Nino Di Pasquale | 5 Minutes With…
About Nino Di Pasquale
What inspired you to study nursing?
It probably started when I was 12 years old. Coming from an Italian background, traditionally older Italian’s are looked after at home. My grandfather was diagnosed with terminal cancer, so he was at home where everyone took turns to look after him. Men had to step up and play their part. I saw my father, his two brothers, as well as my brother and I take turns to care for him. We would have sleepovers or spend the days with him, giving my father and uncles the opportunity to continue working and allow my grandfather to stay at home and be cared for. I was inspired by the nurses and doctors who visited him and the role and interaction I had with my grandfather was something I could actually replicate and why I was inspired to get into nursing.
How has the current COVID-19 environment impacted on your role at Barwon Health?
In the first couple of weeks of March, my Clinical Director, Steve Moylan, tapped me on the shoulder and said “This is a significant clinical issue that requires leadership from the Director of Nursing. I want you to take the clinical lead in how we as a Mental Health Service addresses the pandemic”. I knew this was important, especially because none of us have been through a pandemic.
This meant a lot of engagement on my part with the whole organisation and the acute Hospital in particular, and a lot of engagement with my peers across the state, to understand what we were all doing in addressing the pandemic. We had to change the way we did things; how we maintain a workforce, how we maintain a workforce in a pandemic where we’ve got restrictions, how we deliver services in an environment with restrictions, how our clinicians deliver their work, within an environment where they’re continually adapting to PPE and what it means to wear those things, how we move into the telehealth space and what it means for our consumers to have consultations in that manner rather than face to face.
In our initial lockdown we were able to effectively transform our service in a short period of time. As we moved out of our first lockdown, what we found was that it didn’t necessarily hit the mark either for our consumers nor for our staff. We then had to then re-establish our service delivery and what that still looks like in a pandemic, but in a pandemic with ongoing restrictions and changing demands. Our consumer group has changed, it’s increased in its breadth. We’re seeing consumers we wouldn’t normally see in the population coming to us as a consequence of being socially isolated, potential unemployment and financial distress.
What have been your greatest achievements over the past 12 months?
It’s been about adapting to that change. When I think about one of my major portfolios, which is to have governance and leadership across the teaching and learning in the Mental Health Program and building workforce capability and strategies for that. In an environment where we’ve gone from huge dependence on face-to-face training with large venues to the cancellation of all types of training. Our strategy to address that hasn’t been to just to refer everything to online training modules, whilst they’re useful they don’t help with what is a really fundamental mode of training in mental health clinical settings, which is about narratives, stories and learning from those case studies.
We are in the process of establishing a model of community practice across the whole organisation, with particular emphasis on department led initiatives and contemporary practices, contemporary practices and recovery reforms in the absence of face-to-face. Transforming how we actually deliver education training and knowledge transition across the organisation.
Probably the other greatest achievement is taking the lead on the pandemic planning around staff deployment and redeployment and establishing quarantine plans for bed base facilities and continuing to progress them and update them as the information changes. That again is a major challenge and major achievement, especially as we now move into refurbishing one of our facilities and having to change that plan and evolve that plan in an environment that’s going to be a construction site as well. They’re probably my major challenges and achievements outside of the last 12 months.
What attracted you to the role at Barwon Health?
I had previously worked for Barwon Health; I had moved between working for Barwon and a neighbouring health organisation in the Western Melbourne Metro areas; always being drawn back to Barwon Health because I lived in the area. It’s also a community that I think needs a lot of consideration around mental health services and mental health redesign. Now with the Royal Commission into Mental Health in Victoria, there was also going to be challenges in the role, as well as opportunities for growth.
The role was new, it hadn’t previously existed; I think there’s only about half a dozen similar positions across the state. I was also fortunate enough to have people in positions that I respected that said to me ”Nino, you should think about this, you should go for this job, this is a job that you could do and that the organisation would benefit from”. I was aware of some of the challenges that were occurring, especially in our acute inpatient unit at the time, and I was really up for those challenges and wanted to be part of the change in those areas. Working for my community is a big plus.
What were the benefits of working with an executive recruiter to secure this opportunity? And how has your experience been with Ccentric?
The benefit of going through an executive recruiter is that they understand what the organisation is looking for, they have a real sense of that. Then they take that, and they spend a lot of time trying to understand the candidate. I felt that when I was working with you, you took the time to understand me and what I could bring to the organisation, and what I couldn’t bring if that was the case. I think we even had a couple of conversations that went beyond the time, but certainly, it meant that you understood me. I had an understanding of what you were looking for and what you were doing and that meant that by the time we got to the interview process, the panel really knew who I was. I think although it’s an investment and although it can be costly and not necessarily the most time-efficient approach to recruitment, where you’re employing into hot pivotal roles, I think it’s very important to make that investment, and I enjoyed the process.
How have you seen the development of digital healthcare support mental healthcare and improve outcomes?
We’ve done our very best of Barwon Health to embrace it in the pandemic. Like many of the tertiary mental health services across the state of Victoria, we recognised our reliance on appointment-based outreach and face-to-face assessments. This provided another platform where we couldn’t successfully achieve those normal types of interviews and appointments through face-to-face contact; it’s improved access to people as well as access outside of the normal working hours.
There’s a benefit to that, as there is for us having this conversation now across thousands of miles, there’s a benefit to seeing one another face to face rather than just over the telephone. Whilst it’s not as good as necessarily real life on all occasions, it provided an opportunity for us to still deliver services in what was a challenging environment. We saw positive outcomes for a select consumer profile and more challenging outcomes for another consumer profile.
The Victorian Mental Health Branches helped support that with access to things like mobile phones and those sorts of things. There was also that cohort that because of the nature of their illness, found this mode of communication quite challenging, whether because of psychotic symptomatology or depressive symptoms.
There is often a stigma around speaking about mental health. What do you think we can do to encourage more open and honest conversations?
It’s a difficult question to answer. I believe that we are very good at kind of general mental health promotion activities across the country and across each of the states. I think we’re very good at marketing things like Beyond Blue, R U OK? day and those initiatives like mental health week. The cross-promotion of general health weeks like men’s health week also linking to specific men’s mental health information is also good.
People are still scared to talk about their experiences, there is shame associated with it, how others might judge them. There’s still some stigma around things like it not being a real illness or a real condition. How we change and address that is to continue having open and honest conversations about what is mental illness, how to access services and what it looks like to recover from mental illness, what those symptoms are.
I still think there’s also investment in more broadly around the interface services that certainly public mental health services have with police and ambulance, and the initiatives that can be done in that space to also help reduce stigma. Because we see a lot of consumers sometimes the first experience they might have, especially at the more catastrophic end of mental illness, might be with a police officer or ambulance officer rather than a mental health clinician. So sometimes the mode in which they come to us can also be really problematic. There are systemic issues associated with that as well and the stigma that exists across the public in general. But we’re getting there, and I think we will get there, there’s no doubt.
Mental health in the workplace is also a big problem, what change do you believe needs to be addressed?
Healthcare is probably one of the worst examples of this, doctors and nurses are less likely than members of the public to put their hand up and say, “I’m feeling this way, I need help”. There is a real stigma associated with that.
At Barwon Health and at other organisations I’ve worked with or have connections with, we have strategies in place. We do our very best through initiatives that are supported through our employee assistance programs (EAP) and counselling services to help with that; but it does take changing the culture in the workforce and changing the culture in leadership groups, where the leadership groups might still have a stigmatised vision of mental illness. It does take some investment.
Whilst in healthcare, we might not necessarily be the first people to put our hands up, we do have good systems in place to support people when we do put our hands up. There are other larger organisations that are very good at that, when I think about universities in particular, they are very good at managing that as well and have very well-established EAP processes. I think that comes about because what you hope is that with the most up to date research and evidence coming out would also help to lead that. There are some real standout organisations, of course, government departments are very good at it.
What are your tips for aspiring leaders?
I think the key ones are honesty and integrity as well as values and respect.
Honesty doesn’t necessarily mean that you tell people everything. Sometimes being honest is about saying, “I can’t share that at the moment” and the integrity associated with that. I think engagement is really important, certainly in a mental health sphere, because we’ve got to parallel the skills that we use in clinical practice.
Understanding what it is to be a leader in the role you’re considering. I think sometimes people have a certain idea about what a role might be like without realising, in fact, it’s not all shiny and glossy. It can be challenging, it can be difficult, and it can take a lot of work.
What I will say about aspiring leaders though is reminding people that you don’t have to be in a leadership role to be a leader. Leaders can be some of our most junior nurses working on the ward, as a grade-two who actually lead the most contemporary and up-to-date practice and tell us what we’re doing wrong and what we’re doing right.