The Trouble With Interdisciplinary Studies: Everybody

For those of you contemplating your capstone projects, take heed of the following.

Although social networking is all the rage in health care, I knew when my provider-focused capstone involved a range of mental health disciplines I would have trouble finding a home for it.  The vast majority of responders were nurses, which makes it unsuitable to publish in psychiatry, psychology or social work journals. Not all of the responders were nurses so the nursing journals passed as well.  Many of the social networking journals have gone under, and most of the interdisciplinary ones either make you pay to get published or require you have an MD, PsyD, or LCSW as the primary author. One reviewer mentioned this would be more appropriate for inpatient psych nursing journals, despite the fact most of the responders wee coming from community-based clinics.  In retrospect, I can think of a number of SN topics that would have "sold" better that were patient, disorder, or single-issue focused. I took a risk, it didn't pan out.

While my ego is nursing the bruise of rejection, I have to remind myself that time not only money, it is time. Rather than continue to edit and rework the article to meet the broad ranges of journal editors' criteria for zero-cents-per-word, I am going to do the unthinkable: Share the results on the Internet. This is probably scholarly publication suicide, but suck-it-dry, it is more important to share the findings than wait for the research to go obsolete. This is the PDF proof from one of my submissions:
Social Networking and Mental Health Providers: Practice Trends and Perspectives to Shape Interdisciplinary Guidelines 

Abstract

Background: Social networking activity and media development in health care are advancing rapidly and without a firm understanding of implication for use among mental health providers. Social networking is used to provide education, foster advocacy, promote the profession, and influence policy, but with potential to violate therapeutic boundaries, infringe upon privacy, create liability, and damage professional credibility.  

Objective: This survey was designed to examine current social networking practice trends and perspectives from psychiatric nurses, psychiatrists, psychologists, and therapists. Determining how mental health providers engage in social networking activity and their viewpoints on best practice offers a basis for recommending interdisciplinary guidelines.  

Design: A 20-question online survey was used to gather data from mental health providers recruited through professional member forums, e-mail distribution lists, and social media.  

Results: Key findings demonstrate an extensive use of social networking sites on personal devices for research, continuing education, and peer collaboration; a need to restrict patient communication and access to a provider’s social network; and a desire for specific guidelines to promote prudent, resourceful use of social media that complies with ethical codes, promotes professionalism, and maintains work-life boundaries.  

Conclusions: Results demonstrate the increasing use and evolving nature of social networking requires that clinicians maintain situational awareness of media platforms and technology and a need for further analysis, education, and collaboration to develop a comprehensive consensus model for social networking behavior.


The article is 60 pages with much of it taken up with figures and graphs. If you want to cut to the chase, these are the the proposed guidelines beginning on page 21:

Proposed Guidelines  

The following are proposed key components for foundational interdisciplinary guidelines that each of the professions could expand upon according to their own licensing and regulation requirements.  

• To protect the therapeutic alliance, maintain confidentiality, and prevent dual relationships, providers should refrain from connecting with current patients on their personal social networks.
• To comply with federal regulations, providers should not initiate communication or interact with patients on social networks to discuss health-protected information. 
• Professional profile pages should include a purpose and disclaimer statement with parameters for use on each site (Appendix B). 
• Office or organizational social networking policies should be included as part of informed consent, and discussed with patients as they are updated (Appendix C). 
• To demonstrate respect and trust for the patient, providers should refrain from searching for patient information online unless expressly requested by the patient during formal treatment time.

Poster Preview: What Were We Tweeting?! The Social Networking Patterns & Perspectives of Mental Health Providers

Though I have been advising senior leadership students on capstone posters for years, this is the first one I have personally presented at a national conference. Since I was asked to submit last minute, I have to pat myself on the back for not only getting it done, but uploading it to the online gallery 2 days early. Here's hoping I get a blue ribbon . . . and a publication nod!

Capstone Update (with life thrown in)

Topping out at nearly 7236 words, 53 pages, and more tables and figures than I want to reflect on,  the culmination of nearly two years of work, Social Networking and Mental Health Providers:  Practice Trends and Perspectives to Shape Interdisciplinary Guidelines  has been submitted for subjugation to the red pen. Hallelujah!

Now, who wants to publish it?

For that matter, who want to come along for some travel and networking? In the past two weeks I had the opportunity to hob-knob with writers from the ASJA and entertain guests for Derby Week. Monday I am taking off for Las Vegas to attend the Contemporary Forums #Psych12 conference. The psychopharmacology units will be especially useful as I prepare for my ANCC psych-nurse practitioner boards. Graduation in Memphis comes the following week, then in June I will be attending the Army Medical Experience in San Antonio as he APNAs representative. For some reason I agreed to do a tandem jump with the Golden Knights which is perhaps a sign I need my dosage checked.

In the midst of all this fun come the job hunt and quandary over how best to use my new found genius. One one hand, I can continue to do what I have been doing - adjunct teaching and running a private practice 3-4 days per week.  The freedom is phenomenal and I love the variety of practice with teaching. Option two is to take up teaching on a full time basis with practice taking on more of a part time role. Benefits include . . . well, benefits, loan repayment, and the collaborative opportunities for research and speaking which do not come as a solo-provider. Option three is to focus on intensive clinical experience working with the VA (application submitted) while maintaining my practice on a part time basis. The advantage here is to hone my clinical skills with a population I enjoy working with in an area that is finally getting the funding it requires, and possibly the opportunity to ingrate acupuncture with PTSD treatment.

Any decision is a good decision and I will be able to apply the leadership skill I have learned throughout he DNP program.   Note that every scenario includes an element of private practice. I realized long ago I do not thrive in a 9-to-5-one-job environment.

My routine is variety. Except for sleep.

Mental Health Providers & Social Networking

I have not been blogging much about the DNP experience this semester for a couple of reasons. First, life. Second, class is over with all of the focus and attention going toward our capstone projects. With that in mind, I am embedding the survey here for the next month to try and capture as many mental health providers (nurses, psychiatrists, psychologists, social workers, therapists) as possible. You can also access it at www.SurveyMonkey.com/s/OneDNP 

My goal is to gather at least 500 responses and publish the results later this year. Feel free to post any comments or questions. Thanks!

Create your free online surveys with SurveyMonkey, the world's leading questionnaire tool.

The IRB (Exempt) Stamp of Approval

As any of you following along may have guessed, my DNP project involves an investigation into the current practices of social networking among mental health providers and suggestions for appropriate use. I hope to get a diverse response base and would appreciate help with dissemination to nurses, psychiatrists, psycologists, therapists, and social workers. I spoke on this topic at the APNA conference, but have made some significant revisions to the questionnaire since then. I would appreciate any mental health professional willing to take the time to fill out the survey and pass it along to colleagues:

https://www.surveymonkey.com/s/OneDNP


Thanks!

The New & Improved ANA Social Networking Principles!

While I am not narcissistic enough to believe my contributions during the "open to public comment" period had anything to do with the excellent edits, I like to think the synergy of many like-minded nurses worked to improve the specificity and decrease the Ratched. The ANA was also nice enough to provide a Tweet and Learn #anachat for 0.5 CEU credits. Now we own it!

Benefits

• Networking and nurturing relationships 
• Exchange of knowledge and forum for collegial interchange 
• Dissemination and discussion of nursing and health related education, research, best practices 
• Educating the public on nursing and health related matters 

Risks 

• Information can take on a life of its own where inaccuracies become “fact” 
• Patient privacy can be breached 
• The public’s trust of nurses can be compromised 
• Individual nursing careers can be undermined

 ANA’s Principles for Social Networking 

• Nurses must not transmit or place online individually identifiable patient information.
• Nurses must observe ethically prescribed professional patient — nurse boundaries.
• Nurses should understand that patients, colleagues, institutions, and employers may view postings.
• Nurses should take advantage of privacy settings and seek to separate personal and professional information online.
• Nurses should bring content that could harm a patient’s privacy, rights, or welfare to the attention of appropriate authorities.
• Nurses should participate in developing institutional policies governing online conduct.

6 Tips to Avoid Problems

• Remember that standards of professionalism are the same online as in any other circumstance.
• Do not share or post information or photos gained through the nurse-patient relationship.
• Maintain professional boundaries in the use of electronic media. Online contact with patients blurs this boundary. 
• Do not make disparaging remarks about patients, employers or co-workers, even if they are not identified.
• Do not take photos or videos of patients on personal devices, including cell phones.
• Promptly report a breach of confidentiality or privacy.

"I'm Going to Disneyland!"

I am officially registered for the APNA conference . . . a good thing since I am presenting!

3011: Social Networking for Psychiatric and Mental Health Nurses
Jaclyn Engelsher, RN-BC, APRN, FNP-BC, DOM; Tanitha Moncier, FNP

Abstract
Social networking, a relatively new communication phenomenon, has the ability to provide education, foster advocacy, promote the profession, and influence mental health policy. It also has the potential to violate boundaries, infringe on privacy, create liability, and damage professional credibility. A review of the literature revealed limited research has been conducted concerning the impact and use of social networking sites in nursing practice and other healthcare disciplines. In 2010 the ANA issued an informal resolution regarding use of social media in keeping with the Code of Ethics and called for additional study.

In Psychiatric/Mental Health Nursing, communication is the foundation of the therapeutic alliance. Because social networking communications have the potential to positively and negatively affect this alliance, it is imperative to develop guidelines for prudent and resourceful usage of social networking media that complies with practice acts, promotes professionalism, and maintains work-life balance for the psychiatric mental health nurse. This session will provide an overview of different types of social media outlets, review published position statements from other healthcare disciplines, and consider best practices for Psychiatric/Mental health nursing.

After looking at the schedule, I wish I was multi-planer because there are a lot of interesting topics going on at the same time including a military specific track, integration of mental and physical healthcare practice, and use of complementary modalities from music making to use of heavy quilts as a comfort measure for depression. I must admit, I am hope the LACE discussions are as lively as they were last year. I love a good nurse fight (getting it out is far better mentally and much more entertaining then letting angst fester into lateral violence later on!).