Tag Archives: innovation

Digital Professionalism📱vs The Dinosaurs 🦕

In a famous reddit exchange from about 7 years ago, this question was asked:

If someone from the 1950s suddenly appeared today, what would be the most difficult thing to explain to them about life today? 

Nuseramed replied: 

I possess a device, in my pocket, that is capable of accessing the entirety of information known to man. 

I use it to look at pictures of cats and get in arguments with strangers.

The response went viral.

The iPhone revolutionised how we use mobile phones. Although there were internet-connected phones years before the iPhone came along, it wasn’t until the iPhone was released (2007 in the US + Europe, 2008 in Australasia) that it started to become normal to access the internet while on the run, not just at a desk. Furthermore, the explosion of apps that followed the iPhone release made it clear that making phone calls and sending text messages were the least fun things you could do with a mobile phone. 

Which brings me to the point of this post. Smartphones don’t have to be used for looking at cat videos and getting into arguments with strangers. Smartphones can be a terrific asset to nursing work, but there’s sometimes a weird reluctance from nursing’s leaders to encourage or even permit their use. This reluctance was noted in a recent Journal of Advanced Nursing editorial:

I could wave my hands around and talk about why nurses should embrace, not avoid, using smartphones. It might be a bit abstract though.

We could ask more people to google “mHealth” so they can see their there’s a whole field of study about using smartphones in health care.

Instead, let’s just list a dozen real-life examples of how clinicians use smartphones at work:

  1.  

Google translate does not replace using an interpreter, but for occasional words or phrases it’s terrific, especially if you use the Voice or Conversation functions. 

Overcoming communication barriers often relies on creative solutions. If you can break the ice/engage the person using content you can access on your phone you absolutely would, wouldn’t you? 

In Australia the medication bible is MIMS. Having MIMS on your phone = being able to check on medication info quickly and easily wherever you are. There’s a free 7 day trial, then they’ll charge you $ome monie$ (I’m assuming/hoping it’s tax deductible for nurses, doctors and pharmacists). 

Mindfulness/stress-management can be much easier if there’s a framework and tools to guide you. The free and credible SmilingMind app does just that. 

Google maps is great for this sort of thing.

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

  1.  

Screening tools like the Edinburgh PND Scale don’t have to be paper-based. This one is on the Mediquations app. It calculates the score automagically, and the whole thing can be emailed to cut and paste into the electronic medical record, so the woman can track her changes/progress, and/or shared with others on the clinical team. 

In the last couple of years there has been a push towards making sure that people who experience suicidal thoughts have a safety plan. Some organisations have created forms for this sort of thing. That might be OK for the organisation, but how handy is it for the person? For most individuals it would be MUCH more handy having a shareable safety plan on your mobile phone. If you haven’t done so already, sus-out BeyondNow.

  1.  

I used to struggle with CPD documentation. With an app you can do it in real time, and readily access it PRN. I used to use the C4N app, but it was a bit clunky. The free Ausmed one is better. There are probably other CPD evidence-based record apps. Wouldn’t it be nice if ANMF and/or AHPRA provided their fee-payers with a free, easy-to-use, and fit-for-purpose CPD app? 

A previous blog post called “Phatic Chat: embiggening small talk introduced this example of how Google maps can help bridge cultural and language barriers by demonstrating interest, openness and respect. 

  1.  

I must have been away the day they told us about Klienfelter’s syndrome in nursing school. This app makes me sound much smarter than I really am. 

  1.  

Accessing info online (eg https://www.nmsupport.org.au) is a legitimate way for nurses to improve the safety of their practice and to support each other. Why on earth would nursing’s leaders want to restrict ready information access? 

Score

That’s the end of the list of a dozen real-life examples of how clinicians use their smartphone at work. Here’s the score: 

Digital Professionalism📱= 12
The Dinosaurs 🦕 = 0

Snippily Sarcastic Suggestion

Does your nurse manager, nurse educator, university lecturer or clinical facilitator need to know about this stuff? 

Here 👉 [click link to open] 👈 is a PDF version of this blog post that you can print and mail or fax to them. After all, we wouldn’t want to risk using a modern digital technology like email, would we? 🙄 

End

Do you have other examples of Digital Professionalism? Please feel free to add them in the comments section below. 

Thanks for visiting. 

Paul McNamara, 2 November 2019

Short URL: meta4RN.com/mHealth

APA citation:  McNamara, P. (2019, November 2). Digital Professionalism📱vs The Dinosaurs 🦕 [Blog post]. Retrieved from https://meta4RN.com/mHealth

The 12 tweets used above are collated here: wakelet.com/@metaRN

References 

O’Connor, S. , Chu, C. H., Thilo, F. , Lee, J. J., Mather, C. and Topaz, M. (2019), Professionalism in a digital and mobile world: A way forward for nursing. Journal of Advanced Nursing. doi:10.1111/jan.14224

Rolls, K., Massey, D. & Elliott, R. (2019). Social media for researchers – beyond cat videos, over sharing, and narcissism. Australian Critical Care, Volume 32, Issue 5, 351 – 352 doi:10.1016/j.aucc.2019.07.004

Addit 12 July 2020

Many thanks to Dr Siobhan O’Connor et al for acknowledging this blog post (dinosaur emoji and all) in their recently published paper, namely:

O’Connor, S., Daly, C., MacArthur, J., Borglinde, G. & Booth, R. (2020) Podcasting in nursing and midwifery education: An integrative review. Nurse Education in Practice. https://doi.org/10.1016/j.nepr.2020.102827

 

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

Conversations, not just citations, count: Social Media and the International Journal of Mental Health Nursing

This page serves as a place to collate the Prezi, YouTube video, abstract and list of references, data sources and visuals used for a presentation at the 44th ACMHN International Mental Health Nursing Conference.

Click on the pic to access the Prezi

Presenter Introductions

Paul McNamara is CNC with the Consultation Liaison Psychiatry Service at Cairns Hospital. Paul is also Social Media Editor of the International Journal of Mental Health Nursing.

Kim Usher is Professor and Head of School at the School of Health, University of New England. Kim is also Chief Editor of the International Journal of Mental Health Nursing.

Abstract

Traditionally the impact and reach of a specific journal article has been estimated through the measurement of how many times it is cited elsewhere in scholarly literature. Sometimes years could pass between conducting the original research, writing and refining drafts, submitting and reviewing manuscripts, the article being published, and subsequent researchers including this citation in their published reference list. The resulting time lag means that citations are a retrospective measurement of research impact.

There is however an alternative measure of research impact; a metric that is more immediate. This alternative does not rely on the passive hope that other people will see and share research findings, but allows interested parties to play a hand in generalised and targeted promotion of a published piece of research.

Charlene Li famously described social media not as a technology, but as a conversation (Israel, 2009). Now these online conversations can be quantified, and offer “real‐time” feedback to researchers/authors about the impact and reach of their published research.

In order to support these claims, we will provide an overview of the International Journal of Mental Health Nursing social media strategy. Altmetric data will be presented to demonstrate the measurable effects of this strategy. General information and specific examples will be shared so that researchers, authors, and the institutions that support their work, are exposed to strategies they could use to contribute to future Altmetric scores. In doing so, conference delegates who attend this presentation will be equipped with knowledge on how to improve the impact and reach of their publications on social media, and further their understanding of why this matters.

References, Data Sources + Presentation Visuals

Altmetric attention scores re top 5 IJMHN articles, data as at 18/09/18:

  1. Do adult mental health services identify child abuse and neglect? A systematic review https://wiley.altmetric.com/details/23964454
  2. Mental healthcare staff well‐being and burnout: A narrative review of trends, causes, implications, and recommendations for future interventions https://wiley.altmetric.com/details/30485876
  3. An integrative review exploring the physical and psychological harm inherent in using restraint in mental health inpatient settings https://wiley.altmetric.com/details/31986204
  4. Lethal hopelessness: Understanding and responding to asylum seeker distress and mental deterioration https://wiley.altmetric.com/details/17878566
  5. How many of 1829 antidepressant users report withdrawal effects or addiction? https://wiley.altmetric.com/details/43387887

Altmetric attention scores re IJMHN impact from July 2015 to June 2018, MS Excel spreadsheet data courtesy of Kornelia Junge, Senior Research Manager, Wiley.

Altmetric logo via https://www.altmetric.com/about-us/logos/ (retrieved 06/10/2018)

CrossRef data re IJMHN most-cited articles based on citations published in the last three years, via https://onlinelibrary.wiley.com/journal/14470349 (retrieved 04/10/2018)

Hootsuite logo via https://hootsuite.com/about/media-kit (retrieved 06/10/18)

IJMHN. (03/01/17). The @IJMHN 2017 New Year resolution is to refresh our Twitter home page and Tweeting practices. Watch this space! 🙂 [Tweet]. Retrieved from https://twitter.com/ijmhn/status/816202247604301824?s=21

International Journal of Mental Health Nursing, October 2018, volume 27, issue 5, cover image via https://onlinelibrary.wiley.com/doi/pdf/10.1111/inm.12395

Israel, S. (foreward by Li, C.). (2009). Twitter Ville: How businesses can thrive in the new global neighborhoods. New York: Portfolio.

Tweet activity examples as at 06/10/18

  1. Combining #eMentalHealth intervention development with human computer interaction (HCI) design to enhance technology‐facilitated recovery for people with depression and/or anxiety conditions Amalie Søgaard Neilsen + @RhondaWilsonMHN https://twitter.com/ijmhn/status/1036177022811340800?s=21
  2. Meeting the needs of young people with psychosis: We MUST do better Editorial by @Michael_A_Roche @debraejackson @KimUsher3 + Wendy Cross https://twitter.com/ijmhn/status/1033277919865593858?s=21
  3. Literature review of trauma-informed care: Implications for mental health nurses https://twitter.com/ijmhn/status/1029110510569091072?s=21

Twitter data re IJMHN activity from July 2015 to June 2018 via http://www.twitonomy.com/profile.php?sn=IJMHN (retrieved 20/10/18)

Twitter data re IJMHN impact from July 2015 to June 2018 via https://analytics.twitter.com/user/IJMHN/home (retrieved 09/10/2018)

Twitter logo via https://about.twitter.com/en_us/company/brand-resources.html (retrieved 06/10/18)

Video Version

The YouTube version of the presentation (slightly different to the conference version) can be viewed below and/or shared using this URL: https://youtu.be/vWSI3u4O2Bc

Presentation Tweets

Using Hootsuite, these Tweets using the conference hashtag (#ACMHN2018) were scheduled to be sent during the presentation. Look Mum! No Hands!

 

Citation

To cite this page:
McNamara, P. (2018). Conversations, not just citations, count: Social Media and the International Journal of Mental Health Nursing. Retrieved from https://meta4RN.com/count

To cite the presentation abstract:
McNamara, P. & Usher, K. (2018). Conversations, not just citations, count: Social Media and the International Journal of Mental Health Nursing. International Journal of Mental Health Nursing, Volume 27, Issue S1, Page 31 onlinelibrary.wiley.com/doi/full/10.1111/inm.12539

End

That’s it. Thanks for reading this far down the page. You’re probably the only one who’s bothered. 🙂

In keeping with the theme of the presentation, I’d be grateful if you share the page with your social networks.

As always, questions and feedback are welcomed via the comments section below.

Paul McNamara, 15 October 2018

Short URL meta4RN.com/count

Update: 20 October 2018

There was a flat spot in the original presentation where I struggled to convey clarity and sustain interest. In an effort to overcome this, I deleted a couple of slides from the original Prezi, modified another, and added the data/chart below. Thank you for your helpful critique and suggestions @StellaGRN.

Update: 27 October 2018

The Tweets that were scheduled to coincide with the presentation have now been embedded in the post.

Developing, designing and deploying a perinatal mental health referral pathway

Abstract

Mental health nurses have the skills to collaborate with primary health providers, work side-by-side with tertiary health providers, and provide support and information to those who experience mental health difficulties and their families. But how do we communicate this? How do we make it easy for referrers and consumers to find the ‘best fit’ for identified needs? How do we promote collaborative care? How do we reach our audience?

This poster presentation is the third iteration of a referral pathway that has undergone the usual quality improvement measures of consultation and review. The poster is also a showcase for collaboration: the content was gathered in collaboration with service providers and consumers; this information was then organised, revised and presented in collaboration with a graphic designer; the completed pathway was then deployed, reviewed and made accessible in collaboration with a web designer.

This perinatal mental health referral pathway does not purport to be a template for others, but may serve as one example of how to develop, design and deploy accessible information about local service options. The poster presentation hopes to serve as a starting point for those who are interested in articulating a service’s relationship to the consumer and other agencies. The poster also demonstrates a clinically relevant use for Quick Response (QR) Code – please bring your smart phone if you intend to view the perinatal mental health referral pathway.

NB: This 2011 Version is redundant. NOT for clinical use. Please use only as an example.

Printable/downloadable PDF version here: referralpathwayworkflow2011

Reference/Citation

McNamara, P., Horn, F. & Dalzell, M. (2012) Developing, designing and deploying a perinatal mental health referral pathway. Poster presented at ‘The fabric of life’, the 38th Annual International Conference of the Australian College of Mental Health Nursing, Darwin. http://dx.doi.org/10.1111/j.1447-0349.2012.00878.x

or, if you want to cite/see the journal entry

McNamara, P., Horn, F. & Dalzell, M. (2012) Developing, designing and deploying a perinatal mental health referral pathway. International Journal of Mental Health Nursing, volume 21, issue S1, pages 16-17. http://dx.doi.org/10.1111/j.1447-0349.2012.00878.x

Notes

This flowchart first began to be mapped-out in 2010, the version above was finalised in November 2011, and presented at a mental health nursing conference in October 2012. The workflow and the position that developed/supported it became redundant in 2013.

My versions were smudged pencil on paper versions. Freya Horn, now working as Graphic Artist at www.designerinyourpocket.com.au, turned it into the legible and attractive flowchart you see above. Thanks Freya!

There is some optimism about money flowing back in to perinatal mental health services in Australia. With that in mind, I’m releasing this old work from my USB drive to my website. Hopefully it will save others wasting time “reinventing the wheel”. Updating the wheel will be required, of course, but there’s no need to start from scratch. 🙂

Just to reiterate: This 2011 Version is redundant. It is NOT for clinical use. Please use only as an example for how you/your local service may want to might develop a map of the local referral pathway and workflow.

End

That’s it. Hopefully this will be of interest/use to someone in future.

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

Paul McNamara, 14th June 2018

Short URL: meta4RN.com/pathway

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:

1.

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.

8.

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

Obesity: Personal or Social Responsibility

On 22/05/13 Joseph Proietto presented the keynote “Obesity: Personal or Social Responsibility?” at the International Council of Nurses 25th Quadrennial Congress.

The hashtag #ICNAust2013 took the session beyond the conference walls via generous nurses tweeting with wit and wisdom. [Thanks!]

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 can add value to Twitter content
  4. How nurses can be simultaneously generous, incisive and funny

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Explanation

These Tweets were initially compiled using a social media aggregation tool called Storify
storify.com/meta4RN/obesity-personal-or-social-responsibility

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.

This page is a companion piece to the October 2016 page meta4RN.com/obesity 

End

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

Paul McNamara, 1st April 2018

Short URL: meta4RN.com/ConfTweets

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

Stay connected, stay strong… before and after baby

Copy of Stay connected, stay strong… before and after baby DVD on YouTube (33 minutes):
Update as of 12/10/16: video deleted as requested (scroll to bottom of page for further info).

From the back cover of the DVD:

StayConnectedPregnancy, birth and parenting can be a very positive time, but sometimes it may not be how you expected it to be. Adjusting to life as a mother can be hard and make women feel down and distressed. In Australia, one in every six women experience depression during this time.

This DVD has been created to support Indigenous women, men and families understand the importance of good social and emotional wellbeing during pregnancy and beyond.

Going to get help might feel like the hardest part, but it is the best thing you can do for yourself, your baby and your family. Getting help early gives the best chance of a strong and healthy future.

YouTube URL: http://youtu.be/CLsjgw8pvOA

.

Why is the Video Online?

The video is online so that it can easily reach the target audiences: Aboriginal and Torres Strait Islanders families, and those who support them. It is a great little video: not only does it have a very clear message that there’s no shame in asking for a bit of support, but it also looks and sounds great. My favourite thing is how the narration by Jasmin Cockatoo-Collins ties the whole thing together: even though a couple of dozen people appear on camera, Jasmin’s voice weaves the whole thing together so it kind of seems like one story. Well done to Jasmin and film-maker Jan Cattoni (Jan’s a nurse who became a film-maker).

Knowing that the video is so good that it should be shared is one thing, getting it shared is another.

Stay connected, stay strong… is available for free in Queensland and for $20 elsewhere, all you need is this PDF order form from the Queensland Centre for Perinatal and Infant Mental Health:

Click to access resource-order-form.pdf

youtube---the-2nd-largest-search-engine-infographicFar North Queensland residents can borrow the DVD from Cairns Libraries: link.

Queensland Health staff can access the DVD through the Queensland Health Libraries Catalogue: link

However, as accessible as all that sounds, the truth of the matter is that YouTube is the world’s largest video-sharing portal and the world’s second largest search engine. A video is not really accessible until it is online.

Now we can share the video using this link: http://youtu.be/CLsjgw8pvOA

Eek!

This is by far the riskiest thing I’ve done with my professional social media portfolio. I am not the copyright holder of this excellent short film: the Queensland Government is. Although I won’t make any money out of hosting the video, I might be subject to legal action. If there is a credible threat of legal action I will take the video down immediately. Another risk is that I might be inadvertently causing offence or distress to some person or organisation. This may mean that I will not be considered for future work in perinatal and infant mental health (perhaps funding for services will return to pre-July 2013 levels one day).

So, why take these risks?.

My agenda is simple: to demonstrate that social media can be leveraged as another channel for health promoting information. It’s something I started when working in perinatal and infant mental health in October 2011, as evidenced by this from my now-mothballed Twitter handle @PiMHnurse (now I use a less job-specific name: @meta4RN).

PIMHnurse

 

My big hope is that hosting Stay connected, stay strong… before and after baby won’t get me in too much trouble, but will serve as a spur for a more legitimate stakeholder to host the video on their YouTube or Vimeo site.

When that happens I will update this blog post.

End

That’s it. I’m feeling scared now.

Paul McNamara, 8th June 2014

Important Update 12/10/16

The copy of Stay connected, stay strong… before and after baby that was uploaded to YouTube in June 2014 has now been deleted. Today I was advised that I was breaching copyright, and was requested to take the video down ASAP. In the 28 months that the video was available on YouTube it was viewed 280 times.

stayconnectedstaystrongscrenshot

I’ll add a link if an official online version becomes available.

My intention in knowingly posting a video that I am not the copyright-holder of was to act as an agent of change. If I have caused harm or distress to any person or organisation I am genuinely sorry. That was not my intention.

Paul McNamara, 12th October 2016

Luddites I Have Known

In the never-ending quest to enthuse midwives and nurses about professional use of social media I’ve talked to people about it, given inservice education sessions, demonstrated is use as an adjunct to education, facilitated workshops, submitted conference posters, contributed to journal articles and have been invited to speak at conferences. To spread the word I’ve taken the risk of being called geek wanker narcissist, and even had cards printed:

BusinessCard4

When I talk to people about health care social media, I always mention how it lets information be shared quickly and easily,  and network with people from a range of professions/walks-of-life from all around the world. However, the thing I value the most and try to emphasise the most, is the participative, interactive nature of social media. Social media is where the debates are held; those of us who want to influence and participate in decisions gather and test our ideas on social media. Twitter is especially good for this: it lets anyone join in and contribute to- and be enlightened by- the contest of ideas.

To see how Twitter works to share information and the contest of ideas, see these two recent examples (click on the pics to see the complete conversations unfurl):

In health and education roles I encounter many people who give dumb blanket statements like, “I will never use Twitter – I don’t care what Justin Bieber had for breakfast”. Much to my embarrassment, this is the sort of thing I hear nurses (especially those in positions of influence and power) say all the time. These people are so stubborn that they won’t even look, listen or learn about professional use of social media.

A few months ago two Australian nurse lecturers forthrightly and very confidently told me that Twitter and facts are (somehow) mutually exclusive, and they do not and never will use it. I tried being zen about the whole thing (water flows around resistance, rocks in the stream shift or erode), and celebrated some of the nurse academics who are more enlightned about health care social media (see storify.com/meta4RN/lecturers).

However, the same thing keeps happening: people in positions of power and influence in the health care and higher education systems are still using silly, uninformed, blanket statements to decry the use of social media and warn people off from using it.

No more Mr Nice Guy – I’m calling these people what they are: Luddites.

People being resistive to new technologies and innovations is not new, and in my lifetime I have seen that change is inevitable – the luddites and laggards will catch-up eventually.

In the 1970s I knew people who refused to play video-games like Space Invaders – “No it’s too confusing, I’m sticking with the pinball machine” said my friend when we went into the pinball parlour.

In the 1980s I knew people who refused to use ATMs (automatic teller machines) – “No, you can’t trust a little card and machine. I’ll wait until the bank opens on Monday.” said my relative.

In the 1990s I knew people who refused to use computers. Every now and then I still hear people say, “I don’t believe in computers” as if computers are akin to the tooth fairy or religion.

In the 2000s I knew people who refused to use a mobile phone, “Why would I ever need one?”, people would say. Now, in Australia, there are more mobile phones than people (for more info: meta4RN.com/mobile).

In the 2010s I know people who refuse to use social media. As evidenced by the “I don’t need to know what Justin Bieber had for breakfast” type of statements, the reason they don’t use it is twofold: [1] they do not understand it, and [2] they decline the opportunities to learn.

I guess I should be patient with my resistive colleagues – history shows that they’ll come around eventually. However, for those nurses and midwives in positions of power and influence, I’m hoping people will print and fax you a copy of this picture below. If  you can’t summon the willingness to learn about professional health care social media, please summon the dignity and sense to stop critiquing something you do not understand.

luddites

PDF version (suitable to print and fax to a social media denier of your choosing): Luddites

As always, your comments/feedback is welcome.

Paul McNamara, 3rd May 2014

 

 

 

Zero Tolerance for Zero Tolerance

photoA while ago I wrote about my most frightening workplace experience in a post called “Emotional Aftershocks“, which included a section titled “Zero Tolerance is Unrealistic and Unfair”.

Today, via a Tweet by Nicky Lambert I am reminded of how ridiculous the “Zero Tolerance” approach in hospitals is and (more importantly) have been introduced to an evidence-based alternative strategy that has recently been launched in the UK. To cut-out the middle-man and go straight to source of this pretty-cool strategy, click on the link: www.abetteraande.com

To subject yourself to my ideas and waffle, please read on…

What’s Wrong with Zero Tolerance?

A dumb, shouty poster.

A dumb, shouty poster.

It is inevitable that health services, hospitals especially, will have a large percentage of patients who have cognitive and perceptual deficits due to the very medical condition that has them bought them to the health facility in the first place. About 9% of the over-65s (a significant component of health service users) have dementia. Often these people will not have the cognitive capacity to discriminate between friend and foe, and will, at times, lash out to defend themselves against a perceived threat. All the shouty “Zero Tolerance” signs in the world will not make a difference to this. Why would we want to create a false expectation for staff?

As an aside, during the week I made use of Australia’s Dementia Behaviour Management Advisory Service (DBMAS) regarding strategies to use with a nursing home resident who had been aggressive. I found the service to be very user-friendly and helpful – if you provide care to people with dementia you should keep DBMAS in mind: dbmas.org.au

Huh? Of course people will get angry: it is an unavoidable, natural human emotion.

Huh? Of course people will get angry: it is an unavoidable, natural human emotion.

The “zero tolerance” concept is unfair because it is not reciprocated. We (that’s “we” as in “we the health system”) require patients and their loved-ones to be incredibly tolerant of us. Think waiting lists, physical discomfort, unplanned delays, unclear communication, unmet expectations, cancelled procedures, lack of privacy, lack of dignity, lack of control, lack of compassion, lack of progress… the list could go on. Can you find me a health facility where no patient has ever experienced these things?

Our health system relies on people being tolerant. This “zero tolerance” malarkey doesn’t allow for the reality that people in hospital are often having the most traumatic, frightening and disempowering day(s) of their life. It would be lovely for staff if everyone experiencing acute emotional distress expressed their emotions in a clear, calm and composed manner, but is it realistic?

A Smarter, More Sophisticated Approach

We need a smarter, more sophisticated way to manage difficult emotions in the health care setting. “Zero Tolerance” is jarringly out of step with the nurturing, caring, compassionate, altruistic qualities that most health professionals identified with when choosing their career. We need a new set of posters that are attuned to the needs of patients and the aspirations of health services and clinicians.

Of course, it’s not just posters on the wall that determine the quality and tone of the conversation. All health care workers should have an opportunity to reflect on their practice in a safe, structured way. As I’ve written about before (in “Nurturing the Nurturers“) clinical supervision (aka guided reflective practice) allows this to happen. There is an abundance of evidence that clinical supervision improves management of difficult encounters in health care settings – we should insist on it.

Nevertheless, posters and signage can play an important part in setting clear expectations. Just as they’re doing in UK accident and emergency departments, let’s take a proactive approach to preventing and managing distress. Part of that strategy should be moving way from the authoritative, uncompromising and negative campaigns of the past, to one that demonstrates and models respect.

putyourhandup

This poster is my suggestion of the how we should set the parameters. Let’s not try to shut-down people from expressing distress. Instead, let’s invite patients and relatives to articulate their concerns before the emotions become so intense that they are difficult to contain.

Here’s the script to my poster:

Put your hand up and talk to us.

We don’t want you to feel distressed.

If you are feeling upset, frustrated or unsure about what’s happening please don’t bottle-it-up: talk to us.

One of the nurses, doctors or other hospital staff will listen to your concerns and try their best to help.

pdficonPDF version of the poster here: putyourhandup

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Acknowledgement

Some of the ideas here are taken from and/or informed by a keynote presentation by Professor Eimear Muir-Cochrane at the ACMHN 39th International Mental Health Nursing Conference, held in Perth, Western Australia, 22nd-24th October 2013. Some of the Tweets from that presentation have been collated here: storify.com/meta4RN/zero

What would your poster say?

Please feel free to share your ideas in the comments section below.

Paul McNamara, 7th December 2013

Mental Health Nurses in the Pacific (to be specific) #alajcu2013

A Cool Event

There was 441 years of experience in health care at the Perinatal and Infant Mental Health Workshop, just one part of the month-long event supporting mental health leaders from six Pacific Island nations.

There was 441 years of experience in health care at the Perinatal and Infant Mental Health Workshop, just one part of the month-long event supporting mental health leaders from six Pacific Island nations.

A really cool event happened in Cairns from July 1st to 26th. James Cook University’s School of Nursing, Midwifery & Nutrition hosted eighteen Mental Health Nurses from Western Pacific nations; specifically, Papua New Guinea, Fiji, Palau, KiribatiCook Islands and the Solomon Islands. Funded via an AusAID Australian Leadership Award, leaders in mental health nursing from these countries had the opportunity to attend lectures, participate in workshops, make site visits to public and private mental health facilities, and other activities aimed at providing educational opportunities they may not be able to acquire at home.

This “train the trainer” approach to supporting mental health nurse education amongst our neighbours in the Pacific is a really smart idea: major kudos to Professor Kim Usher and the whole team at James Cook University’s World Health Organisation Collaborating Centre and School of Nursing, Midwifery and Nutrition. For more info about the program please visit these sites:

Also, it is interesting to read this interview with Jeffrey Alphonse, a mental health nurse from Papua New Guinea who attended the course. Jeffrey conveys a sense of life living and working in in a PNG mental health inpatient facility.

I am sure that the JCU crew have evaluations of the event that will probably pop-up in reports/journals/online soon enough. That’s the sort of thing researchers are really good at.

OK. What’s This Blog Post About Then?

For this blog post I just want to touch on two cool outcomes from my perspective: the perspective of one who was not an organiser or “insider” to the event, but not a complete outsider to the event either.

It was an honour to be invited to meet with the Mental Health Nurses from the Pacific for two occasions. The first visit was an opportunity to introduce my role and compare/contrast the way mental health nurses are deployed in Australia and in the Pacific. Something I learnt is that it is easier to have nurse-led programs in Pacific nations because, to put it bluntly, there are often no other mental health professionals available.

There was 441 years of health care  experience at the Perinatal and Infant Mental Health Workshop on 12/07/13.

There was 441 years of health care experience at the Perinatal and Infant Mental Health Workshop on 12/07/13.

The second visit was to facilitate a Perinatal and Infant Mental Health (PiMH) Workshop on 12th July. The workshop was different from the usual ones I run because of the vast amount of diverse cultural and clinical experience in the room. Obviously, the vast majority of the participants were mental health nurse leaders from the six Pacific Island nations listed above, but a couple of social workers from the FNQ Medicare Local and a JCU Student Nurse also participated, and some of the JCU Faculty were also able to pop-in for a while.

I have mentioned the structure of the workshop in a previous blog post (see here). Although this workshop had plenty of differences in participant experiences (great learning for me!), the content/agenda we covered was pretty-much the same as previous PiMH workshops, just presented in a slightly different manner.

The workshop contributed to the first of the two cool outcomes.

Cool Outcome Number One: Perinatal and Infant Mental Health in the Pacific Islands

Cool outcome number one is that the workshop content really resonated with some people attending; so much so that they’re intending to take some of the learnings from the workshop back home with them. I found out about this via Anna Cole-Groth, a JCU student nurse who supported the Pacific Island mental health nurse leaders, and contributed to extending the reach of event by utilising social media (as per these examples below):

Solomon

A few of the participants, including Rose from the Solomon Islands, were interested in the way we have been trying to build mental health screening and support pathways into the day-to-day practice of antenatal and postpartum practice. The notion of a prevention/early intervention, proactive “precovery” approach to perinatal mental health care was welcomed as a way to work in partnership with families, communities and other health professionals.

PNG

The workshop was the first introduction to infant mental health for most of the participants, and had particular resonance with some in attendance. The workshop allowed us to discuss and consider some of the key concepts around infant mental health practice, and to give consideration to how it could be incorporated into healthcare in the Pacific Islands. Many participants, including those from Papua New Guinea, spoke of how it could enhance the way mental health and baby care is catered for in community-orientated village life.

It is fantastic to know that some of the perinatal and infant mental information and models of care we have been using here in Australia might have a positive, knock-on effect with our two closest neighbours: Papua New Guinea and the Solomon Islands. For me personally and professionally, after feeling quite dejected about the loss of a role funded by the National Perinatal Depression Initiative (NPDI), it is an unexpected and very welcome joy to think there may be an echo of the program I facilitated amongst our northern neighbours, via a grassroots, nurse-led, undertaking to trial some of these ideas.

We (those of us who have had access to education and resources in this area) should do everything we can to support these mental health nurse leaders. I hope that the Pacific Islanders will find the email network hosted by the ACMHN (Australian College of Mental Health Nurses) a useful bridge to information, resources and supportive, encouraging peers. Subscription to the Perinatal & Infant Mental Health Nurse eNetwork is free and simple; more info and instructions here and here.

Cool Outcome Number Two: Social Media and Wantoks

“Wantok” is pidgin for “one talk” (say it quick: it’s phonetic), ie: a shared language. In places like Papua New Guinea and the Solomon Islands the use of the word wantok is in context of a nuanced social system that I (a whitefella from Adelaide living in Cairns), may ever fully understand. So, for my benefit, let’s simplify the use of “wontok” to simply “those who share a common language”, as in “those who understand and like each other”.

Mental health nurses, no matter what nation they live and work in, share the common experience of up-close and personal interactions with people experiencing mental illness. Most of us also share the goal/hope that we will find effective ways to promote good mental health, so as to lighten the load for individuals, their families and the community they live and work in. This gives us a shared language: we’re wantoks.

Evan Casella, another JCU student nurse who supported the program participants and used social media to share some of the program content, sent out this great photo with the tweet:

#alajcu2013 participant opinions of SoMe use in nursing. Great to get a South Pacific perspective. Mostly thumbs up!

like

It’s such a good photo – I love the way Evan used the Facebook “like” symbol, and that the participants were straight down the line with whether they thought social media (aka SoMe) would be useful in their context. This, in turn, led to the next cool outcome: three of the program participants joined Twitter before the course ended.

So, although the four-week Pacific Island Mental Health Nurse Leaders program is over, it is easy to stay connected with some of program participants using social media.

If you are a mental health nurse who can share information, resources, ideas and camaraderie, please follow these mental health nurses from PNG: they are your Wantoks.

For those interested in professional use of social media, have a look at the transcript and analytics of the #alajcu2013 hashtag courtesy of www.symplur.com

Analytics via Symplur health hashtag project

Analytics via Symplur health hashtag project

Closing Remarks

Mental health health nurses speak one language; we are wantoks. How do we know? By the connections. As shown above we connected content (perinatal and infant mental health is one example) and we connected clinicians (in person for four weeks, and looking ahead via Twitter).

Congratulations to James Cook University and AusAID for the work that they have done.  Now it is time for mental health nurses and others interested in perinatal mental health to continue the work by sharing information, resources and camaraderie with mental health nurses from Pacific Island nations: they are our wantoks.

Cool Connections (via Twitter)

PNG Wantoks:

JCU Wantoks

Paul McNamara, 31st July 2013