Tag Archives: mental health

#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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Setting The Tone.
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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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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

@WePublicHeath

For the week Monday 27th January to Sunday 2nd February 2014 I was able to use the @WePublicHealth Twitter handle, thanks to the generosity of Melissa Sweet (aka @croakeyblog).


Here’s what happened:

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Explanation

These Tweets were initially compiled using a social media aggregation tool called Storify
storify.com/meta4RN/wepublichealth

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

 

A big shout-out to Melissa Sweet. I am very grateful to Melissa for inviting a mental health nurse to have a stint on @WePublicHealth.

Melissa is a rockstar of public health and health social media in Australia. If you’re not familiar with her work read-up about Melissa here, and “croakey“, the social journalism project of which she is the lead editor, here. More info re @WePublicHealth, the rotated curation Twitter account that Melissa coordinates, here.

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

Paul McNamara, 2nd April 2018

Short URL: meta4RN.com/WePublicHealth

Stay Connected, Stay Strong

“Stay connected, stay strong… before and after baby” is a really cool DVD featuring Aboriginal and Torres Strait Islander parents. Using social media (YouTube, Facebook, Twitter, Instagram and WordPress) I’ve promoted the video with the goal of improving access to it.

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Explanation

These Tweets were initially compiled using a social media aggregation tool called Storify
https://storify.com/meta4RN/stay

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

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

Paul McNamara, 11th March 2018

Short URL: meta4RN.com/connected

A Conversation about Documentation in Consultation Liaison

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

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

Question from regional Queensland 06/02/18

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

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

I think that’s dangerous.

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

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

Response from Melbourne 06/02/18

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

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

Response from Melbourne 06/02/18

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

Response from regional Northern Territory 06/02/18

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

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

Response from Perth 06/02/18

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

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

Response from regional New South Wales 06/02/18

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

Response from Adelaide 06/02/18

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

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

Response from Brisbane 06/02/18

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

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

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

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

Response from Brisbane 06/02/18

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

My concerns are:

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

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

how do any recommendation get carried over?

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

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

Response from regional New South Wales 07/02/18

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

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

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

Response from regional New South Wales 07/02/18

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

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

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

Response from regional Queensland 07/02/18

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

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

Response from Melbourne 07/02/18

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

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

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

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

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

This thread is particularly useful, thank you!

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

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

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

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

Response from Melbourne 07/02/18

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

Simple.

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

Response from Sydney 09/02/18

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

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

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

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

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

Response from regional Queensland 09/02/18

Thanks to everyone for your generous and thoughtful responses.

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

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

The title will make for a good rap refrain.

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

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

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

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

End

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

Consultation Liaison Nurses.
Isolated Geographically. Connected Electronically.

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

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

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

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

Paul McNamara, 20th February 2018

Short URL: meta4RN.com/documentation

Phatic Chat: embiggening small talk.

Small talk is a big deal.

Small talk is the oil that keeps the machinery of interpersonal relationships running smoothly.

Small talk even has its own name. It’s called “phatic chat”.

Phatic chat has been described as “A type of speech in which ties of union are created by a mere exchange of words”  by Bronislaw Malinowski (no relation to Barry Manilow). This is why I think it’s important that us health professionals be intentional about phatic chat.

Every, “Hello. My name is…” and “How are you today?” serves to create a working relationship between people. Health professionals rely on working, therapeutic relationships.

Academics (god bless their cotton socks) have even gone to the effort of researching and naming 12 functions of phatic communication (source):

(1) breaking the silence
(2) starting a conversation
(3) making small talk
(4) making gossip
(5) keeping talking
(6) expressing solidarity
(7) creating harmony
(8) creating comfort
(9) expressing empathy
(10) expressing friendship
(11) expressing respect
(12) expressing politeness

When we think about phatic chat in the health care setting, it’s not just a social lubricant, we can also see it as a stand-alone form of therapy. Think of phatic chat as the nonspecific factors of psychotherapy

BTW: “nonspecific factors of psychotherapy” an actual thing, let me google that for you: here

Phatic chat/the nonspecific factors of psychotherapy show the person that there is someone who is interested in them and their concerns. It helps people feel understood, accepted and respected. In my current gig – providing mental health support in the general hospital – I often get told by patients how good it is to be nursed by someone who is good at phatic chat.

It’s easy to imagine, isn’t it? Who would you rather attend to your vital signs, IV antbiotics, wound dressings, and pain relief in hospital: a friendly person who chats and listens, or someone unfriendly and officious who just goes about the tasks at hand? There’s more than one way to prime an IV line.

It sounds simple, and (to my ear anyway) pretty patronising. However, it’s clear that many clinicians do not routinely engage in phatic chat.

You may already know the story of Kate Grainger. Briefly, for those who don’t, Kate was a doctor in the UK who tweeted her experience of living with a terminal illness. One of the many observations she made was that it was refreshing, but actually pretty unusual, for hospital staff to introduce themselves by name and role when they came to see you in your hospital bed. That observation lead to this tweet:

That simple idea has been one of Kate’s greatest legacies (she died in 2016).

If you’re not familiar with the #hellomynameis story, I urge you to visit the hellomynameis.org.uk website for more info.

#hellomynameis = a very successful campaign promoting phatic chat in healthcare

I live and work a long way from the UK. Although I don’t wear a #hellomynameis badge, I borrow heavily from the idea that phatic chat is important, and toss-in a few more Aussie-fied ways to go about using it in the hospital setting. As argued above, phatic chat is important for building relationships and can be therapeutic in and of itself. Sometimes to be culturally safe you need to try a little harder to facilitate trust and rapport. With that in mind. here’s 4 ideas that usually (not always) work for me:

One

“Are you Cyril? G’day my name is Paul McNamara, I’m a nurse with the psych team here at the hospital. Is it OK if we sit down and have a bit of yarn?”

Two

Shaking hands is a respectful thing to do. I always offer a handshake when introducing myself to patients (they’re often surprised!).

Don’t worry infection control peeps, I’ve got that covered: meta4RN.com/hygiene

Three (this is my second favourite: I stole it from Professor Ernest Hunter)

Make a cup of tea for the patient. Even if they say “no thanks”, let them know that you’re making one for yourself anyway, so are happy to make them one while you’re at it. Take instructions on how the person likes it . Apologise if you make it too hot/strong/weak or spill it. Sip yours when they’re talking: if for no other reason, it let’s them know you’re not about to interrupt.

This might be the best journal article ever written by a psychiatrist:
Hunter, E (2008) The Aboriginal tea ceremony: its relevance to psychiatric practice. Australasian Psychiatry, 16:2, doi: 10.1080/10398560701616221
Despite the paper’s title, the same demonstrations of humbleness, politeness and respect work for whitefellas too.

Four (this is my favourite: I made this one up myself)

I nearly always use when Google Maps when introducing myself to people who have come to the hospital from out of town. “Oh you’re from Aurukun? I’ve been to Wujal Wujal, Laura and Hope Vale, but I’ve never been there. Do you mind if we use this map on my phone to see where you live?” It’s nearly always a great way to break the ice, especially when meeting with someone from a different culture. It sets the right tone of showing that you’re interested and approachable.

I’m lucky to work in a place where I meet with Aboriginal and Torres Strait Islander people all the time. By getting the Aboriginal/Torres Strait Islander person to show me around their community on a map, I’m acknowledging/demonstrating that they know stuff that I don’t know, and I’m prepared to learn from them. Sometimes I’m a bit more skilled at using the Google map app on my phone, so I get to show the person how I can be helpful, in a kind and respectful way. It probably doesn’t hurt that we’re both looking at the map together and working on the same task (it demonstrates that we can work together, and you don’t want to rush into making a heap of eye contact with someone you’ve just met). While we’re using the app to find their house, the local school, favourite fishing or camping spot, and other landmarks we’re getting to know each other a bit. I’m not left in that clumsy position of being accidentally too pushy, too intrusive, too task-orientated.

Spending a few minutes establishing rapport is what phatic chat is all about. The phone/map app is just a prop, but it’s a great prop.

In Closing

That’s it.

A while back I had a gig educating uni students. One of the best tricks-of-the-trade when in a uni lecturer role is to introduce people to words they have not heard before. This makes you look cleverer than you really are, and lends an illusion of credibility.

So, with that in mind, my call-to arms for health professionals is this:

Let’s embiggen phatic chat!
It’s a perfectly cromulent thing to do. 🙂

Acknowledgement

The phrase/notion of “phatic chat” as a defence against the forces that seek to turn nurses into unempathetic box-ticking robots came to my attention via Professor Eimear Muir-Cochrane’s keynote presentation at the ACMHN 39th International Mental Health Nursing Conference, held in Perth, Western Australia, 22nd-24th October 2013.

Storify of the keynote here: storify.com/meta4RN/zero

Follow Professor Eimear Muir-Cochrane on Twitter here: @eimearmuirc

End

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

Paul McNamara, 12th October 2017

Short URL https://meta4RN.com/phatic

 

 

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

Blatant Self-Promotion

Ever written an article about yourself as an act of blatant self promotion?

I have. Here it is:

ijmhn-photo

Paul McNamara, photograph by Vera Fitzgerald

Cairns Nurse on Journal Editorial Board

Cairns CNC Paul McNamara has recently been appointed to the editorial board of the International Journal of Mental Health Nursing (IJMHN). IJMHN is now in its 26th volume, and has built a solid reputation over the last quarter century. The journal’s impact factor of 1.943 is a great achievement.

Paul was specifically invited to join the board to help develop and drive a social media strategy for IJMHN. “I’ve been very active in using social media in a professional sense for the last few years, and have presented at conferences and published about health professionals using social media.”, says Paul. “I guess that’s what caught the attention of the IJMHN Editor in Chief.”

“Twitter is my favourite platform for work-related social media. I think it will be the best fit for IJMHN. Twitter allows information to be shared with the whole world. If it’s good enough for the Pope, the US President and the Australian Prime Minister, maybe it’s good enough for mental health nurses too.”, joked Paul. “Twitter is where the influencers are. As US marketing guru Charlene Li said, ‘Twitter is not a technology. It’s a conversation. And it’s happening with or without you.’ It’s a professional trait of Mental Health Nurses to want to be part of the conversation.” When asked about other social media platforms, Paul said, “We’ll keep an eye on what develops: nothing is static on the internet. Facebook is too big to ignore, so we’ll certainly have a look at smartening-up IJMHN’s presence there too.”

Traditionally the success or failure of a journal article was measured by citations. The only way authors/researchers knew if their work was being read was when other authors referenced their paper. Now that IJMHN is purely an online publication (with an iPhone/iPad app), there is another metric that can be used – how often the article is shared on social media.

Social media can help drive visibility and brand awareness of the journal, and raise awareness of Mental Health Nursing’s work and contributions. For the first time in history, nurses have unmediated access to the public conversation via social media. “Social media provides a terrific opportunity for all health professionals to share and acquire information. It’s a fun way to do professional development.”, Paul said. “It’s also a good way to let people know who we are and what we do.” When asked for a recommendation about using social media, Paul said, “Just be aware that some of your patients, some of your colleagues, and some of your managers will Google your name. Make sure you’re in control of what they’ll find. Don’t be afraid. Be intentional. Make your digital footprint your CV.”

Paul’s professional digital footprint is built around the homophone “meta4RN”, which can be read as either “metaphor RN” or “meta for RN” – try Google or go to meta4RN.com to see what it’s all about.

And follow @meta4RN and @IJMHN on Twitter!

End

This blatant piece of self-promotion could possibly also be included in a newsletter/magazine, but it’s one of those publications that’s organisation/member-specific. That means only a certain group of people will see it, and it will remain unknown to those not part of the organisation. A bit secretive, eh?

Maybe a modern reworking of the biblical “don’t hide you light under a bushel” thing could be, “don’t just do stuff – blog about it!”

Or maybe not.

As always your comments/feedback is welcome below.

Paul McNamara, 9th January 2017.

Short URL: https://meta4RN.com/IJMHN