Tag Archives: nurses

Switching Operating Systems

I really like my iPhone. I’ve owned three smartphones – they’ve all been iPhones. I know the iPhone operating system so well that I can work that elegant little machine one-handed in my sleep. Give me any other phone operating system and I will turn into a slow and clumsy boofhead: nothing falls to hand, nothing is intuitive, nothing looks the same.

If I use my iPhone I’m proficient and confident. If I’m handed anything that’s not an iPhone I’m plodding and anxious.

It’s been like that at work this week.

Obligatory PPE Selfie

Queensland is one of the rare places in the world that pretty-much eliminated the COVID-19 pandemic for nearly 2 years. That gave time for every adult Queenslander to receive at least two doses of the vaccine, if they wanted to, before the borders opened and the virus arrived. Baseline data here: meta4RN.com/baseline

As a reminder, Queensland border restrictions have been reduced in steps starting Monday 13 December 2021. Less than a month ago.

What an amazing three-and-a-bit weeks it’s been! As at 13 December 2021 Queensland had accumulated 2176 COVID-19 cases in the 22 months since the start of the pandemic. In less than 4 weeks that number has grown to more than 66,000 [source]. Exponential af. 😳

We all knew a significant rise in cases was coming, but most of us are shocked by how quick and large the explosion has been.

Yes, there was lots of preparation in the lead-up, but it’s been like switching phones/operating systems. Suddenly we’re doing stuff we’re not familiar with yet: nothing falls to hand, nothing is intuitive, nothing looks the same.

We will adapt, of course, but it is understandable that it might take us a little more time. We are comforted to know that we’re not the only service that is struggling. That confirms that we’re not finding things difficult and stressy because we’re a bunch of boofheads. We’re finding things difficult and stressy because we’re in the guts of a crisis.

In my gig (a mental health nurse in a general hospital) sometimes (eg: NOW! 🙂) it’s useful to be informed by a model of care specifically designed for responding to a crisis: psychological first aid (not to be confused with mental health first aid).

Put simply, psychological first aid is a humane, supportive response to a fellow human who needs a hand. Psychological first aid doesn’t require expertise or qualifications, it requires the motivation and capacity to pitch-in to promote calmness, safety, efficacy, connectedness and hope.

That kind and helpful approach, together with revisiting some ideas we had at the beginning of the pandemic, will do for now while we’re adapting. And – for me anyway – it’s probably easier to do that stuff than switching phones/operating systems. 🙂

Psychological First Aid

If you’re interested in learning more about psychological first aid see my prezi [click here] and/or this PDF from Australian Red Cross:

End

Thanks for visiting.

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

Paul McNamara, 8 January 2022

Short URL: meta4RN.com/switch

Bonus video: Old bloke shaving

Idea to Tackle Nurse Stereotyping (1993-1994 version)

Once upon a time (1993-1994), I had an excellent idea on how to tackle structural corporate nurse stereotyping.

Here is the story:

Part One: The Concept (letter & illustration, 22/11/1993)

22nd November 1993

The Manager
Uni Foods Pty Ltd

Dear Sir/Madam,

I am a habitual, albeit irregular, user of Nurses Cornflour – it is a product that enjoys vegemite-like status in the kitchen. Indeed, I believe that most Australians would consider their cupboard bare without both of these culinary icons. 

However, I can not help but notice that the packaging of your fine product is outdated in style, and at risk of being construed as a sexist portrayal of who is responsible for cooking and nursing. In these politically correct times, the packaging of any product requires a considered, sensitive approach, so as not to offend. It may well be that sales of Nurses Cornflour are being adversely affected by the packet’s picture of a pretty sponge-holding nurse wearing a cap.

As a male, as a nurse, as an occasional sauce and gravy maker, and as a person who is becoming attuned to the politically correct ideals of the 1990’s, I believe I am well qualified for the position of Nurses Cornflour model/promoter. I have enclosed, for your consideration, a crude facsimile of how my face could be used to lend Nurses Cornflour a more contemporary, less sexist, image.

I look forward to your response to this proposal.

Yours sincerely,
Paul McNamara RGN SPN MRCNA

I looked exactly like this in 1993

Part Two: The Follow-Up (letter, 15/02/1994)

15th February 1994

The Manager
Uni Foods Pty Ltd

Dear Sir/Madam,

I have yet to receive a reply to my letter of 22nd November 1993 (copy enclosed). No doubt, like me, you have been giving this matter some serious consideration over the last few months.

I am sure you would agree that this presents an exciting opportunity to give the image of Nurses Cornflour a profile that will have it being talked about in kitchens and advertising boardrooms all over Australia. Any notoriety I might receive would take a back seat to the sales figures of Nurses Cornflour: it is the latter that should take precedence when considering this matter.

As before, I look forward to your response to this proposal.

Yours semi-sincerely,
Paul McNamara RGN SPN MRCNA

Part Three: The Gentle Let-Down (reply letter, 15/03/1994)

15th March 1994

Dear Mr. McNamara,

Thank you for your letter and illustration of 22nd November 1993 and subsequent letter of 15th February 1994. Our apologies for the delay in responding to your letter.

Whilst we agree that the illustration on Nurses Cornflour could be modified to become more contemporary we respect the concerns of our loyal customers who have grown to know and love that familiar pack.

Please be assured that the packaging is in no way intended to be sexist or stereotypical.

Thus, with respect, we will not be taking up your very kind offer. However, our sincerest thanks for the time you have taken to write to us. We enclose one of our new Continental Easy Meals which we hope you enjoy.

Wishing you all the best in your career.

Regards
CATHY RODDA
Brand Manager – Dry Meal Bases
unifoods 
A division of Unilever Australia Ltd

Idea

Nearly 30 years on, I reckon it’s time for someone else to have another crack at becoming the Nurses Cornflour nurse. The current version is an update from the 1936 version, yet the crisp white uniform and crisp white hat on a crisp white woman remain. 🙄

Please consider this blog post a lighthearted clarion call to challenge nurse stereotypes. Even if you’re unsuccessful, like me, you may receive a free sample in the mail for your trouble. 🙂

End

The twaddle and fluff above is all there is for this blog post. Stumbling across the old letters gave me a nostalgic laugh today – hopefully you have had a bit of a giggle too. 

Paul McNamara, 12 December 2021 

Short URL: meta4RN.com/idea 

Queensland COVID-19 Data Compared with Similar-Sized Populations (an amateur pre-border opening baseline)

This is a December 2021 update to data presented in an August 2020 presentation and blog post called Liaison in the Time of #COVID19. It is worth doing it now, I reckon, because the borders will open in a couple of weeks, and Queensland will become one of those rare places who have had the luxury of successfully suppressing the pandemic long enough to allow the population to be vaccinated. Well, those who trust and follow the science, that is.

As noted on previous blog posts [here & here], Queensland’s population is much bigger than Australia’s smaller states/territories (which are all well-under 3 million), but falls a long way short of Australia’s two largest states (which are both well-over 6 million).

So, on population alone (ie: with cavalier disregard to geography, housing density, culture or climate) it is better to compare the 5 million-ish Queensland population to the 5 million-ish populations of Ireland, New Zealand, Norway and Singapore.

Please interrogate the comparative data collated in the table below.

IrelandNew ZealandQueenslandNorwaySingapore
Population 5 011 5005 126 3005 236 1725 415 1665 450 000
Total COVID-19 Cases573 90511 7232 130269 433266 049
Active COVID-19 Cases*6 00816*12 255
COVID-19 Cases in Hospital5786114246993
COVID-19 Cases in ICU117*06962
COVID-19 Deaths5 6522271 092726
% 1st Dose COVID-19 Vaccine91.319486.578.796
% 2nd Dose COVID-19 Vaccine89.778776.471.196
Data as @ 01/12/21
* = number not reported online [][][][][] vaccine % of eligible people (ie: 12yo +)

I do not take my good fortune of living and working in Queensland for the last two years for granted.

It is important to reinforce the obvious: this data comparison is not some sort of macabre competition. The death stats alone remind us that COVID-19 is not a game – as of 01/12/21 WHO report 262,178,403 confirmed cases of COVID-19, including 5,215,745 deaths. On a brighter note, WHO report that as of 28 November 2021 a total of 7,772,799,316 vaccine doses have been administered.

Think Global. Act Local.

Now, let’s look at how we have been faring in FNQ.

As of 01/12/21 Cairns and Hinterland has had 75 COVID-19 cases (none currently), and no deaths . We have been incredibly fortunate.

As of 01/12/21 over 177 000 vaccine doses have been administered in Cairns and Hinterland [source], but there is a bit of variation between the local government areas – as below [source]:

% 1st Dose COVID-19 Vaccine% 2nd Dose COVID-19 Vaccine
Cairns87.9 76.0
Cassowary Coast (Innisfail)85.371.0
Douglas85.575.3
Mareeba75.663.0
Tablelands (Atherton)84.572.5
Yarrabah63.243.5
FNQ vaccination rates of people aged 15+ as @ 28/11/21

Shaded part of map = these LGAs: Cairns, Cassowary Coast, Douglas, Mareeba, Tablelands, Yarrabah.

So What?

I don’t have the qualifications to tell you what all this data means. I certainly don’t have the skills or qualifications to use it to predict future data.

However, I do have the skills to collate and report data from reliable sources.

I intend to revisit this data before I shut down the meta4RN blog in September 2022, and compare how we fare after the borders open compared to the December 2021 baseline data collated above.

Data Sources 

FNQ Data
COVID-19 vaccination – Geographic vaccination rates – LGA https://www.health.gov.au/resources/collections/covid-19-vaccination-geographic-vaccination-rates-lga

Queensland
Population https://www.qgso.qld.gov.au/statistics/theme/population/population-estimates/state-territories/qld-population-counter
COVID Cases & Vaccines https://www.qld.gov.au/health/conditions/health-alerts/coronavirus-covid-19/current-status/urgent-covid-19-update

New Zealand
Population https://www.stats.govt.nz/topics/population 
COVID Cases https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-data-and-statistics/covid-19-current-cases
COVID Vaccines https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-data-and-statistics/covid-19-vaccine-data 

Ireland 
Population https://www.cso.ie/en/releasesandpublications/ep/p-pme/populationandmigrationestimatesapril2021/ 
COVID Cases https://covid19ireland-geohive.hub.arcgis.com 
COVID Vaccines https://covid19ireland-geohive.hub.arcgis.com/pages/vaccinations 

Norway
Population https://www.ssb.no/en/
COVID Cases https://www.vg.no/spesial/corona/
COVID Vaccines https://www.vg.no/spesial/corona/vaksinering/norge/ 

Singapore 
Population https://www.singstat.gov.sg/modules/infographics/population
COVID Cases https://covidsitrep.moh.gov.sg
COVID Vaccines https://www.moh.gov.sg/covid-19/vaccination 

End

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

Paul McNamara, 2 December 2021

Short URL: meta4RN/baseline

Addit

Self Compassion and Post Traumatic Growth amongst Nurses in the Pandemic (Hooray for Grey Hairs!)

You may have seen that COVID-19 related content from the International Journal of Mental Health Nursing has been collated on one page, and is free to read. If not, sus it out here: IJMHN COVID-19

There’s an interesting recent addition to that list of articles by a group of nurses working at Southern Cross University and in the Northern New South Wales Local Health District. The paper reports on the stress risk and protective factors amongst 767 Australian nurses working in acute-care settings during the COVID19 pandemic.

The findings that jumped-out at me from the paper were that more experienced* nurses reported more self-compassion. Greater self-compassion resulted in:
– a reduction in pandemic-related stress
– less symptoms of depression and/or anxiety
– greater post-traumatic growth.

That’s great, right?

The findings from the Australian survey are similar to a large-scale China survey in that post-traumatic stress for nurses during COVID-19 is offset by post-traumatic growth. Understandably, the numbers in the Australian study are less pronounced than they were in the Chinese study, reflecting the difference in the two country’s experience of the COVID-19 pandemic.

Chen, R., Sun, C., Chen, J.‐J., Jen, H.‐J., Kang, X.L., Kao, C.‐C. & Chou, K.‐R. (2020), A Large‐Scale Survey on Trauma, Burnout, and Posttraumatic Growth among Nurses during the COVID‐19 Pandemic. International Journal of Mental Health Nursing.

So What?

If, like me, you’re an experienced * nurse, celebrate and share your self-compassion super-power and with other nurses. This, together with the possibility that the pandemic may cause professional/personal growth to offset the stress, is very encouraging.

If you’re new-ish to nursing, be very deliberate about building-in self-compassion to your work.

People who are attracted to nursing are usually empathetic towards the needs of others. That’s great, of course, but the downside for empaths is that sometimes we put the needs of others before our needs.

That’s the pathway to burnout, my friend.

It is sensible to be intentional about self-compassion, ie: the art of being kind to yourself, and finding a workable, realistic balance between your life experiences, thoughts and feelings. Self-compassion will not dilute your empathy. It will allow you to continue in your empathetic work better for longer.

How do you go about self-compassion?
Maybe finding yourself the right mentor(s).
Maybe just everyday stress management stuff.
Maybe getting some clinical supervision.
Maybe phoning Nurse & Midwife Support.
Maybe you should stop reading dumb nursing blogs, and go outside and do something fun instead. 🙂
Maybe a bit of each of the above.

NB*

*“experienced” is probably code word for “those with grey hairs”

References

Aggar, C., Samios, C., Penman, O., Whiteing, N., Massey, D., Rafferty, R., Bowen, K. & Stephens, A. (2021), The impact of COVID-19 pandemic-related stress experienced by Australian nurses. International Journal of Mental Health Nursing,
https://doi.org/10.1111/inm.12938

Chen, R., Sun, C., Chen, J.‐J., Jen, H.‐J., Kang, X.L., Kao, C.‐C. & Chou, K.‐R. (2020), A Large‐Scale Survey on Trauma, Burnout, and Posttraumatic Growth among Nurses during the COVID‐19 Pandemic. International Journal of Mental Health Nursing
doi.org/10.1111/inm.12796

Declaration of Interests

In the interests of transparency, there are three declarations to be made re this blog post:
1. I am the Social Media Editor of the International Journal of Mental Health Nursing.
2. I have a bias towards promoting nurse mental wellbeing, including my own.
3. What little hair I have left is very very grey.

End

That’s it. If you haven’t gone out to do something fun already, maybe stay where you are and sus-out the the Aggar et al article here, and have a browse through the other IJMHN COVID-19 papers here.

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

Paul McNamara, 16 October 2021

Short URL meta4RN.com/grey

Beginning of the End

Yesterday I confirmed what I’ve been mulling-over for a while: I’ll retire the meta4RN blog in September 2022.

#ihatemytwittertypos

That will make a nice even ten years of nurse-blogging. I’m only a few years away from retirement, and need to start the transition. It’s time for me to use my non-work time doing more non-work stuff.

When I started the meta4RN thing I thought I’ll aim to be the most visible Australian mental health nurse on social media. I’m not sure, but I think I’ve probably achieved that. Even if I haven’t, it’s a remarkably unambitious target.

I’m amazed how many nurses – mental health nurses, in particular – self-censor themselves into silence on social media. I started the meta4RN blog in response to the prevailing “stop it or you’ll go blind” approach to social media by senior health and university people at the time. It’s incredible that nurses are the most trusted profession in Australia [source & source], are employed to go behind the curtains and help people who are having one of the worst days of their lives, but are not considered by some within our ranks not to be mature enough to go online. FFS.

I’m getting bored and tired pushing against the bricks. I’ll use the platform for the next 12 months, and then put meta4RN.com to bed. I haven’t really decided to do with the rest of the meta4RN social media portfolio yet, but I’ll work that out over the next year.

For the uninitiated, and so (hopefully) it with be swept-up by the Wayback Machine and Trove/National Library of Australia bots, below is a list of the other arms of the meta4RN social media portfolio.

Twitter @meta4RN

Facebook facebook.com/meta4RN

YouTube youtube.com/meta4RN

Instagram instagram.com/meta4RN

TikTok tiktok.com/@meta4RN

Prezi prezi.com

Wakelet wakelet.com/@metaRN

SlideShare slideshare.net/paulmcnamara

Reddit reddit.com/user/meta4RN

Tumblr meta4RN.tumblr.com

ResearchGate www.researchgate.net

Orcid orcid.org

LinkedIn www.linkedin.com/in/paulmc

LinkTree linktr.ee/meta4RN

It’s an unnecessarily over-the-top list. I’ve probably overdone the effort to demonstrate that there is an avenue for nurses to promote their profession and voice, should they – like me – get exasperated at being routinely forgotten or sidelined in the public conversation.

End of ‘Beginning of the End’

That’s it.

Just putting it out there so when I pull up stumps next year it comes as no surprise.

If you know of someone who might be interested in the not-so-lofty title of ‘most visible Australian mental health nurse on social media’ let them know that now is a good chance to pounce. 🙂

Paul McNamara, 25 September 2021

Short URL meta4RN.com/end

Q: RUOK? A: Not really. I’m a nurse.

09/09/21 = RUOK Day. More about that here: www.ruok.org.au

Ask a nurse how they are and they’ll probably give a positive answer: “good thanks”, “ticketyboo” and “living the dream” are favourite reflex answers in the hospital where I work.

Scratch beneath the surface though, and the overwhelming answer to the question “Are you OK?” amongst health professionals – especially nurses – in September 2021 would be: “No. Not really.”

Nurses know we’ve been lucky to have secure employment at a time when many others have not. However – as a profession – we are tired and anxious. This is evidenced by articles in the mainstream press, posts on social media, and research published in academic, peer-reviewed, journals.

Source: https://pbfcomics.com/wp-content/uploads/2018/06/PBF-Youll_Be_OK.png

There is some stuff we can do by ourselves.

There is some stuff to manage stress that we can do by ourselves. Simple things like mindfully washing our hands, for instance. I first read about this idea via Ian Miller (aka @impactednurse and @thenursepath) in 2013. When Ian withdrew from the online space, I reprised the idea in a 2016 blog post:

Then refreshed the idea in March 2020 when the pandemic hit Australia:

And made a short video version to accompany the blog post:

The mindful handwashing idea for nurses, as I saw for myself for the first time yesterday, has now been published in a text book:

Being published in a text book makes an idea legit, right? 🙂

Anyway – if you haven’t already – try building-in something like mindful handwashing into everyday practice. Something that you can do for yourself, by yourself, while you’re at work.

On behalf of your boss, I can assure you that she/he/they does not want you to burnout – nurses have never been more valued than they are in September 2021. She/he/they needs you. If taking a couple of extra seconds to wash your hands helps you take care of yourself, your boss will be happy that you’re using that time productively.

There is some stuff that we need to do with others.

Nursing is a team sport. So is self-care.

Those familiar with meta4RN would know already that I’m likely to bang-on about clinical supervision. So as not to disappoint, here you go:

And the other thing that I want to remind readers about is Nurse & Midwife Support – a 24/7 national support service for Australian nurses and midwives providing access to confidential advice and referral.

I was chatting with one of the NMSupport staff members recently, and her only suggestion was to encourage colleagues to NOT leave it until they’re feeling overwhelmed before phoning. It seems as if many of us have the bad habit of not asking for support until we’re in crisis. Now that I think about it, phoning a week or two BEFORE the crisis is probably a better idea. 🙂

Phone NMSupport on 1800 667 877, and/or visit their website (www.nmsupport.org.au), Facebook (www.facebook.com/NMSupportAU), Insta or Twitter:

One last thing (an overt plug for a friend’s book chapter).

In case you missed the subtle plug above, please let me be more explicit about promoting the chapter by a Consultation Liaison Nurse peer and friend, Julie Sharrock. The chapter title and book title say it all:

Sharrock, J. (2021). Professional self-care. In Foster, K., Marks, P., O’Brien, A. & Raeburn, T. (Eds.). Mental health in nursing: Theory and practice for clinical settings (5th ed.). (pp. 86-105). Elsevier Australia. www.elsevierhealth.com.au/mental-health-in-nursing-9780729

I really like that this chapter in a text book by nurses for nurses acknowledges that we need to care for ourselves to care for others. Although it flies in the face of that ridiculous hero narrative, it is legitimate for nurses to seek a long-lasting, satisfying and meaningful career. Julie’s chapter speaks to that, and provides explicit information on strategies for nurses to use.

I recommend that you have a read of the evidence-based ideas for sustaining yourself and your career that the chapter contains. Perhaps your local hospital/university already has a copy of the book.

End.

That’s it. I just wanted to make a point that not all of us are OK. Unlike the caravaner below, not all of us can “Just deal with it Trish.” Well, not ALL the time, anyway.

@meta4rn

“Just deal with it Trish.” #JustDealWithItTrish Trish and Rex: stranded Victorians interviewed in an Albury caravan park, 09/09/21 #RUOKday #RUOK

♬ original sound – Paul McNamara

As always, you are very welcome to leave feedback in the comments section below.

Paul McNamara, 9 September 2021

Short URL: meta4RN.com/RUOK

Voluntary DOES Mean Voluntary; Scaremongering Means Scaremongering

Just a quick blog post to reassure those alarmed by the dodgy “voluntary should mean voluntary” scaremongering campaign. Please see the corrected version below.

Of course neither patients or health professionals will be pressured into voluntary assisted dying under the proposed Queensland voluntary assisted dying legislation. The word “voluntary” in “voluntary assisted dying” makes it pretty clear, but don’t just take my word for it.

Let’s look at some key sections from “A Legal Framework for Voluntary Assisted Dying”, published by the Queensland Law Reform Commission (QLRC) in May 2021 [PDF]. This is the document Queensland politicians will be reviewing next week, prior to casting a conscious vote.

“Voluntary assisted dying is an active and voluntary practice… It is a voluntary practice in that it is undertaken at the person’s request. More than one request is required. The decision to access the process must be made freely and without coercion.” (QLRC, May 2021, section 1.48, page 7)

“In summary, we recommend that the right to refuse to participate in voluntary assisted dying on the grounds of conscientious objection should apply to registered health practitioners (such as doctors and nurses) and to speech pathologists.” (QLRC, May 2021, section 14.96, page 437)

The proposed Queensland voluntary assisted dying law is similar to the existing legal framework for termination of pregnancy, in that neither patients or clinicians are forced into dong something they object to. The proposed Queensland voluntary assisted dying law has additional safeguards.

For example, a patient safeguard includes: “The process of request and assessment involves three separate requests that are clear and documented. The process has a waiting period of at least 9 days between the first and final request.” (QLRC, May 2021, section 8.477, page 248)

An example of a safeguard for health practitioners includes provision for “conscientious objection” (QLRC, May 2021, section 8.103, page 200) and, “The practitioner must have completed the approved training before they accept a transfer of the role of administering practitioner.” (QLRC, May 2021, section 13.187, page 412) To my way of thinking, this is a generous safeguard in that it allows health professionals who are unsure or ambivalent to simply not-get-around-to completing the training. This also safeguards the patient from enduring a clinician who is unsure of their own beliefs, or passively resistant to the patient’s wishes.

There is strong support for voluntary assisted dying (VAD) legislation in Queensland:
~77% of the public support VAD
~87% of nurses support VAD

Source: Queensland Nurses & Midwives Union (QNMU), June 2021, Submission into the Voluntary Assisted Dying Bill 2021 [PDF]

It is interesting to reflect on why nurses have a higher rate of support for voluntary assisted dying than the general public… What do nurses see and know that others don’t see and know?

It is also important to reassure the 13% of Queensland nurses and midwives who did not support voluntary assisted dying in the QNMU February 2021 survey [PDF], that they will not be pressured or compelled to participate. Just as is the case with pregnancy termination, only a very small percentage of the nursing workforce are in roles where they will be directly exposed voluntary assisted dying. Not only is there no pressure to become involved if you do not want to, you can not be involved unless you choose to complete specific voluntary assisted dying training.

Voluntary does mean voluntary. Scaremongering means scaremongering.

End

Obviously, I’m part of the 87% of Queensland nurses who support voluntary assisted dying legislation. I’ve written about it previously in July [here], and wasn’t intending to write about it again. However, the scaremongering campaign can not go unaddressed. I’m realistic. I know the Catholic church has a much bigger audience and budget than me. All I have to counter their scaremongering is integrity and social media (it’s my loudest voice).

Thanks for visiting my blog. As always, your feedback is welcome via the comments section below.

Paul McNamara, 7 September 2021

Short URL: meta4RN.com/Voluntary

Addit on 08/09/21

This makes the same argument as me, but in a more articulate manner:

Vax Facts for Nurses by Nurses

Let’s start with a quote from this ANMF zoom page:

The fast moving pace of COVID-19 science both from disease progression and treatments has been hard to keep up with. As nurses and midwives, we are well-positioned to advocate for science and safety. In this webinar, Dr Jessica Stokes-Parish (RN, PhD) and IPN Romy Blacklaw will present the safety processes, research, surveillance of adverse events (including data on safety so far) and difference between COVID-19 vaccines.

The “Vaccine Science in the Context of COVID-19” webinar was on Thursday 26 August.

ICYMI (like I did), a recording of the webinar is available for free to Australian Nursing Midwifery Federation members, including the QNMU and NSWNMA branches, until 10 September 2021.

Have a sneak peek of the content here:

Want to see more? If so, login to the ANMF continuing professional education portal 👉 catalogue.anmf.cliniciansmatrix.com 👈  by 10 September and search on the word “vaccine”. Despite missing the live event, you’ll still get a certificate in recognition of continuing profession education on completion (see example below).

What’s with the blog post? 

I have three reasons for promoting the webinar.

  1. I think the content of the webinar is worthwhile sharing. I really enjoyed learning about the COVID-19 vaccines in more depth than the info I had picked-up from work, online and in the mainstream media.
  2. Free, quality and easily accessible CPD/CPE for nurses and midwives deserves a shout-out, right? 🙂
  3. I reckon there’s a future for nurses delivering short, sharp and evidence-based information via video online. Not convinced? Have a look at the less-than-two-minute-long video clip above and see if you find it interesting/useful. I do.

Acknowledgement

Sincere thanks to the webinar presenters Jess Stokes-Parish and Romy Blacklaw, and the webinar host Australian Nursing and Midwifery Federation, for permission to use the video excerpt above, and for providing engaging and interesting CPE.

I was distracted for 15 seconds when a Harley loudly blurted past my house, and another 30 seconds by the dog chewing my thongs, so when claiming CPD hours for AHPRA will detract 0.0125 hours from the total. #fulldisclosure

End

That’s it.

You have less than 10 days to:

  1. hit this 👉 catalogue.anmf.cliniciansmatrix.com 👈 website
  2. login using your ANMF/QNMU/NSWNM membership info
  3. search the word “vaccine”
  4. and complete the free “Vaccine Science in the Context of COVID-19” CPD

Quick sticks! Don’t dilly-dally! Get a wriggle-on! 🙂

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

Paul McNamara, 1 September 2021

Short URL: meta4RN.com/VaxFacts 

Addit (to encourage Kiwis and Aussies)

CLovid Communication

This blog post aims to clarify how the clinicians on one Consultation Liaison (CL) Psychiatric Service communicate with general hospital inpatients who are being nursed in isolation during the COVID-19 pandemic.

Why? 

There has been some confusion re nomenclature of how we provide mental health assessment/support to hospitalised people in isolation . Hopefully by describing the pros and cons of the methods we’ve tried to date we’ll clear-up any misunderstandings. 

CLovid Communication options: 1. Videoconference. 2. In-Room (featuring Jelena Botha in PPE). 3. Face-To-Face through a window. 4. Phone.

1. Videoconference Review
ie: using an online videoconferencing platform that works on both the clinician’s computer and the patient’s own device

Pros:

  • No risk of infection transmission
  • When it works there is reasonably good eye contact and exchange of facial expressions and other non-verbal communications, leading to opportunities for engagement/establishing rapport 
  • Since mid-late 2020, nearly all clinicians and many (most?) consumers are familiar with videoconferencing 

Cons:

  • In my clinical practice videoconferencing for these reviews has been mostly unsuccessful. Cross-platform incompatibility and limitations to what the devices/bandwidth that hospital inpatients in isolation have access to have been problematic.
  • At our end, clinical workplaces do not provide access to the same platforms our patients typically use (eg: FaceTime, Video Chat on Facebook or WhatsApp).
  • The technology was getting in the way of the therapeutic relationship, not enhancing it.
  • For these reasons, we pretty-much gave up on trying to videoconference hospital inpatients in isolation back in April/May 2020. 

2. In-Room Review 
ie: in full PPE – face mask, goggles/face shield, gown and gloves

Pros:

  • Physical proximity is standard practice: Clinical staff and the people we care for are familiar with this 
  • Reasonably good eye contact and partial exchange of non-verbal communication, leading to opportunities for engagement/establishing rapport

Cons:

  • PPE obscures facial expressions, thereby inhibiting rapport/assessment
  • An extra clinician(s) using PPE resources
  • With no disrespect to my CLPS clinical colleagues, we’re generally not as well-drilled with donning and doffing as the specialist nursing and medical teams, creating potential risk of infection transmission

3. Face-To-Face Review 
ie: through the window/glass door panel, using phones for easy/clear auditory communication

Pros:

  • Good eye contact and exchange of facial expressions and other non-verbal communication, leading to opportunities for engagement/establishing rapport
  • No risk of infection transmission
  • Low-tech, easy to organise
  • Well received by nearly every hospitalised person in isolation that my team has seen from March 2020 to August 2021

Cons:

  • Reminds me of prison-visit scenes in American movies

4. Phone Review 
ie: speak to the person on their personal mobile or bedside phone, no visual contact

Pros:

  • No risk of infection transmission
  • Low-tech, easy to organise 
  • It’s the go-to method of communication for community mental health intake clinicians/services (ie: thought to be a good-enough tool for most triage and sub-acute presentations; may be familiar to the clinician or consumer)
  • Some people find emotional expression easier without the intimacy/intrusion of eye contact

Cons:

  • Assessment and rapport may be limited
  • Not thought to be adequate for acute or high-risk presentations

And The Winner Is…

Number 3: Face-To-Face Reviews, ie: where the clinician and person in isolation chat through the window/glass door panel, using phones for easy/clear auditory communication. 

It’s cheap, easy and effective. We use it nearly every time when there’s someone in a negative-pressure/isolation room. We’ve saved dozens, maybe hundreds, sets of PPE, and we’ve reduced the likelihood of becoming potential super-spreaders. 

Why Does It Matter?

Like just-about every other specialist mental health nurse on the planet, my clinical practice is influenced by Hildegard Peplau. Back in the 1950s dear old Aunty Hildegard had the audacity to tell nurses that, done right, the nurse-patient relationship = therapy [source]. About 60 years later neuroscience caught up with nursing theory and showed us that Peplau was right: strong relationships and strong attachments help brains heal by building new neural pathways [source]. 

A specialist mental health nurse is, amongst other things, a psychotherapist and a relationship focussed therapist [source]. A face-to-face review, even if has to be through glass, helps establish rapport and build a therapeutic relationship. 

CLovid Acknowledgements

Consultation Liaison Psychiatry Service is a bit of a mouthful, so it’s usually abbreviated to “CL”. CL = mental health in the general hospital

Back in March 2020 John Forster, a CL Nurse in Melbourne, accidentally coined the portmanteau “CLovid” by combining “CL” and “covid” as a typo. 

That’s why I’m calling this blog post “CLovid Communication”. 

Please forgive people like me who take delight in silly things like an accidental neologism. There’s been a fair bit of CLovid in the last eighteen months, and there’s more to come. Staying vigilant to the small joys and moments of lightheartedness is a survival skill. 

Thanks also to Jelena Botha, CL CNC (who arrived on my team just in time for the global pandemic 😳), for allowing me to use her PPE pic.

Further Reading

Cozolino, L. (2006/2014) The Neuroscience of Human Relationships: Attachment and the Developing Social Brain. New York, W. W. Norton & Company. [Google Books]

Hurley, J. and 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, 30(2): 574-582. https://doi.org/10.1111/inm.12836

Peplau, H. (1952/1991) Interpersonal relations in nursing. New York: Putnam. [Google Books

Santangelo, P., Procter, N. and Fassett, D. (2018), Seeking and defining the ‘special’ in specialist mental health nursing: A theoretical construct. International Journal of Mental Health Nursing, 27(1): 267-275. https://doi.org/10.1111/inm.12317

End

What have I missed from this description of CLovid communication? Please add your on-the-job experiences and lessons in the comments section below.

Paul McNamara, 14 August 2021 

Short URL meta4RN.com/CLovid

A Nurse’s Digital Identity

I am a nurse who uses social media a lot. It is my loudest voice.

If you want to see what a nurse’s digital identity looks like, grab your phone and sus-out this QR code.

My role and ambitions are mid-range. As a student nurse I thought it would be cool to be a Nurse Educator or Clinical Nurse Consultant – I’ve achieved that. I have never aspired to one of those senior management/academic gigs. The downside to that lack of ambition is the limited opportunities to set agendas that drive broad change. In fact, even getting ideas heard or considered is difficult at times.

[insert sound of trumpets going “TooDa-TooDa” here] Social media to the rescue!

And, (this is the main point of this blog post), it is OK for nurses to use social media. Actually, it’s not just OK, USING SOCIAL MEDIA IS RECOMMENDED FOR NURSES AND MIDWIVES.

Don’t believe me?

Read on.

In the ‘National Nursing and Midwifery Digital Health Capability Framework‘ there is a section specifically about being online, as below:

1.3 Digital Identity
Nurses and midwives use digital tools to develop and maintain their online identity and reputation.

This section has four parts – feel free to tweet your favourites 🙂

Digital Identity 1.3.1: Maintains a professional development record demonstrating innovation, reflecting upon skills and experience to help monitor professional identity.

You could use a free app or website for that, for example:

Or just keep it all online via the ANMF Continuing Professional Education portal

Digital Identity 1.3.2: Understands the benefits and risks of different ways of presenting oneself online, both professionally and personally while adhering to the NMBA social media policy.

The policy uses slightly more formal language (read it for yourself here), but can be accurately summarised as “Even if you’re prone to being a dickhead at times IRL, when you’re representing yourself as a nurse online don’t be a dickhead.” If you do be a dickhead online occasionally (to err is human, blah blah blah), be sure to proactively delete and/or apologise.

It is MUCH more simple to keep your private and professional social media identities separate. Create a social media portfolio using the same name on your work name badge/AHPRA registration just for work-related stuff. That’s what I’ve done here linktr.ee/meta4RN Look, I know I’ve overdone it (#tryhard), but that was intentional too. I created the meta4RN social media portfolio at a time when the “prevailing wisdom” (“prevailing ignorance”, more like it 🙄) amongst hospital and university influencers was that social media is bad. Some of these people are still impersonating Grandpa Simpson and shaking their fist at the cloud. And the internet. And social media.

Digital Identity 1.3.3: Understands that online posts can stay in the public domain and contribute to an individual’s digital footprint.

If you want an example of how online posts stay in the public domain, visit/search for The Wayback Machine or Trove (part of the National Library of Australia).

Digital Identity 1.3.4: Recognises that their professional digital footprint, where it exists, should showcase their skills, education, and professional experience.

This is where things like LinkedIn or an online Curriculum Vitae (overdue for an update) come in handy.

Don’t hide your light under a bushel. If you’re a nurse please celebrate your achievements – if we don’t, who will?

My (univited) advice to nurses and midwives is this: Don’t be afraid of social media. Be intentional.

Reference

Australian Digital Health Agency, 2020. National Nursing and Midwifery Digital Health Capability Framework. Australian Government: Sydney, NSW.
nursing-midwifery.digitalhealth.gov.au


End

Thanks for visiting the meta4RN.com website/blog. Be sure to use the QR Code above or this link to see other arms of my m̶a̶g̶n̶i̶f̶i̶c̶e̶n̶t̶ m̶e̶t̶a̶4̶R̶N̶ ̶s̶o̶c̶i̶a̶l̶ ̶m̶e̶d̶i̶a̶ ̶e̶m̶p̶i̶r̶e̶ try-hard professional social media portfolio (aka professional digital identity).

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

Paul McNamara, 5 August 2021

Short URL meta4RN.com/ID