Tag Archives: COVID19

On RATs and Nice

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

freedumb

Once upon a time – a long, long time ago (2021, I think it was) – I put a lot of effort into promoting COVID-19 vaccination.

I have stopped doing that.

As of April 2022 it looks like nearly 5% of adult Australians will choose to never be vaccinated against COVID-19 [source]. It’s been over a year since vaccines arrived in Australia. In the first couple of months it was tricky to access the vaccines, but since mid-2021 it’s been pretty easy. The unvaccinated are unvaccinated by intent, not by lack of information or opportunity.

By comparison, about 11.6% of adult Australians smoke tobacco daily [source]. Smokers ignore the health warnings intentionally – it’s certainly not through lack of information: over 75% of packaging space on tobacco products consists of graphic and text information about the harmful effects of smoking [source].

Smoking is not illegal. Vaccines are not mandatory. Adults do what they want and accept the consequences of their choices. 

Despite what people have been shouting at their ‘freedom rallies’ and in courtrooms, vaccines are not mandatory. Never have been. On 07/04/22 it was reported that Simon Ower QC said his client did not get vaccinated because she believed the mandate direction left her with no choice and it was being forced on her [source]. There was a choice then, wasn’t there? It’s not mandatory/forced on you if, as per this example, you get to say “no thanks”.

Vaccines are a condition of employment for many jobs and remain condition of entry for some venues, but they’re not mandatory. Never have been. Nobody will hold you down and inject you with a vaccine. You get to choose. As articulated in a recent eloquent editorial in the International Journal of Mental Health Nursing, “The heavy hand of coercive care is still reserved for those hearing voices and seeing things, rather than someone at risk of spreading a deadly pathogen to an unvaccinated community.” (Keep, 2021).

Let’s not muck-around here. The people who have chosen not to be vaccinated have grabbed more than their share of media space, and some people (eg: Clive Palmer and Craig Kelly) are prosecuting a peculiar political message to tap-in to that disaffection.

Let’s not buy into their frogshit. It’s more sensible to mock people like Clive Palmer and Craig Kelly (fragile manipulative narcissists hate mockery), and stick with the data.

The data shows that Australia’s COVID-19 strategy has been pretty successful [source]:

Cumulative COVID-19 deaths 29 February 2020 – 6 April 2022 (comparison of selected countries)

Out of interest, Australia’s anti-smoking strategy has also been pretty successful [source]:

Annual smoking death rate 1990 – 2019 (comparison of selected countries)

With the exception of people under the coercive/mandatory treatment conditions of the Mental Health Act, people get to choose what – if any – health advice they follow and what health interventions they receive. .

Smoking is not outlawed. Although smoking and death rates have fallen markedly in that last 20 years, more than 11% of Australian adults choose to smoke daily.

Vaccines are not mandatory. Although more than 95% of Australia adults have had two or more COVID-19 vaccines, over 4% of Australian adults have decided not to have the COVID-19 vaccine.

Some people make good health decisions. Some people make not-so-good health decisions.

Clinicians are very accustomed to providing health care to those who make not-so-good health decisions and/or are pre-contemplative to change. My concern is that if people are taking health advice from Clive Palmer and Craig Kelly are they exercising freedom or freedumb?

Reference

Keep, J.R. (2021), Enter the plague. International Journal of Mental Health Nursing, 30:5, pp. 1037-1039. doi.org/10.1111/inm.12924

End

That’s it for this angrier-than-usual blog post. The blatant distortions of truth by some incredibly well-funded politicians has made me a tad cranky.

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

Paul McNamara, 8 April 2022

Short URL: meta4RN.com/free

Surfing the Omicron Wave

There isn’t much in the way of surf in Cairns because the Great Barrier Reef is – ahem – a great barrier. Nevertheless, this year heaps of people who live and work in Cairns showed how skilled they are at big-wave-surfing.  

The Queensland borders did not open until Monday 13 December 2021. This allowed every adult who wanted to get vaccinated the opportunity to do so. Comparing what happened locally to what’s happened elsewhere around the world, it’s clear that having more than 90% of the adult population with some vaccination coverage before opening the borders made a huge difference to how high and long the Cairns omicron wave has been.  

In Cairns our COVID-19 omicron wave started slowly. There was just a trickle of COVID-19 positive people who required hospitalisation either side of Christmas 2021. From early in the New Year the omicron wave behaved more like a tsunami. The wave came in much faster and was much larger than most of us had anticipated. It was pretty scary. Two thirds of the way through January some of us were worried about drowning. At that stage we had three wards 100% dedicated to caring for COVID positive patients, plus a smattering of positive people in other wards and in ICU.

Much to our relief the wave crested and crashed nearly as quickly as it arrived. At the end of the first week of February we still had three COVID-dedicated wards, but they weren’t quite as full or as intense as the week before. A week later we were down to one ward 100% dedicated to COVID. A week after that we had zero wards 100% dedicated to COVID; positive patients were being nursed in negative-pressure rooms as per pre-pandemic practice. Amazing.

In Queensland, especially in Cairns, we know we’ve been very fortunate compared to many people and places in the world, but that doesn’t diminish the admiration I have for all the big-wave-surfers at work. Don’t forget, as argued previously [here] , they are NOT heroes – they are health professionals. Heroes tend to be blokes who are big, boofy and fictional. People in the hospital working with COVID patients are mostly women who are not-big, not-boofy and they are real lanyard-and-PPE-wearing nurses, ward clerks, cleaners, wardies, physios, doctors, specchies, OTs, security and catering peeps.

Despite the lack of practice we have with waves in Cairns there are heaps of really good big-wave-surfers here. This is evidenced by how gracefully and expertly they surfed the omicron wave. 🏄‍♀️

Not All Good News

It would be disrespectful not to acknowledge that it’s not an entirely good news story. The wave has diminished in size and strength, but has not disappeared yet. Also, some of the people who were hospitalised with COVID during this period have a very slow, difficult pathway towards recovery. Poignantly, twenty seven local people did not survive COVID during this period. Their families and friends are in our thoughts.  

End Notes

Data Sources: The hospital/ICU numbers were released every few days via internal “Team Brief” emails and/or via social media – these were the sources of the data used to create the chart above.

Thanks for reading. If you know someone who has surfed that omicron wave I’d be grateful if you make sure they get to see their portrait above. 🙂 🏄‍♀️

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

Paul McNamara, 22 February 2022

Short URL: meta4RN.com/surfing

Switching Operating Systems

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

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

It’s been like that at work this week.

Obligatory PPE Selfie

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

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

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

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

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

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

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

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

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

Psychological First Aid

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

End

Thanks for visiting.

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

Paul McNamara, 8 January 2022

Short URL: meta4RN.com/switch

Bonus video: Old bloke shaving

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

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

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

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

Please interrogate the comparative data collated in the table below.

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

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

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

Think Global. Act Local.

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

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

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

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

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

So What?

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

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

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

Data Sources 

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

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

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

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

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

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

End

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

Paul McNamara, 2 December 2021

Short URL: meta4RN/baseline

Addit

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

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

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

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

That’s great, right?

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

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

So What?

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

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

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

That’s the pathway to burnout, my friend.

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

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

NB*

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

References

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

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

Declaration of Interests

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

End

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

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

Paul McNamara, 16 October 2021

Short URL meta4RN.com/grey

Vax Facts for Nurses by Nurses

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

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

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

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

Have a sneak peek of the content here:

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

What’s with the blog post? 

I have three reasons for promoting the webinar.

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

Acknowledgement

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

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

End

That’s it.

You have less than 10 days to:

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

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

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

Paul McNamara, 1 September 2021

Short URL: meta4RN.com/VaxFacts 

Addit (to encourage Kiwis and Aussies)

CLovid Communication

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

Why? 

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

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

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

Pros:

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

Cons:

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

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

Pros:

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

Cons:

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

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

Pros:

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

Cons:

  • Reminds me of prison-visit scenes in American movies

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

Pros:

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

Cons:

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

And The Winner Is…

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

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

Why Does It Matter?

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

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

CLovid Acknowledgements

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

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

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

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

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

Further Reading

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

Hurley, J. and Lakeman, R. (2021), Making the case for clinical mental health nurses to break their silence on the healing they create: A critical discussion. International Journal of Mental Health Nursing, 30(2): 574-582. https://doi.org/10.1111/inm.12836

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

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

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

Paul McNamara, 14 August 2021 

Short URL meta4RN.com/CLovid

Vaccination Celebration

2020 was ‘Year of the Nurse’, but it wasn’t until 2021 – when we had access to COVID-19 vaccinations – that we celebrated.

If you had told me in March 2020 that I would be vaccinated against COVID-19 before the end of March 2021, I would have told you you were crazy. And yet, here we are. I had my second injection this morning. Yay!


Dose 2 of 2 ✅ #COVID19 #COVIDvaccine

In keeping with the TGA guidelines (read them if you’re a health professional: www.tga.gov.au/advertising-covid-19-vaccines-australian-public), I shall not use “the tradename and/or active ingredient of the specific vaccine” I was given. That little formality out of the way, I’d like to thank the following:

Science and Scientists who, in less than a year, have developed eleven vaccines. Not all of them have completed clinical trial or the WHO approval process yet (more info here), but still… Amazing.

Australia’s federal government for shutting the borders on 20 March 2020, and securing the purchase and manufacture of safe, effective, free COVID-19 vaccinations.

Queensland’s state government for being humble, smart and brave enough to seek and follow the health advice. As I’ve blogged previously (here, here and here). those of us living and working in the health sector in Queensland have a lot to be grateful for. Queensland has a lower incidence of COVID-19 than any other state or territory (source), and despite having a larger population than New Zealand has had fewer COVID19 cases and deaths (source and source). This all holds true today (30 March 2021) despite a current Brisbane lockdown and state-wide mandate to wear masks indoors because of recent community transmission.

My employer for including my small but dynamic team in the 1A rollout. My clinical role takes me to pretty-much every ward in the hospital, so I’ve be carrying the anxiety of being a potential super-spreader for the 12 months. A weight has been lifted. Thank you @CairnsHHS.

Finally, thanks to Frankie and Laura for giving both of my injections so painlessly and professionally. Thanks for the lollypops too :-).

I am very, very grateful to be be amongst the thousands of Australian nurses having a vaccination celebration.

Wait. There’s More.

Check-out more stories about Australian Nurses also having a vaccination celebration via this online curation: wakelet.com/@metaRN (recommended – it’s uplifting to scroll through all the news stories featuring heaps of nurses getting and giving COVID-19 jabs).

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

Curious about the vaccine or when you’re likely to be invited to have it? Check out this website: health.gov.au/covid19-vaccines

Paul McNamara, 30 March 2021

Short URL: meta4RN.com/vax 

Addit @ 2 November 2021

I’m a little conflicted between celebrating my good fortune and flaunting my privilege, but I am very pleased to have received a third vaccination today. This is prophylaxis/risk reduction in preparation for the borders opening next month, and the inevitability of the virus circulating in my community/hospital.

Twenty Twenty Hindsight

Back on 1 January 2020 I published a blog post called “20 Tweetable Fun Facts for 2020: Year of the Nurse” [link]. Anyway, not sure of you’ve heard about it, but there has been a worldwide pandemic since then. Hardly anyone talks about it and it’s rarely mentioned in the media [insert eye roll emoji here].

Rather than ramble on trying to make meaning out of a chaotic year, I’ve tried to summarise 2020 in a collage of photos I’ve taken of social-distancing floor decals and a QR code. It’s not especially profound, but it kind-of tells a story.

2020

That’s it really.  Regular readers will note that this post is just a reworked version of my post-holiday blog post [link]. The only thing to add is that an idea from 2012 re using QR codes in health care settings should be revisited now  – QR codes have never had better market penetration or acceptance.

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It’s an intentionally short blog post. It’s been a weird year and I’m tired.

Thanks for reading. As always, you’re welcome to leave feedback in the comments section below.

All the best for 2021.

Paul McNamara, 31 December 2020

Short URL meta4RN.com/MMXX