Pre mental health nursing
You can read the backstory About Me to give you an understanding of how I got to here………. how I loved mental health nursing – then I got sick
I was on the road to recovery from my own mental illness when I realised I wanted to study. I wasn’t sure I was clever enough and I wasn’t sure what I actually wanted to study.
Studying massage part-time
I thought I’d start small so took evening and weekend courses in Shiatsu, followed by Swedish Massage, Seated Massage, Aromatherapy and finally, Indian Head Massage. I loved it and so too did my family and friends, who I practised on.
I had the massage table, the massage chair, the fluffy white towels and a full kit of aromatherapy oils. However, despite passing all my exams with distinction, I couldn’t ask for money. I just loved providing massage, but I realised it would never be a paid job.
Studying to become a mental health nurse
In February 1997 I’d seen a large advert looking for General Nurses to study at my local University and Hospital. This didn’t so much interest me but, right at the bottom of this ad, there was a few lines about becoming a Mental Health Nurse. It just felt so right and I knew my own experience of mental illness would help to make me a good nurse.
So, during my own recovery from, what I learnt was, a lengthy psychotic episode, depression, anxiety and anorexia (which you can read here), I applied to train as a Mental Health Nurse.
On becoming a mental health nurse
After three long years of study, I worked successfully as a Mental Health Nurse in various settings before eventually becoming a Ward Manager. I was already working more than double my previous hours but now earning half the salary but I didn’t care — I’d found my purpose, my reason to get out of bed.
However, despite being a qualified MH nurse, I still felt that I just didn’t know enough, that I was a fake and I’d soon be found out. This drove me to attend further specialist courses including the one-year Thorn Nursing programme which taught nursing interventions for schizophrenia and a Cognitive Behavioural Therapy (CBT) course for psychosis.
Outside of the NHS, I also trained to become a Mental Health First Aid (MHFA England) Instructor, a Mental Health Awareness Trainer, Mental Health First Aid Youth and Mental Health Armed Forces Instructor.
Working in various mental health settings
I was enjoying every aspect of my job and had the honour of working with some amazing people; patients, families and their carers, together with colleagues from lots of different disciplines. I spent time working in the community, visiting patients in their own homes and seeing how they lived when they were ill and well.
I worked on various acute in-patient mental health wards where patients could be extremely unwell, distressed, chaotic, occasionally angry and aggressive towards staff and others. Unfortunately some had to be restrained for the safety of both patient and others. Whilst it can look quite alarming, nurses tend to take the brunt of the drops to the floor, ensuring patient safety at all times. Our patients were acutely unwell, experiencing:
- panic attacks, depression and/or anxiety disorders as well as obsessive compulsive disorder (OCD), borderline personality disorder (BPD) and post traumatic stress disorder (PTSD)
- severe mental illnesses like schizophrenia, bipolar disorder and schizoaffective disorders
Acting as ward manager for three years with the elderly was definitely an experience but it wasn’t always easy as many patients had both mental and physical illnesses. The lack of family or visitors on this ward saddened me and of course, often patients had to be transferred to general wards, where sometimes they’d pass away – which always broke my heart.
I’d worked in A&E which was fast-paced and never a boring moment; working with disturbed patients, the Police, distressed families and community colleagues. Then with the Home Treatment Team (HTT) and in the Mental Health Emergency Department where we’d see patients in various stages of illness who needed support, perhaps admission or to go home with the HTT.
Duty Senior Nurse
From Band 6 (Charge Nurse) upwards you’re on the rota to carry out two shifts a week as Duty Senior Nurse (DSN), which could be early, late or night shift and you have responsibility for the whole mental health hospital.
Despite The Mental Health Code of Practice saying a patient in crisis should only ever be transferred to hospital by an NHS vehicle, quite often an extremely psychotic and aggressive patient arrived in a police van, in handcuffs. It was always great when the patient recognised you, calmed down and agreed to walk in with you, rather than being practically dragged in by the police.
Unfortunately I’ve been on DSN shift when the police come to tell you bad news such as they’d found a body somewhere, it would be one of our missing patients. Or they came to ask you to identify a missing patient who had died by suicide. Once they came to tell me of a double suicide and I was raced off to the scene to identify the patients.
Favourite mental health settings
One of my favourite places was the Day Hospital (despite a bully of a manager), where we saw up to seventy patients each day, who all came to attend various therapies and activities. This was part of their recovery and they might been referred from an in-patient ward in preparation for their discharge.
I loved being able to use all the knowledge and skills I’d gained together with my own personal experiences to support our patients. Part of my role was training less senior staff from both the day hospital and the ward, something I got a lot of satisfaction from. And of course, I enjoyed the positive feedback.
Another favourite and sadly my last post was as ward manager on an all female acute in-patient ward. It was an absolute nightmare when I first arrived, the ward was in chaos! It was initially managed by three male staff, the ward manager and two Band 6 nurses. The patients had previously been allowed to yell and swear at staff; they’d tried to attack them, thrown dining table and chairs around and generally behaving badly.
Some of the nurses were said to be worried about my arrival and chose to transfer to other wards, which saved me the job of managing them on the Capability programme. Some had attitude problems and didn’t like that I’d adhere to Company policies regarding the Trust Dress Code; no inch long nails, no big dangly earrings, wearing id, their inappropriate dress like tight leggings and vest type tops. If I hadn’t already known the staff, I would have wondered who were nurses and who were patients.
My Personnel Management skills came in handy as I was well aware of the need to know company policies and procedures. I was able to use them to guide me through how to manage patients abusing our staff and the ward. During my first year our team was able to reduce the number of violent incidents on the ward by 74%, something we were all very proud of and actually gained recognition for it.
We were to present our ‘work’ at Head Office, after which I was asked to present it to all Ward Managers within the Trust. I was so excited and even more so when our Nursing Director suggested that in the future, I become more involved in training staff from Band 4 – 7.
The onset of my physical illness
Within days of that presentation I was struck down with a rare disorder – idiopathic (cause unknown) Transverse Myelitis (TM), which is normally caused by a virus but, despite the hundreds of tests, mine wasn’t, hence the idiopathic.
According to Mayoclinic.org, TM is an inflammation of both sides of one section of the spinal cord. This neurological disorder often damages the insulating material covering nerve cell fibers (myelin).
TM interrupts the messages that the spinal cord nerves send throughout the body. This can cause pain, muscle weakness, paralysis, sensory problems, or bladder and bowel dysfunction.
Due to my physical disability and ongoing mental health problems I am no longer able to work in the job I loved and even after nine years I still miss it terribly.
I became physically disabled overnight and though the NHS paid full salary for six months and half salary for six months, they still ought to have kept my job open. However, they needed a Ward Manager and after around nine months they replaced me.
It was then that the snotty young HR dogsbody decided that medical retirement was the best option. I was devastated at losing the job I loved but I was too exhausted both physically and mentally to fight — in hindsight, I wished I taken them to a tribunal — just to wipe the smirk of the HR dogsbody’s face. You know that look, when someone thinks they got one over you, which she did in this case.
I often reflect on some of the most amazing and inspiring patients, remembering some of their journeys and the extremely difficult changes they made on their personal road to recovery. I’ll never forget how humbling it was working in mental health — and I like to think I made a difference during the course of my nursing career.
As mental health nurses, we see people at their lowest point, emotionally, which makes us very significant, not only in their survival, but also their growth. Along the way, sometimes our lives are even changed because we feel their struggle, so it sharpens our emotions as well as our skills, and sometimes in rare cases, it can touch our lives as well — Anon
I hope this might help and inspire both students and nurses alike — aim high and be the best nurse you can be.