Tag Archives: nursing

Why on earth would a Mental Health Nurse bother with Twitter? (my #ACMHN2016 presentation)

This post is a companian piece to my oral presentation at the Australian College of Mental Health Nurses 42nd International Mental Health Nursing Conference, 25 – 27 October 2016, Adelaide Convention Centre (the conference hashtag is #ACMHN2016). The function of the online version is to be a collection point to list references.


The Prezi is intended as an oral presentation, so I do not intend to include a full description of the content here.

Regular visitors to meta4RN.com will recognise some familiar themes. Let’s not call it self-plagarism (such an ugly term), I would rather think of it as a new, funky remix of a favourite old song. Due to this remixing of old content I’ve included previous meta4RN.com blog posts on the reference list (which, in turn, makes the reference list look stupidly self-referential). Anyway, with that embarrassing disclosure, here are the references:.

References for Prezi “Why on earth would a Mental Health Nurse bother with Twitter?”

Australian College of Nursing (n.d.) Social media guidelines for nurses. Retreived from http://www.rcna.org.au/WCM/…for_nurses.pdf

Australian Health Practitioner Regulation Agency. (2014, March 17). Social media policy. Retrieved from http://www.ahpra.gov.au/News/2014-02-13-revised-guidelines-code-and-policy.aspx

Casella, E., Mills, J., & Usher, K. (2014). Social media and nursing practice: Changing the balance between the social and technical aspects of work. Collegian, 21(2), 121–126. doi:10.1016/j.colegn.2014.03.005

Citizen Kane DVD cover. (n.d.). Retrieved from http://www.currentfilm.com/dvdreviews4/citizenkanedvd.html

Facebook. (2015). Facebook logo. Retrieved from https://www.facebookbrand.com/

Ferguson, C., Inglis, S. C., Newton, P. J., Cripps, P. J. S., Macdonald, P. S., & Davidson, P. M. (2014).  Social media: A tool to spread information: A case study analysis of Twitter conversation at the Cardiac Society of Australia & New Zealand 61st Annual Scientific Meeting 2013. Collegian, 21(2), 89–93. doi:10.1016/j.colegn.2014.03.002

Fox, C.S., Bonaca, M.P., Ryan, J.J., Massaro, J.M., Barry, K. & Loscalzo, J. (2015). A randomized trial of social media from Circulation. Circulation. 131(1), pp 28-33

Gallagher, R., Psaroulis, T., Ferguson, C., Neubeck, L. & Gallagher, P. 2016, ‘Social media practices on Twitter: maximising the impact of cardiac associations’, British Journal of Cardiac Nursing, vol. 11, no. 10, pp. 481-487.

Instagram. (2015). Instagram logo. Retrieved from https://help.instagram.com/304689166306603

Li, C. (2015). Charlene Li photo. Retrieved from http://www.charleneli.com/about-charlene/reviewer-resources/

lifeinthefastlane. (2013). #FOAMed logo. Retrieved from http://lifeinthefastlane.com/foam/

McNamara, P., & Meijome, X. M. (2015). Twitter Para Enfermeras (Spanish/Español). Retrieved 11 March 2015, from http://www.ausmed.com.au/es/twitter-para-enfermeras/

McNamara, P. (2014). A Nurse’s Guide to Twitter. Retrieved from http://www.ausmed.com.au/twitter-for-nurses/

McNamara, P. (2014, May 3) Luddites I have known. Retrieved from http://meta4RN.com/luddites

McNamara, P. (2013) Behave online as you would in real life (letter to the editor), TQN: The Queensland Nurse, June 2013, Volume 32, Number 3, Page 4.

McNamara, P. (2013, October 25) Professional use of Twitter and healthcare social media. Retrieved from http://meta4RN.com/NPD100

McNamara, P. (2013, October 23) A Twitter workshop in tweets. Retrieved from http://meta4RN.com/tweets

McNamara, P. (2013, October 1) Professional use of Twitter. Retrieved from http://meta4RN.com/poster

McNamara, P. (2013, July 21) Follow Friday and other twitterisms. Retrieved from http://meta4RN.com/FF

McNamara, P. (2013, June 7) Omnipresent and always available: A mental health nurse on Twitter. Retrieved from http://meta4RN.com/twit

McNamara, P. (2013, January 20) Social media for nurses: my ten-step, slightly ranty, version. Retrieved from http://meta4RN.com/rant1

McNamara, P. (2016, October 15) Learn about Obesity (and Twitter) via Nurses Tweeting at a Conference. Retrieved from  https://meta4RN.com/obesity

Moorley, C., & Chinn, T. (2014). Using social media for continuous professional development. Journal of Advanced Nursing, 71(4), 713–717. doi:10.1111/jan.12504

New South Wales Nurses and Midwives Association [nswnma]. (2014, July 30). Women now have unmediated access to public conversation via social media for 1st time in history @JaneCaro #NSWNMAconf14 #destroythejoint [Tweet]. Retrieved from https://twitter.com/nswnma/status/494313737575096321

New South Wales nurses and Midwives’ Association. (2014). NSW Nurses & Midwives Association logo. Retrieved from http://housingstressed.org.au/wp-content/uploads/2011/08/NSWNMA.png

Nickson, C. P., & Cadogan, M. D. (2014). Free Open Access Medical education (FOAM) for the emergency physician. Emergency Medicine Australasia, 26(1), 76–83. doi:10.1111/1742-6723.12191

Nursing and Midwifery Board of Australia (2010, September 9) Information sheet on social media. Retrieved from http://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD10%2F3224&dbid=AP&chksum=qhog9%2FUCgKdssFmA0XnBlA%3D%3D

Tonia, T., Van Oyen, H., Berger, A., Schindler, C. & Künzli, N. (2016). International Journal of Public Health. 61(4), pp 513-520. doi:10.1007/s00038-016-0831-y

Twitter. (2015). Twitter logo. Retrieved from https://about.twitter.com/press/brand-assets

Wall Media. (2015). Jane Caro photo. Retrieved from http://wallmedia.com.au/jane-caro/

Wilson, R., Ranse, J., Cashin, A., & McNamara, P. (2014). Nurses and Twitter: The good, the bad, and the reluctant. Collegian, 21(2), 111–119. doi:10.1016/j.colegn.2013.09.003

WordPress. (2015). WordPress logo. Retrieved from https://wordpress.org/about/logos/

Wozniak, H., Uys, P., & Mahoney, M. J. (2012). Digital communication in a networked world. In J. Higgs, R. Ajjawi, L. McAllister, F. Trede, & S. Loftus (Eds.), Communication in the health sciences (3rd ed., pp. 150–162). South Melbourne, Australia: Oxford University Press.

YouTube. (2015). YouTube logo. Retrieved from https://www.youtube.com/yt/brand/downloads.html


If there’s anything here of use, you can either cite this web page as:

McNamara, P.  (2016, 21 October) Why on earth would a Mental Health Nurse bother with Twitter? Retrieved from http://meta4RN.com/ACMHN2016

or, if you’re pulling info direct from the abstract, use the more academic-sounding citation that’s in the IJMHN (the ACMHN journal):

McNamara, P. (2014) Why on earth would a Mental Health Nurse bother with Twitter? (presentation, ACMHN’s 42nd International Mental Health Nursing Conference Nurses striving to tackle disparity in health care 25 – 27 October 2016, Adelaide Convention Centre). International Journal of Mental Health Nursing, Vol 25, Issue S1, Pg 34. doi: 10.1111/inm.12771


That’s it. As always your comments are welcome.

Paul McNamara, 21st October 2016

Learn about Obesity (and Twitter) via Nurses Tweeting at a Conference

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 like Storify can add value to Twitter content
  4. How nurses can be simultaneously generous, incisive and funny


Small sample of conference Tweets. Click to see the whole story

Small sample of conference Tweets. Click to see the whole story: https://storify.com/meta4RN/obesity-personal-or-social-responsibility

So What?

Sometimes I have trouble explaining to health professionals how Twitter works at conferences. It’s easier to show an example, rather than just chin-wagging and flapping-about like a chook in a cyclone. That’s why I have created this example: https://storify.com/meta4RN/obesity-personal-or-social-responsibility

Haven’t I Seen This Before?

Maybe. Back in 2013 this example was buried about halfway through a long blog post called #ICNAust2013: Looking Back at a Nursing Conference through a Social Media Lens, At time of writing this self plagiarising (yet again!) post, the original post has been read 578 times, and the Storify version has been viewed 595 times. You may be one of the lucky few to have seen it before.🙂

Huh? I Don’t Get It.

Follow this link: https://storify.com/meta4RN/obesity-personal-or-social-responsibility, take 5 minutes to read through the collated Tweets, and then you’ll get it. Promise.


As always, you’re very welcome to leave feedback/suggestions/questions in the comments section below.

Paul McNamara, 15 October 2016

Short URL: https://meta4RN.com/obesity


What can Mental Health Nurses learn from the Amazing Story of a Catholic Patron Saint? (my #ACMHN2016 conference poster)

Welcome to the online companion to my poster presentation at the Australian College of Mental Health Nurses 42nd International Mental Health Nursing Conference, 25 – 27 October 2016, Adelaide Convention Centre.

If you have 6 minutes to spare, please watch the YouTube version:

“What can mental health nurses learn from the amazing story of a catholic patron saint?” was initially submitted as an #ACMHN2016 oral presentation, but accepted as a conference poster. So, instead of updating and reworking the YouTube presentation (as I had planned), I started again. I’m not sure that the poster meets the brief (well, abstract) as well as an oral presentation would have, but anyway…


Mental health nursing has a long tradition of story-telling as a tool for developing relationships, undertaking mental state assessment and informing clinical practice. This presentation aims to add to mental health nursing’s discourse about “how we do business”, and add another layer of cultural diversity to our narrative and identity. A review of the literature regarding a catholic patron saint called Dymphna has been undertaken. This will be summarised and presented in a manner in keeping with philosopher Alain de Botton’s proposal that religious teachings should not be trusted to the religious alone – they can be re-purposed and re-mixed to inform atheists too. The historical and mystical story of a 7th century European teenage martyr and saint will be aligned to 21st century Australian language and values. Dymphna’s tale takes unexpected twists and turns which will raise questions about Australia’s appetite for innovative models of mental health care, and whether more could be done to promote mental health nursing as a profession and an identity. This presentation will appeal to those interested in consumer-focused mental health care, innovative alternatives to mainstream care, celebrating mental health nursing, and amazing stories.



Catholic Online (n.d.) St. Dymphna. Retrieved from www.catholic.org/saints/saint.php?saint_id=222

Catholic Saints Info (2016, 27 July) Saint Dymphna. Retrieved from catholicsaints.info/saint-dymphna

de Botton, A. (2011, July) Alain de Botton: Atheism 2.0 [Video file] Retrieved from www.ted.com/talks/alain_de_botton_atheism_2_0

Franciscan Mission Associates. (n.d.) The Story of St. Dymphna. Retrieved from franciscanmissionassoc.org/prayer-requests/devotional-saints/st-dymphna/story/ 

Goldstein, J.L. & Godemont, M.M.L. (2003) The Legend and Lessons of Geel, Belgium: A 1500-Year-Old Legend, a 21st-Century Model. Community Mental Health Journal. 39: 441. doi: 10.1023/A:1025813003347

Ireland’s Eye (n.d.) Saint Dymphna. Retrieved from www.irelandseye.com/irish/people/saints/dympna.shtm

Jay, M. (2014, 9 January) The Geel question. Retrieved from aeon.co/essays/geel-where-the-mentally-ill-are-welcomed-home

Kirsch, J.P. (1909). St. Dymphna. In The Catholic Encyclopedia. New York: Robert Appleton Company. Retrieved from New Advent: www.newadvent.org/cathen/05221b.htm

McNamara, P. (2013, 14 May) Dymphna: The Amazing Story of a Catholic Patron Saint. Retrieved from meta4RN.com/dymphna

McNamara, P. (2013, 20 May) Should May 15th be International Mental Health Nurse Day? Retrieved from meta4RN.com/may15

Novena (n.d.) Feast of St. Dympna. Retrieved from novena.com/2013/05/15/feast-of-st-dymphna/

Openbaar Psychiatrisch Zorgcentrum (OPZ) – Geel website www.opzgeel.be/en/home/htm/intro.asp

Rabenstein, K.I. (1998) Saint of the day. Retrieved from www.saintpatrickdc.org/ss/0515.shtml

Wikipedia (2016, 21 September) Dymphna. Retrieved from en.wikipedia.org/wiki/Dymphna

Image References

In an effort to engage conference delegates in the story of Dymphna, the poster has been made in a colourful quasi-comic style. At time of writing this (a fortnight before the conference starts),  I feel a bit anxious that someone will misinterpret the effort to visually engage people as trivialising the subject. This is a bit of a worry, because Dymphna’s story includes nasty stuff, not the least of which includes threatened incest, family violence and two people being beheaded. Even Donald Trump would know that these are not topics to be trivialised.

Although I don’t treat Dymphna’s story with the same reverence as The Pope, I do hold the stories I learnt as a catholic schoolboy with a nostalgic affection. My telling of Dymphna’s story is through the prism of a happily-lapsed-catholic, and with the words of Kirsch [see reference list above] ringing in my ears: “This narrative is without any historical foundation, being merely a variation of the story of the king who wanted to marry his own daughter, a motif which appears frequently in popular legends.” Dymphna’s amazing story is a centuries-old remix of a made-up myth. It’s not the news.

Le martyre de sainte Dymphne et de saint Gerbert (Martyrdom of St Dymphna and St Gerebernus), Seghers Gérard (1591-1651) http://www.photo.rmn.fr/archive/09-524783-2C6NU09M4JRG.html

Le martyre de sainte Dymphne et de saint Gerbert (Martyrdom of St Dymphna and St Gerebernus), Seghers Gérard (1591-1651) http://www.photo.rmn.fr/archive/09-524783-2C6NU09M4JRG.html

Openbaar Psychiatrisch Zorgcentrum (OPZ) – Geel http://www.opzgeel.be/en/home/htm/intro.asp

Openbaar Psychiatrisch Zorgcentrum (OPZ) – Geel http://www.opzgeel.be/en/home/htm/intro.asp

The Technical Stuff

The poster was made using Apple Pages running on a 2011 iMac.

The poster was made for non-commercial reasons, and full attribution has been given to the authors/works used to inform/illustrate the poster. I expect the same in return, so “What can mental health nurses learn from the amazing story of a catholic patron saint?” by Paul McNamara is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Creative Commons License

There’s a description of how the video was made here: meta4RN.com/Dymphna 


You can either cite this web page as:

McNamara, P.  (2016, 11 October) What can mental health nurses learn from the amazing story of a catholic patron saint? Retrieved from http://meta4RN.com/amazing

or, if you’re pulling info direct from the abstract, use the more academic-sounding citation that’s in the IJMHN (the ACMHN journal):

McNamara, P. (2016) What can mental health nurses learn from the amazing story of a catholic patron saint? (poster, ACMHN’s 42nd International Mental Health Nursing Conference Nurses striving to tackle disparity in health care 25 – 27 October 2016, Adelaide Convention Centre). International Journal of Mental Health Nursing, Vol 25, Issue S1, Pg 34. doi: 10.1111/inm.12771


I’ll leave a copy of the PDF here (amazingstoryposter2) just in case I need it one day. Things are much easier to find/share when they’re online.

Previous visitors to my website will know that I’ve covered the Dymphna story previously back in 2013. It’s not self-plagiarising if it’s referenced, is it? It’s more like a funky new remix.🙂

If you’re at the conference, please say howdy if you see me skulking about, and/or share this web page or your pics of the poster using the #ACMHN2016 hashtag.

As always, your comments are welcome below.

Paul McNamara, 11th October 2016.


Nurses, Midwives, Medical Practitioners, Suicide and Stigma

Trigger Alert – this blog contains info re suicide which may be unsettling for some people.

Alarming Data

Click to enlarge. To keep the data handy, save the image to your phone.

Click to enlarge. To keep the data handy, save the image to your phone.

A retrospective study into suicide in Australia from 2001 to 2012 uncovered these alarming four findings:

Female Medical Professionals 128% more likely to suicide than females in other occupations
(6.4 per 100,000 vs 2.8 per 100.000)

Female Nurses & Midwives 192% more likely to suicide than females in other occupations
(8.2 per 100,000 vs 2.8 per 100.000)

Male Nurses & Midwives 52% more likely to suicide than males in other occupations
(22.7 per 100,000 vs 14.9 per 100.000)

Male Nurses & Midwives 196% more likely to suicide than their female colleagues
(22.7 per 100,000 vs 8.2 per 100.000)

Data source: Milner, A.J., Maheen, H., Bismark, M.M., & Spittal, M.J. (2016) Suicide by health professionals: a retrospective mortality study in Australia, 2001–2012. Medical Journal of Australia 205 (6): 260-265

Suicide is a complex matter that does not lend itself to easy understanding or simple solutions. However, something we know about health professionals is that they know that there are mental health services and supports. Health professionals know that these services can be accessed by people who who are feeling suicidal. The data suggests that health professionals have an actual or perceived barrier to accessing these existing supports. I wonder what that barrier is.


Could it be that nurses, midwives and medical professionals suicide at a greater rate than the other occupations because of actual or perceived stigma? We have the peculiar privilege of providing care for strangers who are/have been suicidal, but perhaps we aren’t so good at extending that nurturing care to ourselves and each other.

I have a suggestion for health professionals. If you ever come across a colleague who says something derogatory or stigmatising about a person experiencing mental health problems or suicidality, politely show them the data,. Save the chart above to your phone and show them that suicide is a bigger problem for nurses, midwives and female medical professionals than it is for people in other occupations. Say something like, “Suicide is an important issue for our colleagues too. Let’s both care for this patient like we would like to be cared for.”

You’re very welcome to share the chart above or this blog post with your colleagues – the short URL is https://meta4RN.com/stigma

There’s also a PDF version of the chart here: stigma

Hopefully, sometime down the track, the data will result in targeted support for the prevention of suicide by health professionals. However, we need not wait for our political masters, health bureaucracies and professional organisations before we walk-the-walk and talk-the-talk of fighting stigma.

If we see mental health/suicide stigma we should address it on the spot.

In the words of Lieutenant General David Morrison, “The standard you walk past, is the standard you accept.” As the data shows, it is dangerous for nurses, midwives, medical professionals and other health professionals to accept stigma.



It’s important to acknowledge that talking and thinking about suicide can be distressing. People in Australia can access support via:

Lifeline – 13 11 14

Suicide Call Back Service – 1300 659 467

MindHealthConnect www.mindhealthconnect.org.au

phone_hotline-40Outside of Australia and not sure where to get support? Google usually displays a red telephone icon and your country’s suicide support phone number when searching for a suicide-related topic.


That’s it. As always your comments are welcome in the section below.

Paul McNamara, 26th September 2016

The short URL for this page is https://meta4RN.com/stigma

Just in case you missed it above, here’s the original paper citation and link:
Milner, A.J., Maheen, H., Bismark, M.M., & Spittal, M.J. (2016) Suicide by health professionals: a retrospective mortality study in Australia, 2001–2012. Medical Journal of Australia 205 (6): 260-265

Mental State Examination: Looking, Listening and Asking

Mental State Examination: Looking, Listening and Asking
By Paul McNamara @meta4RN
Adapted from the original work of Jenni Bryant @JenCLNinja
RN, RPN (NPC) RGN (BDH), MRN(MH), BN(UNE), MN (Research) (UoN), FACMHN

Every Australian undergraduate nurse is introduced to mental health and undertaking mental state examinations/assessments. However, only about one in every twenty nurses will specialise in working in mental health. For the majority of nurses (ie: those not working in mental health) undertaking a mental state assessment can often become a forgotten skill. This, in turn, deskills the nurse and disadvantages the patient – it’s not holistic care if mental health isn’t considered along with the medical/surgical/maternal aspects of care. As the adage says: there is no health without mental health.

If you’re not accustomed to incorporating mental state examinations (MSE) into your everyday role, it can feel a bit intimidating. Nurses I’ve worked with sometimes feel that they’re not adequately equipped to assess someone’s mental state. Of course they are – as long as they have a bit of emotional intelligence (self-awareness, self-regulation, social skills, empathy and motivation), and break down mental state examination to the three core skills that Jenni Bryant identified in her original powerpoint presentation: looking, listening and asking (adapted, online version available via www.slideshare.net/paulmcnamara).

This online version is in response to a few people requesting to have a print-friendly version (here: MSE), and/or something they’ll always have “in their pocket”, via internet-connected smartphones. The meta4RN.com website readily acknowledges that .edu and .gov websites have more credibility. However, many of those websites are not device-agnostic, so don’t render as well as meta4RN.com does on smartphones and tablets.

It’s a good habit to document a brief MSE for all your patients, not just those with a diagnosed mental illness. Mental state can and does change over a shift, day or week – it’s important to notice and communicate changes.

A comprehensive mental state assessment will include a full history: medical history, psychiatric history, medication history and personal history (developmental, relationship, education, employment, social). As history is static, there is no need to make this part of your “everyday” regular MSE.

A MSE is a snapshot as the person as they are at the time. A well-documented MSE conveys this impression for the reader. Using non-judgemental language, direct quotes of what the person says, and finding the right descriptors/adjectives makes for good MSE documentation. No need to worry about sentence construction. Dot points are fine.

Hopefully the following info will assist.

Mental Sate Examination (Looking, Listening and Asking)

General Description (Looking)

Level of Consciousness
drowsy, alert, sleeping, fluctuating

grooming, makeup, posture, clothing, obvious physical deformities or characteristics

eye contact, rapport, level of activity (do you see psychomotor agitation or psychomotor retardation? if so, describe it), body language, mannerisms, specific activities

Speech (Listening)

smooth, hesitant, interrupted, staccato
easy to interrupt/redirect?
are responses prompt or delayed?

fast (pressured), slow, or unremarkable?

soft, loud/pressured, unremarkable.

flat, monotonous, restricted range, expressive

the capacity to maintain a normal progression from one stream of thought to the next: over-inclusive, poverty, circumstantial, perservation or blocking?

assess for abnormalities of form of speech, not form of thought eg stammer/stutter, dysarthia, expressive or receptive aphasia.



Affect (Looking)

An objective assessment of facial and bodily expression of mood state.
Is affect appropriate to content? (congruent)
Assess the range, appropriateness, intensity and quality of affect
Rapid shift from one emotive response to another? (lability)

Some Useful Adjectives:

sad, tearful, angry, irritable, elated, euphoric, frightened, despondent, animated, expansive, cooperative, ingratiating, distressed, discouraged, anxious, hostile, guarded, anxious, calm, ambivalent, dysphoric, euthymic, suspicious, fatuous, bewildered, perplexed

Mood (Asking)

A subjective assessment of mood state:
How has your mood been lately?
How do you feel within yourself?
What has given you happiness, joy or enjoyment recently?
Are you a good person?
Have you been feeling guilty or sad?
If 10 is as good as you ever feel and 0 is as low as you go, where on the scale have you been over the last couple of weeks?

Neurovegetative signs and symptoms:

Thoughts (Asking & Listening)

coherent? rational? sequential/linear?
amount – poverty, flight of ideas, vague
continuity of ideas – incoherent, blocking, circumstantial, tangential, irrelevant
disturbance in meaning or use of language – neologisms, word salad

delusions, obsessions, compulsions, suicidal ideation, phobias, paranoia, preoccupations?
Do you feel safe here/at home?
Are you able to project your thoughts onto others?
Are other people able to insert ideas/thoughts into your head?

Perception (Looking, Listening & Asking)

Hallucinations = false sensory perception that occurs in the absence of a stimulus.
Can affect any of the senses:
Have you been experiencing any unusual sensations that you can’t easily explain?
Do you any special powers?
Sometimes when people are really stressed they hear voices/noises, but there’s nobody there. Has that ever happened to you?
You seem distracted by something I can’t see. Can you help me understand what you’re experiencing?

Ideas/delusions of reference
Do you have any unusual experiences when watching TV, or listening to music?
Do you ever feel that the TV has special messages just for you?

Illusion = misinterpretation of sensory stimulus
eg: responding to a pyjama top on a chair as if it were a cat; being startled by something out the corner of their eye.

Cognition (Asking & Listening)

time, place, person, situation
Clock Drawing Test [brief frontal lobe assessment]
please draw a large circle, then insert numbers to make it look like a clock.
now draw in the hands to show ten past eleven

MMSE: Mini Mental State Examination
– screening [ie: not diagnostic] tool for cognitive impairment – best for mild to moderate
– does not differentiate between delirium and dementia
– used to detect impairment, to follow course of illness, to monitor treatment response
– affected by education, intelligence, age, literacy, culture and inter-rater reliability

MMSE alternatives include:

MoCA: Montreal Cognitive Assessment
ACE-R: Addenbrooke’s Cognitive Examination
RUDAS: Rowland Universal Dementia Assessment Scale
KICA: Kimberley Indigenous Cognitive Assessment

Insight & Judgement (Asking & Listening)
Insight = to see one’s self as others do
Judgement = capacity to make reasoned decisions

Does the person recognise symptoms (eg: confusion, hallucinations) as symptoms?
Is the person aware that they are ill and understand the effects and implications?
Is the person seeking assistance/information or rejecting help?
Good, partial or poor? As evidenced by…

Risk (Asking & Listening)

Estimation of risk will be influenced by the person’s history (ie: previous experiences, behaviours and exposures) – the static factors.

Risk is best explored after rapport has been established, and the person knows that you are a safe, non-judgemental person. If somebody discloses intent/plans of harming themselves or others, thank them for trusting you, and let them know that it is too important a matter for just the two of you to handle alone. You’ll arrange for support.

The suggested questions below are for dynamic, “here and now”, factors only

Risk to Self
Do you still have “the fighting spirit”?
Do you ever think, “what’s the point in going on?”
What’s keeping you going?, what makes life worth living?
Have you thought you would be better off dead? How strong are these thoughts?
Have you thought of suicide?
Have you made a plan? [if “yes”, does the person have access to means?]
When would you do this?
What can I do to help you to stay safe?

Risk to Others
You seem pretty angry.
Are you able to express that anger safely?
Do you feel like acting on that anger?
Do you feel like hurting someone?
Are you safe to be around at the moment?
Am I safe with you? What about the other staff and patients here?
What can I do to help you to stay safe?

Alcohol, Tobacco & Other Drugs (Asking & Listening) 

Most substance abuse is contextual
Give “permission” for honest answers

“Sounds like you’ve had a lot of stress lately. How have you been coping?”
“You’ve got a lot of stuff going on at the moment… are you drinking or smoking more than usual?”
“In FNQ plenty of people use the bottle shop or a bit of choof or speed to try to manage stress. How about you?”

Quantity. Frequency. Recency. Route.


  • Alcohol
  • Tobacco
  • Cannabis (choof, gunja, yarndi, weed, dope)
  • Amphetamines (speed, goey)
  • Methamphetamines (ice, crystal meth)
  • MDMA = methylenedioxymethamphetamine (ecstasy)
  • Opioids (codeine, morphine, methadone, heroin)
  • Benzodiazepines (benzos: diazepam, oxazepam, nitrazepam/moggies, temazepam/normies, alprazolam/xannies)
  • Hallucinogens (LSD, magic mushrooms)


That’s it. Hopefully you’ll find it as a handy memory-prompt/word-finder/confidence booster when providing holistic patient care.

There is a printer-friendly version here:

There is a slideshow version here:

The short URL for this page is: meta4RN.com/MSE

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

Paul McNamara, 22nd July 2016

Example of Nursing Curriculum Vitae

A question this morning via Twitter from @BoxedUpHeart:

unnamedLooking for a nursing cv template if such a thing exists

Any ideas?

Ping the lads @TheNursePath @Inject_Orange @meta4RN

So, to answer the question, I’m sharing my CV online. The version I want you to look at is here as a PDF. pdficon


Why do I want you to look at that version? It is because I’ve spent time formatting it to look pretty. Prettier than I can manage on this website. However, I thought I might as well dump the content of the CV on this page too – it’s nice to have more options than those that LinkedIn accommodates.

I won’t pretend for a moment that this is the ideal way to write a CV. In fact, I know I’ve been over-inclusive on mine – it’s far too long (not just a problem of being a nurse from the 80s). However, the headings may be useful to somebody, even if that somebody is  @BoxedUpHeart alone. So, with no further ado, here goes:

Paul McNamara

address [omitted from online version] Cairns Q 4870
phone [omitted from online version]
email [omitted from online version]
twitter @meta4RN
facebook facebook.com/meta4RN
youtube youtube.com/meta4RN

Curriculum Vitae is true and correct as at 12/06/16


  • Registered General Nurse Certificate (Royal Adelaide Hospital)
  • Registered Mental Health Nurse Certificate (Glenside & Hillcrest Hospitals)
  • Bachelor of Nursing (Flinders University)
  • Authorised Mental Health Practitioner (as per S499 of the Mental Health Act 2000, Queensland)
  • Credentialed by the Australian College of Mental Heath Nurses Board of Credentialing since 2006
  • Master of Mental Health Nursing (University of Southern Queensland)
  • Certificate of Infant Mental Health (Child, Youth & Women’s Health Service of South Australia)
  • Current Registration with the Nursing and Midwifery Board of Australia (ID No: NMW0001444629)

Professional & Community Interests

  • Professional Social Media portfolio: meta4RN.com
  • Fellow, Australian College of Mental Health Nurses (ACMHN) since 2008
  • Member, Queensland Nurses Union
  • Social Media Facilitator, Australian Clinical Supervision Association, since February 2015
  • Member, Queensland Clinical Senate (2012 – 2014)
  • Member, QCPIMH National Perinatal Depression Initiative Steering Committee (August 2010 – June 2013)
  •  Member, Reference Group and Working Group of the Aboriginal and Torres Strait Islander Health Workforce Capacity Building – Perinatal Social and Emotional Wellbeing Project (October 2012 – June 2013)
  • Founder & Facilitator, ACMHN Perinatal & Infant Mental Health Nurse eNetwork (2011-2013)
  • Facilitator, ACMHN North Queensland Sub-Branch Email Network (2008 – 2009)
  • Adjunct Lecturer, James Cook University (2007 – 2008)
  • Inaugural Secretary, ACMHN Consultation Liaison Special Interest Group (2005–2007)
  • Founder & Facilitator, Mental Health Consultation Liaison Nurse Email Network (2002 – 2010)
  • Inaugural Member, Management Committee, Worklink Employment Support Group Inc. (1996 – 1999)


  • 2012: The Health Roundtable, Innovation Award – Quality Care Stream ($6000)
  • 2007: Australian College of Mental Health Nurses (Queensland Branch), Student Award for Clinical and Academic Achievement in Mental Health Nursing
  • 1996: Queensland Health, Quality Award for Excellence in Consumer Outcome Focus and Consumer & Caregiver Involvement (awarded to the Cairns MIT Team)


Peer Reviewed Journals

Happell, B., Wilson, R. & McNamara, P. (2014) Undergraduate mental health nursing education in Australia: More than Mental Health First Aid. Collegian (Royal College of Nursing, Australia) http://dx.doi.org/10.1016/j.colegn.2014.07.003

Wilson, R., Ranse, J., Cashin, A. & McNamara, P. (2014) Nurses and Twitter: The good, the bad, and the reluctant. Collegian (Royal College of Nursing, Australia) 21(2) 111-119 http://dx.doi.org/10.1016/j.colegn.2013.09.003

McNamara, P. & McCauley, K. (2013) ‘Precovery’: A proactive version of recovery in perinatal mental health. Australian Nursing Journal 21 (1) 38

McNamara, P., Bryant, J., Forster, J., Sharrock, J. & Happell, B. (2008) Exploratory study of mental health consultation-liaison nursing in Australia: Part 2 preparation, support and role satisfaction. International Journal of Mental Health Nursing 17 (3) 189–196

Sharrock, J., Bryant, J., McNamara, P., Forster, J. & Happell, B. (2008) Exploratory study of mental health consultation-liaison nursing in Australia: Part 1 demographics and role characteristics. International Journal of Mental Health Nursing 17 (3) 180-188

Usher, K., Foster, K. & McNamara, P. (2005) Antipsychotic drugs & pregnant or breastfeeding women: the issues for mental health nurses. Journal of Psychiatric & Mental Health Nursing 12 (6) 713–718

Acknowledgements & Contributions

De Costa, C. & Howat, P. (2007) Clinical cases in obstetrics, gynaecology and women’s health McGraw-Hill – acknowledged for contribution of case vignette/source material (page ix)

Elder, R., Evans, K. & Nizette, D. (2005) Psychiatric and Mental Health Nursing Elsevier, Sydney – contributions of case vignettes to this textbook (pages 370, 373, 374 & 415)

Other Publications

McNamara, P. (2014) A Nurse’s Guide to Twitter, Ausmed Education http://aus.md/tfn

McNamara, P. (2011) Perinatal mental health, O&G Magazine, The Royal Australian and New Zealand

College of Obstetricians and Gynaecologists, Vol 13, No 2, p. 56 (invited column)

McNamara, P. (2011) PND: what the experts say, Cairns Parenting Companion, Autumn (March) Issue, p. 10 (invited column)

McNamara, P. (1998: revised 2001, 2007 & 2008) That was bloody stressful: what’s next? (staff resource re stress management) Queensland Health Electronic Publishing Service (QHEPS) intranet: http://qheps.health.qld.gov.au/cairns/docs/12553.pdf

McNamara, P. (2003) ‘Movies, myths, mistakes’, The Cairns Post, 14 August, p.13 (invited guest column re common misrepresentations of schizophrenia)

McNamara, P. (2003) ‘Humanity to man’, The Cairns Post, 29 March, p.19 (invited guest column re men in nursing)

Conference Presentations (last 5 years only)

McNamara, P. (2015) Understanding and managing anxiety disorders. Presented at ‘Cairns Nurses Conference’, Ausmed Education, Cairns.

McNamara, P. (2015) Social media and digital citizenship for health professionals. Presented at ‘Cairns Nurses Conference’, Ausmed Education, Cairns.

McNamara, P. (2015) Social media for nurses and midwives. Keynote presentation at ‘Australian Nurses & Midwives Conference’, Australian Nursing & Midwifery Federation (Victorian Branch), Melbourne.

McNamara, P. (2015) Health professionalism and digital citizenship. Keynote presentation at ‘Primary Mental Health Care in the Digital Age’, Australian College of Mental Health Nurses, Canberra.

McNamara, P. (2014) Mental health in the general hospital. Presented at ‘Cairns Nurses Conference’, Ausmed Education, Cairns.

Happell, B., Wilson, R. & McNamara, P. (2013) Beyond bandaids: Defending the depth and detail of mental health in nursing education. Presented at ‘Collaboration and partnerships in mental health nursing, the 39th Annual International Conference of the Australian College of Mental Health Nursing, Perth.

McNamara, P. (2013) Turbocharging mental health nursing collaboration and partnerships: professional use of Twitter. Poster presented at ‘Collaboration and partnerships in mental health nursing, the 39th Annual International Conference of the Australian College of Mental Health Nursing, Perth.

McNamara, P. (2013) Omnipresent and always available; a mental health nurse on twitter. Plenary session at the 11th ACMHN Consultation Liaison Special Interest Group conference, Noosa.

McNamara, P. (2012) Deploying complex information via a QR Code. Presented at ‘Innovations Workshop and Awards’, The Health Roundtable, Sydney. [NB: recipient of 2012 Innovation Award, Quality Care Stream]

McNamara, P., Horn, F. & Dalzell, M. (2012) Developing, designing and deploying a perinatal mental health referral pathway. Poster presented at ‘The fabric of life’, the 38th Annual International Conference of the Australian College of Mental Health Nursing, Darwin.

McNamara, P. (2012) The nature of nurture: lessons from a baby, story of a saint. Opening plenary presentation at the 10th ACMHN Consultation Liaison Special Interest Group conference, Melbourne.

McNamara, P. (2011) Between the flags, but beyond the breakers; addressing perinatal mental health in calmer, deeper water. Presented at ‘Mental health nurses: swimming between the flags?’, the 37th Annual International Conference of the Australian College of Mental Health Nursing, Gold Coast.

Trott, R. & McNamara, P. (2011) Mental health interventions targeted at youth. Presented at ‘Nurturing, Providing, Gathering for Better Health’, the 2nd Indigenous Women’s Health Meeting of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), Cairns.

McNamara, P. (2011) Establishing a Perinatal Mental Health Service, presented at the Perinatal Mental Health Forum, Queensland Centre for Perinatal and Infant Mental Health, Brisbane, 30th November 2011.

McNamara, P. (2011) Research and data collection, presentation & facilitated discussion at the National Perinatal Depression initiative (NPDI) State & Territory Project Officer’s Meeting, Brisbane, 29th November 2011.

McNamara, P. (2011) Cairns perinatal mental health. Presented at ‘Stay connected, stay strong’, Indigenous Perinatal and Infant Mental Health Forum, Cairns, 25th May 2011.

Ryan, T., McNamara, P., Swain, T. & Brownlie, A. (2010) Playing nicely in the north: Developing clinical supervision in and for North Queensland. Presented at the 11th Annual Tropical Symposium of the North Queensland Branch of Australian College of Mental Health Nurses, Magnetic Island.

Haines, S., Henley, I., McNamara, P., Nizette, D., Porter, V. & Ryan, T. (2010) Great Expectations: Resourcing, reviving and reinventing clinical supervision in mental health nursing. Presented at the 11th Annual Tropical Symposium of the North Queensland Branch of Australian College of Mental Health Nurses, Magnetic Island.

Workshop Facilitation

McNamara, P. (2005-2013) Perinatal mental health. Multiple sessions at multiple sites meta4RN.com/links

Bailey, P. & McNamara, P. (2009-2014) Introduction to supervision. Queensland Centre of Mental Health Learning (QCMHL) one day clinical supervision workshop, QCMHL code QC8; multiple sites http://www.health.qld.gov.au/qcmhl/supervision_res.asp

Bailey, P. & McNamara, P. (2009-2014) Supervisor. Queensland Centre of Mental Health Learning (QCMHL) two day clinical supervision workshop, QCMHL code QC4; multiple sites http://www.health.qld.gov.au/qcmhl/supervision_res.asp

McNamara, P., Butterfield, C. & Mignacca, E. (2013) Engaging with social media. Australian College of Mental Health Nurses 39th International Mental Health Nursing Conference, Perth meta4RN.com/tweets

Casella, E. & McNamara, P. (2015) The use of Social Media in Nursing., Australian College of Nurses workshop, James Cook University, Cairns research.jcu.edu.au/cnmr/news-and-events/news/hits-for-nurses

Rayner, N. & McNamara, P. (2016) Supervising supervisor. Queensland Centre of Mental Health Learning (QCMHL) two day clinical supervision workshop, QCMHL code QC12


Certificate of Infant Mental Health 2012
Child, Youth & Women’s Health Service of South Australia
– 10 week course of lectures, tutorials & immersive learning

Master of Mental Health Nursing 2006
University of Southern Queensland
– High Distinction in all graded subjects; Grade Point Average (GPA) = 7.0
– Australian College of Mental Health Nurses (Queensland Branch), Student Award for Clinical and Academic Achievement in Mental Health Nursing

Bachelor of Nursing 1993 to 1995
Flinders University of South Australia
– six subjects awarded Distinction & one High Distinction; GPA = 5.86

Mental Health Nursing Certificate 1993 to 1994
South Australian Mental Health Service, at Glenside & Hillcrest Hospitals
– theoretical components structured on the tertiary education model
– successfully merged theory with practice during this eighteen month course
– placements included acute admission inpatient unit, slow- and fast- stream rehabilitation units
– forensic inpatient unit, and community based services

Graduate Nurse Certificate 1992 to 1993
Royal Adelaide Hospital
– a twelve month course to consolidate abilities in team management and clinical practice

Registered General Nurse Certificate 1988 to 1991
Royal Adelaide Hospital
– a three year course which provided the opportunity to apply theory in practice across a diverse range of speciality inpatient units

Employment History

Clinical Nurse Consultant
July 2015 – current
June 2013 – November 2014
July 2000 – August 2010
Consultation Liaison Psychiatry Service
Cairns & Hinterland Hospital & Health Service (based at Cairns Hospital)
– demonstrated professional leadership re mental health care in the general hospital setting
– significant contribution to the development of this role: it has become a highly respected & – valued component of Cairns Hospital’s multidisciplinary approach to care
– negotiated highly effective inter-department & inter-agency referral relationships
– proven capacity for innovation and a proactive approach to problem resolution
– contributions to the development of CL practice at state & national levels
– regular provision of inservice/staff education
– co-facilitation of QMCHL clinical supervision workshops
– regular provision of clinical supervision

December 2014 – June 2015 [temporary contract]
College of Healthcare Sciences
James Cook University
– Subject Coordinator: Mental Health – nursing undergraduate subjects NS3360/NS3361/NS3362 – revised and delivered lecture program
– revised teaching/learning activities and workbook for Professional Experience Workshops (PEWs)
– delivered PEWs for four cohorts of students
– recruited sessional staff to deliver PEWs across four JCU sites
– reviewed and revised exam content
– tutor for 1st year subject ‘Communication in Nursing and Midwifery’ HS1111
– tutor for 2nd subject ‘Law and Ethics for Nursing and Midwifery’ NS2015
– delivered lecture: ‘Social Media Use for Nurses and Midwives’

Clinical Nurse Consultant
August 2010 – June 2013
Perinatal Mental Health
Cairns & Hinterland Mental Health Service
– established and developed this newly-created position
– established outpatient clinical assessment and treatment across three sites
– developed and delivered a recurrent program of inservice education & half-day workshops to
clinical staff in the primary care sector, tertiary health sector & mental health services
– workshop evaluations (participator qualitative assessments) have been very positive
– established an online presence http://www.health.qld.gov.au/cairns_hinterland/html/pmh_referral_pathway.asp
– a number of conference presentations, including invited Opening Plenary Address at Australian College of Mental Health Nurses conference
– two publications
– 2012 Innovation Award, The Health Roundtable (Quality Care Stream)

Online Facilitator
Dec 2009 – Feb 2011 [part-time]
– Primed/Medeserv delivered much of the content to Queensland Health’s online education portal: the Clinician Development Education Service (CDES)
– Online Facilitator for three courses: Mental Health (QHLTH5209), Social Dysfunction (QHLTH5208) & Diagnostic and Pharmaceutical Processes (QHLTH5212)
– demonstrated ability to facilitate a positive learning environment across a number of subjects using information technology and asynchronous communication
–  very positive feedback on performance via the Education Services Manager

Nursing Professional Leader
October 2009 – June 2010 [0.4FTE temporary position]
Clinical Supervision
– appointed via Queensland Health Office of the Chief Nurse, position hosted by Cairns & Hinterland Mental Health Service
– co-facilitated workshops for Clinical Supervisees and Clinical Supervisors
– proven capacity to implement workplace initiatives that drive change
– demonstrated ability to collect and present workplace survey findings
– proven ability to move segments of the workforce towards best practice
– integration of Clinical Supervision with mental health nurse transition program
– alignment of Clinical Supervision with Authorisation as a Mental Health Practitioner
– reporting relationship with the Office of the Chief Nurse

Lecturer in Nursing
August 2008 – July 2009
School of Nursing, Midwifery & Nutrition
James Cook University of North Queensland
– Subject Coordinator for NS1211 Foundations of Nursing 1 (a 1st year undergraduate subjectthat had over 250 students enrolled in 2009, across four campuses and externally)
– developed, delivered and recruited guest lecturers for a program of lectures delivered via videoconference to campuses in Cairns, Townsville, Mount Isa & Thursday Island
– developed and delivered podcasts and slidecasts of lectures via the subject website
– created and maintained a dynamic subject website for student and staff access to subjectmaterials, discussion boards, grades and announcements
– developed and implemented a tutorial guide for the eight tutors teaching into this subject
– developed and implemented an assignment marking guide to promote inter-rater reliability
– elected to the School’s Strategic Planning Committee
– lectures and tutorials for mental health, crisis management and grief/communication subjects

Tutor/Laboratory Leader/OSCE Assessor
casual contracts: 2002 – 2003, 2005 – 2010
School of Nursing, Midwifery & Nutrition
James Cook University of North Queensland
– deliver components of the undergraduate nursing degree curriculum using a range of teaching methods
– utilised small group work in a tertiary, adult education setting
– assessment of written assignments, acquired skills and learning participation
– student appraisal of my teaching was overwhelmingly positive

Youth Health Nurse (Clinical Nurse)
1999 – 2000
School-Based Youth Health Nurse Program
Cairns District Community Health (based at Cairns High & Yarrabah State Schools)
– established this newly created position
– attracted appropriate resources, including recruiting & establishing clinical supervision
– demonstrated capacity to across sectors with a broad range of people
– delivering health promotion and curriculum support including an educative role

Nurse Educator
1997 – 1998 (12 month secondment)
Transitional Care Program
Cairns District Community Health
– established this newly created position
– targeted skills-development program in wound management & infection control
– provision of outreach education services to Nurses and Indigenous Health Workers in Yarrabah, Cooktown, Wujal Wujal, Hopevale and Laura

Case Manager (Clinical Nurse)
1995 – 1997 & 1998 – 1999
Mobile Intensive Treatment Team (MITT)
Cairns Integrated Mental Health Program
– founding team member of this successful team established as a QHealth pilot project
– demonstrated success through collecting and reporting on data
– in 1996 the team received the Queensland Health, Quality Award for Excellence in Consumer Outcome Focus and Consumer & Caregiver Involvement

Clinical Nurse Educator
casual contracts: 1996 & 1997
Department of Nursing Sciences
James Cook University of North Queensland
– proven ability to facilitate experiential learning and consolidate theoretical learning for Bachelor of Applied Science (Nursing) students
– utilised a creative and pragmatic approach to assist students to gain “hands on” experience in mental health & drug and alcohol services
– assessment of written and practical skills

Community Mental Health Nurse (Clinical Nurse)
after-hours on call: 995 – 1996
Psychiatric Emergency Team and Crisis Assessment & Treatment Team
Cairns Integrated Mental Health Program
– proven ability to assist clients requiring acute assistance on the teams which were the precursors to the Cairns & Hinterland Mental Health Service’s Acute Care Team (ACT)

Mental Health Nurse (Registered Nurse)
1993 – 1994
Glenside & Hillcrest Hospitals
South Australian Mental Health Service
– experiential learning across acute, forensic, rehabilitation & residential care inpatient units

Registered General Nurse
1992 – 1993
High Dependency/Intensive Care Units and Neurology/Neurosurgery Unit
Royal Adelaide Hospital
– experiential learning across a diverse range of clinical settings
– mentored student nurses and new graduates

Registered General Nurse
1991 – 1992
Miroma Nursing Home Pty Ltd

Registered General Nurse
1991 – 1992
Nurses Specialling Bureau

Student Nurse
1988 – 1991
Royal Adelaide Hospital
– experiential learning across a broad range of medical, surgical and speciality units
– as per the orthodoxy of hospital-based nurse education in a large teaching hospital, mentored student nurse peers and juniors

Warehouse Manager
Herbalife Australasia
” demonstrated capacity to provide leadership and deliver change

Sales Representative
Dairy Vale-Metro Cooperative Ltd
” proven capacity to engage with a diverse range of people

Accounts Clerk
Dairy Vale-Metro Cooperative Ltd


[omitted from online version]


So that’s it – that’s my CV. I’ll probably update the online version PRN… as the parable goes, there’s not much point in hiding one’s light under a bushel.🙂

As I said in the intro, this isn’t necessarily the way to present a nursing CV, but it’s an example you might be able get some ideas from. Do you have any suggestions re a nursing CV? If so, please feel free to share them via the comments section below.

Paul McNamara, 12th June 2016

Short URL: meta4RN.com/CV

The Last 40-Odd Weeks

This blog post has one purpose only.

It is to explain why I have been so uncharacteristically vague, and often distracted, for the last 40-odd weeks.

During that time many dozens of people (most of them uni students, but also friends, family and colleagues) have asked this question: “Are you still teaching at the uni?” My wishy-washy responses have been along these lines:
“I’m not sure.”
or the hilariously inaccurate “Ask me again in a couple of weeks.”

FullSizeRender copy

Let me explain/elaborate by using a timeline:

1995: Started working for the health department full-time [see LinkedIn]

1996: Started working for the uni temporarily/part-time – an arrangement that continues sporadically over the years that follow [see LinkedIn]

May 2015: I’m working at the uni. Casual chat between senior uni colleague and I. Outcome = let’s think about the possibility of a shared position between the uni and the health department. There would be some benefits to both organisations. It’d be a pretty cool gig, I reckon.

June 2015: Senior uni colleague says “let’s do it!”. A meeting is held between senior uni colleague and a senior health department colleague. Verbal agreement established. The uni sends a contract to the health department. The first draft of the role description is drawn up by the uni and sent to the health department. The contract and position description cite an October 2015 start date.

July 2015: I’m back at the health department. I make sure that people who need to know about the new position coming know, and offer to help progress things along if I can. Funding’s an issue, of course, but there should be a way…

August 2015: I make occasional enquiries. Bureaucracies need processes and time. Be patient.

September 2015: More enquiries. It’s all about the paper-trail, funding, signatures. Be patient.

October 2015: My enquiries must be getting a bit too shrill. Emails are not answered. Phone calls are not returned. The intended start-date for the position passes.

November 2015: I’m getting anxious about the delayed start not leaving enough time for 2016 subject preparation. I start pulling on the very few levers that are available to me: someone who knows someone who knows someone will look into it. I rescheduled my December flights: if I happen to get this job I won’t have time to go to Japan in December. The teaching starts in January, and there needs to be subject preparation.

December 2015: The position is advertised. Yay!
My request for consideration of transfer at level so as to expedite the position starting in a timely manner is declined. Bugger.
I send in my application and hope for the best.

8th January 2016: Interviewed for the position. I was phoned after the interview and offered a 3 month secondment into the position. That’s weird. It’s funded for 5 years. I ask to think about it over the weekend.

8th-10th January 2016:  Consult with my wife and trusted friends. Consensus is that if I’m good enough to do the job for 3 months, it’s weird that I’m not good enough to do the job for the term of the contract. I find myself thinking of the refrain from Bob Dylan’s Ballad of a Thin Man:
Because something is happening here
But you don’t know what it is
Do you, Mister Jones?

11th January 2016: “Thank you very much for offering me a 3 month position. However, I applied for a 5 year position. I can only commit to the position if the organisation commits to me.” Nice try Paul. “We’ll let you know when we schedule another interview.”

18th January 2016: The uni teaching period starts. The subject is underway without the position being filled.

2nd February 2016: Interviewed for the position again.

2nd February – 31st March 2016: I hear nothing at all officially. Other people do. It makes its way along the health department grapevine that someone else has been successful. One of those whispers reaches me via a convoluted track. I’m disappointed, of course, but not surprised. Silence is the polar opposite of someone enthusiastically saying, “Congrats! We reckon you’ll be great! When can you start?”

1st April 2016 (no, not joking): An email from noreply@smartjobs.qld.gov.au that says “I wish to advise that on this occasion you have not been successful in obtaining the position.”

So that’s it.

I can drop the vague, unknowing responses to enquiries now. It’s a relief to know. It’s a relief to be able to be open and transparent again. I didn’t get the job that I was hoping for. Yes, of course I am disappointed. However, I am totally accepting of the obvious fact that there was another candidate for the position who is better credentialed, better prepared and/or more meritorious for the role.

Ricky Ponting wouldn’t feel bad if somebody said Don Bradman was a better cricketer than him. Same-same, but different. Not that I’m the Ricky Ponting of mental health nurse education. More like Boof Lehmann, I reckon.🙂

I am disappointed by how long the whole recruiting process took. The uni sent the contract and position description to the health department in June 2015. It’s taken the health department until April 2016 to fill the position. That’s longer than a human pregnancy.


Despite being there for the courtship, conception and gestation, I now know it’s not my baby.

The other lesson I’ve taken from this is to cautiously self-monitor my behaviour at work (I’m a mental health nurse in a general hospital ). In clinical supervision we recognise that there are parallel processes: how a nurse treats a patient can be influenced by how the organisation treats the nurse. It is prudent that I be especially intentional and vigilant to treat my patients in a timely manner, and with the kindness and respect they deserve.

The last 40-odd weeks have been odd. Sorry about all my distractibility and wishy-washy responses to questions during that time. I hope this timeline/blog post explains it all.


That’s it. Thanks for reading.

Paul McNamara, 3rd April 2016

Short URL: http://meta4RN.com/40weeks