This blog post is to simply share the content, JPEG and PDF of a poster that will be presented at the FNQ (Far North Queensland)/CHHHS (Cairns and Hinterland Hospital and Health Service) Research and Innovation Symposiumon 16 September 2022.
EAT Target (Eating disorder planned Admission via Transit lounge)
Background and Rationale
It was observed there was a prolonged delay in commencing nasogastric feeds for some people who had a planned admissions via the Cairns Hospital Transit Lounge for nutritional resuscitation in relapse of an eating disorder.
Delayed nutritional resuscitation in eating disorders increases refeeding risk, decreases medical stability, may cause health deterioration, and delays safe hospital discharge.
To address the concerns re delayed nutritional resuscitation, a nurse- and dietitian-led response was discussed, solutions were brainstormed by the presenters, and the “EAT Target” was proposed (EAT = Eating disorder planned Admission via Transit lounge).
Since that brainstorming session the EAT Target has been refined and drafted as a workplace instruction named “Initiation of nutrition for patients with Eating Disorders admitted via Transit Lounge.” This is expected to be implemented in August/September 2022.
Results (ie: content of new time-critical work instruction)
⏰ On admission to transit lounge obtain baseline observation including lying and standing BP and HR, 12 lead ECG, IV cannula, routine bloods and baseline height.
⏰ Liaise with medical team for admission. Aim for timely charting of medications including IV thiamine and PRN anxiolytics to assist with NG tube insertion if appropriate.
⏰ Insertion of Nasogastric tube (pending medical order) within 2 hours of presentation either at transit or in General Medical ward depending on bed availability.
⏰ Confirm position of NG tube as per clinical guidelines (ie: low risk patients can have placement confirmed by pH strip, and may not need to proceed to x-ray).
⏰ Liaise with Dietitian to document NG feeding regime within 2 hours of presentation. For after-hours presentations please follow Initiation of Nutrition for Patients with Eating Disorders (ADULT) General Medical and Mental Health Teams.
⏰ Liaise with Consultation Liaison Psychiatry Service CNC via ext 66175. Aim for nursing care plan, clarification regarding AIN special etc within 2 hours of presentation.
⏰ Commence NG feed within 3 hours of admission to Transit lounge (NB: ensure IV thiamine is administered prior to NG feed).
⏰ Offer resource plus if NG feed is delayed beyond the 3-hour mark.
⏰ Enter “orders” on ieMR for nursing care as per QuEDS guidelines: QID Lying and standing BP/ pulse, QID BGL & 2am BGL monitoring, Daily ECG, Weight – Monday and Thursday.
⏰ Quantitative Pre- and post- comparison data re time taken for NGT insertion and commencement of feeding.
⏰ Qualitative Feedback from inpatients with the lived experience of planned admission for nutritional restoration in eating disorder.
⏰ Nutritional Resuscitation is Time Critical ⏰
Dozens of staff on the CHHHS multidisciplinary team collaborate to provide safe, timely care to people experiencing eating disorder relapse. The CHHHS values of compassion, accountability, integrity and respect are embedded in our practice together. It is a pleasure to work with you.
Mental Health and ATODS Nursing Director kindly funded this poster for the 2022 Cairns and Hinterland Hospital and Health Service Research and Innovation Symposium. Thanks Gino. 🙂
The presenters are a collaboration of medical nurses with an interest in caring for people with eating disorders, together with a specialist dietitian and two specialist mental health nurses.
⏰ Rekha Thomas, RN, BN, Grad Cert Clinical Nurse, General Medical Unit, Cairns Hospital
⏰ Nicolle Hogan, RN, BN, Grad Cert Nurse Unit Manager, General Medical Unit, Cairns Hospital
⏰ Emma Coleman, APD, NEDC Dietitian, North Queensland Eating Disorder Service (NQuEDS) & Cairns Hospital
⏰ Jelena Botha, RN, BN, Grad Cert, MMHN Clinical Nurse Consultant, Consultation Liaison Psychiatry Service, Cairns Hospital
I’m home with time on my hands recovering from a minor procedure. That’s why there’s been a flurry of online activity. Don’t worry. I’ll be back at work soon, and will stop cluttering-up the internet then.
Observation: it’s MUCH easier to spruik about work-stuff when you’re not busy and tired doing work-stuff. 🙂
Technical note: the poster above (and this one from yesterday) was made using Apple Pages on an iMac from about 2017ish. The formatting was pretty easy, but took me quite a few hours. I don’t think I could earn a living out of it. I would have to drop my hourly rate to about 50 cents.
That’s it. Thanks for visiting. As always, feedback is welcome via the comments section below.
Sometime in the early 2000s (2001 or 2002, I think) my local health service went on a recruitment drive titled, “Nursing in the Tropics: Experience the Lifestyle!”.
The poster featured ten nurses.
Nine of the nurses are female and doing stuff.
One of the nurses is male and just standing around not obviously participating in a task. That nurse is me. However, to be fair, I may have been reflecting on-, or planning for-, something important. I don’t know. It was a long time ago. Don’t judge me man. 😬
Anyway, I was pleased to be reminded of the campaign poster today, and wanted to plonk it here on the website for nostalgia’s sake and so I can find it again PRN.
Nursing in the Tropics: Experience the Lifestyle! Cairns Health Service District poster (circa 2002)
One More Thing
The “Nursing in the Tropics: Experience the Lifestyle!” campaign ran its course many years ago. There is a fresher, funkier campaign in its place. Check out the Cairns and Hinterland Hospital and Health Service (CHHHS) #HealthUpNorth hashtag on social media, and/or check out the CHHHS careers page: cairns-hinterland.health.qld.gov.au/careers
I’ve been working here since the mid-90s (actually working, not just standing there like I am in the poster), and it’s good. The people are what makes it great, but the climate and user-friendliness of living in a compact city with world-class attractions and an international airport on its doorstep help too. Working in Cairns was, and remains, a quality of life decision that I’ve never regretted.
That’s it. As always, feel free to leave feedback via the comments section below.
Sincere thanks to Mick Blair for the tweet/nostalgia trip. 🙂
Coral Wilkinson has been a Registered Nurse for over 30 years. We’ve crossed clinical paths a lot, especially during Coral’s stints as a Clinical Nurse Consultant and Nurse Navigator for older persons, and when she was working on the Aged Care Assessment Team. Coral is one of those very capable and kind characters – the sort of person who lifts the standard and reputation of nursing.
In recent years Coral has started an organisation called See Me Aged Care Navigators which is described as ‘the human compass you need to guide and support you through Australia’s aged care system’. As an adjunct to the organisation and its informative website, Coral has written a book aimed at the adult children of older people in need of support, who are a bit unsure on what services are available and how to access them.
When a nurse in the know writes a book you probably should read it. Especially if it’s about something as mysterious and baffling as Australia’s aged care system. There’s a lot of experience, knowledge and acquired practical wisdom in this book. I am sure that the information provided will assist readers to understand and negotiate complex pathways to care.
It’s pretty common in my job to field enquiries re whether hospital inpatients should be seen by mental health even if they decline. It’s not for me to say, of course, that’s articulated elsewhere in legislation (link to Queensland (2016) Mental Health Act here – BTW it’s a 641 page PDF). My job is to do my best in clearly communicating what’s appropriate and legal.
As you’ll see in the brief (16 seconds) video above, it’s good practice to document something re these sorts of enquiries. I usually do a quick SBAR thingy, and then – for completeness – drop a plain-language summary of mental health act criteria (which I have saved as ieMR autotext) into the file entry.
For those interested, a copy of the content of this ieMR autotext is included below.
Discussion re consent vs involuntary psychiatric assessment.
The Mental Health Act 2016 provides a legislative framework for the treatment and care of persons with a mental illness without their consent.
One of the key rights under the Act is that a person is presumed to have capacity to make decisions about their treatment and care, and the right to consent, or not consent, to healthcare.
Involuntary mental health assessment can be imposed by completing a Recommendation for Assessment. This can be completed by a doctor or authorised mental health practitioner who has examined the person within the preceding 7 days.
The Recommendation for Assessment asks for this information:
1. The reasons you believe the person may have a mental illness
2. The reasons you believe the person may not have capacity to consent to be treated for the illness:
3. The reasons you believe that not providing involuntary treatment for the illness may result in: i. imminent serious harm to the person or others; or ii. the person suffering serious mental or physical deterioration
4. The reason you believe that there appears to be no less restrictive way for the person to receive treatment and care for the person’s mental illness
The blog post is not just about the content. The idea behind doing a screen capture video is to show people the advantage of having ieMR autotext options for you/your speciality area. Is there any stuff you find yourself typing into patient notes repeatedly? You’re busy enough – get the machine to do it for you.
This blog has mentioned creating autotext/templates as an advantage that electronic medical records offer previously (here). Recently this has popped-up in conversations again, as members of the nursing team at the hospital I work at aims to get smarter with how we support Assistants In Nursing (AINs) to safely support patients.
A worry I have as a specialist mental health nurse in a general hospital is that AINs are often allocated as a “nursing special” when there are concerns that a suicidal person may abscond and/or harm themselves again, or to support and monitor the safety of a person who is medically unwell because of acute relapse of an eating disorder. These are people with some of the most complex needs in the general hospital, and AINs are the least qualified (and lowest paid) members of frontline clinical workforce. I’ve written about this concern previously (here).
It’s risky business. Risky for the patient. Risky for the AIN. Risky for the Registered Nurse (RN) or Enrolled Nurse (EN) delegating tasks to the AIN.
The Nursing and Midwifery Board of Australia RN Standards for Practice addresses this: “The RN appropriately delegates aspects of practice to enrolled nurses and others, according to enrolled nurse’s scope of practice or others’ clinical or non-clinical roles” [see Standard 6.3].
The Australian Nursing & Midwifery Federation (ANMF) AIN position statement elaborates: “The assistant in nursing assists registered nurses and enrolled nurses in the provision of delegated aspects of nursing care within the limits specified by their education, training and experience. At all times, assistants in nursing work within a plan of nursing care developed by the registered nurse, and work under the supervision and direction of a registered nurse and, where deemed appropriate by the registered nurse, an enrolled nurse.” [see Number 6].
The ANMF position statement on Specialling includes that “all staff providing specialling, regardless of qualification, should receive an appropriately comprehensive handover from the registered nurse or midwife delegating care“, and elaborates that this should include thorough documentation [see Number 7].*
An RN or EN can delegate tasks to an AIN, but they can not delegate responsibility. It is with that in mind that I’m sharing the content of the ieMR autotext/template that I’ve been using for the last few years.
The content below is individualised to the person’s circumstances (ie: additions and subtractions are common). To my slow-typing fingers, it’s helpful to start with a pretty comprehensive framework and tweak it from there.
Hopefully you’ll note the intentionally non-technical language and tone. The aim is to have a document that clearly describes the delegated tasks. To my way of thinking its important to do so in a way that models and promotes understanding, safety and empathy.
INFO FOR AIN SPECIALS
Why is XXXX here?
XXXX has simple explanation of the medical problem, and has recently experienced symptoms of deteriorating mental health, including: – – Context/contributing factors for this include: – –
Why am I here?
To keep XXXX safe.
XXXX is not/is considered to be at risk of intentional self harm, and/but is at high risk of absconding/misadventure.
For XXXX’s protection they have been placed under a Recommendation for Assessment which expires @ Treatment Authority – this is a part of the Mental Health Act that allows the hospital to keep people in hospital even if they want to leave – if XXXX were to insist on leaving it is not you job to physically restrain them; it is your job to let the RN/TL know immediately
What should I do?
1. Introduce yourself by name and role at the beginning of the shift.
2. One of the first things you should do at the beginning of your shift is to do a thorough scan of the room to make sure there are no sharps (eg: scissors, syringes with needles insitu) or other potentially risky items in the room. It’s a good idea to re-check the room after any procedures/interventions (eg: after wound care, cannula insertion).
3. Ask XXXX if there are any specific concerns that they need a hand with now. They may speak of unrealistic ideas: please use your judgement and liaise with RN/TL if unsure.
4. XXXX does/does not need to be supervised in the bathroom/toilet.
5. XXXX does/does not have to stay in bed, but/and can not leave the ward.
XXXX may find this frustrating – it’s OK to make it clear that this is at the insistence of the Mental Health team.
6. Meal Support (highlighted because this is really important for XXXX) – if you have not done the course already, please go to iLearn and do the online training called “The Shared Table” ilearncatalogue.health.qld.gov.au/course/1493/the-shared-table – it’s also available via EDQ: edqsharedtable.com.au – the key message from the course is that distraction and/or mindful calmness assist at meal times. Please encourage bathroom use PRIOR to meal times, and discourage bathroom use for 30 minutes AFTER meal times. Meal completion times: – 20 minutes for snacks, then – if snack not completed – on to supplementary nutrition as ordered – 30 minutes for meals, then – if meal not completed – on to supplementary nutrition as ordered Documentation of meal completion: – please complete the nutrition chart after each meal – if unable to complete meals, please let the RN know so that s/he can facilitate supplementary nutrition as per Dietitian’s plan
7. Naturally, it’s OK to have a chat with with XXXX. Wondering what to talk about? Try these ideas: – steer conversation away from dark and depressing topics towards the more everyday and cheerful topics (eg: current news stories. movies, TV shows, sport, pets/animal, books, the weather, hobbies/recreation activities, travel/holidays) . This knack for friendly, distracting conversation is known as “Phatic Chat”, more info via meta4RN.com/phatic – sometimes simple hand gestures and body language can be used to help people slow down and get their thoughts organised – it’s probably obvious to you already, but just in case: it is inappropriate to share your personal experiences of mental health problems/recovery, or talk about your religious/spiritual beliefs. That boundary between our personal lives and professional lives is important. One last thing on this topic: it’s very important to be aware that talking about food/diets/weight loss/exercise/physical appearance and related topics with someone who is experiencing disordered nutrition can cause harm.
8. Aim for a low stimulus environment. When experiencing agitation it is helpful if there is not too much noise or stimulation. – one of the strategies for this is to sit in the TV/sun room, rather than stay in the shared room all the time – if a single room will become available, that would be helpful too
9. Stay close enough to ensure that XXXX doesn’t leave hospital doesn’t harm themself doesn’t harm anyone else who is vulnerable (this includes you) – although we are not expecting you to be in harm’s way, it is always sensible to be closer to the door than the person you are caring for: sometimes we need to leave the room quickly to keep ourselves safe from a physically agitated person – if XXXX is tiring of having company and/or is sleeping, it is fine to move your chair outside the doorway, rather than in the room
10. Sometimes XXXX gets a bit sweary. Mostly this is not verbal abuse directed at you, but is just “lalochezia” (emotional relief through using foul language). More about that via meta4RN.com/lalochezia
The mental health team will be reviewing XXXX daily. If there are any changes in expectations for the Special AIN we will update this info sheet.
If you have any suggestions on changes to these guidelines, please jot them down – we can modify this info sheet PRN.
Thanks very much for looking after XXXX – you are playing an important part in their recovery.
Paul McNamara Clinical Nurse Consultant Consultation Liaison Psychiatry Service ext 99999
That’s it. Thanks for visiting.
If you have ideas for improvements, please contribute them below in the comments section – wiki style 🙂
*Addit on 17/07/22: Many thanks to Tara Nipe for bringing the ANMF Specialling position statement to my attention. BTW: It’s worth checking-out Tara’s blog, Twitter and general online profile. Tara’s one of the Australian pioneers of nurses on social media.
Recently I trawled through the history of the International Journal of Mental Health Nursing (IJMHN) – if you’re curious please see this editorial and this blog post.
Amongst the things revealed was the encouraging upward trend in the Impact Factor – a metric that reflects how many citations individual academic journals attract over a two year period. I was especially encouraged that a targeted social media strategy, together with the increased volume of articles, coincide with the Impact Factor upward trend since 2017.
Today this arrived in an email:
The 2022 Journal Citation Reports were released overnight, and I am very pleased to let you know that International Journal of Mental Health Nursing’s 2021 Impact Factor is 5.100 – a significant increase from 3.503 for 2020. This result places the Journal in the rankings: 2/125 (Nursing), 2/123 (Nursing (Social Science)), 57/155 (Psychiatry), 43/142 (Psychiatry (Social Science)).
Alison Bell, Journal Publishing Manager, Wiley, email of 29 June 2022
That is – to put it bluntly – bloody amazing!
Don’t believe me? Look at the chart below…
The journal had very humble beginnings. It was just an idea amongst a few Mental Health Nurses in Australia in July 1978. The first issue consisting of just two articles and editorial followed in September 1980 (source and source).
2021 data reveals this humble little journal is now ranked the second most impactful nursing journal on the planet.
Mental Health Nursing is punching above its weight. Mental Health Nursing ranks 5th as principal specialty, after Aged Care, Medical, Surgical and Peri-operative (source and source). Yet, we have a journal that rates 2nd most cited nursing journal, behind the International Journal of Nursing Studies (IJNS).
That’s something to celebrate – not just for the authors, reviewers and editors who put in the hard work to make it happen – but for all Mental Health Nurses.
Please spread word about the impact of the International Journal of Mental Health Nursing – it’s a good news story 🙂
Extracting information from www.gg.gov.au below is a list/summary of the 13 Nurses named on the 2022 Queen’s Birthday Honours List.
Paula Maree Duffy PSM Public Service Medal (PSM) Worongary, Queensland For outstanding public service in nursing and the response to the COVID-19 pandemic.
Paula Duffy has worked for the Gold Coast Hospital and Health Service for 20 years and was promoted to the role of Executive Director of Nursing, Midwifery and Patient Experience, after formerly holding the position of Executive Director of Integrated Ambulatory and Community Services, incorporating one of the largest Emergency Departments in Australia.
Ms Duffy’s professional relationships and concentrated efforts across the organisation have been fundamental to the management of COVID-19 at Gold Coast Hospital and Health Service. Extremely well regarded by the leadership in the Queensland Ambulance and Police service, her strong leadership has been the glue that helped the Gold Coast navigate the challenges of being the first region to experience the Omicron variant peak in Queensland. She coordinated the hospital response which required the opening of 9 dedicated COVID-19 wards and 2 ICU pods.
Ms Duffy is a leader across all aspects of the COVID-19 response, ranging from the creation of testing centres in the community to facility screening desks, quarantine hotels, dedicated COVID-19 wards, virtual wards and partnering with private hospitals to increase public patient capacity. For the last two years she has been the key contact for the Gold Coast, reporting to the state bodies and coordinating complex arrangements across the city to support the COVID response.
The contribution by Paula Duffy to her profession, and the high regard in which she is held, is testament to her quality standards and consistent contribution to the public health sector over decades.
Caroline Farmer PSM Public Service Medal (PSM) Padstow, New South Wales For outstanding public service to New South Wales Health, particularly during the COVID-19 pandemic.
Currently serving as the Director of Nursing & Midwifery and Clinical Governance within the Western Sydney Local Health District, Ms Caroline Farmer has made significant contributions to public health throughout the COVID-19 pandemic.
In June 2020, Ms Farmer’s executive leadership was pivotal during Western Sydney Local Health District’s (WSLHD) initial COVID-19 response. She liaised with key staff from the Commonwealth, the New South Wales Ministry of Health and residential aged care facilities to ensure the availability of adequate nursing workforce to support local outbreak sites.
Ms Farmer also ensured the coordination of a nursing workforce to disability homes, local facilities, vaccinations centres and the Greater Western Sydney COVID-19 Community Accommodation. As a result of the continual demand for nursing staff, Ms Farmer established a District COVID-19 Nursing Workforce Unit which provided a centralised point for the coordination of nursing staff deployment across Western Sydney. Throughout this time, as the WSLHD Emergency Operations Centre’s executive lead for Planning, Ms Farmer was integral in the coordination and finalisation of a number of key initiatives, such as the WSLHD Intensive Care Workforce Plan, the COVID-19 Ward Model of Care and the WSLHD Clinical Governance Safety and Quality Priorities.
Ms Farmer continues to foster the next generation of leaders amongst nurses and midwives in WSLHD, ensuring this cohort have the right skill set, insight and vision to drive improvements in health care services and future innovations. In recognition of this priority, in February 2021, a pilot WSLHD Nursing & Midwifery Leadership Program was launched, with 12 participants from across the region selected for the opportunity to develop and grow on their leadership journey. Upon graduation, this cohort were empowered to enact upon their future leadership goals, influence positive change at a local level through shared learnings, actions and individual leadership practice, and effectively support service operations to deliver better care and services to patients across Western Sydney.
Ms Farmer is an exemplary public servant who is a role model for collaborative leadership and innovative contributions. She is a trusted voice within the public health community and shows unwavering commitment and resilience to deliver results.
Wendy Leeanne Hellebrand OAM Medal of the Order of Australia (OAM) in the General Division Victoria For service to the community through a range of roles.
Lions V Districts Cancer Foundation, Lions Australia
Skin Check and Dermoscopy Coordinator, Mobile Skin Check Project, since 2019.
District 201V2, Lions Australia
Chairman, Zone 3, since 2002.
Chairperson, Family Welfare and Children’s Mobility, current.
Past Region Chairperson.
Past Chairperson, Drug Awareness Program.
Past Chair, Independent Third Person Program.
Past Chairperson, Youth of the Year, Young People in Service and Youth Exchange Program.
Inverleigh Leigh Valley Lions Club
Past Vice President.
Liaison Officer, Campaign Sight First Program, 2007-2008.
Community Health and Welfare Officer, since 1999.
Member, since 1995.
Council Member, Royal Geelong Agricultural and Pastoral Society, since approx 2000.
Practice Nurse, Bannockburn Surgery, current.
Past Sexual Health Nurse and Counsellor, (then) Headspace Geelong.
Multicultural Award for Excellence, Africa Day Australia, 2013.
Ambassador for Peace, Universal Peace Foundation, 2010.
Vicki Anne Simpson PSM Public Service Medal (PSM) Coffs Harbour, New South Wales For outstanding public service to the Mid North Coast Local Health District, particularly during the COVID-19 pandemic.
Mrs Vicki Simpson is currently serving as the Director of Nursing, Midwifery and Service Reform, and as the Health Service Functional Area Coordinator in the Mid North Coast Local Health District.
Mrs Simpson’s professionalism, resilience and leadership has been influential in the Health District’s response to catastrophic bushfires, a once in a generation flood and the COVID-19 pandemic over the last three years.
In an unprecedented and evolving global pandemic, Mrs Simpson has been exceptional in her role as the Health Service Functional Area Coordinator. Developing and rapidly implementing strategies for her nursing staff to ensure a well-managed response to COVID-19, she also took on the responsibilities of coordinating logistics, equipment (including ventilators and personal protective equipment), testing, and emergency accommodation. Further, she led early morning planning meetings coordinated with the State Health Emergency Operations Centre and liaised closely with community partners such as aged care facilities and local councils to ensure a coordinated COVID-19 response.
Mrs Simpson also spearheaded the mass vaccination program for the Health District, resulting in more than 95 percent of the eligible local population reaching double vaccination status.
Mrs Simpson is committed to providing opportunities for First Nations people to embark on careers in nursing and midwifery. She has mentored staff through the trainee and cadetship process to senior nursing and midwifery roles, something she is most proud of.
With over 30 years of public service, Mrs Simpson is an integral part of the Mid North Coast Local Health District. She is an energetic, compassionate, and inspiring leader who is enormously respected among her peers and patients for her exemplary standard of professionalism and service delivery.
Kathleen Mary Sloane AM Member of the Order of Australia (AM) in the General Division Richmond, Victoria For significant service to nursing, and to global women’s health.
Uro-gynaecology Presenter/Clinician, Uro-gynaecology workshops in Africa, Asia and the Pacific, including:
Myanmar, 2017, 2018 and 2019.
Bangladesh, 2003, 2004 and 2018.
Victoria/Tasmania Branch, Continence Nurses Society Australia
Committee Member, 2002-2005 and 2007-2011.
Former Clinical Preceptor, Pelvic Floor Workshops.
St Vincent’s Health, Melbourne
Team Leader and Clinical Nurse Consultant, Continence Clinic, St Vincent’s Hospital, Melbourne, since 2008.
Royal Women’s Hospital, Melbourne
Clinic Coordinator and Clinical Nurse Consultant, Uro-gynaecology, 2002-2008.
Continence Nurse Advisor, 2001-2002.
Midwife and Clinical Nurse Specialist, 1990-1999.
Nursing – Other
Continence Nurse Advisor, National Continence Helpline, 1999-2002.
Former Critical Care Nurse, Alfred Hospital, Melbourne.
Registered General Nurse, since 1983.
Registered Midwife, since 1990.
Member, Australian Nursing and Midwifery Federation.
Member, Continence Nurses Society Australia.
Awards and recognition include:
Connie Award, Continence Care Champion, 2013.
Jean Smith Prize, for Excellence in Women’s Health Nursing, Royal Women’s Hospital, Melbourne, 2007.
Karolyn Vaughan OAM Medal of the Order of Australia (OAM) in the General Division Queensland For service to nursing.
International Board Certified Lactation Consultant Examiners
Director, Asia Pacific and the Africa Region, since 2006.
International Board Certified Lactation Consultant, since 1992.
Clinical Nurse Consultant, Child and Family Health, Wentworth Area Health Service, 1997-2006.
Clinical Nurse Consultant, Karitane, mid 1990s.
Community Nurse and Early Childhood Nurse, Western Suburbs of Sydney, 1990s.
Registered Midwife, since 1989.
Registered Nurse, since 1986.
Too long; didn’t read?
Tweet the list of 13 Nurses named on the 2022 Queen’s Birthday Honours List instead. 🙂
Paula Duffy PSM, Caroline Farmer PSM, Wendy Hellebrand OAM, Jennifer Jones OAM, Therese Lee OAM, Victor McConvey OAM, Michele Rumsey AM, Mary (Maria) Said AM, Lesley Salem AM, Shillar Sibanda OAM, Vicki Simpson PSM, Kathleen Sloane AM. Karolyn Vaughan OAM
This will be the last year for the meta4RN blog/collating these lists (see “Beginning of the End“). Why don’t you take over the job next year on a blog/site of your own? As per the methodology above, it’s a pretty easy way to attract a couple of thousand hits in about 48 hours. More importantly, you will help spotlight achievements of nurses without resorting to those cringeworthy hero tropes (see “Batman is a hero. I am a health professional.“).
Please let me know via the comments section below if I missed any Nurses on the 2022 Queen’s Birthday Honours List. Naturally, I’m happy to correct any oversights.
Queen’s Birthday? WTF?
What the hell is Australia doing celebrating our best and brightest by linking them to the not-actual-birthday of an unelected foreign multi-millionaire? It makes no sense. We should get behind the Australian Republic Movement, get the Union Jack off our flag, and get the Queens’s head (soon to be Charles’ head) off our coins. Australia has a history that is much, much longer than the British royal family’s history. See: republic.org.au
Since late 2016 I have been the Social Media Editor for the International Journal of Mental Health Nursing (IJMHN). If you’re interested in how that started, see meta4RN.com/IJMHN. The years that have followed have resulted in heaps of Tweets, Facebook posts and LinkedIn updates. As a byproduct, I’ve been keeping a closer eye on the journal than I would have otherwise, and stumbled across the fact that 2022 marks the anniversary of three important milestones in the journal’s history:
✅ 30 years as a fully refereed journal (1992) ✅ 20 years as the International Journal of Mental Health Nursing (2002) ✅ 10 years on social media (2012)
That observation has been explored and elaborated-on via my first (and probably only) editorial. Please read and share the article far and wide:
Below are some abbreviated highlights and a video summary from the editorial.
What’s in a name?
1980 Journal of the Australian Congress of Mental Health Nurses 1990 Australian Journal of Mental Health Nursing 1994 Australian and New Zealand Journal of Mental Health Nursing 2002 International Journal of Mental Health Nursing
1980 Dennis Cowell 1982 Ron Dee 1986 Owen Sollis 1987 Linda Salomons 1988 Andrew King 1990 Michael Clinton 1999 Michael Hazelton 2004 Brenda Happell 2015 Kim Usher
I have not attempted to discover the names of everyone who has served on the journal’s editorial board – there would many dozens (in the hundreds?) of people of who have contributed over the years. For what it’s worth, below is a May/June 2022 snapshot of the editorial board.
Beyond the Walled Gardens
It is sensible to promote the work of IJMHN authors/researchers beyond the walled gardens of mental health nursing and academia. Below are links to the journal’s first excursions from behind the paywalls and exclusion zones that prevent people seeing the work and research of mental health nurses, and out to ‘the village square’ that is social media:
As I’ve argued previously (here and here), there’s not much value in spending weeks/months/years doing research, then pushing through the tedium of academic writing, and finally jumping through the flaming hoops of peer review only for your work to sit around unread and gathering dust. Authors and the institutions that support them should promote the paper to its greatest readership. The IJMHN has a strategy to promote mental health nursing’s research and work on social media – do you?
Average Number of IJMHN Articles
2000–2006 = 35 per year 2007–2017 = 62 per year 2018–2021 = 135 per year
Making an Impact
The first IJMHN Impact Factor was 1.427 (2010). At time of writing, the most recent available Impact Factor is 3.503 (2020). That’s pretty amazing – the IJMHN is the highest-ranked mental health/psychiatric nursing journal, and is rated as the 5th most cited nursing journal in the world (in a field of 124 nursing journals).
Time will need to pass before we know whether the most recently reported Impact Factor is an anomaly of the pandemic. I make this observation because, at time of writing, the three most cited IJMHN papers are all from 2020, and each of these highly-cited articles discuss contemporary-at-the-time COVID-19 issues (see the “Most Cited” tab here: onlinelibrary.wiley.com/journal/14470349).
This blog post accompanies a chat with 3rd / 4th year James Cook University (JCU) Nurse/Midwife students at an industry presentation day on 12th May 2022. Here is a copy of the slide show I’ll be using for the presentation @ JCU on the day:
Below are snippets and elaborations of the info we will touch-on/discuss on the day. Parking the information online just in case any of the JCU Students want to come back to it, and/or if it happens to be of interest to others.
Slide 1 As part of introducing myself, I’ll also introduce the idea/example of nurses intentionally making themselves visible on social media (eg: linktr.ee/meta4RN). More about that sort of thing here and here.
Slide 2 The day of the JCU student nurse industry presentation = 12th May = Florence Nightingale’s birthday = International Nurses Day. Coincidence? Yeah, probably. But anyway, here’s a link to 20 tweetable fun facts that I like to trot-out to celebrate International Nurses Day: meta4RN.com/nurses2020 Also, check out the #IND2022 hashtag on social media.
Slide 3 Mental Health Nursing is vastly different to other hospital-based specialist nursing roles. I reckon it’s a very good fit for people who are very adaptable. A few years ago Australian researchers coined the ‘Ten P’s of the professional profile that is mental health nursing’:
present personal participant partnering professional phenomenological pragmatic power-sharing psycho-therapeutic proud profound
Slides 4 & 5 Part of what makes Mental Health Nursing different is the structure of public mental health services. Inpatient care is just a small part of the service structure, and there is a lot of emphasis on outpatient/community based services. There are options to specialise (as I have done, more about that here and here), or – as Mental Health Nurses who work in rural and remote areas do – do a little bit of nearly everything on the list of services of slide 5/in the table below.
Central Intake Service Emergency Department Consultation Liaison Psychiatry Service
Psychiatric Intensive Care Unit Mental Health Unit Step-Up/Step-Down Unit Community Care Unit
Acute Care Team Continuing Care Teams Mobile Intensive Treatment Team Older Persons Mental Health Service Child & Youth Mental Health Service Evolve Therapeutic Services Perinatal & Infant Mental Health NQ Eating Disorder Service Forensic & Prison Mental Health Alcohol Tobacco & Other Drugs Rural Mental Health Remote Mental Health
Examples of mental health services/settings
Slide 6 On any given day, less that 1% of people who are open the Mental Health/Alcohol, Tobacco & Other Drugs Service that I work for are receiving specialist psychiatric inpatient treatment. The vast majority of mental health and addiction support and recovery happens in community settings, as evidenced by the data (collected on 12/04/22) below:
Cairns Hospital PICU/MHU Beds, n = 48 Cairns & Hinterland MHATODS Case Load, n = 5531
Slide 7 What do Mental Health Nurses do? Well, it’s pretty varied, but includes:
Complete a Graduate Diploma, Postgraduate Diploma or Masters in Mental Health Nursing
(Optional) Undertake additional training in specific psychological therapies
Successfully apply to be credentialed by the Australian College of Mental Health Nurses – the peak professional mental health nursing organisation and the recognised credentialing body for Australia’s mental health nurses.
Slide 12 That’s it. Questions? 🙂
Key References/Further Reading
Australian College of Mental Health Nursing acmhn.org
Hurley, J. & Lakeman, R. (2021), Making the case for clinical mental health nurses to break their silence on the healing they create: A critical discussion. International Journal of Mental Health Nursing.doi.org/10.1111/inm.12836
Isobel, S., Wilson, A., Gill, K., Schelling, K. & Howe, D. (2021), What is needed for Trauma Informed Mental Health Services in Australia? Perspectives of clinicians and managers. International Journal of Mental Health Nursing.doi.org/10.1111/inm.12811
McKenna Lawson, S. (2022), How we say what we do and why it is important: An idiosyncratic analysis of mental health nursing identity on social media. International Journal of Mental Health Nursing.doi.org/10.1111/inm.12991
Moyo, N., Jones, M. & Gray, R. (2022), What are the core competencies of a mental health nurse? A concept mapping study involving five stakeholder groups. International Journal of Mental Health Nursing.doi.org/10.1111/inm.13003
Santangelo, P., Procter, N. and Fassett, D. (2018), Mental health nursing: Daring to be different, special and leading recovery-focused care?. International Journal of Mental Health Nursing.doi.org/10.1111/inm.12316
As always, feedback is welcome via the comments section below.
Naturally, if you think it will be of interest to any nurse/nearly-nurse you know, you are very welcome to forward the info on by whatever means you see fit. 🙂