First day nerves on placement at an acute in-patient ward in an NHS mental health hospital

My first morning on placement

Beyond the door, people were milling about in all states of undress, one lady baring her breasts as she had a hospital gown on backwards and the ties were undone. Fortunately she had knickers on, albeit they were large white paper ones, which covered her modesty. Others had hospital-issue pyjamas bottoms on, some bare-chested and barefoot while some had on what looked like their own dressing gowns, clothing and footwear.

I could see more dusky coloured walls, on the left was old artwork, curling at the edges and hanging precariously with tattered tape. A large perspex covered board with photographs of unsmiley people and nametags, who appeared to be staff, hung on the right. Alongside, was a wonky shelf with welcome leaflets and other ward related information. Looked like someone had a fallout as they’d scribbled on the perspex over one particular nurse’s face.

Heart thudding and having pressed the buzzer to get in I watched as this guy, who looked like an all-American Quarterback sporting a huge white smile, sauntered lazily towards the door. He unlocked it with one of the keys from a large bunch and nodded me in then he locked the door behind me. I guessed that, because he had keys dangling from his belt, he was staff. Other than the pyjamas, it was difficult to identify who was a patient and who was staff. Man mountain was wearing jeans, a sweatshirt and trainers. He introduced himself as Adeola and pointed me toward the nurses office where, because the door was locked, I stood for a few seconds, hoping one of the three people in there would let me in.

“Hello. You must be Nancy, our new student. Come in now, come sit. Moreblessings get up and give this wee lady a seat now, will ye?” A young Northern Irish guy also in jeans, t-shirt and trainers raced on “I’m Derry, that’s Moreblessings and there’s Abimbola, Nancy. Would ye like a wee cuppa tea Nancy, would ye? Give us a wee minute and we’ll get ye one, eh”? I loved him already and despite some humphs and tuts from Moreblessings, I knew I was going to like it here.

The office was tiny. There was a rickety desk with some stacked filing drawers, a telephone and some office paraphernalia on it, and two old swivel chairs. Two battered-looking four-drawer filing cabinets stood opposite each other, a formica top stretched along one side of the office and held a fax machine, photocopier and few loose files. Above was a couple of  flimsy shelves holding lots of precariously balanced files and some nursing books. Dressed in a neat flowery jumper, a calf length skirt with thick black tights and flat black shoes, poor Moreblessings huffed and puffed her bulk out of the chair in the far corner, between the filing cabinets, to give up her seat. Derry slid into her empty chair, leaving his for me.

Just at that, the office door burst open and in bungled two others, out of breath and laughing as they attempted to get their coats off in such a small space. “Yer late again Alison, Fadhili. Come on now. Hurry up.”

“Keep your hair on, I’ll just grab some coffee.” giggled Alison as she winked at me.
“You’ll just not. Come on. Some of these folks want to go home this morning.” said Derry. “Anyway, this is Nancy, our new student.” he added. Alison smiled and Fadhili nodded at me.

The heat from the six of us steamed up the office window and I was getting a rather icky whiff of body odour, badly covered up with strong but not unpleasant cologne. However, as Alison sat her neat bum on the table edge, she was closer to me and the sweet, floral scent that she wore helped mask the other smells. She too was wearing faded jeans with a striped shirt and trainers while Fadhili had on trousers, a shirt and tie and shiny black mock croc shoes.

Derry looked towards Abimbola who started to read out names from  a large whiteboard on the wall. “Helen, slept all night, no problems. Peter, he’s okay, just waiting to go home. Isaac, restless and sat in the day area most of the night.” He went on, discussing the twenty patients on the ward that morning. This was called handover and it happened at the beginning of each shift. It was brief and didn’t give me too much information, but enough to begin with as I had to memorise the staff names first.

Finished, Abimbola snatched up his coat and heaved his large frame through everyone and left the office, waving wearily as he went. It was like a mass exodus then, as everyone else made a mad dash too.

“Coffee Nancy?” I heard Derry say over his shoulder as he went next door to the kitchen so I followed him and said I’d have a coffee with milk. Out came the toaster, cereal and coffee mugs, clattering onto the stainless steel worktop and I watched as some staff helped themselves to breakfast. Derry just made two coffees and handed one to me saying “Do you smoke Nancy?” As I nodded he made eyes at me to follow him and we crossed the narrow hall to the smoking room.

We walked into the stench and a dark yellow fog that you get when there’s half a dozen smokers and no ventilation. The smoke stained windows were open but only half an inch, obviously so no one can escape. Several pairs of lifeless eyes turned towards us, though many remained staring blankly, either at the grubby windows or the soiled floor which was littered with fag ends, empty crisp packets, screwed up plastic cups and old cola tins.

Derry sat on one of the chairs, inviting me to sit next to him, and I hoped my fixed smile hid my disgust at the state of the stained chairs with their cigarette burns and other unidentifiable debris.

Still, I smiled around nervously and offered my introduction “Hi, I’m Nancy and I’m a new student on the ward.”
“Alright Nancy. I like students. You got a spare fag?”
Derry interrupted “Pete, the wee lass just started today. Leave her alone.”
“No it’s okay.” I said and offered the pack to Pete then watched as others eyed the box, willing me to offer them one too. I didn’t feel I had a choice so I was five ciggies down already, and it was just gone eight o’clock.

At that, there was a loud rattling of the kitchen hatch going up and Moreblessings was yelling “Breakfast time, breakfast……” as she loped along the hall. “Time to move.” said Derry. “I’m your mentor for this placement Nancy, but bear with me and I’ll catch you up in a wee bit. I’m coordinating the shift today. Have a wee seat, chat to a few patients and see how you get on, eh?”

Moreblessings was still yelling and now Fadhili had joined in, “Medication.” he sang and I watched as he went down the hall, knocking on bedroom doors “Medication. Breakfast. Medication………” Patients trickled out from rooms, heading in various directions, some to the hatch between the kitchen and dining room for breakfast and others towards the queue for medication. One or two just flopped on chairs in the living area and gazed at the television.

I thought I’d be best in the kitchen helping with breakfast, as there wasn’t much I could offer on the medication side, being a new student. This also aided in putting a wide barrier between me and a slightly aggressive young female who was eyeing me up and down and glaring at me. However it didn’t protect me from the stale morning breath and unwashed bodies.

There was no queue as such and patients just leant over each other to reach for cereal, milk and sugar or the hot buttered toast, some burnt and some still white. Not sure if this was a defect with the toaster or the domestic, who was also busy handing out green plastic cups of hot water so that patients could add either tea or coffee. Drinks and cereal sloshed as patients shuffled to small tables in the dining area.

Soon, vacated tables had crumbs, slops and spills so I went round the other side of my barrier to wipe some of it up, but I practically flew back when Mandy, I learned, screamed “Fucking lesbian. Stop fucking staring. You ugly white bitch.” This was the young lady who’d earlier on, had her nightgown on back to front. “Oh, ignore Mandy. She harmless really.” said Mrs Farrell, this tiny, sweet domestic lady in her Jamaican twang “She just having a bad morning.”

Breakfast was almost over and the last of the dawdlers were still in the queue for medication. I popped into the office to see that Derry had allocated patients to the four staff on duty; two qualified mental health nurses being Derry and Alison while Moreblessings and Fadhili were the  two nursing assistants. I had Supernumerary status which means that student nurses are additional to the clinical workforce and undertake a placement in clinical practice to learn, not as members of staff.*

I asked Derry what I could do to help as I was feeling a bit like a spare part and quite out of my depth, what with Mandy following me, cursing like a sailor on a drunken holiday! Derry said to just shadow one of the staff and not to worry about Mandy; she’ll be fine after some medication. Alright for you to say,  I thought as I bumped into Mandy when I backed out of the office and turned with a wobbly smile to say “Hi, I’m Nancy, a new student here. Is there anything I can I do to help you this morning Mandy?”

“Ah, you’re a student, I thought you was one of the Doctors, I ‘ate Doctors. Ask if I can have leave, will ya? It ain’t ward round today and that’s the only time you get to ask for leave, but I’m not fucking waiting ’til Wednesday. I need some clothes, look at me in this fucking dirty ‘ospital gear.” she ranted.

I asked where her clothes were, what did she come in with and whether we could perhaps find them together. “They ain’t here. Someone nicked them in the night. Jealousy, that’s what it is. Jealous cos I’m a model and I get given good gear to wear. And that’s why they nick it. Fucking poofs and lesbian, all of them. And the staff, they’re at it too. All of ’em” she rambled. I didn’t know what to think about her clothing. I offered to help find her clothes but she wandered off, still cursing and muttering. Quieter now though.

“Go and have a wee break Nancy, you deserve it.” Derry grinned.

*Nursing & Midwifery Council, 2014

Author: mentalhealthfromtheotherside.wordpress.com

Mum to two amazing sons. Following recovery from a lengthy psychotic episode, depression, anxiety and Anorexia, I decide to train as a Mental Health Nurse and worked successfully in various settings before becoming a Ward Manager. I am a Mental Health First Aid Instructor and a Mental Health Awareness Trainer, Mental Health First Aid Youth and Mental Health Armed Forces Instructor. Just started my mental health from the other side blog.

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