Tag Archives: education

The Last 40-Odd Weeks

This blog post has one purpose only.

It is to explain why I have been so uncharacteristically vague, and often distracted, for the last 40-odd weeks.

During that time many dozens of people (most of them uni students, but also friends, family and colleagues) have asked this question: “Are you still teaching at the uni?” My wishy-washy responses have been along these lines:
“Hopefully!”
“I’m not sure.”
or the hilariously inaccurate “Ask me again in a couple of weeks.”

FullSizeRender copy

Let me explain/elaborate by using a timeline:

1995: Started working for the health department full-time [see LinkedIn]

1996: Started working for the uni temporarily/part-time – an arrangement that continues sporadically over the years that follow [see LinkedIn]

May 2015: I’m working at the uni. Casual chat between senior uni colleague and I. Outcome = let’s think about the possibility of a shared position between the uni and the health department. There would be some benefits to both organisations. It’d be a pretty cool gig, I reckon.

June 2015: Senior uni colleague says “let’s do it!”. A meeting is held between senior uni colleague and a senior health department colleague. Verbal agreement established. The uni sends a contract to the health department. The first draft of the role description is drawn up by the uni and sent to the health department. The contract and position description cite an October 2015 start date.

July 2015: I’m back at the health department. I make sure that people who need to know about the new position coming know, and offer to help progress things along if I can. Funding’s an issue, of course, but there should be a way…

August 2015: I make occasional enquiries. Bureaucracies need processes and time. Be patient.

September 2015: More enquiries. It’s all about the paper-trail, funding, signatures. Be patient.

October 2015: My enquiries must be getting a bit too shrill. Emails are not answered. Phone calls are not returned. The intended start-date for the position passes.

November 2015: I’m getting anxious about the delayed start not leaving enough time for 2016 subject preparation. I start pulling on the very few levers that are available to me: someone who knows someone who knows someone will look into it. I rescheduled my December flights: if I happen to get this job I won’t have time to go to Japan in December. The teaching starts in January, and there needs to be subject preparation.

December 2015: The position is advertised. Yay!
My request for consideration of transfer at level so as to expedite the position starting in a timely manner is declined. Bugger.
I send in my application and hope for the best.

8th January 2016: Interviewed for the position. I was phoned after the interview and offered a 3 month secondment into the position. That’s weird. It’s funded for 5 years. I ask to think about it over the weekend.

8th-10th January 2016:  Consult with my wife and trusted friends. Consensus is that if I’m good enough to do the job for 3 months, it’s weird that I’m not good enough to do the job for the term of the contract. I find myself thinking of the refrain from Bob Dylan’s Ballad of a Thin Man:
Because something is happening here
But you don’t know what it is
Do you, Mister Jones?

11th January 2016: “Thank you very much for offering me a 3 month position. However, I applied for a 5 year position. I can only commit to the position if the organisation commits to me.” Nice try Paul. “We’ll let you know when we schedule another interview.”

18th January 2016: The uni teaching period starts. The subject is underway without the position being filled.

2nd February 2016: Interviewed for the position again.

2nd February – 31st March 2016: I hear nothing at all officially. Other people do. It makes its way along the health department grapevine that someone else has been successful. One of those whispers reaches me via a convoluted track. I’m disappointed, of course, but not surprised. Silence is the polar opposite of someone enthusiastically saying, “Congrats! We reckon you’ll be great! When can you start?”

1st April 2016 (no, not joking): An email from noreply@smartjobs.qld.gov.au that says “I wish to advise that on this occasion you have not been successful in obtaining the position.”

So that’s it.

I can drop the vague, unknowing responses to enquiries now. It’s a relief to know. It’s a relief to be able to be open and transparent again. I didn’t get the job that I was hoping for. Yes, of course I am disappointed. However, I am totally accepting of the obvious fact that there was another candidate for the position who is better credentialed, better prepared and/or more meritorious for the role.

Ricky Ponting wouldn’t feel bad if somebody said Don Bradman was a better cricketer than him. Same-same, but different. Not that I’m the Ricky Ponting of mental health nurse education. More like Boof Lehmann, I reckon. 🙂

I am disappointed by how long the whole recruiting process took. The uni sent the contract and position description to the health department in June 2015. It’s taken the health department until April 2016 to fill the position. That’s longer than a human pregnancy.

IMG_7564

Despite being there for the courtship, conception and gestation, I now know it’s not my baby.

The other lesson I’ve taken from this is to cautiously self-monitor my behaviour at work (I’m a mental health nurse in a general hospital ). In clinical supervision we recognise that there are parallel processes: how a nurse treats a patient can be influenced by how the organisation treats the nurse. It is prudent that I be especially intentional and vigilant to treat my patients in a timely manner, and with the kindness and respect they deserve.

The last 40-odd weeks have been odd. Sorry about all my distractibility and wishy-washy responses to questions during that time. I hope this timeline/blog post explains it all.

End

That’s it. Thanks for reading.

Paul McNamara, 3rd April 2016

Short URL: http://meta4RN.com/40weeks

Movies, Myths, Mistakes

The Cairns Post, 14th August 2003:

my say 1 140803As if schizophrenia isn’t enough of a burden to those who have it, they also have to put up with the myths and misunderstandings that accompany it, and the discrimination that follows.

So, let’s try to get some of the facts about schizophrenia right.

Probably the most common myth is that schizophrenia means split personality. Comparisons to Jekyll and Hyde are commonplace, but utterly wrong.

In Latin schizophrenia means split mind. This refers to the split between perceiving the world in the way most of us do and perceiving it in other ways.

To illustrate, someone with schizophrenia may interpret everyday events as having significance beyond their intent.

In health, our jargon terms for these sorts of symptoms are delusional beliefs and/or ideas of reference.

my say 2 140803In the film Angel Baby the main character sought special meaning from a game show. I have met plenty of people with schizophrenia and haven’t heard anything quite like that, but then I don’t have to make a living by entertaining people either.

I think what the movie-makers were doing was jazzing-up and stylising the experience of perceiving the everyday in another way.

Speaking of jazzing-up and stylising, A Beautiful Mind certainly did a good job with making paranoia look exciting (it’s not).

Perhaps because movies are visual, this film gave the impression the main character was experiencing his paranoia as a visual experience.

Some people with schizophrenia do have paranoid beliefs and delusions when they are unwell. Nobody I’ve met has described this visually, although quite a few have spoken about hearing things, usually voices,.

It seems these auditory hallucinations are an intrusive and exaggerated version of what all of us experience when we have those little conversations with ourselves throughout the day.

From what I’ve heard, most people’s idea of what a mental health ward looks and functions like comes straight out of One Flew Over The Cuckoo’s Nest.

Anyone who has been inside our local mental health unit at CBH will be able to tell you that it is a modern, light-filled place where there’s direct access to fresh air from just about every room.

In my opinion, the layout and design is the best of all the wards in the hospital.

Finally there’s the violence myth. Hollywood has created a perception that schizophrenia means danger.

I don’t associate violence with schizophrenia at all. I know that on occasions tragic things have happened, but this is rare.

I’ve met dozens of people with schizophrenia who would not  hurt a fly.

I guess if you’re making movies you’re not interested in a story about an ordinary-looking person doing everyday stuff in a pretty average way, other than taking medications to control uninvited symptoms.

Final Notes

Back in 2003 a journalist from The Cairns Post invited me to submit this article for the My Say column (a daily feature presenting the views of a cross-section of the community). The article’s reference to man’s inhumanity to man is in the context of current events at the time – it was published during the second week of the war in Iraq.

As I was identified as an employee of a local hospital, at the time of publication the content of the article had to be approved by the hospital’s media department. The media department approved the article without changes to content.

In 2003 I used some phrases that I find a bit jarring now. I was tempted to correct it in this 2014 version, but decided it was more authentic to leave the original unaltered.

Anyway, I stumbled across the very-low-resolution JPG version of the article today and thought it might be worth reprising. Stigmatising representations of schizophrenia still pop-up in Hollywood, – this is a tiny, inadequate bit of counter-balance.

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

Paul McNamara, 26th October 2014

Short URL:  meta4RN.com/movies

Originally:
McNamara, Paul (2003). Movies, myths, mistakes. The Cairns Post, 14 Aug 2003, pg 13.

Defending Mental Health in Nursing Education

NHS

The Guardian (UK ed), 29 Sep 2014

There was an article in The Guardian (UK edition) recently where a nurse described how ill-equipped they felt to support patients experiencing mental health difficulties. The article included the startling information that, “My nursing course, which I think was excellent, contained no more than three days structured education on caring for patients with mental health problems.”

Umm. That wasn’t an excellent nursing course. That’s a crap nursing course.

Look, us Aussies like to tease the Brits about their weather and cricket team every chance we get, but I’m not accustomed to criticising their nursing courses. The truth is, I do not know enough about nursing courses in the UK to hold any strong opinions about how good or bad they are.

That said, I wonder what the general public would think of hospitals being staffed by nurses who had undertaken, as reported, a three year nursing course that includes only three days of teaching in mental health. I am glad that doesn’t happen in Australia.

Dumbing Down is Dumb

Since July 2000 most of my work has been about supporting mental health care in the general health settings as Consultation Liaison CNC (more about that here) and as Perinatal Mental Health CNC (more about that here). These roles have direct clinical input, but also have a lot to do with supporting general nurses and midwives to feel more confident and become more skilled at providing direct clinical care to people experiencing mental health difficulties. It’s inevitable that they’ll need these skills – a significant proportion of people who access general hospitals and/or maternity services also experience symptoms of depression, anxiety etc. Dumbing-down mental health education for general nurses and midwives is dumb.

elistIn August 2012 a Mental Health First Aid (MHFA) instructor proposed using MHFA as inservice education for hospital-based nurses. I mounted my high horse to defend the depth and quality of nursing education sprouting the opinion that MHFA is not suitable training for RNs. My rant went along the lines of it’s great training for many community and professional groups, but it’s inadequate for those working in health role. Undergraduate nursing programs have more than the 12 contact hours that MHFA offers, and we should re-awaken/build-on that education. Nurses in particular need to know a bit about:

  • symptom detection
  • meanings/implications of diagnostic groups
  • medication effects and side-effects
  • the biopsychosocial model of mental health
  • social determinants of health
  • risk assessment/management
  • emotional intelligence and therapeutic use of self

confpresTo give MHFA their due, they have never claimed their training to be an alternative to formal nursing education (others have). MHFA does a good job at informing first responders, but does not address mental health in a manner suitable for a frontline clinician. There is a community expectation that nurses and midwives will have a depth of understanding of mental health beyond that of the general community, beyond basic fist aid.

This conversation started off as a discussion in the workplace, then became a topic of discussion on the Australian College of Mental Health Nurses e-lists, then morphed into a conference presentation and, more recently, was articulated as this journal article:

Happell, B., Wilson, R> & McNamara, P. (2014) Undergraduate mental health nursing education in Australia: More than Mental Health First Aid. Collegian (2014), http://dx.doi.org/10.1016/j.colegn.2014.07.003

Happell, B., Wilson, R. and McNamara, P. (2014) Undergraduate mental health nursing education in Australia: More than Mental Health First Aid. Collegian (2014), http://dx.doi.org/10.1016/j.colegn.2014.07.003

Anyway, I guess there are two points to this blog post:

One: Quality Control
Let’s make sure that we continue to defend the quality and depth of undergraduate nursing and midwifery training in Australia. We must never let it slip like the UK example of just three days training in three years. That is woefully inadequate.

Two: Speak Up 
If you’re a nurse or midwife with strong opinions about a subject, it doesn’t hurt to discuss these opinions online. As per this example, a discussion held online morphed into a conference presentation and a journal article. For me, anyway, the difference between it being a rant and a paper was the interest and input from a couple of Nursing Academics: Brenda Happell (@IHSSRDir on Twitter) and Rhonda Wilson (@RhondaWilsonMHN on Twitter).

References

Happell, B., Wilson, R. L. & McNamara, P. (2013). Beyond bandaids: Defending the depth and detail of mental health in nursing education. Paper presented at the Australian College of Mental Health Nurses 39th International Mental Health Nursing Conference Perth, Western Australia, Australia. Abstract in International Journal of Mental Health Nursing, Vol 22, Issue Supplement S1, pp 11-12 http://onlinelibrary.wiley.com/doi/10.1111/inm.2013.22.issue-s1/issuetoc

Happell, B., Wilson, R. L. & McNamara, P. (2014) Undergraduate mental health nursing education in Australia: More than Mental Health First Aid. Collegian (In Press) http://dx.doi.org/10.1016/j.colegn.2014.07.003

End

Thanks for reading this far. As always, your feedback is welcome in the comments section below.

Paul McNamara, 21st October 2014

Short URL: meta4RN.com/defend

Free Open Access Mental Health Education for General Nurses and Midwives #FOANed

If you’re a nurse or midwife, and own an internet-enabled device you have unprecedented access to information.

Information + motivation = education.

Borrowing from the very successful #FOAMed initiative, recently there has been a flurry of activity regarding Free Open Access Nursing Education (aka #FOANed).  That is:

Free
Open
Access
Nurse
education

The #FOANed hashtag makes it’s easy to share info and resources via social media. If you’re cruising Twitter, Facebook, Google+ or even Instagram, have a look for the #FOANed hashtag.

Still not sure what the #FOANed hashtag is all about? Perhaps it’s just easier to see for yourself via this Storify (click here).

Mental Health #FOANed

Anyway, in the spirit of #FOANed, here are four suggestions for free open access nursing education re mental health for general nurses and midwives (click on each picture for more info):

1. Physical and Mental Health Care via Australian College of Mental Health Nurses:

2. Mental Health Liaison in General Hospitals via New South Wales Health:

inkysmudge.com.au/eSimulation/mhl.html

inkysmudge.com.au/eSimulation/mhl.html

3. Perinatal Mental Health Training for Midwives via Monash University:

perinatal.med.monash.edu.au

perinatal.med.monash.edu.au

4. MIND Essentials via Queensland Health:

Obviously, this is not an exhaustive list of the mental health #FOANed available online, but hopefully it’s enough to get you started if you’re looking for some CPD/info.

Please feel free to add your suggestions for other free open access nursing education re mental health in the comments section below.

Paul McNamara, 20th October 2014

Short URL: meta4RN.com/FOANed