What about poor nursing in mental health?

I studied mental health nursing because I wanted to be a nurse. I wanted to help people overcome the battles that come with mental illness, to support them through crisis and recovery. I wanted to teach and educate patients and their families about mental illness, the medication, expected outcomes and how to stay well by offering them evidence based information and treatment.

I wanted to nurse and I never thought about being in management again. I’d spent almost twenty years in management, particularly Human Resources management and I was bored with it all. However, as I moved up the ranks and got to attend various meetings both within our hospital and at Head Office, I soon learnt that the higher up you went, the more you understood. Previously unaware, I now appreciated the hierarchy, the mechanics of the various departments and where, why and how systems, policies and procedures were developed.

I was first promoted from the old D Grade to E Grade within six months, then six months after that I was offered F Grade (now Band 6) within the Day Hospital and I loved it. This is where I was able to access most of my further education i.e. CBT for Schizophrenia and Thorn Nursing (after which, I was qualified to provide interventions and education for the patient and their families). I was to work on this unit for almost three years (where my then Manager was a disgrace and I had to complain) and that in itself is another post.

However, I was offered the Acting Manager post (Band 7) on Care of the Elderly (you’ll find the name changes always happen in Mental Health i.e. previously called Old People’s Ward) with no interview. I asked the Service Director, “Why me?” and he said “because I thought you’d be good at it.” Most of the original team were delighted but there remained several who weren’t quite so happy as apparently, my reputation preceded me.

Two nurses immediately requested moves to other wards and thankfully they were taken on by their previous managers (saved me the job). The two other nurses stayed but were given the opportunity to apply elsewhere – they weren’t good nurses anyway and I’d rather they just left. However, they said they’d heard good things about my management style from colleagues and decided to ‘give it a go – working with me.’ Ha, like they were doing me a favour. The Band 6, Chris (Assistant Manager) was Mauritian, he was married and had two young children and he didn’t like me at all.

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Chris went everywhere with his notepad tucked under his arm and could be seen scribbling away in every given situation, despite being asked not to. As part of his role, he was Supervisor to six qualified nurses which meant that he ought to meet with each of them to look through their patients care plans and risk assessments to ensure that they were relevant and up to date. Other things would be to ensure that all their mandatory and statutory training was up to date and if not, arrange it

During Chris’s supervision with me, it was my responsibility to ensure that he was fully supported in doing his job, that he had the training and tools necessary to carry out his role. He was immediately defensive, telling me he’d been doing this job for two years already and there was nothing he needed support with “thank you very much!” he huffed.

“That’s great Chris. So can you tell me why X, Y and Z’s supervision hasn’t been completed for two months?”

“I don’t have time. You always want me to do other things. And anyway, supervision doesn’t have to be every month,” he smirked.

“Okay, tell me what time you need and when and, as previously suggested, I’ll cover your role on the ward while you complete supervision. How does that sound?”

“Yes, but you’re always busy.”

“Chris, let me know when you have booked the supervision for X, Y and Z and I’ll put it in my diary so that I can cover for you. Yes?”

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Eye rolls “If you say so.”

“Now Chris, what is it I always have you doing?”

“Mmm. Audit patients’ paperwork.” He suggested.

“Okay. But you’re doing that while you’re carrying out supervision by ensuring that your staff have all paperwork up to date. Yes? Is there anything else you need time for?”

“Mmmm. I’ll think about that.”

“Great. You do that Chris, and get back to me with a list of things you need from me before your next supervision. Let’s put a date in the diary now. And just so we’re clear, have a quick read through the supervision policy, I think you’ll see that supervision must be done every month and if not, why not needs to be documented.”

“Sorry. Can you repeat that please. Slowly this time so that I can write it all down?”

It became clear that Chris was put out, angry even, that I’d been given the post as Acting Manager when he thought the job would be his, as next in line. Chris made it almost impossible to work with him, constantly declining tasks, ignoring any requests from myself and colleagues, generally being disruptive and spending lots of time in corners, scribbling notes. I spoke with my line manager who spoke with Chris. The upshot was that he put in a 32 double-sided typed complaint against me and I had to meet with the Human Resources Manager.

Sixty four pages of nonsensical garbage, saying anything from “She doesn’t like me typing in capitals,” (I don’t. It’s known as shouting) and “She doesn’t like me being late,” (I didn’t. Especially when he was thirty minutes late and he would walk straight past me without a word – just a smirk) to “She doesn’t tell me where she is going when she goes on holiday,” He was informed by HR that he only needed to know when I would return. Chris was given a written warning for wasting Trust time and for malicious gossip.

He eventually moved to another ward but left soon after to become a tube driver for Transport for London. I had to interview him about a year later for a Band 5 post.

Eric was from Africa but had studied to become a nurse in the UK before applying for a post on out ward. He was articulate, polite and seemed theoretically knowledgeable so he was successful and joined our ward. His first shift was an afternoon shift, starting at 1.30 pm but he didn’t arrive until almost 3 pm and just walked past my office, with no apology or reason. Okay, I gave him the benefit of the doubt, first day and all that. However, on the second day, the same thing happened so I called him in for a quick word. “Okay, that’s two days in a row Eric and you haven’t even acknowledged your lateness.”

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“Ah. I live up very far north London and it take me about two hours to travel here.”

“You knew when you came for your interview how far you’d have to travel and you need to take that into consideration when you leave for work.”

“Ah. I’m not sure how I will make it for the early shifts then if I have to leave home two hours before.”

I don’t know how he made it into work on time every shift after that. I didn’t ask.

From my office one afternoon I heard and saw a commotion in the day area so I stuck my head out and beckoned Eric. I said for him to sit and I’d be back soon then I went over to a forlorn looking Clive, on of our elderly African patients. “Clive, hey what’s wrong?” But I’d already spotted that he’d wet himself. I called over a nursing assistant to help me get Clive to the shower room and to get some clean clothes before I went back to my office.

“Okay Eric, talk me through what happened there please.”

“You saw him. Clive. He is lazy and jus’ piss ‘imself. On the chair. He raise his walking stick to me so I tell him, if you do that, I’ll hit you back.”

“Yes, I heard you shout at him Eric and why did you raise your hands to him?”

“Him have to know he can’t threaten me. Now he know and so everyone else too. Don’t threaten me.”

I asked so many questions of Eric, hoping he would see his wrongdoing; what he had done wrong, not what Clive had done, “And what would the other patients think?”, “How would Clive’s family feel if they saw that incident?” Nope – nothing! I then asked him, “What would you do if you saw a nurse raise their hands to your mother or father……” Ah! The penny dropped.

Eric got sent home and was given a written warning…………….. I got a another Bullying and Harassment complaint.

How would you manage staff like these? I’d really love to know.