Tag Archives: nurse

#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.
1.

2.

Introductions.
3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

Setting The Tone.
14.

15.

16.

Communication and Confidentiality.
17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

Mobile Phones.
38.

39.

40.

41.

42.

43.

44.

45.

46.

47.

48.

49.

50.

51.

52.

53.

Social Media.
54.

55.

56.

57.

58.

59.

Individualising Communication & Confidentiality.
60.

61.

62.

63.

64.

65.

66.

67.

68.

69.

WiFi for Hospital Patients.
70.

71.

72.

73.

74.

75.

76.

77.

78.

79.

80.

81.

Compassion.
82.

83.

84.

85.

86.

87.

88.

89.

90.

91.

Prank Call.
92.

93.

94.

95.

96.

97.

98.

99.

100.

Targeted Crisis Support.
101.

102.

103.

104.

105.

106.

Clinical Supervision (aka Peer Supervision, aka Guided Reflective Practice).
107.

108.

109.

110.

111.

112.

113.

114.

115.

Supportive Workplaces.
116.

117.

118.

119.

120.

121.

122.

123.

124.

125.

126.

127.

128.

129.

130.

131.

132.

133.

134.

135.

Preventative/Early-Intervention Resources.
136.

137.

138.

139.

140.

The 6Cs (Care, Compassion, Competence, Communication, Courage & Commitment).
141.

142.

143.

144.

145.

146.

Integrating Defusing Emotions into Clinical Practice.
147.

148.

149.

150.

151.

152.

153.

154.

Finishing-Up: Key Learnings.
155.

156.

157.

158.

159.

160.

161.

162.

163.

164.

Closing Remarks.
165.

166.

167.

168.

169.

170.

171.

172.

Farewells.
173.

174.

175.

176.

177.

178.

179.

180.

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:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

38.

39.

40.

41.

42.

43.

44.

45.

46.

47.

48.

49.

50.

51.

52.

53.

54.

55.

56.

57.

58.

59.

60.

61.

62.

63.

64.

65.

66.

67.

68.

69.

70.

71.

72.

73.

74.

75.

76.

77.

78.

79.

80.

81.

82.

83.

84.

85.

86.

87.

88.

89.

90.

91.

92.

93.

94.

95.

96.

97.

98.

99.

100.

101.

102.

103.

104.

105.

106.

107.

108.

109.

110.

111.

112.

113.

114.

115.

116.

117.

118.

119.

120.

121.

122.

123.

124.

125.

126.

127.

128.

129.

130.

131.

132.

133.

134.

135.

136.

137.

138.

139.

140.

141.

142.

143.

144.

145.

146.

147.

148.

149.

150.

151.

152.

153.

154.

155.

156.

157.

158.

159.

160.

161.

162.

163.

164.

165.

166.

167.

168.

169.

170.

171.

172.

173.

174.

175.

176.

177.

178.

179.

180.

181.

182.

183.

184.

185.

186.

187.

188.

189.

190.

191.

192.

193.

194.

195.

196.

197.

198.

199.

200.

201.

202.

203.

204.

205.

205.

206.

207.

208.

209.

210.

211.

212.

213.

214.

215.

216.

217.

218.

219.

220.

221.

222.

223.

224.

225.

226.

227.

228.

229.

230.

231.

232.

233.

234.

235.

236.

237.

238.

239.

240.

241.

242.

243.

244.

245.

246.

247.

248.

249.

250.

251.

252.

253.

254.

255.

256.

257.

258.

259.

260.

261.

262.

263.

264.

265.

266.

267.

268.

269.

270.

271.

272.

273.

274.

275.

276.

277.

278.

279.

280.

281.

282.

283.

284.

285.

286.

287.

288.

289.

290.

291.

292.

293.

294.

295.

296.

297.

298.

299.

300.

301.

302.

303.

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

Obesity: Personal or Social Responsibility

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

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

If you read this I guarantee that you will learn 4 things in 5 minutes:

  1. How obesity works
  2. How Twitter at a healthcare conference works
  3. How an aggregation tool can add value to Twitter content
  4. How nurses can be simultaneously generous, incisive and funny

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.
25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

38.

39.

40.

41.

42.

43.

44.

45.

46.

47.

48.

49.

50.

51.

52.

53.

54.

55.

56.

57.

58.

59.

60.

61.

62.

63.

64.

65.

66.

67.

68.

69.

70.

71.

72.

73.

74.

 

Explanation

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

Unfortunately, Storify is shutting-down on 16 May 2018 and all content will be deleted.

I’m using my blog as a place to mimic/save the Storify pages I created and value.

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

End

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

Paul McNamara, 1st April 2018

Short URL: meta4RN.com/ConfTweets

My White Privilege

As far as I know it started with Cory Bernardi. On 31 January 2018 Cory wrote these two untruths, amongst others:
1. “The nursing and midwifery board, from 1 March this year, will insist their members acknowledge “white privilege” on demand.”
and
2. “Nurses must acknowledge white privilege and voice this acknowledgment [sic] if asked – which is compelled speech.” Source www.corybernardi.com/nursing_bruised_egos

Neither of these statements are remotely true.

When Cory and his political party repeatedly Tweeted the lie, I was really irritated that nurses were being intentionally misrepresented by non-nurses, and responded:

.

Please do not trust me because I’m a nurse.
Please do not mistrust Cory because he’s a politician.
Please read the actual policy yourself.
Read it and make up your own mind. The relevant section is a one-pager:

Nursing and Midwifery Board of Australia (01/03/18) Code of conduct for nurses, via http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

See how it says nothing at all about white privilege? You’d think that would be the end of the story. But no.

A few weeks later another non-nurse started trotting out the same nonsense as Cory Bernardi. This time it’s a bloke called Graeme Haycroft chatting to Peta Credlin on SkyNews. Graeme was on TV representing an organisation called Nurses Professional Association of Queensland (NPAQ). He acknowledged that his organisation was the only one that was fighting the new code of conduct, and that the Australian Health Practitioners Registration Authority and all the mainstream nursing unions have agreed to it. Graeme also acknowledged that he was quoting from the glossary of the code, not the code itself. Nevertheless Graeme and Peta broadcast the lie that nurses and midwives would need to stop and discuss their white privilege with their Aboriginal and Torres Strait Islander patients, before providing any clinical care [source].

Doesn’t that sound unbelievable?

Well, that’s because it is.

Don’t trust me because I’m a nurse.
Don’t mistrust Graeme because he’s setting-up a business.
Read the actual policy yourself.

NPAQ describes itself as an alternative to the Queensland Nurses and Midwives Union, which is the Queensland branch of Australia’s largest union: the Australian Nursing and Midwifery Federation. At the end of the SkyNews segment it becomes clear what Graeme’s interest in this matter is. Remember, he’s not a nurse. He’s described as the founder of NPAQ. Graeme makes it very clear that he’s making a pitch for more members to join NPAQ instead of the union. It’s just that he’s misrepresenting the truth to do so. The little rascal.

OK, got it.

Graeme needs a lever to make his business work. That’s probably all we need to know about him and NPAQ.

But the lie is a contagion. The media is its vector.

The lie was spread on South Australia’s Today Tonight, it pops-up in news.com.au and affiliates  some UK papers, and via a Melbourne political blogger & illustrator who explained her understanding thus: “…nursing staff are required to acknowledge white privilege using dialogue & communication.”

Aha! Now I see the problem!
Yoda they are reading like.
Backwards talking are they.
Twisted are the words being.

The actual excerpt from the glossary (that is: the glossary, not the policy) reads “…cultural safety provides a de-colonising model of practice based on dialogue, communication, power sharing and negotiation, and the acknowledgment of white privilege.” Turning the words around backwards creates a slightly different meaning. That’s what Cory, Graeme and Peta have done. The little rascals.

Look, these people have pretty good language skills. I don’t think they’re stupid. I don’t think they’re making an naive error. I think their actions are intentional. I think they are intentionally misrepresenting a single phrase in the glossary as a policy instruction. I think they’re being loose with the truth. I reckon they’re as dodgy as.

Even if they not dodgy, they’re the wrong people to be commenting.

Cory Bernadi is not a nurse.
Graeme Haycroft is not a nurse.
Peta Credlin is not a nurse.
The various journalists who repeated the lie are not nurses.

Yet each of them have taken it upon themselves to speak on behalf of nurses and about nursing policies that nurses were consulted and collaborated on.

It’s infuriating!

I’ve been muttering into my iPad thinking/saying things like, “Keep your uninvited uninformed opinions to yourselves you irritating bunch of arseclowns!”

And that’s when the penny dropped.

That’s when I realised that Cory, Graeme, Peta and the journos were giving me a lesson in white privilege.

I was getting angry that these people dared to speak on my behalf, on my area of experience and expertise, without consulting with me or others from my nursing background.

How dare they?

It’s as if they don’t respect nurses. It’s as if they don’t really understand nurses, the nursing world view, our nursing political systems or our nursing culture.

I’m not used to shabby treatment like that. White blokes like me with a steady job don’t get much practise in being patronised, belittled or having our opinions hijacked in the mainstream media.

The mainstream media is much more likely to misrepresent Aboriginal and Torres Strait people (looking at you Sunrise). They’re not alone: refugees, Africans, Muslims and Asians cop their fair bit of flack too (looking at you Pauline Hanson). It goes further: women who dress too slutty or not sexily enough, or are too skinny, too fat, too bossy, or too opinionated will also cop it in the media – especially if they have one of those race or religion things going on as well.

But not me. I’m a white employed male. I don’t usually cop that crap.

What Cory, Graeme and Peta have done is they’ve given me a small taste of what it’s like to have your self-identity misappropriated and misrepresented. They’ve shown me what it’s like when non-nurses assume the voice of nurses. These three, and others, talking about- and over- nurses gives me a small taste of how disempowering and degrading it would be to have that happen all the time.

The discredited rants of Cory, Graeme and Peta will be a brief flash-in-a-pan, and I probably didn’t need to get angry. However, they have helped me to reflect. It has given me a small insight into how it must be a nagging irritation for those who often have their identities misappropriated and misrepresented.

I acknowledge that I have privileges as a white employed man. I don’t take those privileges for granted, and am grateful for my good fortune. #countingmyblessings

Although Cory, Graeme and Peta have amplified my insight, I don’t intend to thank them. I still think they’re as dodgy as.

 

Addit

NPAQ are trying a fear argument now (see Twitter). It needs rebuttal.

I was introduced to this definition of cultural safety as a student nurse (1988-1991). It’s a good fit for nursing. It’s a humble, nurturing mindset. Nurses understand that pain, nausea, kindness and cultural safety are all subjective patient experiences.

Wait. There’s more.

There are better credentialed and more articulate responses to this matter than mine,

Recommended references/readings include:

  1. Tara Nipe (25/03/18) On the matter of privilege (this is the blog that I wish I wrote: it’s much clearer and more succinct than mine)
  2. Joint statement by the Australian Nursing and Midwifery Federation, the Australian College of Nursing, the Australian College of Midwives and the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (23/03/18) Cultural safety: Nurses and midwives leading the way for safer healthcare 
  3. Ruth DeSouza via Melissa Sweet/croakey (26/03/18) Busting five myths about cultural safety – please take note, Sky News et al 
  4. Janine Mohamed, CEO @CATSINaM (24/03/18) Cultural safety matters – the conversation we need to keep having
  5. Media Watch (26/03/18) White privilege outrage
  6. Luke Pearson (24/03/18) The truth behind the Nursing Code of Conduct lie
  7. Sarah Stewart (29/03/18) Fake news and lies! Nurses, midwives and white privilege 

End

Thanks for reading.

As always your comments are welcomed in the section below.

Paul McNamara, 28 March 2013

Short URL: meta4RN.com/white

+update on 29/03/18 re typos + references/recommended reading

+update on 30/03/16 as rebuttal to NPAQ

#OzNurses

A curated compilation of tweets celebrating the union support of Australia’s nurses and midwives using the hashtag #OzNurses

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

Explanation

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

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/OzNurses

In praise of marking assignments

A short story about luck and rapid responses.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Explanation

These Tweets were initially compiled using a social media aggregation tool called Storify https://storify.com/meta4RN/in-praise-of-marking-assignments

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, 10th March 2018

Short URL: meta4RN.com/marking

Delirium Risks and Prevention

Tweets re the guest lecture by Prof Sharon Inouye at Royal Brisbane and Women’s Hospital (and Cairns via videolink) on 16th October 2017.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

Explanation

These Tweets were initially compiled using a social media aggregation tool called Storify https://storify.com/meta4RN/delirium-risks-and-prevention

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, 10th March 2018

Short URL: meta4RN.com/delirium

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

Nurses on the 2018 Australia Day Honours List

Extracting information from www.gg.gov.au/australia-day-2018-honours-list, below are the Nurses named on the 2018 Australia Day Honours List.


Sandra Joyce Berenger AM
Member (AM) in the General Division of the Order of Australia
Cardiff, New South Wales
For significant service to nursing in the field of infection prevention and control, as a clinician and consultant, and to medical associations.

Service includes:

Hunter New England Local Health District:
District Infection Control Clinical Nurse Consultant and Nurse Manager, Infection Prevention Service, since 2005.
Infection Control Consultant, since 1983.
Board Member, Hunter Area Health Service, 1990-1993.
Infection Control Supervisor/Consultant, Hunter Area Health Service, 1983-2004.
Charge Sister, Royal Newcastle Hospital, 1972-1981.

Project Officer, New South Wales Department of Health, 1990-1992, to develop infection control policy and education for health care workers in HIV/AIDS.
A range of short term international consultancy roles for AIDS and Infection Control, World Health Organisation, 1989-1992.

Assisted with establishment and work of Mackillop House (a respite care centre for HIV patients) in conjunction with Sisters of St Joseph and Make Today Count, 1989-2000.

Australian Infection Control Association (now Australasian College of Infection Prevention and Control):
President, 1991-1993.
Life Member.

Fellow, Infection Control Association of New South Wales (FICA).

Awards and recognition includes:
Co-Recipient, Clinical Excellence and Patient Safety Winner, Australian Council on Healthcare Standards Quality Improvement Awards, 2015.
Recipient, Community Award, AIDS Council of New South Wales.

 

********************************************

Margaret Ann Bradford-Seeley OAM
Medal (OAM) of the Order of Australia in the General Division
Bindoon, Western Australia
For service to community health in Western Australia.

Service includes:

Registered Nurse, Western Australia and Northern Territory Section, Royal Flying Doctor Service, circa 1990s-2005.

Registered Nurse, Road Primary Health Care Program, Royal Flying Doctor Service on the Road, 2008-2014.

Lions Cancer Institute:
Board Member, 2 years.
Skin Cancer Screening Consultant, since 2005. Member, Lions Club of Gingin Chittering.

Served in a range of roles with Gingin-Chittering Anglican Parish including as: Lay Pastoral Minister.
Treasurer.
Member, Rural Executive Committee.

Australian Women Pilots’ Association: President, Western Australia Branch, 2008. Member, Victorian Branch, 1994.

Committee Member, Bindoon Arts and Crafts Centre, current. Steward, Bindoon Agricultural Show, current.

********************************************

Charlotte Francis Champion De Crespigny AM
Member (AM) in the General Division of the Order of Australia
Netherby, South Australia
For significant service to nursing, and to nurse education, particularly in the field of drug and alcohol care, and to Indigenous health projects.

Service includes:

University of Adelaide:
Adjunct Professor, School of Nursing, since 2015. Professor of Drug and Alcohol Nursing, 2008-2015.

Flinders University and Drug and Alcohol Services South Australia:
Joint Chair, Professor of Drug and Alcohol Nursing, School of Nursing and Midwifery and Alcohol Services SA, 2000-2008.
Clinical Nurse, Nurse Educator and Frontline worker trainer and Aboriginal workforce, 1988- 2000.
Lecturer, Senior Lecturer and Researcher, 1996-2000.

Leader and co-author, Alcohol, Tobacco and Other Drugs: Clinical Guidelines for Nurses and Midwives statewide, 2003 and 2012 (revised).

Leader, co-author and educator, National Alcohol Treatment Guidelines for Indigenous Australia, Commonwealth Department of Health competitive funding, 2005-2009.

Leader, co-author and researcher, Comorbidity in the North (CAN), Commonwealth competitive funding and SA Mental Health funding, 2011-2014.

Leader, Coordinated Aboriginal Mental Health Care (CAMHC), Alcohol and Other Drug and Mental Health Program, 2000-2004 and 2005-2009.

Convenor, First International Conference for Drug and Alcohol Nurses and Midwives, Adelaide, 2003.

Drug and Alcohol Nurses of Australasia: Member, since 1991.
Past President.
Life Member.

Annual Adams, M, de Crespigny, C, and Harvey Oration, since 2011.

Founder, Alcohol, Tobacco and Other Drugs (ATOD) Nurses and Midwives Statewide Action Group, 2000-2015.

********************************************

Glenys Elizabeth Chapman OAM
Medal (OAM) of the Order of Australia in the General Division
Late of Kellyville, New South Wales
For service to nursing, and to international outreach programs.

Service includes:

Open Heart International:
Leader, Burn Surgery Project, Nepal, 2014- 2017. Member, Burn Surgery Project, Nepal, 2004-2017. Member, Nepal Plastic Surgery Program, 1996-2004. Member, Cleft Lip and Palate Team.
Volunteer, 1996-2017.

Volunteer/Fundraiser/Supporter, Adventist Development and Relief Agency, Nepal, 2004- 2017, (The Agency has supported education improvement initiatives for children in Nepal including sponsorship of over 160 children to attend school and upgrades to educational facilities).

Nursing Unit Manager, Surgical Centre, Sydney Adventist Hospital, 1995-2017.

********************************************

Karen Michelle Glaetzer AM
Member (AM) in the General Division of the Order of Australia
Torrensville, South Australia
For significant service to nursing, particularly in the field of palliative care, to people living with Motor Neurone Disease, and to professional groups.

Service includes:

Southern Adelaide Palliative Care Service:
Palliative Care Nurse, since 1988.
Was the first Palliative Care Nurse Practitioner to be endorsed in Australia, 2003.

Palliative Care Nurses Australia: First Elected Chair, 2006. Treasurer, several years.

Foundation Fellow, Australian College of Nurse Practitioners.

Member, Motor Neurone Disease Association of South Australia (MND SA), since 1991.

Panel Member, Australian Health Practitioner Regulation Agency, current.

Academic Status, School of Medicine, Flinders University, current and has been involved with curriculum development.

Awards and recognition includes:
Recipient, Nina Buscombe Award, ‘for commitment to people living with MND’. Recipient, Churchill Fellowship, 2013.
Recipient, Inaugural South Australian Palliative Care Nurse Award, 2009. Recipient, SA Premier’s Nursing Scholarship, 2000.

********************************************

Margaret Mary Miller OAM
Medal (OAM) of the Order of Australia in the General Division
Warwick, Queensland
For service to the community of Warwick.

Service includes:

Warwick and District Branch, Leukaemia Foundation of Queensland (now Leukaemia Foundation of Australia):
Founder and President, 1985-2015.
District Support Person, current.

Life Member.
Member, Warwick Show & Rodeo Society Ladies Auxiliary, since 1977; Life Member.

Registered Nurse, Warwick Benevolent Society, 1997-2015. Registered Nurse, 50 years.

Awards and recognition includes:
Recipient, Professor Ian Frazer Humanitarian Award, Warwick Lions Club, 2010. Recipient, Paul Harris Award, Rotary Club of Warwick, 2010.

********************************************

Susan Lindley Oakey OAM
Medal (OAM) of the Order of Australia in the General Division
Bolton Point, New South Wales
For service to aged welfare.

Service includes:

Mercy Community Services: Chair, 2008-2014.
Board Member, since 2005.

Chair, Mercy Aged Care Singleton, 2008-2014.

Anglican Church of New South Wales:
Director of Care, Anglican Care Newcastle/Lake Macquarie, 1995 – 1998. Director of Nursing, 1977-1984 and 1986-1995.
Matron, 1965-1968.

Former Member, Anglican Diocese of Newcastle.
Past Parish Councillor, Toronto Anglican Church.
Diocesan Director of Aged Care Services, Samaritans Foundation, 1984-1986 and Volunteer, Toronto Community Relief Centre.

********************************************

End

Please let me know via the comments section below if I missed any nurses on the 2018 Australia Day Honours List. I’m happy to correct any oversights.

Paul McNamara, 26 January 2018

She ignored her emotions while labelling his corpse #8WordStory 

Look. I’m a terribly busy and important person.

I barely have time to write this blog post, let alone satisfy my lazily-never-pursued fantasy of writing a novel.

Luckily, the Queensland Writers Centre offered a solution: the eight word story.

Eight words is the perfect length for somebody with the attention span of a stoned goldfish (eg: me).

Yesterday, one of my eight word stories was published by the Queensland Writers Centre. Published on electronic billboards, that is. Billboards that grace the busy roads, roundabouts and motorways in and around Brisneyland.

Billboard at Bowen Bridge Road, Hertson

The story published was one of three stories I submitted on Twitter for the #8WordStory project.

THREE whole stories! That’s TWENTY FOUR words, you know! #TypistCramp

Intentionally, all three of the stories relate to my work experiences. When writing these stories I was ambitious to be ambiguous. When there are only eight words to write, the reader needs to be able to bring their imagination to the story.

Interestingly, the story that was the most ambiguous of the three is the one that made it to the billboards.

#8WordStory x3

She ignored her emotions while labelling his corpse. [source]

I wrote this remembering my experiences of being with patients during the last hours of their life and for the first hours of their death. Nursing’s unique role of caring for a person’s body both in life and death is rarely spoken about or acknowledged. It’s one of those peculiar privileges of nursing.

The story is ambiguous enough for people to project their own meaning (eg: Lea’s tongue-in-cheek Tweet). I’m cool with that.

Impersonating a calm person, the nurse continued working. [source]

I was thinking of a young medical ward RN who had just intervened when a patient tried to harm himself. We had a quick “corridor consult”. She asked a couple of unanswerable questions, shed a couple of tears, wiped her eyes, washed her hands, then assumed her usual energetic and positive demeanour.

One minute there’s a crisis. Next minute it’s business as usual.

Hold and contain three things: the crisis, the patient, your emotions (not necessarily in that order).

The midwife didn’t smile until he heard crying. [source]

About 1 in every 60 Australian midwives is a male. I thought it would be more interesting and ambiguous to cite that minority in this story.

Crying is usually considered in a negative light in mainstream society, but midwives know crying as a sign of life.

Billboard on Lutwyche Road, Lutwyche

My 15 minutes 8 words of fame.

Billboard on Beaudesert Road, Moorooka

The story provides the frame. The imagination does the work.

Billboard on Logan Road, Upper Mount Gravatt

Finishing-Up

Why don’t you give an #8WordStory a go too? Submit yours via Twitter or web page.

Big shout-out to the Queensland Writers Centre for this great initiative.

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

End

Paul McNamara, 3rd November 2017

Short URL: meta4RN.com/8WordStory