

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

My body’s a car. I’m the driver.

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

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

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

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

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

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

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

Thats when it gets REALLY dangerous.

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

That’s when I need to come into hospital.

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

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

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

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

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

An impressive person, and a fantastic metaphor. 

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

car
End

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

Paul McNamara, 20th February 2017.

Short URL: https://meta4RN.com/car

Hand Hygiene and Mindful Moments

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

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

batman

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

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

poster1

5 moments for hand hygiene & head hygiene!

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

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

Mindful Moment (The 30-Second Handrub Version) 

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

Mindful Minute (The 60-Second Handwash Version)

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

Clean hands save lives. Clear heads save lives too!

Acknowledgements & Context

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

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

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

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

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

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

and this video:

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

5mindfulmoments

End

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

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

Paul McNamara, 26 November 2016

Short URL: http://meta4RN.com/hygiene

The Broken Leg/Psychosis Metaphor

Preamble

Below is a metaphor I heard in 1994 via an impressive man called Greg Holland. Greg is retired now, but when I met him he was a CNC with a public community mental health service. Even after all the years that have followed, Greg remains one of the most skilled communicators and mental health nurses I’ve ever worked with.

Greg was talking with a couple of young fellas who had been diagnosed with schizophrenia. Greg was explaining the importance of trying to avoid relapses of psychosis. The key messages for these young blokes was to keep taking the prescribed medications, and stay away from things that make psychosis more likely: things like cannabis, amphetamines or heaps of alcohol. That’s when Greg used this metaphor (his verbal version was shorter than my written version, but the general story is the same):

The Broken Leg/Psychosis Metaphor

If you accidentally broke your leg skateboarding or playing football, you’d have to have your leg in plaster for about 6 weeks. You would have to be really careful with it during that time, and it would probably get really uncomfortable and itchy most days. Then, if there were no complications, after 6 weeks you’d be able to get the plaster cast off, and start building up your strength in that broken leg. A physio might recommend some exercises, but you probably wouldn’t get back to playing football or skateboarding for a few months. Rehabilitation takes a bit of time and effort, but as a young fit man you’ll make a full recovery. No worries.

If you broke the same leg again, it might be more of a big deal. You might need surgery, and they might need to strengthen the bone with steel plates or rods and screws. Sometimes people need to have external fixation: metal devices that are screwed into the bones, but sit outside the body, above the skin to stabilise the fractures. It will be messier, more painful, take longer to get out of hospital, and your leg muscles will get pretty weak. You’ll probably make a full recovery still, but it will just take more time and effort.

If you break your leg a third time, the orthopaedic nurses and doctors are going to think you’re either really unlucky or stupidly reckless. They’ll suggest that you stop skateboarding and playing football altogether. Your leg will get operated on, and the fractures will get stabilised, but the recovery will be really slow. You could end-up with a bit of a limp.

If you keep on breaking the same leg over and over again, say five, six, seven times, you will definitely end up with a limp. Might need a walking stick or something.

If you break the same leg often enough and bad enough you’ll probably end up lame: permanently disabled and unable to walk. You’ll wish you’d listened to the orthopaedic nurses and doctors, and had never gone back to skateboarding or playing football.

It’s kind of the same with psychosis.

If you lose touch with reality once or twice you’ll probably make a full recovery.

But if you keep on having psychotic episodes your brain might develop a bit of a “limp” – it will still work, but not as good as it used to work.

If you have lots of psychotic episodes you might end up disabled and unable enjoy life to the fullest. You’ll wish you’d never gone back to smoking gunja or getting pissed.

That’s why I’m working with you to prevent or cut down on psychotic relapses. Does that make sense to you?

End

I really like the broken leg/psychosis metaphor. I use a shortened version of the above script a fair bit at work, and people usually respond well to it. I’m very grateful to Greg Holland for introducing the analogy to me. It’s a good metaphor that I hope that others will find useful to use/adapt in their clinical practice too.

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

Paul McNamara, 17th November 2016

Short URL: meta4RN.com/leg

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

Learn about Obesity (and Twitter) via Nurses Tweeting at a Conference

If you read this I guarantee that you will learn 4 things in 5 minutes:

  1. How obesity works
  2. How Twitter at a healthcare conference works
  3. How an aggregation tool like Storify can add value to Twitter content
  4. How nurses can be simultaneously generous, incisive and funny

 

Small sample of conference Tweets. Click to see the whole story

Small sample of conference Tweets. Click to see the whole story: https://storify.com/meta4RN/obesity-personal-or-social-responsibility

So What?

Sometimes I have trouble explaining to health professionals how Twitter works at conferences. It’s easier to show an example, rather than just chin-wagging and flapping-about like a chook in a cyclone. That’s why I have created this example: https://storify.com/meta4RN/obesity-personal-or-social-responsibility

Haven’t I Seen This Before?

Maybe. Back in 2013 this example was buried about halfway through a long blog post called #ICNAust2013: Looking Back at a Nursing Conference through a Social Media Lens, At time of writing this self plagiarising (yet again!) post, the original post has been read 578 times, and the Storify version has been viewed 595 times. You may be one of the lucky few to have seen it before. 🙂

Huh? I Don’t Get It.

Follow this link: https://storify.com/meta4RN/obesity-personal-or-social-responsibility, take 5 minutes to read through the collated Tweets, and then you’ll get it. Promise.

End

As always, you’re very welcome to leave feedback/suggestions/questions in the comments section below.

Paul McNamara, 15 October 2016

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