I have worked in mental Health for over 20 years, from child learning disabilities to elderly mental health, from hospital settings to community based settings and I have come across some good things and some not so good things. One thing people will realise while working in any setting in mental health is that you are always learning. Whether it be on how to deal with people of different abilities from physical to mental abilities or some people’s abilities within poor or high social settings. Unfortunately you will often hear about the bad things that happen but not so much on the great work the nursing, doctors, managers, occupational therapists, physio therapists and social workers can perform. The work (job) is and can be very rewarding, especially when you have a patient (client) moves on to a better placement or back home into the community. I will write about the possibilities of what could happen with in a mental health setting but nothing has actually happened when I have worked. Working as a nurse whether it is as a health care worker or a qualified nurse you will always be going on courses and learning in the work place. Some courses you may come across are basic to advanced life support, first aid, manual handling and lifting and some form of conflict management like Prevention and Management of Violence and Aggression (PMAV) or Control and Restraint. The last two are to teach you how to take control of a potentially aggressive situation and possibly move a violent patient safely for them and others around you. These courses are usually paid for by the company you may work for and usually have no cost to you.
Myself, I have worked mainly in a hospital setting but also in the community. I have worked in this setting for over 20 years and enjoyed near enough every day so far, but there has been days that I have thought ‘why do I do this?’ don’t get me wrong the job is great but it can be very draining on you depending on the setting you work in. If you are thinking of this line of work, the best thing you can do is to make sure you get regular supervision, this means that you will have a regular member of staff usually a qualified nurse but it can be a senior healthcare assistant to off load too. You should have this, usually an hour and talk about what is bothering you, the things you find stressful and also talk about the good things you come across. I have found over the years that the supervision has helped me a lot while working in mental health. Sometimes they will also supply a professional councillor for you to talk to but don’t worry what you talk about in this session usually confidential. The only time the things you talk about get passed forward are if they are detrimental to your work place for colleagues or patients. What you need to remember while working in mental health is that the patients are here for a reason and they need someone that is compassionate, Understanding, someone that will make time for them and also guide them on the right way on how to deal with problems.
One thing you should try to understand is that you will come across many different patients and people with in the services but try not to take anything personally. Some patients my hear or see hallucinations which could be upsetting for them and sometimes if you disturb this event they could become verbally hostile, upset or even on some occasion aggressive. Sometimes these hallucinations could be telling them to hurt themselves and telling them that they are worthless. Telling them bad things such as people are out to get them, hurt them or the government is spying on them making them very paranoid. So if you come across a patient that may be verbally aggressive or physically aggressive, what you need to try and remember is why are they aggressive is it due to the hallucinations, they could see something bad in you like past abuser or something evil. So if this does happen remember to try and be companionate towards the patient. If the aggression does occur this does not mean that the patient needs to be secluded ( locked in a room for safety) try to control the situation and try talking to the patient and discover what is going on but mainly have a lot of patience in the situation. Speak gently and do not use long complicated words or long sentences. TAKE YOUR TIME this is very important, you will usually find that the patient is usually frightened of what is happening and does not usually mean any harm.
You may come across patients but mainly females but sometimes some males also that have an urge to hurt themselves. This can come in many forms such as cutting themselves with sharp objects as broken plastic, razors or glass just to name a few things. Some patients may rip items of clothing and tie what is known as ligatures around their necks or a limb, usually if it is around their neck and they are serious you may not know they have done it at first until you check on them and find they have tied something around their neck. If you ever come across this it is not a nice thing to witness but try and remain calm and call for assistance. Some patients may tie it around their wrists, legs or fingers just to name a few. It could be a cry for help as they do not know how to ask for help whether it be for thoughts and they are struggling with these thoughts. If a patient is cutting themselves it could be due to pressurising thoughts and seeing blood or feeling the pain is the only release from the pressure that they know at the minute how to deal with this. Sometimes it could be due to voices in their heads telling them to hurt themselves, probably saying to them that they deserve to be hurting or they are not worthy and this is their punishment. What you need to do as a staff member is be understanding and whatever you do, DO NOT JUDGE no matter what they do or say to you.
Once in a while you will come across a patient that will build a therapeutic relationship with you and starts to build up trust. Do not overstep the boundaries on this. They may feel ok to open up to you and talk about past events, if you feel comfortable with this let the patient speak but never put words in the patients mouth or direct the topic of conversation. At points of the conversation you may find that the patient could become emotional or stop talking for a while, this is when you should be compassionate and understanding and give them time. If you ever find yourself in this situation, after wards please go and talk to the nurse in charge (NIC) and let them know what has been spoken about in the conversation. Then after wards you should enter a detailed entry in the patient’s notes whether it be electrical or paper. Then after this try and see if you can talk to your supervisor or a senior member of staff and just talk about what was said to you and how it may of affected you and don’t take the stresses of this home with you. You may be told some good things from their past but also some bad things about their past and at times you may come across some patients that may possibly make things up but always take this information and speak to the nurse in charge.
I have in my time have attended some sessions within a patient setting and enjoyed nearly all of them. One session I have enjoyed attending is physical activities, education, ward rounds and coping skills just to name a few. Whether it be with working with adults, learning disabilities or adolescents, there are many sessions staff can join in with and support the patients. In the community I have taken clients (patients) to college and attended art. This was fun as the staff I worked with were looking after clients with learning and physical disabilities. One time we took the clients to college and painted pictures that the teacher had already drawn, this was to get the clients hand and eye coordination working better and faster. We sat helping the clients to pick the colours they wanted and to paint the pictures. We have taken clients out for birthday meals and made it into a huge deal for them and their families, Gone out to restaurants for meals and a drink non-alcoholic as some alcohol can affect their medication and their mental health. We have gone for days in the local parks and taken a picnic with us and also on a few occasions taken them on holiday to other countries or places around England which could be fun for both parties.
What you got to realise in this line of work it is not for the money it is because you have a devotion to caring and want to help people. You should never judge the patients no matter what they tell you, or how they treat you and it is never personal. You will always be learning on the job on how to deal with situations such as upsetting times, confrontations verbal or aggressive, how to deal with gratitude and how to deal with loving families loving and not so caring. You may also find patients that don’t like hearing the word NO and at times you may come across complaints made about you but don’t worry if you remember to always talk the truth. It is a wonderful job to be in and educational job as well and you will meet a very wide verity of people in this line of work. You are there to help them learn ways to cope with thoughts and feelings and deal with their emotions. You are the nurse and they are a patient so always remember that and never cross these boundaries and you will always do well.