#Australian #nursesunite #NursesShareYourStethoscopes #nohealthwithoutmentalhealth

#NursesShareYourStethoscope in Rural NSW

Last week a Miss Universe contestant, also a nurse, told the world about her love of nursing – she dressed in a typical nursing outfit (scrubs and steth) ready for work… and … she was at the brunt of some very public ridicule for doing so.

The nursing world spoke out – a line had been crossed. Nurses are proud of their contribution to world health. Nurses contribute more human resource to world health care delivery than other other health profession. We use a multitude of tools to do that… just one of those tools is the humble stethoscope… We use it to listen to many parts of the body – to check and monitor functioning, and to assess when health is compromised. It is a basic tool that many health professionals use everyday. To be mocked for doing so is wrong… Nurses around the world have risen up and taken to social media with #NursesShareYourStethoscope .

Here is my contribution as I travelled through northern NSW and southern Qld – Australia over the weekend. I tweeted ‘selfies’ along the way to cheer on rural nurses everywhere – keeping rural people healthy :) See more @RhondaWilsonMHN

A big shout out to rural nurses everywhere – but especially to the ones in the towns I travelled through on my #NursesShareYourStethoscope tour:

  • Armidale, NSW
  • Guyra, NSW
  • Glen Innes, NSW
  • Deepwater, NSW
  • Glencoe, NSW
  • Tenterfield, NSW
  • Ballandean, Qld
  • Stanthorpe, Qld
  • Warwick, Qld
  • Allora, Qld
  • Toowoomba, Qld

My challenge to all rural nurses everywhere: #ShowUsYourStethoscope !

Fail fast & Retry, Retry & Retry again… Rural health professional tenacity in a nutshell

I heard a leading rural public health professor speak last night (at the Robb College (@robbcollege) annual Health Lecture and Dinner  – University of New England @healthune) about the challenges and opportunities that exist in rural and regional health in Australia and across the world. I was spurred on… motivated… inspired… to keep pressing forward in contributing to rural health progress. Professor Ian Wronski, Deputy Vice Chancellor  – James Cook University, shared some of what he has learnt along the way while working in public health in rural Australia.

Some of what got me thinking…

  • When you get stuck without many resources… try new things!
  • Rural politics… often not enough marginal seats to attract funding and resources…
  • Sustainability in the primary care workforce is vital for the health of rural communities. Not limited to a sending-in style of health care delivery… but embedding and internally generating health workforce within rural communities.

My entire health career has been played out in rural committees… These three points struck a chord with me because they aligned with what I know of rural communities. A dollar, please, for every time I have had to innovate my practice because the oily rag needed to be squeezed a little tighter!

Trying new things is something that rural people are good at! Using our strengths! That is, the skills that are so much second nature to us that we sometimes forget that they are indeed special skills. Trying something new, and finding a way to make something work, finding the work-around solution, finding a new way using the resources we have at hand… that is innate rural culture. That is… what rural people do extremely well… but of course – there are limits!

Rural people conduct themselves resourcefully. They are not wasteful of resources because they work hard to obtain the resources that are carefully matched to the needs, ensuring they get the last drop of ‘oil out of the rag’. They make do!  Where I grew up we had one (thinking back – very small!) water tank to collect rain water for household use. Nobody wasted a drop – it was valuable, it was used wisely and recycled where possible. Never a tap was left to drip… the sentiment permeates and translates to rural life and culture in general. I think these are key characteristics of rural people and communities, and these attributes help to make up the social capital and the human ecology of rural communities. I have written a bit about that...  and have explored the contributions that nurses in particular make to the mental health care of young rural people.

There is something to be said about the dynamics of rural politics though. Political pressures underpin resources allocation for public health and especially in regard to mental health of rural people. The national and state spend on rural mental health (or mental health generally) is consistently poor. Nationally this bears out with a stable suicide rate over the past ten years  – not a reduction… but rather a complacent stability, with rural communities bearing a disproportionate burden. The reality is that many rural political seats are ‘safe’… and one of the limitations that is associated with this political condition impacts adversely on public health resource allocation. It is a bit like the water tank of my childhood never benefiting from sufficient rains to fill it up… and for us constantly monitoring the water level by tapping the sides of the tank to listen for the tympanic changes to signal volume levels.   Worrying about how much water was left and guessing how far it might need to go before the rain came again… reducing our use to reflect the remaining residue, and not having enough to do anything extra. I could still show you the corrugation groove around the one third full mark that changed the mood in our family to austere use of water and restrictions for our family – indelibly marked in my psyche! When the rain doesn’t fall in the rural mental health budget – there is never enough resource to do the prevention, mental health promotion and early intervention care because those elements of health care provision can be thought of as when the tank is only one third full – so restrictions need to heeded and the valuable resource only used for the most serious circumstances – often too little, too late. But – in marginal seats – it appears that the weather forecast is often more promising… Try someone new might be a good rural political slogan for the future… ?

Professor Wronski had Six Tips to enhance rural public health:

1. Invest in locally driven solutions because local proximity to the problem drives finding solutions. (Rural people are close to the problem so they are likely to also be close to the solution)

2. Take intellectual risks. (Think about things and then do things!)

3. Use evidence to drive decision making. (Not whims and hunches… but take the time and effort to generate and gather the evidence  – then apply it!)

4. Fail fast and use it to learn from. Then, Retry, Retry and Retry again. (Fail fast… I like that… but don’t give up especially if you are doing 3 & 4 above… learn more – try again… love it!)

5. Facilitate collaboration and co-creation. (Working together) 

6. Identify scalable solutions that will have disproportionate impacts as you scale them up. (‘From little things – big things grow’)

A lot of good advice! Some good signposts for keeping public health on track  – out back!

writing where the energy is

Originally posted on patter:

The conventional writing advice offered to people who have some trouble writing is to engage in free writing. Write, usually in timed sessions, whatever comes into your head about a particular topic. Write without stopping. Write perhaps to prompts about a particular aspect of your work. Write without stopping to think, because it is the thinking that gets you into trouble. Shut off your inner editor and just write.

There are many versions and modifications to free writing. One that I like is what is called “Writing without a parachute”. Parachute-free writing, or what Barbara Turner-Vessalago calls free fall writing, is a process designed for creative writers. It has five basic tenets, three of which are easily applicable to academic writing:

1. write what comes up for you – this suggests that you don’t have a plan or prompts, you just write what comes into your mind

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A new generation of qualitative researchers

Originally posted on Jane Mills:

This blog post is an excerpt from our new book (Mills, J & Birks, M. Qualitative Methodology: A practical guide, 2014. SAGE Publications). When it came to the final chapter for the book one of the issues I wanted to address was the impact of generational difference on how groups of scholars think about qualitative research. In particular, I wrote about the thorny issue of research impact and how receptive or otherwise qualitative researchers are to appraising the impact of their work and why that might be so. If you are interested in reading more about the politics of evidence and generational difference you can source the book from SAGE, Amazon or Footprint Books in Australia.

The politics of evidence

Current debates, largely conducted within the dominant North American qualitative research community, constitute a backlash against what is conceived as the growing dominance of positivistic science in major western…

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Ten Tips for a successful career…plus a one extra late edition!

Ten Tips I picked up this week from a very successful retiring academic colleague about securing a long and successful professional life:
1. “If you live long enough- things happen” – you’ll need endurance and tenacity
2. Make sure you can recognise luck when it comes along and don’t waste the opportunity it brings with it
3. Have broad interests – look beyond your own discipline and always be ready to learn
4. Travel
5. Networks are everything – build strong networks
6. Find innovative ways to manage difficult people
7. Choose your battles carefully – let some things ride…
8. Take risks…
9. For academics…Remember: Teaching pays the bills!
10. Be nice to people – listen to them… hear them… be quick to say thank you.

an 11th has been added by another highly regarded sage academic (retired) – Do not forget to privilege research and publication. Sequester time for this and guard it ferociously. So easy for it to be eaten into. Create research groups.

….and my observation to add to this list… wash all down with plenty of ‘faith’ and confidence in yourself/your abilities… and a moderate amount of Shiraz!

#headspace & #MentalHealth reform for #rural Australian young people. #nurses #heretohelp

At the moment, the media is laden with calls for reform for youth mental health in Australia. My research informs the debate:

My research specifically addressed the problem of rural young people accessing mental health care. Following one Masters (Hons) and one PhD examination of the problem, I have formed some evidence-based views on ways forward: Here is an extract (Thesis Chapter 5: pages195-197) one that relates to headspace and the potential nurses have to be a more effective contributors to early mental health care if funds were redirected from headspace for a more equitable distribution to help young rural people:

         Implications for policy…

  • The national mental health strategy headspace, does not currently possess the capacity to be extended to every rural community in Australia. E-headspace does have some scope to contribute a useful component to a rural youth mental health strategy if rural e-mental health knowledge brokers are available in community rural nursing settings or Medicare Local centres to facilitate this strategy in the rural environment.
  • The headspace initiative should be reviewed by the Department of Health and Ageing with an aim to facilitate the redistribution of federal funds to include a contribution to the operational costs of rural nurses to act as e-mental health knowledge brokers for young rural people on a per capita basis, so that at least population-based equity of distribution of youth mental health financial resources is available in all communities, rather than, as is currently the case, restricted to one service centre in one regional community in the study site region.
  • Further reform of youth mental health services is required to ensure that rural young people have reasonable access to mental health services in keeping with international progress and development about youth mental health services that challenge the traditional paradigms of youth mental health service delivery (Coughlan et al., 2011, 2013). There is wide agreement in the literature that young Australian people are underserviced in early mental health care, and that for rural young people this circumstance is further amplified (Coughlan et al., 2011; Mendoza et al., 2013; Rickwood, 2012; S. P. Rosenberg & Hickie, 2013).
  • Rural nurses should be adequately funded to support e-mental health kiosks in appropriate community settings such as hospitals, multi-purpose health facilities, community agencies, schools and police stations. Rural nurses are able to collaborate with professionals from all of these sectors in such a way that collaboration of mental health helping and capacity building in rural communities is achieved and coordinated. The architects of health, social and law policy will need to accommodate the inclusion of new and innovative roles in the future. In particular, the function, role description of rural nurses, and specifically the role of rural community nurses will need to be expanded so that meaningful mental health help can be provided to early mental health help-seekers.

In press now:

Wilson, R.L. & Usher, K. (2015) Rural nurses: A convenient co-location strategy for rural mental health care of young people. Journal of Clinical Nursing. (in press April 2015).

#nurses #heretohelp