Tag Archives: ACMHN

Why choose Mental Health Nursing?

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This blog post accompanies a chat with 3rd / 4th year James Cook University (JCU) Nurse/Midwife students at an industry presentation day on 12th May 2022. Here is a copy of the slide show I’ll be using for the presentation @ JCU on the day:

Below are snippets and elaborations of the info we will touch-on/discuss on the day. Parking the information online just in case any of the JCU Students want to come back to it, and/or if it happens to be of interest to others.

Slide 1
As part of introducing myself, I’ll also introduce the idea/example of nurses intentionally making themselves visible on social media (eg: linktr.ee/meta4RN). More about that sort of thing here and here.

Slide 2
The day of the JCU student nurse industry presentation = 12th May = Florence Nightingale’s birthday = International Nurses Day.
Coincidence?
Yeah, probably.
But anyway, here’s a link to 20 tweetable fun facts that I like to trot-out to celebrate International Nurses Day: meta4RN.com/nurses2020
Also, check out the #IND2022 hashtag on social media.

Slide 3
Mental Health Nursing is vastly different to other hospital-based specialist nursing roles. I reckon it’s a very good fit for people who are very adaptable. A few years ago Australian researchers coined the ‘Ten P’s of the professional profile that is mental health nursing’:

present
personal
participant partnering
professional
phenomenological
pragmatic
power-sharing
psycho-therapeutic
proud
profound

(Santangelo, Procter & Fassett, 2018)

Slides 4 & 5
Part of what makes Mental Health Nursing different is the structure of public mental health services. Inpatient care is just a small part of the service structure, and there is a lot of emphasis on outpatient/community based services. There are options to specialise (as I have done, more about that here and here), or – as Mental Health Nurses who work in rural and remote areas do – do a little bit of nearly everything on the list of services of slide 5/in the table below.

Intake PointsInpatient/Residential ServicesOutpatient/Community Services
Central Intake Service
Emergency Department
Consultation Liaison Psychiatry Service		Psychiatric Intensive Care Unit
Mental Health Unit
Step-Up/Step-Down Unit
Community Care Unit		Acute Care Team
Continuing Care Teams
Mobile Intensive Treatment Team
Older Persons Mental Health Service
Child & Youth Mental Health Service
Evolve Therapeutic Services
Perinatal & Infant Mental Health
NQ Eating Disorder Service
Forensic & Prison Mental Health
Alcohol Tobacco & Other Drugs
Rural Mental Health
Remote Mental Health
Examples of mental health services/settings

Slide 6
On any given day, less that 1% of people who are open the Mental Health/Alcohol, Tobacco & Other Drugs Service that I work for are receiving specialist psychiatric inpatient treatment. The vast majority of mental health and addiction support and recovery happens in community settings, as evidenced by the data (collected on 12/04/22) below:

Cairns Hospital PICU/MHU Beds, n = 48
Cairns & Hinterland MHATODS Case Load, n = 5531

Slide 7
What do Mental Health Nurses do? Well, it’s pretty varied, but includes:

  • Responding to trauma/people experiencing crisis
  • Assessment – this mostly consists of looking, listening and asking – not necessarily in that order.
  • Coordinating and collaborating with the person and their family to plan and deliver care
  • Liaising with other members of the clinical team and other local services (eg: @CairnsHelp) to ensure holistic, person-centred care
  • Providing support
  • Act as an educator/resource person
  • Provide therapy (eg: Solution-Focused Therapy, Acceptance & Commitment Therapy)
  • Work across clinical and community settings
  • Work anywhere – including rural and remote areas (see: The challenges of mental health nursing in rural Australia)
  • Provide holistic care (ie: specialising as a Mental Health Nurse doesn’t suddenly mean you forget everything you’ve learned as student nurse/RN)
  • Being consumer-focused and trauma-informed
  • Acquiring and using specialised skills and knowledge

More info @ ACMHN.org/what-mental-health-nurses-do

Slide 8
As articulated by Hildegard Peplau (one of the earliest rockstars of Mental Health Nursing) our speciality places a premium on therapeutic use of self, and the therapeutic relationship.

Slide 9
Mental Health Nurse core competencies include:

  • assessment and management of risk
  • understanding recovery principles
  • person- and family-centred care
  • good communication skills
  • knowledge about mental disorders and treatment
  • evaluating research and promoting physical health
  • a sense of humour
  • physical and psychological interventions

(Moyo, Jones & Gray, 2022)

Slide 10
A specialist Mental Health Nurse is a…

  • psychotherapist
  • consumer advocate
  • physical health therapist
  • psycho-pharmacological therapist
  • relationship-focused therapist
  • aggression management therapist

 (Hurley & Lakeman, 2021)

Slide 11
Steps to becoming a Credentialed Mental Health Nurse:

  1. Graduate with an undergraduate degree in Nursing
  2. Complete a Graduate Diploma, Postgraduate Diploma or Masters in Mental Health Nursing
  3. (Optional) Undertake additional training in specific psychological therapies
  4. Successfully apply to be credentialed by the Australian College of Mental Health Nurses –  the peak professional mental health nursing organisation and the recognised credentialing body for Australia’s mental health nurses.

Slide 12
That’s it. Questions? 🙂

Video

Key References/Further Reading

Australian College of Mental Health Nursing acmhn.org

Hurley, J. & Lakeman, R. (2021), Making the case for clinical mental health nurses to break their silence on the healing they create: A critical discussion. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12836

Isobel, S., Wilson, A., Gill, K., Schelling, K. & Howe, D. (2021), What is needed for Trauma Informed Mental Health Services in Australia? Perspectives of clinicians and managers. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12811

McKenna Lawson, S. (2022), How we say what we do and why it is important: An idiosyncratic analysis of mental health nursing identity on social media. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12991

Moyo, N., Jones, M. & Gray, R. (2022), What are the core competencies of a mental health nurse? A concept mapping study involving five stakeholder groups. International Journal of Mental Health Nursing. doi.org/10.1111/inm.13003

Santangelo, P., Procter, N. and Fassett, D. (2018), Mental health nursing: Daring to be different, special and leading recovery-focused care?. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12316

End

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

Naturally, if you think it will be of interest to any nurse/nearly-nurse you know, you are very welcome to forward the info on by whatever means you see fit. 🙂

Paul McNamara, 15th April 2022

Short URL meta4RN.com/JCU

Liaison in the Time of #COVID19

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This page is an accompaniment to a brief presentation at the Inaugural ACMHN Consultation Liaison Special Interest Group online webinar via zoom – it is just a place to plonk things that I’ll talk about in case anyone wants to clarify anything for themselves.

So, here goes:

As noted on a previous blog post, Queensland’s population is much bigger than Australia’s smaller states/territories, but falls a long way short of Australia’s two largest states. 

 

Queensland’s population size compares better to New Zealand, Ireland, Norway and Singapore than other Australian states and territories.

 

All the data below is true as of 1 August 2020 (as you probably know, 1st of August = the Horses Birthday in Australia).

 

It is interesting to compare the number of Covid-19 cases across similar-sized populations. Obviously there are many differences between the populations too – not the least of which is land area – so I’m doubtful that a proper epidemiologist or public health professional would put much stock in this comparison. That disclaimer aside, it is noted that Queensland has a larger population than New Zealand – which is held-up as a shining-light of Covid-19 control – but, to date, has a lower incidence of Covid-19 positive people.

 

I’m not sharing the data about number of Covid-19 deaths 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. That said, isn’t it interesting how low Singapore’s death rate is compared to that of Ireland and, to a lesser extent, Norway? Both New Zealand and Queensland have been very fortunate to date in limiting the number of deaths.

 

Comparing the number of new cases of Covid-19 in the last 24 hours (as at 01/08/20) is also interesting.

 

Links to Data Sources
New Zealand
Ireland
Queensland
Norway
Singapore 

 

In the session there will be mention of the “Clean Hands. Clear Head.” strategy to embed anxiety-management into everyday clinical practice. More info about his via the blog post and video of the same name: meta4RN.com/head

 

Also in the session there will mention of “Positive Practice Environment (the other PPE)” Again, there is more info about this via a blog of the same name: meta4RN.com/PPE

 

Finally, here is a link to the Prezi that was used to make the video. My understanding is that all these pretty Prezis will stop working at the end of 2020 when everyone stops using flash (just letting you know in case you’re looking at this page in 2021).

 

In Support of our Victorian Colleagues

 

End

That’s it. I hope some of this info is of interest. As always, you’re welcome to leave feedback via the comments section below.

Paul McNamara, 3 August 2020

Short URL: meta4RN.com/zoom

How can we be integrated if nobody knows about us? #ACMHN2019

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I’ve been asked to be one of the keynote speakers at the 45th International Mental Health Nursing Conference in Sydney, being held from 8th to 10th October 2019 (see the #ACMHN2019 hashtag on Twitter). To be an invited speaker at such a prestigious conference is a pretty big deal to me.

This blog page serves as a place to find my presentation quickly and easily [here], and as a place to collate and list references.

Click to go to Prezi

Bio (from www.acmhn2019.com/speakers)

Paul McNamara has been a nurse since 1988, a mental health nurse since 1993, a credentialed mental health nurse since 2006, and a fellow of ACMHN since 2008. He works as a consultation liaison CNC at Cairns Hospital. Paul also tinkers online quite a bit; he has a social media portfolio built around the homophone “meta4RN”, which can be read as either “metaphor RN” or “meta for RN”.   

Screengrab from the ACMHN2019.com website

More info about the conference here: www.ACMHN2019.com

References/Further Reading 

Altmetric Attention Score for Share or perish: Social media and the International Journal of Mental Health Nursing wiley.altmetric.com/details/62929297

Altmetric Attention Score for Do adult mental health services identify child abuse and neglect? A systematic review wiley.altmetric.com/details/23964454

Australian Health Practitioner Regulation Agency. (2014, March 17). Social media policy. Retrieved from www.ahpra.gov.au

Bec @notesforreview (2019, October 2). Because of Twitter I have – ^ academic/clinical knowledge – Learnt about current prof issues – Learnt from experts by experience – Gained new perspectives – Challenged biases – Made wonderful connections – Received & given support – Co-authored an article for ‘s magazine [Tweet]. https://twitter.com/notesforreview/status/1179344079609577472?s=21

Buus Lassen, Neils. (2019, September 11). in ‘Researchers: “We waste time and money writing articles none cares to read”‘, CBS Wire. Retrieved from cbswire.dk/researchers-we-waste-time-and-money-writing-articles-no-one-cares-to-read

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. www.collegianjournal.com/article/S1322-7696(14)00033-X/abstract

Facebook. (2015). Facebook logo. Retrieved from www.facebookbrand.com

Garfield, Stan. (2016, September 14). 90-9-1 Rule of Thumb: Fact or Fiction? www.linkedin.com/pulse/90-9-1-rule-thumb-fact-fiction-stan-garfield

Google. (2019). Map retrieved from www.google.com.au/maps/place/Cairns

#HealthUpNorth info www.health.qld.gov.au/cairns_hinterland/join-our-team/healthupnorth

#HealthUpNorth pics www.instagram.com/explore/tags/healthupnorth

Li, C. (2009). Foreword. In: S. Israel (Ed). Twitter Ville: How businesses can thrive in the new global neighborhoods. New York: Portfolio. books.google.com.au

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

Luddites I have known: meta4RN.com/luddites

McNamara, P. (2014). A Nurse’s Guide to Twitter. Retrieved from web.archive.org/web/20190607185707/https://www.ausmed.com.au/twitter-for-nurses

McNamara, P., & Meijome, X. M. (2015). Twitter Para Enfermeras (Spanish/Español).
Retrieved from web.archive.org/web/20151004183805/http://www.ausmed.com.au/es/twitter-para-enfermeras

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. meta4RN.com/TQN

McNamara, P. and Usher, K. (2019), Share or perish: Social media and the International Journal of Mental Health Nursing. International Journal of Mental Health Nursing, 28(4), 960-970. doi:10.1111/inm.12600

Professional use of Twitter: meta4RN.com/poster

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 twitter.com/nswnma/status/494313737575096321

Nurse and Midwife Blogroll www.nurseuncut.com.au/blog-roll

Salzmann‐Erikson, M. (2018), Mental health nurses’ use of Twitter for professional purposes during conference participation using #acmhn2016. International Journal of Mental Health Nursing, 27: 804-813. doi:10.1111/inm.12367

Thinking Health Communication? Think Mobile. meta4RN.com/mobile

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

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

Ward, Kylie. (2019, May 21). Nurses: the hidden healthcare professionals. The Sydney Morning Herald. Retrieved from www.smh.com.au/healthcare/nurses-the-hidden-healthcare-professionals-20190521-p51pq2.html

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 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.

Ye Olde Yahoo CL Nurse eMail Network meta4RN.com/email

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

 

End 

Thanks for reading this far. You might be the only person who has. 🙂

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

Paul McNamara, 4 October 2019

Short URL meta4RN.com/ACMHN2019

Diagnostic Overshadowing

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Consultation liaison psychiatry services (CLPS) are, typically, based in a general hospital setting to provide the dual services of mental health clinical assessment/treatment and clinician support/education. The clinical and education roles overlap – a lot.

A significant part of the CLPS job is undiagnosing mental illness. Undiagnosis is often correcting a misdiagnosis, and also serves to validate the emotions and experiences of people (Patfield, 2011; Lakeman & Emeleus, 2014). It is not unusual for CLPS to be asked to see somebody who is emotionally overwhelmed or dysregulated. Sometimes this is in the context of mental health problems often in the context of significant stress. Naturally, we do not want to ‘psychiatricise’ the human condition. Of course, you cry when you are sad, and of course you are anxious when, like Courtney Barnett in ‘Avant Gardener’, you are not that good at breathing in. Of course, you’re frustrated when you are in pain or do not understand what’s going on.

Validating understandable and proportionate emotions is important.

It is equally important to make sure that somebody who has experienced mental illness previously does not have every presentation to the hospital/outpatient clinic seen through that lens. That is called “diagnostic overshadowing”; which is a significant problem.
Diagnostic overshadowing is where physical symptoms are overlooked, dismissed or downplayed as a psychiatric/ psychosomatic symptom. It must be one of the most dangerous things that happen in hospitals.

The President of the Royal Australian and New Zealand College of Psychiatrists, Professor Malcolm Hopwood, said in May 2016, “I sometimes think that the worse thing a person can do for their physical health is to be diagnosed with a mental health disorder.” Prof Hopwood cited stigma and discrimination in the health sector as contributing problems to early mortality amongst people with mental health problems.

People, hospital clinical staff included, are often shocked when they find out that people diagnosed with mental illness die between 10 and 25 years younger than the general public. Although suicide is a contributing factor to high mortality rates amongst this part of the community, it is alarming to note that the overwhelming majority – 86% – of people with mental health problems who had a premature death did not die from suicide (Happell & Ewart, 2016).

About 60% of people who experience mental health problems experience chronic physical health problems too. Poor mental health is a major risk factor for poor physical health, and vice versa (Harris et al, 2018).

The lived experience

Diagnostic overshadowing happens outside of hospitals too. In the example below, understandable and proportionate human emotions were misinterpreted as psychopathology. The cascade of events that followed makes for a sobering read:

Eight years ago I was diagnosed with bipolar affective disorder (BPAD) and recovered enough to commence a PhD. Unable to obtain travel insurance for a conference due to my diagnosis, I disclosed the reason to my supervisor. Unfortunately, he began to see all stress (normal to a PhD student) as BPAD symptoms and decided I was incapable of completing the PhD and progressively began to discriminate against me. My mental health started to decline. I imagine this must have validated his belief that I was an unsuitable student.

I received some help from the university, with an advisor indicating that my supervisor was undermining my work. The advisor was promoted. Despite not knowing me, his replacement did not believe my account and disagreed with my psychiatrist’s assessment of my mental state. Other staff and graduate students joined the belief that I could not cope, alienating me from the entire department.

After almost 18 months of fighting, I was once again depressed and felt defeated. I left the degree and lost my scholarship. It was one of the hardest things I have done. After, I was unable to gain employment; overqualified for most positions, lacking experience for the rest, and no references. After five months of constant rejections and lingering grief from losing the PhD, my self-worth and coping ability were so diminished, I made a very serious suicide attempt. I was so distressed that I could not see another solution.

Seven months later and I still have no paid employment. I have been undertaking volunteer work to regain some meaning in my life and have set myself up for the long-term with a new field of study. However, this does not pay the bills, and living like this is taking its toll. Sometimes I do not know where my next meal will come from, I have lost friends because of their attitude towards mental illness, and have withdrawn from health-related activities because of a lack of finances. Most days I cope and can find meaning in what I do, some days are much harder.

Questions for Reflection

Assuming that you – the person reading this – is a health professional, we have some questions we would like you to reflect on.

Have I ever witnessed a person’s mental health history influence how their presenting complaint was investigated or treated?

How does my workplace prevent mental health stigmatising and diagnostic overshadowing?

What can I do to support good holistic patient care without falling into the trap of diagnostic overshadowing?

References

Happell, B. & Ewart, S. (2016). ‘Please believe me, my life depends on it’: Physical health concerns of people diagnosed with mental illness. Australian Nursing and Midwifery Journal, 23(11), 47.

Harris, B. Duggan, M. Batterham, P. Bartlem, K. Clinton-McHarg, T. Dunbar, J. Fehily, C. Lawrence, D. Morgan, M. Rosenbaum, S. (2018). Australia’s mental health and physical health tracker: Background paper. Australian Health Policy Collaboration issues paper no. 2018-02, Melbourne, AHPC.

Lakeman, R. & Emeleus, M. (2014). Un-diagnosing mental illness in the process of helping. Psychotherapy in Australia, 21(1), 38-45.

Patfield, M. (2011). Undiagnosis: An Important New Role for Psychiatry. Australasian Psychiatry, 19(2), 107–109.

Seriously mentally ill ‘die younger’. (2016, May 10). SBS News. Retrieved from https://www.sbs.com.au/news/seriously-mentally-ill-die-younger

PDF version

A one page PDF version [suitable for printing] is available here: DiagnosticOvershadowing

Citation

McNamara, P. & Callahan, R. (2018). Diagnostic Overshadowing. News, Summer 2018 edition (published December 2018), Australian College of Mental Health Nurses, page 17.

End Notes

The article above is a tidied-up version of a blog post that Bec and I collaborated on in October 2018 (see meta4RN.com/shadoworiginal). This is not called self-plagiarising, it’s more like doing a studio version of a demo tape. 🙂

Many thanks to Sharina Smith for encouraging us to submit the article to ACMHN News.

Paul McNamara, 15 December 2018

Short URL meta4RN.com/shadow

 

 

Your Ordinary is Extraordinary

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“I have come to learn that it is fundamental for mental health nurses to establish relationships of trust and provide care to people who are in need, setting aside any bias or prejudice. What this means is that, as mental health nurses, you are championing human rights on a daily basis by simply doing your jobs. It must seem so ordinary to you as you go about your lives, but your ordinary is extraordinary.”
Sharina Smith
Communications and Publications Officer
Australian College of Mental Health Nurses
September 2018

Cite in text
(Smith, 2018. p. 2)

Cite in reference list
Smith, S. (2018, September). Welcome. ACMHN News. Spring 2018 edition. Australian College of Mental Health Nurses: Canberra.

Context

I was flicking through the most recent edition of ACMHN News, themed “mental health and human rights”, one last time before consigning it the recycling bin. Sharina Smith is editor of the publication, and always offers a short “welcome” column introducing the content. Stopping my trip to the bin, the three sentences quoted above jumped off the page.

It’s instructive to have someone from an unrelated field (in Sharina’s case marketing and communications), examine mental health nursing through their lens of education and experience. Sharina’s comments shine a spotlight on an incredibly important part of our work that we often take for granted.

Just as the paper of the magazine deserves to be recycled, so do Sharina’s observations about human rights and mental health nursing. That’s the purpose of liberating the excerpt above from the printed page to the internet.

End

Sincere thanks to Sharina Smith, and all the office staff at ACMHN. Your ongoing support of Australian mental health nurses is very much appreciated.

Find out more about ACMHN here: www.acmhn.org

Paul McNamara, 10 November 2018

Short URL meta4RN.com/ordinary

#ACMHN2018 on Twitter

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Information from and about ACMHN’s 44th International Mental Health Nursing Conference went well beyond the walls of the Cairns conference venue, and bounced around the world via social media.

Over the week of the conference more than 320 separate Twitter accounts used the #ACMHN2018 hashtag. There were over 2,750 tweets. 40 or so (less than 50, anyway) of the conference delegates, keynote speakers and sponsors were using the #ACMHN2018 hashtag – the content they generated was shared by over 250 people not in attendance. Many thanks to the relatively small percentage of conference participants who have amplified mental health nursing’s voice and values.

Free access to the #ACMHN2018 data and content is online,

One last thing. People are already talking about next year’s conference in Sydney using the #ACMHN2019 hashtag. Will you be part of the conversation?

End

That’s it. I’ve done detailed dissections of conference tweeting previously. This time I’m just dropping the info that was published in the ACMHN “Tuesday Times” on 30/10/18.

Short and sweet. 🙂

If you’re after more info about the conference content, I suggest that you browse the #ACMHN2018 tweets via this link, or the conference abstracts via this link.

Paul McNamara, 31 October 2018

Short URL: meta4RN.com/ACMHN2018

 

Conversations, not just citations, count: Social Media and the International Journal of Mental Health Nursing

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This page serves as a place to collate the Prezi, YouTube video, abstract and list of references, data sources and visuals used for a presentation at the 44th ACMHN International Mental Health Nursing Conference.

Click on the pic to access the Prezi

Presenter Introductions

Paul McNamara is CNC with the Consultation Liaison Psychiatry Service at Cairns Hospital. Paul is also Social Media Editor of the International Journal of Mental Health Nursing.

Kim Usher is Professor and Head of School at the School of Health, University of New England. Kim is also Chief Editor of the International Journal of Mental Health Nursing.

Abstract

Traditionally the impact and reach of a specific journal article has been estimated through the measurement of how many times it is cited elsewhere in scholarly literature. Sometimes years could pass between conducting the original research, writing and refining drafts, submitting and reviewing manuscripts, the article being published, and subsequent researchers including this citation in their published reference list. The resulting time lag means that citations are a retrospective measurement of research impact.

There is however an alternative measure of research impact; a metric that is more immediate. This alternative does not rely on the passive hope that other people will see and share research findings, but allows interested parties to play a hand in generalised and targeted promotion of a published piece of research.

Charlene Li famously described social media not as a technology, but as a conversation (Israel, 2009). Now these online conversations can be quantified, and offer “real‐time” feedback to researchers/authors about the impact and reach of their published research.

In order to support these claims, we will provide an overview of the International Journal of Mental Health Nursing social media strategy. Altmetric data will be presented to demonstrate the measurable effects of this strategy. General information and specific examples will be shared so that researchers, authors, and the institutions that support their work, are exposed to strategies they could use to contribute to future Altmetric scores. In doing so, conference delegates who attend this presentation will be equipped with knowledge on how to improve the impact and reach of their publications on social media, and further their understanding of why this matters.

References, Data Sources + Presentation Visuals

Altmetric attention scores re top 5 IJMHN articles, data as at 18/09/18:

  1. Do adult mental health services identify child abuse and neglect? A systematic review https://wiley.altmetric.com/details/23964454
  2. Mental healthcare staff well‐being and burnout: A narrative review of trends, causes, implications, and recommendations for future interventions https://wiley.altmetric.com/details/30485876
  3. An integrative review exploring the physical and psychological harm inherent in using restraint in mental health inpatient settings https://wiley.altmetric.com/details/31986204
  4. Lethal hopelessness: Understanding and responding to asylum seeker distress and mental deterioration https://wiley.altmetric.com/details/17878566
  5. How many of 1829 antidepressant users report withdrawal effects or addiction? https://wiley.altmetric.com/details/43387887

Altmetric attention scores re IJMHN impact from July 2015 to June 2018, MS Excel spreadsheet data courtesy of Kornelia Junge, Senior Research Manager, Wiley.

Altmetric logo via https://www.altmetric.com/about-us/logos/ (retrieved 06/10/2018)

CrossRef data re IJMHN most-cited articles based on citations published in the last three years, via https://onlinelibrary.wiley.com/journal/14470349 (retrieved 04/10/2018)

Hootsuite logo via https://hootsuite.com/about/media-kit (retrieved 06/10/18)

IJMHN. (03/01/17). The @IJMHN 2017 New Year resolution is to refresh our Twitter home page and Tweeting practices. Watch this space! 🙂 [Tweet]. Retrieved from https://twitter.com/ijmhn/status/816202247604301824?s=21

International Journal of Mental Health Nursing, October 2018, volume 27, issue 5, cover image via https://onlinelibrary.wiley.com/doi/pdf/10.1111/inm.12395

Israel, S. (foreward by Li, C.). (2009). Twitter Ville: How businesses can thrive in the new global neighborhoods. New York: Portfolio.

Tweet activity examples as at 06/10/18

  1. Combining #eMentalHealth intervention development with human computer interaction (HCI) design to enhance technology‐facilitated recovery for people with depression and/or anxiety conditions Amalie Søgaard Neilsen + @RhondaWilsonMHN https://twitter.com/ijmhn/status/1036177022811340800?s=21
  2. Meeting the needs of young people with psychosis: We MUST do better Editorial by @Michael_A_Roche @debraejackson @KimUsher3 + Wendy Cross https://twitter.com/ijmhn/status/1033277919865593858?s=21
  3. Literature review of trauma-informed care: Implications for mental health nurses https://twitter.com/ijmhn/status/1029110510569091072?s=21

Twitter data re IJMHN activity from July 2015 to June 2018 via http://www.twitonomy.com/profile.php?sn=IJMHN (retrieved 20/10/18)

Twitter data re IJMHN impact from July 2015 to June 2018 via https://analytics.twitter.com/user/IJMHN/home (retrieved 09/10/2018)

Twitter logo via https://about.twitter.com/en_us/company/brand-resources.html (retrieved 06/10/18)

Video Version

The YouTube version of the presentation (slightly different to the conference version) can be viewed below and/or shared using this URL: https://youtu.be/vWSI3u4O2Bc

Presentation Tweets

Using Hootsuite, these Tweets using the conference hashtag (#ACMHN2018) were scheduled to be sent during the presentation. Look Mum! No Hands!

 

Citation

To cite this page:
McNamara, P. (2018). Conversations, not just citations, count: Social Media and the International Journal of Mental Health Nursing. Retrieved from https://meta4RN.com/count

To cite the presentation abstract:
McNamara, P. & Usher, K. (2018). Conversations, not just citations, count: Social Media and the International Journal of Mental Health Nursing. International Journal of Mental Health Nursing, Volume 27, Issue S1, Page 31 onlinelibrary.wiley.com/doi/full/10.1111/inm.12539

End

That’s it. Thanks for reading this far down the page. You’re probably the only one who’s bothered. 🙂

In keeping with the theme of the presentation, I’d be grateful if you share the page with your social networks.

As always, questions and feedback are welcomed via the comments section below.

Paul McNamara, 15 October 2018

Short URL meta4RN.com/count

Update: 20 October 2018

There was a flat spot in the original presentation where I struggled to convey clarity and sustain interest. In an effort to overcome this, I deleted a couple of slides from the original Prezi, modified another, and added the data/chart below. Thank you for your helpful critique and suggestions @StellaGRN.

Update: 27 October 2018

The Tweets that were scheduled to coincide with the presentation have now been embedded in the post.

Top 5 Tips for #ACMHN2018 Delegates

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In October 2018 hundreds of mental health nurses will descend on Cairns for the 44th ACMHN International Mental Health Nursing Conference. As part of pre-conference publicity ACMHN have put their “Top 5 Tips for #ACMHN2018 Presenters” online [link].

That got me thinking that it might be helpful to have some “Top 5 Tips for #ACMHN2018 Delegates”, ie:  a local mental health nurse’s suggestions on what to do when you’re NOT at the conference. FNQ (Far North Queensland) is worth exploring – be sure to tack-on some rest and recreation time before and after the conference.

With no further ado, please read on…

Top 5 Places for a Drink

Mondo www.mondoonthewaterfront.com.au
Mondo is my favourite place for afternoon drinks or lunch. It’s a 500m walk from the conference venue. The location is fantastic, with views across Trinity Inlet and nearly always a cool breeze.
Local’s tip: If you do decide to eat here try the sizzling fajita. Yum!

Hemingways www.hemingwaysbrewery.com
Hemingways opened in June 2018, and sits in a beautifully restored/repurposed dockside cargo shed. It has an industrial chic look and feel about it, and they make their own beers on site. Hemingways is less that 200m from the conference venue… stumbling distance 🙂
Local’s tip: craft beer not your thing? the AIX Rosé is delicious!

Salt House salthouse.com.au
A 10 minute walk from the conference venue, Salt House has a new deck that overlooks the marina and a larger area where there is often live music. It’s cool and casual, and a favourite with the after-work crowd.
Local’s tip: have the Bloody Mary oyster shooter!

RSL www.cairnsrsl.com.au
Do you have an image of a RSL as a dingy old place full of dingy old people? Forget it! From the conference venue take a 10-15 minute stroll along the lively, cosmopolitan esplanade to take a seat at the light and breezy bar with tilt-up windows.
Local’s tip: the bar’s resident willy wagtail is called Russell

Vine Room www.facebook.com/thevineroomurbanprovedore
Situated just across Florence Street from the RSL, Vine Room is an open air, slightly elevated spot for an afternoon/evening drink. Watch the dive trips come in from the reef with a cool beverage.
Local’s tip: if you’re with 3 or 4 others grab one of their platters for a nibble

Top 5 Places to Eat

Fusion www.fusionartbar.com.au
Less than 200m from the conference venue, this groovy little place is great for just a drink, but the food is too yummy to miss. My favourites are the tapas dishes, which the friendly staff will match to your wines if you ask them to.
Local’s tip: the specials are nearly always amazing!

Splash www.splashrestaurant.com.au
This seafood restaurant on The Nard (local speak for “The Esplanade”) is a great spot to watch the world go by while eating delicious things. It’s a 10-15 meander from the conference venue.
Local’s tip: the seafood chowder is a delicious and surprisingly cheap meal; if you want to treat yourself have the Morton Bay Bugs in garlic butter

Iyara www.facebook.com/IyarabySakare
The best Thai restaurant in Cairns is also on The Nard, but is a bit harder to find than the others. Look for the casual and fun Courtyard at street level. The door to the stairs taking you up to Iyara is to the right of the entrance to Courtyard. It’s a very good restaurant, and if you’re seated on the balcony you’ll be able to see the blinking lights of the shipping channel snaking out to sea.
Local’s tip: the starter that has a prawn, lime and peanuts wrapped in a betel leaf is fantastic!

Tha Fish www.thafish.com.au
Situated on the boardwalk of The Pier, Tha Fish overlooks the marina – it’s a 5-10 minute walk from the conference venue. Great food, great wine list and great service.
Local’s tip: order from “tha fish list” where you choose from one of 5 fishes and one of 5 cooking styles

Ochre ochrerestaurant.com.au
If you found Mondo you can find Ochre – it’s just another 50m or so along the boardwalk that fronts Trinity Inlet. A creative menu using lots of native Australia ingredients. Classy!
Local’s tip: if there are two or more of you have a tasting platter (be sure to include the salt and pepper quail)

Top 5 Things to Do in Cairns

The Lagoon/Boardwalk www.cairns.qld.gov.au/esplanade
The boardwalk is a nice stroll, and well used by locals and visitors alike. If you do the whole thing it connects Hemingways to the mangroves near the airport, but that’s not much fun in full sun. Around sunrise or sunset it’s pretty nice though.
Local’s tip: there are a couple of avenues of large trees that converge at the lagoon – go via the shade if it’s sunny!

Rusty’s Markets www.rustysmarkets.com.au
The markets are a couple of blocks from the conference venue fronting both Grafton and Sheridan Streets. They markets are well-worth a visit on a Friday, Saturday or Sunday. There’s a bit of standard hippy bling near the Grafton Street entrance, but the cool stuff is the food in the middle and Sheridan Street end of the markets.
Local’s tip: buy a few tropical fruits you’ve never tried before – the stallholders are generous with showing/telling you how to eat them

The Tanks www.tanksartscentre.com
If there’s a show on at The Tanks that coincides with your trip to Cairns get there. Tank 5 is a fantastic venue to see bands/other acts. If there are no live shows that appeal sus-out any art exhibitions. The Tanks are about $10-15 in an Uber or $20-25 in a taxi from the conference venue. There’s also a bus (see below).
Local’s tip: the botanic gardens are next door if you’re doing a day trip

The Beaches travelnq.com/cairns-beaches
It shits me when people say Cairns doesn’t have a beach. It doesn’t have a beach in the CBD, but then neither does Sydney. But you don’t hear people say Sydney doesn’t have a beach. The nine Cairns beaches are all north of the city. If you don’t have a hire car, take the sunbus to the beaches of your choice: www.sunbus.com.au/cairns
Local’s tip: stinger season usually starts in November, but they can come early some years.

The Red Arrow www.cairns.qld.gov.au
For a sweat-inducing but beautiful walk head to The Red Arrow near The Tanks/botanic gardens. Green exercise is better for mental health than gym-based exercise, and when you’re puffing for breath looking down on the airport/city from Mount Whitfield you’ll notice a smile pass over your lips between gasps.
Local’s tip: your accom provider may be able to provide a bike for you to get there – if so you can do the whole trip on designated bike tracks away from nasty killer cars [maps here]

Top 5 Trips out of Cairns

Great Barrier Reef www.cairnsattractions.com.au
You can see the Great Barrier Reef from outer space or from a boat from Cairns or Port Douglas. Boat trips are much cheaper than rocket trips, but it’s worth paying a bit extra for one that goes to the outer reef – that’s where the cool stuff is. Snorkelling is pretty easy unless you’re very unfit.
Local’s tip: don’t pre-book your trip, watch the day-to-day weather forecasts before booking – ideally you’ll go on a day when the wind is 10kmh or less.

Daintree Rainforest/Cape Tribulation www.destinationdaintree.com
You can do this as a day trip in a hire car easily. Here’s my special secret itinerary which, until now, I’ve only ever shared with family and friends: 

Wake up early. An early start means you beat the tourist buses heading up to the Daintree. It doesn’t have to be a pre-dawn take-off, but this is written as if you’re in the car and driving at 7:00am(ish) – if you’re not on the road before 8:00am you’re too late.

Drive north up Sheridan Street/Captain Cook Highway. If you didn’t get proper coffee before you left town, too bad: get it in the Daintree instead.

You’ll drive past all the suburban beach turnoffs and Palm Cove in the way out of town. Relax. By leaving early you can see any of them on the way back.

Drive through Ellis Beach. About 15-20 minutes later you’ll see the signs/parking area for Rex Lookout. Stop there for photos and fresh air. Lovely.

Keep driving north, don’t turn off to Port Douglas: keep going towards Mossman. If you’re REALLY desperate for coffee you can try your luck in Mossman, but it’s better to keep driving. 

20-30 minutes later you’re at the ferry that crosses the Daintree River. Get a return ticket, and officially start to relax. You’ve beaten the traffic. You’re in a lovely part of the world.

You’ve crossed the river now. Chill. Soon after you get off the ferry you’ll see the sign pointing to Florence Lookout on the right. Take the turn. Take some photos.

Now you’re less than half an hour away from stopping for breakfast. Keep driving north until you get to Thornton Beach. There’s a place next to the beach that makes good coffee and breakfast. You can take your time.

Along the way there a free boardwalks. Take the time to walk along all of the free ones. There’s a commercial boardwalk/skywalk thingy too. You’ll see it advertised. It’s good, but so are the free boardwalks. You can choose to go on the paid boardwalk/skywalk on the way back if you want to.

Putter your way to Cape Tribulation. There are lovely beaches there – check with a local on whether it’s safe to get in the sea (irukandji likely to be a bigger risk than crocs).

Take your time. Late brunch/early lunch in Cape Trib. Soon the tourist buses will start arriving. You don’t care, you’re turning around and leaving Cape Trib now.

Enjoy the drive south. Turn -off/stop wherever you want. Make sure you stop in at that tropical fruit ice-cream place you saw on the way up.

After you’ve crossed the river again, plan to drop into Mossman Gorge on the way home. If you couldn’t swim before, you can here: fantastic clear, cold, croc-free fresh water.

How’s the time going? You’ll be time to have a look at Port Douglas: make sure. to get photos @ Four Mile Beach, somewhere down the other end of Macrossen Street near the Courthouse Hotel. Hang a right, and go up to the lookout. 

Take your time driving home. Be sure to stop at Rex Lookout again (the light has changed, it looks different, there may be hang-gliders). 

Do you have time to stop at Ellis Beach? It’s more about the beach than anything else.

Do you have time to stop at Palm Cove? It’s more about the bars and restaurants than anything else, but there is a nice jetty for a walk, and an irukandji net to allow safe(ish) swimming. 

There a few more beaches on the way back to Cairns. They all have different looks/qualities, visit whichever you like: most are only 10 minutes off the highway, Yorkeys Knob is more like 15.

That’s it.. 

Have fun! 

Mossman Gorge www.mossmangorge.com.au
Mossman Gorge is beautiful. If you can’t get to The Daintree for whatever reason go here instead – it’ll give you a good taste of the wet tropics with the bonus of cultural context.
Local’s tip: if you’re feeling the heat/humidity pack your togs – the croc-free water is always cool in Mossman Gorge

Port Douglas www.tourismportdouglas.com.au
Port is a pretty town which somehow maintains a small town feel despite all the tourist infrastructure. It’s definitely worth staying in Port for a night or two if you have time.
Local’s tip: the Sunday morning markets and Sunday arvo session at The Courthouse are fun

The Waterfall Circuit www.millaamillaa.com
This is another do-able as a day trip in a hire car thing. It’s lovely up on the tablelands, and a good way to see the good stuff is to ignore the advice of TLC and DO go chasing waterfalls. There’s a map in the link above,
Local’s tip: if you’re up that way definitely drop into the Mungulli Creek Dairy for cheese, chocolate and other yummy stuff

End

That’ll do for now.

My meta4RN website does not accept paid advertising – in fact, I pay a bit more each year to have a website without advertising. This is a prelude to say that my “Top 5 Tips for #ACMHN2018 Delegates” are just my opinion. It’s OK to ignore or disagree with my suggestions or – better still – add your suggestions in the comments section below… if enough people do add their suggestions, I’ll create another category: Top5 Reader Suggestions. 🙂

See you in Cairns for #ACMHN2018!

Paul McNamara
27th August 2018 [Twitter pics/updates on 9th September 2018]
Short URL: meta4RN.com/tips

2018 ACMHN Consultation Liaison / Perinatal Infant Mental Health Conference on Twitter

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The 16th ACMHN Consultation Liaison Special Interest Group annual conference, held in conjunction with the 7th ACMHN Perinatal Infant Mental Health Special Interest Group annual conference, was held at the Royal Brisbane and Womens Hospital from Wednesday 6 June to Friday 8 June 2018. The theme of the conference was “The Art of Applying the Science: Consultation Liaison and Perinatal & Infant Mental Health Nurses in Action”. As is typical of healthcare conferences, a conference hashtag was announced; #ACMHN was used on Twitter by six of the fifty-ish conference participants.

One of the observations made by Martin Salzmann-Erikson in his paper Mental health nurses’ use of Twitter for professional purposes during conference participation using #ACMHN2016 was that conference participants who do not engage with Twitter may feel that they’re excluded from a “privileged backchannel” of communication. On one hand this is complete nonsense. No conference participants are excluded from Twitter. Those who do not use Twitter/the conference hashtag are just exercising a choice. On the other hand, they may not be using Twitter and/or a conference hashtag simply because they have not been exposed to a reason to do so. It is with the latter in mind that the Tweets using the #ACMHN hashtag over the course of the conference are collated below.

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#ACMHN Tweeps

If you’ve scanned through the content above you’ll see that two Tweeps (ie: people who use Twitter) generated the vast majority of the #ACMHN Tweets. It’s not obvious from a quick glance, but many of the #ACMHN Tweets were retweeted (ie: shared). Seventeen Tweeps used/retweeted the #ACMHN hashtag 167 times over the course of the conference [data source], they are:
Cynthia Delgado @Cyn4CLMH*
Kim Foster @FostKim*
#HELLOMYNAMEISBJ @FewingsBj*
Anabel de la Riva @AnabeldelaRiva*
Chris Egginton @ChrisEgginton*
NWMH Graduate Nurses @NWMHgrads*
Peta Marks @petamarks*
Sharene Duncan @brisequine*
Chelesee @Chelesee1*
Veriti @Veritihealth*
A/Prof Rhonda Wilson @RhondaWilsonMHN*
Australian College of Mental Health Nurses @ACMHN*
Melissa Sweet @croakeyblog*
#HelloMyNameIs Kenny (RN) @kennygibsonnhs*
International Network of Nurse Leaders @inNurseLeaders*
Dr. Anja K. Peters @thesismum*
Paul McNamara [me] @meta4RN*
Key
* #ACMHN conference delegates [n = 6]
* Australian #ACMHN retweeters [n = 7]
* International #ACMHN retweeters [n = 4]

Many thanks to all who shared conference info with the #ACMHN hashtag. Thanks also to those who commented on/interacted with Tweets using the hashtag, but did not use the hashtag themselves (these Tweeps are not listed above).

Final Notes

  1. Each of my Tweets that announced a workshop or presentation were pre-scheduled using Hootsuite (ie: I wasn’t as busy Tweeting during the conference as it seems).
  2. Collating Tweets on a web page is irritatingly time-consuming. It used to be much quicker and easier (missing you Storify!). The upside of collating Tweets on a web page is that they serve as a record/brief notes of the conference, so if I need to come back to anything it’s all in one easy-to-find place.  Hopefully others will find it of interest too.
  3. Just in case you skipped-over it: watching the vid attached to Tweet 92 is definitely worth it – a highlight of the conference!
  4. Previous visitors to meta4RN.com may be experiencing a sense of déjà vu. To rid yourself of spooky feels, visit this same-same-but-different companion piece:
    #ACMHN Looking back at the 2013 Consultation Liaison / Perinatal Infant Conference through a Social Media Lens meta4RN.com/noosa 

End

That’s it. Thanks for visiting. As always your thoughts and feedback are welcomed in the comments section below.

Paul McNamara, 10th June 2018

Short URL: meta4RN.com/Brisneyland

PS:

https://platform.twitter.com/widgets.js

A Conversation about Documentation in Consultation Liaison

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De-identified info from the ACMHN Consultation Liaison Nurse Network www.acmhn.org/home-clsig

PPT slide from the report given at the Australian College of Mental Health Nurses Consultation Liaison Special Interest Group Annual General Meeting on 5th June 2008.

Question from regional Queensland 06/02/18

My team serves two digital masters: CIMHA (the mental health only file/application) and ieMR (the electronic general hospital file/application).

Our flesh + blood masters have now suggested that we should stop documenting in ieMR.

I think that’s dangerous.

However, I  want to see if there’s any CL service(s) that does NOT document in the hospital file.

If so, how does it work? Do you spend a lot of time in coroner’s court?

Response from Melbourne 06/02/18

I can’t imagine not documenting in hospital/clinical file – what part of consultation are they missing?

Sorry – this is a redundant reply to your question but can’t not respond.

Response from Melbourne 06/02/18

I agree it is dangerous and wrong. If we don’t write in the hospital file, how do our referees know what we advise, how else do we educate them? The nurses would often tell me that they loved reading my notes as it helped them make sense of what was going on. Definitely fight it. Do the other consult teams to the hospital have a separate file? I doubt it.

Response from regional Northern Territory 06/02/18

The other justification is documenting a diagnosis for clinical coding, which may or may not be relevant to activity based funding depending on where you are working.

The issue we have found in the NT with printing notes from an electronic system and placing them in the paper file, is the mental health notes often go missing, are filed incorrectly or do not even make it to medical records after discharge, meaning our input, suggestions and recommendations don’t make it into discharge summaries or correspondence for future presentations. Hence why we also handwrite in the file.

Response from Perth 06/02/18

I agree with you – I think it is dangerous to say the least.

We currently primarily document in the general hospital file (as these patients are admitted under general medical teams) as the teams who refer to us are asking for advice, suggestions or assistance with these patients.  We do not admit these patients to MH and have no beds.  If we assess that the patient requires a MH admission only then do we refer and  complete the required MH documents (which would go with the patient to MH).  We are however, required to enter our patient contacts in to the statewide MH database in order to generate statistics for our service.

Response from regional New South Wales 06/02/18

I am lucky as we do not use the local MH electronic documentation system. Our patient files are still paper based. I would be concerned about the medicolegal aspects of not having your notes available to the general hospital staff.

Response from Adelaide 06/02/18

We use both systems (MH Community AND hospital EPAS).

Hospital is where we work; therefore MH record gets ‘cut and pastes’ for ongoing CMHT requirements (if at all)

Response from Brisbane 06/02/18

Given our clients/customers are the treating medical/surgical team it’s imperative we write all our notes within the clinical chart. At this hospital all clinical notes are uploaded into iEMR once the patient is discharged; this means our notes can be accessible by anyone with access to this system. As yet we don’t directly input notes into iEMR but I think over the years this will change.

Because our notes are also useful to MHS we either write directly into CIMHA, print off the note and put it in the clinical chart or print off the note we’ve written in the clinical chart and then upload this into CIMHA.

If a patient is clearly delirious with no mental health history we don’t usually upload anything into CIMHA, we just write in the clinical chart.

It’s helpful for the referring teams to be able to ALL aspects of a patient’s care during in-patient stays, including MH input as when the patient is next admitted it gives them a more holistic view of the patient and encourages them to think more about how their MH problems may impact on their admission.

Response from Brisbane 06/02/18

I write in the hospital chart Progress Notes and then scan and upload to CIMHA the electronic MH record.  The reason I do this is because CIMHA printouts get filed under correspondence and not chronologically in the Progress Notes of the patient chart.  I often have the debate with MH clinicians who see a patient in ED or a general ward on the weekend, come back and write an excellent entry on CIMHA but the receiving medical team has absolutely no idea that the patient has been seen, what the outcome was nor any plan for ongoing review.

My concerns are:

how are any risk issues handed over to the medical areas? If an adverse event like a suicide/attempt happened would the coroner think notes on a database not accessible from the current treatment are or team or the current record be seen as satisfactory?

the medical team who owns the patients care within the care structure and has asked for the MH input gets no report, feedback nor result from their request,

how do any recommendation get carried over?

I would also ask how MH would feel if cardiology came to review someone in the MH unit and returned to cardiology, noted their review on a bespoke cardiac notation system and not the record within MH and left it at that, if that would be seen as satisfactory practice and care.

I suspect the scope to debate this would be well achieved through the accreditation standards, documentation and/or handover, would this pass the accreditors?

Response from regional New South Wales 07/02/18

I agree with the observation made regarding fact that the treating team caring for the person must be aware of all essential clinical details and interactions that all clinical services are providing to the person.

For services that maintain separate mental health and medical records it is essential that the clinicians responsible for that episode of care (i.e. the inpatient staff) have ready access to the clinical record in the location they would be presumed to be consulting. I would strongly suggest this means mental health consultation notes should be entered into the ward medical record and a copy be provided to add to the mental health record.

I have been aware of MH clinicians and managers occasionally expressing anxiety about non-specialist health staff accessing mental health documentation for fear that clinicians will inappropriately access and use such information. All health employees in Australia are bound by a code of conduct which strictly prohibits the inappropriate access to and use of privileged information from a clinical record – the consequences of breaching this element of the code of conduct can be quite serious. One of the benefits we have in our health service in NSW is that the majority of our services are now recording in common electronic files (EMR), meaning the issue of which file to record a clinical intervention in is not an issue, and any time a clinician accesses those records a digital finger print is left on the file. This means any time a clinician accesses a file without just cause there is evidence that a breach of confidentiality has occurred.

Response from regional New South Wales 07/02/18

It is interesting this discussion has arisen now as it has been the hot potato topic of our area and specifically my role in recent months.

Prior to the review I had been documenting in the clinical file AND our electronic community record CHIME, double dipping if you please, and very time consuming.

It is now the case that I write in the clinical notes, but I will also in addition complete a form based comprehensive mental health assessment for those patients who are being referred to the MHS. That form is scanned and emailed to an email address specifically set up for each CMHT, it is then added to the electronic file, the original assessment form remains with the patients hospital file as correspondence.

Response from regional Queensland 07/02/18

CLP writes notes in CIMHA and places them in the medical record in the relevant admission or community section of the medical note. This seems to flow smoothly here and has the advantage that if the consumer is discharged to a rural area the CLP notes are available to general hospital staff in the viewer. We use the CLP templates  which are in CIMHA.

The community mental health teams no longer write notes in medical records. Their notes are all recorded in CIMHA and no hard copy is placed on the medical record.

Response from Melbourne 07/02/18

We used to have two separate files but now have EMR and record directly on to the medical file under mental health (there is a function to put it “behind the glass”) so you can record more sensitive information if necessary. Someone has to “break the glass to look at it”.  We’ve had this system now for about 18 months and it has cut down our paper work enormously.

Anyone we refer within our region to the community can be accessed through their own service on EMR and we link our referral to the UR of the patient.

If they are referred to another service (outside our region) we print out and fax our assessment to them from EMR.  Everyone we see is recorded on CMI (demographics, clinician, contacts, diagnosis, advance statement etc but we don’t record assessments or impressions there.)

So just for those in Victoria, so you know, once they hit the adult system you will be able to see their registration date etc and can always make contact for more info.

Response from Sydney-based, covers many NSW Local Health Districts (LHDs) 07/02/18

This thread is particularly useful, thank you!

The clients/patients we see via telehealth, have an open encounter/MRN/electronic Medical Record (eMR) – including community/inpatient – in the referring/responsible LHD, and we need to create a new encounter/MRN/eMR in my LHD. I then extract notes from eMR, create a letter of feedback (impression and recommendations) which I email same day, with request that the MH Clinician at the other end upload the feedback into their local eMR, then to maintain privacy, delete the email and attachment from their inbox and deleted folders.

Uploaded files/feedback appear in ‘correspondence’ which as pointed out in this thread, need to be hunted for. Getting the feedback into the eMR also relies on the receiving Clinician to access their email and process it.

Many of the women we see are at high risk of relapse or first episode psychosis around the time of childbirth so Maternity Services would benefit from seeing our notes.

I have taken initial steps toward a pilot project whereby we may be able to write directly in the eMR in the other, usually rural LHD.

Response from Melbourne 07/02/18

We document in the hospital paper file in the episode of care.

Simple.

It works for us but we are getting an electronic medical record “soon”

Response from Sydney 09/02/18

Our system here is all eMR and went this way last year with MH going this way before the major hospital. So anyone can see anything from D&A, MH, general inpatient and community services. There are just a couple systems that work differently (oncology – which includes our psych oncology outpatient) and maternity.

It has made life so much easier to be able to see recent interactions and it has also stopped the need to fax assessments etc as it can be seen.

Like others, if it is an individual who is from outside our area health, we fax it and give verbal handover.

Prior to this, we only ever wrote in the medical file as they are the services that we work with. We use to fax to same AHS but no longer do this 🙂

I would be very worried for all the reasons that others have stated in relation to medico-legal issues as well.

Response from regional Queensland 09/02/18

Thanks to everyone for your generous and thoughtful responses.

I had been given the impression that there was something peculiar about my stubbornness on the matter. The reassurance and wisdom of the CL Nurse community is very much appreciated.

Attached is a deidentified version of our conversation about documentation in consultation liaison.

The title will make for a good rap refrain.

I’ve left-out names of people and hospitals/districts, and the side-conversation re timeliness (no offence meant; hopefully none taken).

I didn’t ask the question to gather data for a conference presentation, but I might use the attached for something more academic than a funky rap refrain.

If you’d rather your info be excluded please contact me directly (off-list).

The Mental Health Consultation Liaison Nurse Network started-off in 2002 as a Yahoo email list. More info: http://www.acmhn.org/index.php/home-clsig

End

Many thanks to all those who participated in the email discussion. I’m reminded of our old flyer for the email network which was headed by this catchphrase:

Consultation Liaison Nurses.
Isolated Geographically. Connected Electronically.

I’m leaving the transcript of the conversation here for three reasons:

  1. There may be others who battling the same/similar issues. This page is googleable, so may be of assistance.
  2. The conversation isn’t about nuclear missile launch codes. There’s no need to keep it secret or hidden away from the world.
  3. I, and others who are interested, will be able to find the conversations (ie: qualitative data) quickly and easily PRN.

To find out more about the Australian College of Mental Health Nurses Consultation Liaison Special Interest Group and/or the email network, go to: www.acmhn.org/index.php/home-clsig

As always, your comments and feedback are welcome in the space below.

Paul McNamara, 20th February 2018

Short URL: meta4RN.com/documentation