Tag Archives: mental health

Snow White, Complex Trauma and Twitter

On Tuesday 4th December 2018 Naomi Halpern’s workshop “Working with Complex Trauma: The Snow White Model” was delivered at the Royal Brisbane and Women’s Hospital. I was amongst the small group of mental health nurses and social workers who joined the workshop via videoconference from Cairns Hospital. Here are my notes/tweets:

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What’s all this then?

Some people take notes in workshops using ye olde method of pen and paper. I’m not criticising – pen and paper are cute and quaint. But how on earth do they find their notes quickly and easily after the workshop has ended?.

I tweet my notes. They’re quickly and easily retrieved via phone, tablet or computer at anytime. Sometimes, if the presenter is OK with it, I collate workshop/conference tweets and plonk them all on my webpage for even quicker and easier future reference. That’s what this is all about.

Also, sometimes I have trouble explaining to other health professionals why I’m enthusiastic about Twitter for work-related stuff. It’s easier to show examples of how I use it, rather than just chin-wagging and flapping-about like a chook in a cyclone.

End

Sincere thanks to Naomi Halpern (aka @halpernnaomi1) for an engaging, informative workshop. For a single person to hold the attention and interest of those of us who were joining via videoconference for a whole day is very impressive. Also, I’m grateful to Naomi for agreeing to my request to collate these tweets here.

That’s it. As always, your feedback is welcome via the comments section below.

Paul McNamara, 8th December 2018

Short URL: meta4RN.com/SnowWhite

Your Ordinary is Extraordinary

“I have come to learn that it is fundamental for mental health nurses to establish relationships of trust and provide care to people who are in need, setting aside any bias or prejudice. What this means is that, as mental health nurses, you are championing human rights on a daily basis by simply doing your jobs. It must seem so ordinary to you as you go about your lives, but your ordinary is extraordinary.
Sharina Smith
Communications and Publications Officer
Australian College of Mental Health Nurses
September 2018

Cite in text
(Smith, 2018. p. 2)

Cite in reference list
Smith, S. (2018, September). Welcome. ACMHN News. Spring 2018 edition. Australian College of Mental Health Nurses: Canberra.

Context

I was flicking through the most recent edition of ACMHN News, themed “mental health and human rights”, one last time before consigning it the recycling bin. Sharina Smith is editor of the publication, and always offers a short “welcome” column introducing the content. Stopping my trip to the bin, the three sentences quoted above jumped off the page.

It’s instructive to have someone from an unrelated field (in Sharina’s case marketing and communications), examine mental health nursing through their lens of education and experience. Sharina’s comments shine a spotlight on an incredibly important part of our work that we often take for granted.

Just as the paper of the magazine deserves to be recycled, so do Sharina’s observations about human rights and mental health nursing. That’s the purpose of liberating the excerpt above from the printed page to the internet.

End

Sincere thanks to Sharina Smith, and all the office staff at ACMHN. Your ongoing support of Australian mental health nurses is very much appreciated.

Find out more about ACMHN here: www.acmhn.org

Paul McNamara, 10 November 2018

Short URL meta4RN.com/ordinary

#ACMHN2018 on Twitter

Information from and about ACMHN’s 44th International Mental Health Nursing Conference went well beyond the walls of the Cairns conference venue, and bounced around the world via social media.

Over the week of the conference more than 320 separate Twitter accounts used the #ACMHN2018 hashtag. There were over 2,750 tweets. 40 or so (less than 50, anyway) of the conference delegates, keynote speakers and sponsors were using the #ACMHN2018 hashtag – the content they generated was shared by over 250 people not in attendance. Many thanks to the relatively small percentage of conference participants who have amplified mental health nursing’s voice and values.

Free access to the #ACMHN2018 data and content is online,

One last thing. People are already talking about next year’s conference in Sydney using the #ACMHN2019 hashtag. Will you be part of the conversation?

End

That’s it. I’ve done detailed dissections of conference tweeting previously. This time I’m just dropping the info that was published in the ACMHN “Tuesday Times” on 30/10/18.

Short and sweet. 🙂

If you’re after more info about the conference content, I suggest that you browse the #ACMHN2018 tweets via this link, or the conference abstracts via this link.

Paul McNamara, 31 October 2018

Short URL: meta4RN.com/ACMHN2018

 

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.

Diagnostic Overshadowing

Source: I had a black dog, his name was depression https://youtu.be/XiCrniLQGYc

I work in a general hospital doing mental health clinical work and education. The two roles overlap. A lot.

A significant part of the job is undiagnosing mental illness. It’s not unusual for us to be asked to see somebody who is emotionally overwhelmed or dysregulated. Sometimes this is in the context of mental health problems, often it’s in the context of significant stress. We don’t want to psychiatricise the human condition. Of course you cry when you’re sad. Of course you’re anxious when, like Courtney Barnett in ‘Avant Gardener‘, you’re not that good at breathing in. Of course you’e frustrated when you’re in pain and/or don’t understand what’s going on.

It’s important to validate understandable and proportionate emotions.

It’s equally important to make sure that somebody who has experienced mental health problems previously doesn’t have every presentation to the hospital/outpatient clinic seen through that lens. That’s called “diagnostic overshadowing”. It’s a real problem.

Diagnostic overshadowing is where physical symptoms are overlooked, dismissed or downplayed as a psychiatric/psychosomatic symptom. It must be one of the most dangerous things that happens in hospitals. The President of the Royal Australian & New Zealand College of Psychiatrists, Professor Malcolm Hopwood, said in May 2016, “I sometimes think that the worse thing a person can do for their physical health is to be diagnosed with a mental health disorder.”

It often comes as a shock to people when they find out that those diagnosed with mental illness die between 10 and 25 years younger than the general public. The next shock comes when discovering suicide accounts for only about 14% of premature death. [source: ‘Please believe me, my life depends on it’: Physical health concerns of people diagnosed with mental illness]

It’s a big deal. About 60% of people who experience mental health problems experience chronic physical health problems too. Poor mental health is a major risk factor for poor physical health, and vice versa. [Source: Australia’s mental and physical health tracker 2018]

Diagnostic overshadowing happens outside of hospitals too. In this example, understandable and proportionate human emotions were misinterpreted as psychopathology. The cascade of events that followed makes for a sobering read:

Questions for Reflection

Assuming that you – the person reading this blog post – is a nurse, midwife or other health professional, I have some questions I’d like you to reflect on.

Have I ever witnessed a person’s mental health history influence how their presenting complaint was investigated or treated?

How does my workplace prevent mental health stigmatising and diagnostic overshadowing?

What can I do to support good holistic patient care, without falling into the trap of diagnostic overshadowing?

References

Happell, B. & Ewart, S. (2016). ‘Please believe me, my life depends on it’: Physical health concerns of people diagnosed with mental illness [online]. Australian Nursing and Midwifery Journal, 23(11), 47.

Harris, B. Duggan, M. Batterham, P. Bartlem, K. Clinton-McHarg, T. Dunbar, J. Fehily, C. Lawrence, D. Morgan, M. Rosenbaum, S. (2018). Australia’s mental health and physical health tracker: Background paper. Australian Health Policy Collaboration issues paper no. 2018-02, Melbourne, AHPC.

Lakeman, R. & Emeleus, M. (2014). Un-diagnosing mental illness in the process of helping. Psychotherapy in Australia, 21(1), 38-45.

Patfield, M. (2011). Undiagnosis: An Important New Role for Psychiatry. Australasian Psychiatry, 19(2), 107–109.

Seriously mentally ill ‘die younger’. (2016, May 10). SBS News. Retrieved from https://www.sbs.com.au/news/seriously-mentally-ill-die-younger

End

Sincere thanks to Bec (aka @notesforreview on Twitter) for giving permission to share her tweets re mental health stigma and diagnostic overshadowing. Her first-hand account is a powerful cautionary tale.

Paul McNamara, 1st October 2018

Short URL meta4RN.com/shadow

Why on earth would a mental health nurse use social media?

Here’s my contribution to Chapter 15 “E-Mental Health” in “Mental Health: A Person-Centred Approach, 2nd edition.”

There is a famous quote attributed to author, speaker and Harvard Business School graduate Charlene Li that states, “Twitter is not a technology. It’s a conversation. And it’s happening with or without you.” This is not unique to Twitter – the same notion applies to all of social media.

Over the years a lot of talk about healthcare matters and nursing has happened without including nurses. Since the emergence of social media, nurses don’t have to wait to be invited to join in these conversations. We nurses we can share our experience, knowledge and values with the world, whether the world want to hear us or not. To paraphrase author, feminist and media expert Jane Caro, social media allows nurses and midwives unmediated access to public conversations for the first time in history.

We would be foolish to let that opportunity slip by.

I’m a mental health nurse working in consultation liaison psychiatry in a busy general hospital in a regional city in Australia. People like me often go unheard in the “big picture” discussions. As a busy clinician, I’m not ever likely to pump-out dozens of journal articles or write books about my role.

Clinical nurses like me are more likely to share ‘war-stories” with each other. A lot of interesting, funny, sad and (sometimes) scary things happen on the frontline. There’s a strong oral tradition of story-telling amongst nurses and midwives, and we learn a lot from each other. Social media allows us to share our stories beyond our workplace and beyond our immediate workmates. We can share our stories with nurses, midwives, and anyone else who is interested all over the world. As our circles of communication and connection become wider and more diverse, our minds expand, we learn more, we have an opportunity to reflect on our work more. It’s a fun way to do professional development.

Some of your patients, some of your colleagues, and some of your current or future employers will use a search engine like google to find out more about you. They probably won’t be malicious or creepy. They’ll probably just be idly curious. Either way – no matter their intent – don’t you want to be in charge of what they find?

I think it’s important to be clear and intentional when using social media. Nurses already know about boundaries and confidentiality, and are nearly always good at in the flesh. Sometimes nurses blur boundaries between their social life and professional life online. That’s where it gets tricky.  I suggest having two distinctly different social media identities: a personal one for family and friends, and a professional one for patients, colleagues and employers.

Personal use of social media is where you share photos of holidays and parties with family and friends on services like Facebook or Instagram. Relax. Have fun with it. Don’t bother naming your employer, or talk too much about work there. It’s a place to enjoy yourself. Do you have to use your actual name? A nickname will increase your privacy.

Professional use of social media is based on your area of expertise and interests. This use of social media allows you to share information and interact with other individuals and organisations that have the similar interests. Here you don’t want to hide your light under a bushel: use your real name.

I have a blog that I usually update every month or so with posts that are of interest to me: have a look at meta4RN.com if you’re interested in what a nursing blog looks like. It’s not the only nursing blog out there – in fact, there are many nursing blogs that are much fancier and more regularly updated than mine. Visit the NurseUncut Blogroll (www.nurseuncut.com.au/blog-roll) to track down others.

Twitter is a fantastic way to connect with people all over the world. The best way to learn about Twitter is to follow people who are already using it – please feel free to follow me via my Twitter handle: @meta4RN. By way of explanation, “meta4RN” is a homophone: read it as either “metaphor RN” or “meta for RN”.

I also use the meta4RN handle on Facebook, YouTube, Instagram, Prezi and other online accounts. Nearly all of the things I share on these social media platforms relate to my professional life, but there’s room for a bit of playfulness and fun too. Professional doesn’t have to be boring. Just check on yourself as go, and ask, “is this something I want my patients, colleagues and managers to see?” If not, either it belongs on your personal social media accounts, or shouldn’t be posted at all.

So, back to the opening question: why on earth would a mental health nurse use social media? To connect and collaborate with others, for professional development, to make sure that ordinary clinical nurses have a voice online, and to expand my horizons. Also, it doesn’t hurt that when people do search for me online I am in control of what is seen.

Explainer

You may be wondering why I’m sharing this excerpt now. Simple – I’m drawing attention to this news:

Being named best in category for “Tertiary (Wholly Australian) Teaching and Learning Resource: blended learning (print and digital)” at the Educational Publishing Awards 2018 is a pretty big deal. The authors and editors deserve to be congratulated.

I’m very grateful to Rhonda Wilson (aka @RhondaWilsonMHN) for inviting me to contribute to the book. It’s not false modesty to note that my contribution isn’t what won the book the award, but I’m pleased as punch to be part of it!

End

Thanks for reading. While you’re at it, have a squiz at Rhonda’s blog: rhondawilsonmhn.com 🙂

Paul McNamara, 22nd September 2018

Short URL: meta4RN.com/book

References

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

Wilson, R. (contribution by McNamara, P.) . (2017). E-mental health. In Procter, N., Hamer, H., McGarry, D., Wilson, R., & Froggatt, T. (Editors.), Mental health : a person-centred approach, second edition (pp. 360-362). Cambridge University Press, Port Melbourne, Australia.

Clinical Care and Clinical Supervision

On Monday 17th September 2018 I’ll be presenting to the Cairns & Hinterland HHS palliative care team regarding clinical care and clinical supervision. It is planned as an interactive session accompanied by visual cues to give the discussion a bit of structure. Consequently, the transcript/dialogue of the presentation can not be included here.  The visual presentation itself doesn’t use powerpoint slides. It uses the prettier (and free!) platform Prezi instead: http://prezi.com/gtsqjgs9zdby

This page serves as a one-stop directory to the online resources used to support the discussion, and as an easy way for me to find the presentation. 🙂

I’m recycling and combining a lot of old ideas for the session (there’s that self-plagiarist vs groovy remix of favourite old songs thing again), so this list below is ridiculously self-referential:

Care goes in. Crap goes out. Ian Miller @ The Nurse Path, 30 May 2017
thenursepath.blog/care-goes-in-crap-goes-out

Emotional Aftershocks (the story of Fire Extinguisher Guy & Nursing Ring Theory) meta4RN.com/aftershocks

First Thyself (the core source of info for the visual aspects of this presentation) meta4RN.com/thyself

Flowchart courtesy of Dr Alex Psirides (aka  on Twitter), ICU, Wellington, New Zealand, sourced here:

Football, Nursing and Clinical Supervision (re validating protected time for reflection and skill rehearsal) meta4RN.com/footy

Hand Hygiene and Mindful Moments (re insitu self-care strategies) meta4RN.com/hygiene

Joseph Heller quote from Catch-22 (1961):
“People knew a lot more about dying inside the hospital, and made a much neater, more orderly job of it. They couldn’t dominate Death inside the hospital, but they certainly made her behave. They had taught her manners. They couldn’t keep death out, but while she was in she had to act like a lady.”

Living Close to the Water (re #dyingtoknowday and emotional intelligence) meta4RN.com/water 

Nurses, Midwives, Medical Practitioners, Suicide and Stigma (re the alarming toll of those who undertake emotional labour) meta4RN.com/stigma

Nurturing the Nurturers (the Pit Head Baths and clinical supervision stories) meta4RN.com/nurturers

Sample Clinical Supervision Agreement (no need to reinvent the wheel – start with a wheel that works and tailor it to your needs) meta4RN.com/sample

Woody Allen quote from Without Feathers (1975)
“I’m not afraid of death; I just don’t want to be there when it happens.”

End

That’s it. Please feel free to play with the pretty prezi: prezi.com/gtsqjgs9zdby

Also, as always, please feel free to leave comments in the section below.

Thanks for visiting.

Paul McNamara, 2nd September 2018

Short URL: meta4RN.com/care