Tag Archives: pandemic

On RATs and Nice

Leave a reply

A few months ago a half-formed idea about idea about continuing to take pandemic precautions, being kind to each other, and dumb luck began to take shape. The idea was in the context of my favourite human (@StellaGRN) testing positive to COVID-19, and me not.

Same precautions. Same knowledge-base/education. Same vaccination status. Same workplace. Same bedroom, bathroom, kitchen and sofa. Different results.

Follow the science. Hope for luck.

Follow the science. Hope for luck. (don’t do it the other way round)

I – a mental health nurse – didn’t get around to progressing that half-formed line of thought into something coherent. Then in early July I stumbled across a twitter thread by Trent Yarwood – an infection diseases physician. Trent articulated my half-formed ideas about following the science and hoping for luck (not the other way round) better than I could have.

With Trent’s permission, that Twitter thread has been copied and pasted below:

There’s plenty to be upset about in the pandemic.

It’s ruined our social lives, stuffed up our travel plans. More importantly, it’s killed millions of people, disabled some, forced people out of work and had a myriad of other effects.

You can make a pretty solid argument that the public health communication has been woeful. Frequently changing, late, technically complex, not always helpful.

You could equally talk about the incredible difficulty in communicating uncertainty about a rapidly changing situation, balancing the needs of “you told us this at 5pm Friday” vs “why did you wait the whole weekend to tell us this”.

You can (and people have) done entire careers’ worth of research on techniques for best practice in doing this sort of communication.

But the CHOs (and the talking heads) haven’t all done PhDs in risk comms, so they didn’t always get it right. Just like the advice which turned out to be not-entirely correct with the advancement of knowledge and time was – unless you are tin-foil-hatter – the best it could be at the time it was delivered.

But here’s a few questions to ponder.

Imagine you’re late for work. Is it because:
a) you didn’t leave early enough to have some slack
b) that dickhead in the volvo was in the right lane?

You’ve had a minor surgical procedure and the wound has gotten infected. Is it because:
a) Sometimes, Staph happens.
b) The surgeon must have done something wrong

Your washing machine has just broken and ruined your favourite 80s band t-shirt. Is it because:
a) it’s 10 years old and it’s had a good life
b) your landlord is a tightarse and bought dodgy-brand

What is your locus of control?

Is someone else (God, fate, other stupid dickheads) responsible for everything that happens in your life? Or do you make the best of what you have and sometimes, chance fucks you over?

If you’ve been through relationship counselling, you’ll know that they tell you that you can’t hope to change the other person, you can only change yourself. So is being angry at the dickheads “who gave you COVID” going to change the way they behave? Or is it just going to make you angry?

And finally, don’t forget it’s baked into the name. Pandemic: pan-demos – all of the people.

Railing against inevitability is a pretty sure way to make yourself miserable.

Of course this doesn’t mean we shouldn’t be doing what we can to reduce transmission. But take control of the things you can.

Get your third (or fourth) dose. Encourage your friends to do the same.

Physically distance. Stay home if you have symptoms.

Mask.

Wash your hands

And finally, be nice to each other.

Isn’t the world shitty enough already?

ID EQ BC and AD

Trent’s articulation of emotional intelligence (EQ) isn’t unique for someone with an Infectious Diseases (ID) and/or public health background. This is evidenced below by two tweets from BC (Before Covid) and one from AD (After Disaster).

🙂

End Notes

Sincere thanks to Trent Yarwood for permission to reproduce his Twitter thread. The original thread can be accessed here and is collated here. To find out more about Trent follow him on Twitter (@trentyarwood) and/or check-out his profile and articles on The Conversation.

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

Paul McNamara, 20 September 2022

Short URL meta4RN.com/RATs

An end of April #COVID19 snapshot (Queensland perspective)

2 Replies

The chart below shows confirmed cases of #COVID19 as at 4.30pm (GMT/UTC + 10:00h) on Thursday 30/04/20. The chart sourced via www.covid19data.com.au

I’m not sharing this info as a macabre version of State of Origin or the Bledisloe Cup. It’s not a competition. It’s certainly not a game. Thousands of families across the world are in mourning.

Nevertheless, it is useful to have a benchmark of how we are faring. To give us perspective it’s useful to compare progress across areas/populations. As per the list below, Queensland’s population size compares better to New Zealand, Ireland, Norway and Singapore than other Australian states and territories.

Population Comparison (Australian states/territories + selected countries, small to large)
Northern Territory 245,000
Australian Capital Territory 428,000
Tasmania 535,000
South Australia 1.75 million
Western Australia 2.63 million
New Zealand 4.82 million
Ireland 4.94 million
Queensland 5.11 million
Norway 5.37 million
Singapore 5.85 million
Victoria 6.63 million
New South Wales 8.12 million

So What?

Hopefully, the encouraging data in this chart serves as an anxiolytic for Queensland health workers and their patients. That’s the intent.

End

That’s it. If you know an anxious Queenslander please share this information with them.

Paul McNamara, 1 May 2020

Short URL meta4RN.com/qld

Positive Practice Environment (the other PPE)

4 Replies

At this point in time (the beginning of April 2020) PPE is popping-up in news and social media feeds frequently. Understandably, with the outbreak of the #COVID19 pandemic, clinicians are much more conscious of Personal Protective Equipment (PPE) than usual. Even crusty old mental health nurses like me have revisited and refreshed our knowledge on PPE.

That’s sensible. It’s also sensible to acknowledge that there’s more than one type of PPE.

Positive Practice Environment (PPE)

Today some nurses who work on a ward receiving patients suspected/confirmed to have COVID-19 identified elements that are contributing to their ward working well. Although there’s still some anxiety, of course, generally it is a PPE (positive practice environment). Some of the things nursing staff identified were:

  1. Team Nursing. The RNs highlighted this as a part of the PPE. In a team you never feel like it’s your burden to bear alone, there’s someone to check with donning and doffing personal protective equipment, and there’s always someone to help if you’re in the isolation room and need something extra.
  2. Communication. Communciation within the nursing team, and between the nursing staff and senior medical staff is much better than usual. Regular meetings both formal and informal are really helpful.
  3. Working Smarter. For example: before entering an isolation room, call the patient on their bedside/mobile phone to see if they need anything extra. Similarly, making an arrangement with the patient that they can buzz or phone if they need anything. Increased use of phone = decreased frequency of entering isolation room = decreased use of personal protective equipment.
  4. Getting Smarter. Asking questions and brainstorming solutions. Everyone acknowledges that they aren’t experienced or experts in pandemics, and that collaborative care is the only way to problem-solve the way forward. Patients generate solutions too
  5. Staying Focused. There is so much information swirling about regarding COVID-19, that it is important to limit the sources and exposure. We need to trust the health department that employs us to give us the correct information at the correct time. We can’t afford the time or mental/emotional energy to look at everything that’s out there.
  6. Downtime is Sacred. When everything at work seems to have a COVID-19 twist to it, it’s important to shield against overload. Strategies include:
    • Don’t watch the news, watch a movie.
    • Be careful how much time we spend in the social media echo chamber.
    • Switch off social media and the TV and listen to music.
    • Ask friends and family not to use “the C word” around you.

Downtime is Sacred.

Three Final Thoughts

One
It’s not just about wearing PPE (as in personal protection equipment) it’s about creating a PPE (as in positive practice environment) too. Nobody pretends for a moment that there are not more and/or better ideas than those above, but being intentional about both lots of PPE is helping.

Two
What’s more contagious: COVID-19 or anxiety?

Three
I can’t believe that it’s been less than 2 months since the term “COVID-19” was first coined. It has infected nearly every news article and conversation since early February 2020.

End

That’s it. Thanks for reading.

As always your feedback is invited via the comments section below.

Paul McNamara, 1 April 2020

Short URL meta4RN.com/PPE

Clean Hands. Clear Head.

4 Replies

Part 1. Clean Hands. Clear Head.

“Clean Hands. Clear Head.” is an animation of a mindfulness script that distills the content of my 2016 blog post “Hand Hygiene and Mindful Moments” into a short (less than 2 minutes) video. The voice part was recorded on an iPhone at a hospital sink #authentic. The visuals were done on Prezi.

Here’s a link to the Prezi version of “Clean Hands. Clear Head.” prezi.com/jehramlhdkcm

Addit 29/03/20: to my surprise, some people want a text version. I won’t write out the whole thing (too long, a bit dull), but below are some key phrases:

This is my mindful moment.
The anxiety and tension will be washed away.
I will rub in the resilience and kindness that sustains me.
After 20 seconds or so I will pretend I’m TayTay, and shake it off. 🙂
I will smile, then will intentionally slow my breathing.
Me and my hands will be safe.

Feels free to use/modify PRN. I would be grateful for source attribution as “meta4RN.com/head”
Just in case it’s handy here is a PDF: CleanHandsClearHead
And here is a MS Word version: CleanHandsClearHead

Part 2. Surviving Emotionally Taxing Work Environments. March 2020 version.

On a related topic, for the last few years I’ve facilitated many hour-long, interactive sessions called “Self Care: Surviving Emotionally Taxing Work Environments.” for my fellow nurses at the hospital where I work. As at March 2020, I’m not confident that we’ll have an opportunity to meet face-to-face as a group all that often, so I’ve tweaked the session, tried to cut-down on the rambling, and have switched from hour-long interactive, to 20 minutes of well-intentioned, a tad-amateurish, youtube video embedded below:


Self Care: Surviving Emotionally Taxing Work Environments. March 2020 version.
(video, 20 mins)

Here’s a link to the Prezi version of “Self Care: Surviving Emotionally Taxing Work Environments. March 2020 version”: prezi.com/xcejt9pgd0b3

Part 3. References & Resources.

I’m recycling and combining a lot of old ideas for the March 2020 version of  “Self Care: Surviving Emotionally Taxing Work Environments.” Self-plagiarism? Nah – it’s a groovy remix of some favourite old songs. Regular visitors to meta4RN.com may recognise the repetition, and be quite bored with me using the website as a place to store updated versions of old stuff. Sorry about that, but it’s just so damn convenient. 🙂

Here are the resources and references used in the presentation: (because I’m recycling old ideas this list is ridiculously self-referential).

Australian College of Mental Health Nurses [www.acmhn.org], Australian College of Nursing [www.acn.edu.au], and Australian College of Midwives [www.midwives.org.au] (2019) Joint Position Statement: Clinical Supervision for Nurses + Midwives. Released online April 2019, PDF available via each organisation’s website, and here: ClinicalSupervisionJointPositionStatement

Australian Government (24 March 2020) Coronavirus (COVID-19) current situation and case numbers
www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert

Basic Life Support Procedure
https://qheps.health.qld.gov.au/__data/assets/pdf_file/0030/607098/pro_basiclifesprt.pdf

Eales, Sandra. (2018). A focus on psychological safety helps teams thrive. InScope, No. 08., Summer 2018 edition, published by Queensland Nurses and Midwives Union on 13/12/18, pages 58-59. Eales2018

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

Employee Assistance Service (via Queensland Health intranet)
qheps.health.qld.gov.au/hr/staff-health-wellbeing/counselling-support

Employee Assistance Service (via Benestar – the company that CHHHS contracts out to)
benestar.com

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

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

Lai. J, Ma. S, Wang. Y, et al. (23 March 2020) Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Network Open.
jamanetwork.com/journals/jamanetworkopen/fullarticle/2763229

Lalochezia (getting sweary doesn’t necessarily mean getting abusive) meta4RN.com/lalochezia

Nurse & Midwife Support nmsupport.org.au  phone 1800 667 877
– we have specifically targeted 24/7 confidential support available

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

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

Queensland Health. (2009). Clinical Supervision Guidelines for Mental Health Services. PDF

Spector, P., Zhiqing, Z. & Che, X. (2014) Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: A quantitative review. International Journal of Nursing Studies. Vol 50(1), pp 72-84. www.sciencedirect.com/science/article/pii/S0020748913000357

That was bloody stressful! What’s next?
Web: meta4RN.com/bloody
QHEPS: https://qheps.health.qld.gov.au/__data/assets/pdf_file/0038/555779/That-was-bloody-stressful.pdf

Zero Tolerance for Zero Tolerance (a reframing of reducing aggression) meta4RN.com/zero

Part 4. An update for the 2021 version

The updated Prezi is here:

There’s an update to the reference list too:

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

End

Thanks for visiting. Let’s join the kindness pandemic to offset some of the crap that goes with the COVID19 pandemic.

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

Stay safe.

Paul McNamara, 25 March 2020, with an update on 8 December 2020

Short URL: meta4RN.com/head

Creative Commons Licence
Clean Hands. Clear Head. by Paul McNamara is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.