Preparing for going out on Clinical Placement or Practicum (Prac) takes personal courage… every Registered Nurse has been there… Personally, I think I loved all my pracs. I was able to choose a major theme for mine… no surprises… I chose mental health. Acute care and community… and loved every second. I am still in contact (and even have enduring treasured personal friendships) with some of my student-days lecturers and clinical facilitators/ mentors… some very special nurses! I remember I felt challenged with each new practicum…
IN real life…. a story for my student practicum days: I recall one experience on prac on an orthopaedic ward, where we had admitted a patient as ‘overflow’ from another ward… he had no orthopaedic problems… but he did have a tracheotomy tube in place (a consequence of smoking that he was quick to point out and recommend that smoking was a bad health choice to others)… he was a lovely fellow, and I was asked to look after him (under the supervision of a Registered Nurse). He was to be my patient load for the day… and I was determined that he would get the best nursing care known to humankind!
There was one problem though… there were no emergency dilators on the ward, should his tracheotomy tube dislodge. I was quick to note that these should be at the bedside in case of an emergency… staff around me were not too concerned about the missing equipment, after all, they wouldn’t have sent a high risk patient to the ortho ward! And… the Clinical Nurse Specialist was booked to do a round to see him each day… it should be fine!
I wasn’t satisfied with the responses I had from my ward nursing team… so I decided to discuss it further with my Clinical Facilitator when she came around to check on me later in the morning…. See, we had practised the care of a patient with tracheotomy in the simulation labs back at university the week before – something just wasn’t right. My Clinical Facilitator and I went and checked the hospital policies and procedures together… it was a book in those days, (but you would check the intranet now)! We discovered the policy concurred with my hunch that dilators should be present at the bedside at all times… so with my Clinical Facilitator, we tracked down a pair of the dilators required at the Central Sterilising department… and took them back to tape to the the bed unit wall… I reported in the handover that the safety equipment was now located at the bed unit (the Nursing Unit Manager thanked me for my diligence) I went home from that shift feeling very happy that even if they were not ever required (and it was not clinically likely in this case), I had made sure that my patient was safe!
The next morning… off my patient went for his shower… and while he was in the shower I made up his bed beautifully, refreshed his water jug, and tided-up his bed unit. I checked that the oxygen tubing was intact and the suction was working…. and the dilators were still safely taped to the wall. I was very eager to be a fine nurse… All was sparkling clean, fresh and ready for his return. As he sat on the edge of his bed… he coughed – and enormous cough…. his tracheotomy tube dislodged… fell out completely…. I could not believe my eyes… we were located in an alcove at the end of the ward… I buzzed three times for others to come and take over … (my plan in the event of an emergency was to assume a notetaker role… and being so eager to learn all I could… I would take very good notes!). Nurses came from everywhere… arriving in the room and know one knew what to do… so, I found myself applying the dilators to the patients tracheotomy to maintain his airway, while a code was called. The Junior Medical Officer appeared… and had never inserted a tracheotomy tube before…. so there I was, after practising the procedure over and over again in the simulation lab at university… guiding a bunch of senior health professionals in the procedure! My flashbulb memory persists years later… The NUM wrote a lovely commendation, and offered me a graduate position for the following year (you could do that then!). (I didn’t take her up on that offer… as it turned out… the cardiac intensive care unit offered me a spot and I took that instead). But, that was my first lesson in speaking up respectfully, being brave, being prepared and being safe.… with real life and death consequences in the balance. So… some tips from my prac to yours…
- Be brave! Yes, you will see and do things you never imagined – even on student prac! Each day will make you stronger.
- Be prepared… be ready to try new things… have a go (under appropriate supervision).
- Say yes! And, respect no!
- Mind your manners! Be quick to introduce yourself, don’t stand back and wait for introductions. Hello – my name is… I am from… I am here to help you with… Thank your patients and nursing teachers for guiding you and supporting you as you learn.
- Talk it thorough… what you’re doing, why you’re doing, how you’re doing, where you have been, and where you’re going, and … who you are doing with, and to… talk about your feelings, your thoughts and your actions as they relate to your developing practice with a trusted and confidential nursing mentor.
- Be kind to your student peers, mentors, teachers and of course – patients and their families.
- Be safe… do safety checks where and when ever you can – check the safety of equipment, processes, bed unit and environment. Every time you do a safety check you reinforce your learning and you train yourself to deliver quality care while keeping your patients and colleagues safe.
- Read all the policies and procedures you can… knowing the organizational structure helps you to navigate your way through the health care maze… and helps you to guide others towards the assistance they need too.
- Ask questions… don’t be put off by the unofficial-student-code-of-conduct that says ‘don’t ask questions so we can get out of here quicker’! Rather engage, immerse, ask, read, and listen.
- Turn-up, show-up, put-in… make yourself useful. Be ready to play an active role in the health care team, be prepared to help-out and chip-in. Onlookers need not apply.
To prepare for you own nursing practicum… you can learn more if you read Chapter One (by me and some of my past nursing students) The Australian healthcare context, Clinical Nursing Skills: An Australian Perspective. Cambridge University Press, Pages 11-19… here’s the link:
Or – ask your nursing school library for a copy.
If this has been useful to you – remember to share it with others too!
Whether you are a consumer/user/patient, carer or family member, clinician, or a researcher… if you have some experience with mental health… you probably have some information that you have learned along the way about improving mental health opportunities for others in the future. And information from all of these sources contributes to the pot of all known knowledge about mental health. Sharing the gems of knowledge we have can be challenging (and a bit scary sometimes too!) But, sharing makes a useful contribution. This blog is about one way to contribute to the convincing tried and tested evidence end of the knowledge spectrum…
These days in mental health conferences in particular we are seeing more people with lived experience speaking, and being included in conference discussions and agendas – respect is growing, the environment is becoming more inclusive. Clinicians are also increasingly being included, and asked to share their practice rich knowledge. Meanwhile researchers and scholars have a long experience in speaking and writing about mental health topics, however, they are becoming increasingly challenged to do so using some co-design and co-creation principles. The collaborative and inclusive shared environment of knowledge production (evidence) to improve, prevent illness, promote health and well-being and to support recovery is slowly changing and hopefully becoming stronger and more informed as a result.
Some of the traditional formats for knowledge exchange have a procedure for selecting and screening information. The abstract, a very brief and concise overview that summarises a longer discussion, makes a first impression, and is the first hurdle you encounter if you want to present your ideas to mental health professionals, and have them taken seriously. The abstract is a hard hitting pitch to your reviewers who will ultimately decide if your argument is convincing enough, and accurate enough to be included in a peer reviewed context such as a scientific conference or a journal.
Peer review is widely considered to be the ‘gold standard’ of ensuring that ideas, have sufficient merit, have been obtained in an ethical fashion, are organised and analysed using a reliable, logical and trustworthy processes, and can be considered dependable and credible. Of course it has its limitations… but it is how the scientific world revolves at the moment, and if you want to add your voice and your ideas to the scientific mental health audience – this is the process your ideas must undergo to show they are indeed valid!
For conferences, a call for abstracts is sent out up to a year before the conference date. Three common conference presentation styles are: a Poster; an Oral paper; or as part of a Symposium.
For most journals you can submit a full manuscript anytime, and you will be asked to include an abstract. You will be asked to follow the authors instructions and these must be adhered to very closely – otherwise, your submission will simply be rejected – no one will read it at all. Don’t be overwhelmed though… just go through the step by step list, do as they ask… and things can proceed very smoothly.
When you submit your paper – your abstract is your ‘sales pitch’… Manuscripts and abstracts usually are sent to experts in the field – but only about 4 people in the first instance. You have to gain the interest of (usually) 3 peer reviewers and an editor or scientific chair person. The reviewers are called ‘blind’ – but only because they are not given your name or details, and theirs are not revealed to you! They are asked to critically analyse your submission and to make a judgement on whether it should be accepted and presented to the wider mental health audience (conference delegates or journal readership). It is complicated, and a big responsibility for the reviewers and editors – because they are to some extent the guardians of the evidence on which good practice is based. So – we want it to be a very rigorous, process so we can all trust it as much as possible, for the public good. It is a very serious business. What is more, is that reviewers don’t get paid for this work… it is volunteer on top of their other responsibilities, as a service to their discipline. So, don’t cheese them off with a half baked abstract!
So – here is the How To guide!
- You have 250 words (average) and that is all. Automated functions will only allow a certain number of words or characters and you simply can’t enter anymore than what the programmed file will allow. 250 words is common – you will soon find that when you start writing, they get get used up very quickly.
- Your 250 words must be captivating, interesting and thoughtful! (Remember your reviewers are volunteering to review your work… they have probably opened your file after dinner at night… after a long day at work… they are hoping to open something that will be inspirational – something new… now is not the time to let them down!)
- Make sure that you are reporting what you have actually done... not what you hope to do, unless you are presenting a protocol.
- Use key words that will help your work to be found in the literature searches of others in the future!
- Make sure you acknowledge your co authors and affiliations.
- Make sure your ideas are aligned to your audience – a good fit – you need to match the right audience, with the right time and the right ideas.
- Use a framework like this to organise your ideas and communicate them effectively (you don’t need to use heading but you can):
- Background/ Significance
- Make sure your work can be reviewed as recent, relevant, and reliable. (Don’t let it get too old… and don’t slice the salami too many times).
- Make sure the topic of your abstract matches the conference themes.
- Make sure you have a tight, concise and well argued discussion. Get a trusted mentor to read it through and critique prior to submitting.
Remember – if you get rejected – don’t lose heart… try again, look at the feedback, try to work on a new more convincing draft, seek feedback from someone with more experience than you, find a mentor… and of course – the reviewers aren’t infallible… sometimes they get it wrong, and you have to wear it. You will have to muster some resilience, be brave – refine… revise… rework... and try again another time.
A Christmas message for my mental health friends and colleagues... looking back with a grateful heart…
…looking forward in anticipation of more adventures, successes and exciting discoveries ahead!
What an amazing year 2017 has been from my perspective! With Christmas only a few days away… and a New Year about to dawn… I wanted to take a moment to reflect on my journey through 2017, and the companionship of the people who have journeyed with me! And, to pay respect…
This time last year, I was busy packing up our family home in Armidale, Australia… I was saying goodbye to my previous workplace, University of New England… farewelling my home town…
And, my husband, family and I were preparing for our usual big family Christmas traditions… the weather was hot… the days were long! There were plenty of mangoes…
Eleven and a half months ago (January 10) I arrived (with some of my family) in Odense, Denmark… to take up a new position at the University of Southern Denmark… about as far away from my home town as I could be, and still be on planet Earth! It was cold… dark… icy… People said it was brave… I think it was too… some times life requires that you step up to an uncomfortable plate… and be courageous. It is risky… but opportunities are!
It was hard to leave behind the old … and exciting to discover the new…
Milestones since leaving Australia:
- moved house 8 times
- emptied two precious jars of vegemite
- travelled to about 15 countries (some on repeat visits… and some in transit…)
- discovered the hygge phenomenon and acquired more candles than my husband approves of!
- published 9 book chapters/journal papers (that is my job!)
- learned to drive on the wrong side of the road
- there have been conferences, keynotes, grant proposals, reports… lots of successes… some near misses… and there are plenty of ‘ducks lined up’ for 2018 to look forward to!
There are many people to acknowledge and thank over the last year…
Always at the top of my list are my husband and family… but in my professional life, there are so many colleagues and old and new friends who have been such a great pleasure to work with this year.
I have throughly enjoyed working with every single one of my new Danish colleagues at the E Mental Health Research Unit and the Telepsychiatric Centre… Institute of Clinical Research in the Faculty of Health, University of Southern Denmark; the Region of Southern Denmark; and Odense University Hospital, and the Middelfart Psychiatric Hospital. Thank you to all for the wonderful welcome… kindness… and for the amazing work we have been able to contribute to the mental health discipline and the evidence-base for the care of people with mental health conditions this year!
To my colleagues in our various advisory committees, steering committees, and working groups, and partnership consortiums – it has been a tremendous year working with you also, and I am looking forward to continuing with you all in 2018.
All my co-authors and co-investigators… you are all amazing people and I value the work we have done in the past, and continue to do in 2018 immensely! We all need each other, and together we succeed, in the sometimes lonely and slow business of research. I absolutely love working with you all – and have the deepest respect for each of you and your skills, expertise and dedication to our collaborative work.
To my mental health and nursing colleagues and friends in Australia (and throughout the world…) thanks so much for your continued support and encouragement… some treasured mentors among you (especially Kim… Debra…)! Some have visited… (Cath & Eimear)… and more with plans to visit in 2018… and some I have been able to reconnect with in Europe (Kurt… Helen…) the world is actually a very small place! And the mental health research population, minuscule! The encouragement from colleagues and friends at the Australian College of Mental Health Nurses and the Congress of Aboriginal and Torres Strait Nurses and Midwives has been very warmly received as well. Mange tak! Many, many thanks… I am cushioned by such a fabulous network of mental health professional around me – and it is a source of strength and refreshment for me.
2017 has been fabulous, and if you are reading this blog – you probably played a part in making to so fabulous! Thank you!
There is a great deal more to be done in reducing the burden of world mental health problems… I am utterly convinced that technology has a very prominent place in delivery of safe, quality and effective mental health care of the future… and I am looking forward to working to increase the capacity we have further in 2018 along side my teams, students and collaborators.
I wish you all a very happy Christmas – God Jul til alle. Best wishes for 2018.
A short photo gallery 2017 in review:
Another hot off the press publication… in it we (Wilson & Usher) give some practical guidance about how to recruit using social media to ensure that mental health research is reaching the right informant audience to investigate mental health questions.
In this paper we argue that research protocols that engage only in traditional forms of media (eg newspaper, TV, radio) to recruit participants may in fact be missing an important informant group – those people who only use social media sources and no longer consume traditional media. We contend that there are ethical and practical implications if we miss these individuals in our samples … and that this might adversely impact our results…
This one has a paywall – so you need to use your library account to access a copy – but if you have trouble – message me and I will find a suitable solution for you to see a copy!
If you are a health or social researcher – you will be interested… if not… this one might be a little on the dull side… (boring disclaimer for the most of the world!) But – fascinating if you are into research and want to make sure we ask the right questions to the right people in the right way to answer our important research questions…
Click here to read the abstract/ summary and download if you can!
My latest publication with my Australian computing science colleagues is about using gamification (an app game on a smart phone) to address the problems of Metabolic Syndrome associated with medication taking to treat some severe mental health conditions. In this paper we describe some of the computing science considerations for testing a new health app, and particularly … the way we included clinicians in our testing to check that the way we developed the lifestyle modification interventions in a game format that retained the integrity of the face-to-face as usual treatment for this condition. The good news is – it did… So, the next phase will be to test a new edition of the app in a clinical population.
Research – it is SO exciting…. creating the evidence for future practice… designed to help real people, with real mental health challenges. It is all about the people, people!
PS – and bonus… it includes pictures!
Pass it around! Available in full at this link: https://www.researchgate.net/publication/321938987_GAMIFICATION_IN_E-MENTAL_HEALTH_DEVELOPMENT_OF_A_DIGITAL_INTERVENTION_ADDRESSING_SEVERE_MENTAL_ILLNESS_AND_METABOLIC_SYNDROME
If you have a holiday break over Christmas and your body is resting but your brain just won’t stop struggling with big issues… this list of things to read will only make it worse… it is a collection of ‘odd socks’… in one sense… but each tells a tale… if you let it. Curious…? (Make sure you scroll all the way to the bottom… in case the best is left to the last!
A mixed bag of compelling reads that will cause you to delve deep into thinking (or… frustrated emotion) about the the values of diversity, inclusion, fairness, and the decency and dignity of being human… and back again! One thread is that our environments and our decision making about how we interact fairly with others is intertwined with complexity from the minute structural neurological architecture and environment in our own brains…
You will be challenged to consider the way we organise our understanding of complex human circumstances and make meaning of phenomena… through to the ways we (learn) to behave and interact with each other… how can we train ourselves and others to make better, fairer, respectful, inclusion decisions about the ways we see, think and act about others and their circumstance/s… or not…
How can we contribute to a world that is less racist, less stigmatised, less cruel, less colonised, more decent, more fair, more respectful…. or not…
And then a slightly cynical take on wading through the leadership language that lingers around oiling the inertia and languishing of any real-world change… or not…
I will be interested to hear the thoughts of others after working thought this reading list…
Reading 1. Some neuroscience… it is a journal article.
This paper is heavy going… but very interesting… it explains (neurologically) how we weigh up and make decisions – based on past experiences and our ability to predict the most suitable decision – learning from our experiences… but the bit that is especially interesting is that when we are faced with making a decision (informed by our past successes)… if the environment is volatile and changed (not your usual set of circumstances) – then you make poorer decisions… The extent that you are comfortable, familiar with the situation… plays a part in the way you make decisions… unstable, uncomfortable, less familiar circumstances impact on your capacity to make successful decisions… Why did I enjoy this paper so much… From my mental health perspective… because it is a good reminder that the brain and our thinking requires a safe, familiar setting, and positive past experiences as determinants for mental health and well being… If we don’t get the environment right for the brain to thrive… then dysfunction, disability and perhaps even disease occurs… In terms of resilience building … this is important news as well. And, in terms of acute care nursing… it is important news as well (say for rural patients treated in metropolitan hospitals… right out of their zone of comfort and trying to cope with health changes and recovery… ) Nice paper! See what you think…put it on your Christmas reading list! Open access: https://www.nature.com/articles/s41467-017-02169-w.pdf
Reading 2. Racism and privilege
If you read one book… this is it! The Hate Race: by Maxine Beneba Clarke will make you think… ‘or else whats a story for…’ And when you think about the lived experiences of others – the way they tell their own stories… there are always mental health implications… I loved her book. She is an amazing storyteller – she has reflected on her own lived experiences and conveyed them in her memoir… an Australian woman who can teach us much… if we are prepared to listen to her story tell about what it is like to walk in her shoes… a knowledge that is so relevant… just read it 🙂
You can follow her on twitter too – she curates an interesting discussion. Her handle is: @slamup
Reading 3. Case Study Research Design.
Yin has a new 6th edition out: the ‘gold standard’ for Case Study methods… if you are looking for a nice method to investigate a ‘How’ or ‘What’ type of a question… this might be worth a read. Or if, like me… you are a dyed-in-the-wool Case Study old-hand… here is the next edition. I can’t wait to see what has been updated! My copy is ordered!
Reading 4. Behrouz Boochani twitter feed: @BehrouzBoochani
Behrouz Boochani is a refugee on Manus Island – he is also a novelist & journalist. His twitter feed is confronting reading. His reporting from the front line as an insider and with his embedded experiences of detention, asylum seeking – and his experiences of Australian authorities is graphic and chilling, and provides a real life account that is a stark contrast to the the tweeter feed of his chief gaoler: https://twitter.com/PeterDutton_MP
Your social conscience will be propelled to advocacy and action… and if you are still not convinced then read https://twitter.com/nickbootnick @nickbootnick – a whistleblower doctor, refugee decency advocate with previous background serving as a medical doctor in war zones…and my friend… who was recently the head medical officer at Nauru and ‘saw worse in his Nauru clinic than in any war zone hospital’ … it is not rocketry…
Reading 5 Management Language Syndrome – another journal commentary article… not so heavy!
For the leaders… and the managers… and those on the receiving end… a little on the cynical end of the spectrum… a great explanation of a everything you thought you knew about leadership, but were afraid to ask… (you will still be afraid!).
Read this – and then cast your mind back to reading one… the environments we create… the implications… the neurological reinforcement… aarrrggghhhh!
A new podcast discussing E Mental Health Research…