How To Change Your Career And Become A Mental Health Nurse

"Self-care is the most important tool in ensuring your own mental health and ability to practice as a Mental Health nurse."

Deputy Ward Manager, Naomi, outlines how she got out of her career rut and requalified to move into Forensic Nursing, and discusses why Mental Health Nursing can be so rewarding.

Topics covered in this article

When I Decided To Be A Mental Health Nurse

What Qualifications Does A Mental Health Nurse Need?

Gaining Mental Health Experience

My First Post As A Mental Health Nurse

What To Expect From This Role

What Keeps Me Excited About Being A Mental Health Nurse

What Kind Of Person Makes A Good Mental Health Nurse? (Key Soft Skills)

What Does A Typical Day For A Mental Health Nurse Look Like

What Kind Of Settings Do You Work In?

How Do You Deal With The Emotions Of The Job?

When I Decided To Be A Mental Health Nurse

Prior to working in healthcare role I had found myself in a career rut.

I had spent time thinking what I should be doing after working in various other non-healthcare roles.

I realised I was happiest when I was supporting people/helping others, and after working as a healthcare assistant (HCA) at band 2 level I found myself wanting to do more and more.

The more time I spent working with the patient group the more training I could see that would help me support these individuals much more effectively.

It was after starting as a band 2 and completing training available that I realised I wanted to become a nurse.

What Qualifications Does A Mental Health Nurse Need?

In order to become a qualified Mental Health Nurse, academically, you need to get a degree in your chosen field, for me this was Mental Health.

This does of course encompass physical health which was a heavy feature particularly in the first year.

There are various ways to get accepted onto a university course at present.

I had completed an access course prior to gaining a place at university due to being a ‘mature’ student at 25.

Gaining Mental Health Experience

Once I had started working in healthcare I would be fully immersed in all aspect of patients’ care.

The potential for further training within mental health is so diverse due to the various specialities.

This is something that I wanted to experience as much of as possible working in different remits; initially older adults in nursing home settings.

In working in various settings, something that I found was how emotionally charged but so rewarding each area was despite the differences.

It was an absolute privilege to be able to work with people and make sure they were treated with nothing short of the absolute respect and dignity they deserved.

My First Post As A Mental Health Nurse

Once I had gained my NMC registration I started my first qualified role within Forensics, something that is still from my own experiences a much stigmatised area of nursing.

I had also been surprised to find that to some the perception of a nurse or any healthcare worker in this area is that of sitting and drinking tea all day or being prison officers.

Most surprising to me was that that the prison officer perception had actually come from a staff member within a general hospital.

I politely informed the staff that we are healthcare staff and nurses, we just happen to work in a forensic environment.

What To Expect From This Role

It is hard to know what to expect before you’ve gone into a role, particularly when transitioning from recently being a student to being a qualified nurse with your own pin number.

The important thing to remember is that the first post will involve a lot of learning, adapting and mentally adjusting to no longer being a student,

As such you need to try to be kind to yourself, and give yourself a chance to adjust and find your feet.

Don’t be afraid to ask questions if you’re not sure as forensics is a very niche area with unique and specific policies and restrictions you simply won’t see in other areas of Mental Health.

The forensic environment will place some very unique scenarios in front of you so my advice would be expect the unexpected.

The most important point I would make particularly within this area is to not put too much pressure on yourself.

You meet a hugely diverse range of people both within your patient group and your colleagues; unfortunately at times this can mean working with people who have negative viewpoints about their patient group.

This can be difficult to challenge this viewpoint especially if it is your first post as a nurse or new to the forensic field.

What Keeps Me Excited About Being A Mental Health Nurse

The most rewarding part of being a Mental Health Nurse is seeing genuine results for each of the patients you care for.

Each one is so different to the next, however being able to have a positive effect on their lives and hopefully leave the individual with lasting coping skills.

I have been very fortunate to have had some amazing managers and support networks whilst working in healthcare particularly within NHS employment.

Each one of these managers has instilled a drive to constantly improve and want to emulate their own attitudes and practice.

There is a constant stream of research coming out, and the chance to educate myself more effectively keeps me feeling positively challenged.

What Kind Of Person Makes A Good Mental Health Nurse? (Key Soft Skills)

There are a whole host of personal skills that make for a good Mental Health Nurse, however there are some very crucial ones that I would argue are the most important.

You need to be able to adapt to anything that you are faced with.

Working face to face with people particularly those that are acutely unwell; for a brief or extended period, it is important to be able to relate to the person and make them feel at ease and able to talk to you.

Being approachable is vital as you want your patients to be able to communicate with you how they are feeling and be able to trust that you will support them, regardless of whether their situation is because of a poor choice.

This brings me onto the next point. Being non-judgemental is so important, especially if you are experiencing an unpleasant situation, feeling mistrusting of others and fearing recrimination for a choice or decision.

If you then feel you will be negatively judged or treated as a result of this you are less likely to communicate and potentially lead to more distressing situation that may be prevented.

Ensuring the individual feels listened to is also crucial as when any of us are experiencing a bad time in our lives we need to feel listened to and valued.

Within forensics particularly you need to able to deal with potentially negative interactions where an individual may not be very well and transferring their own feelings onto you as the nurse.

Being able to continue providing the same care to them without letting any negative emotions that may be targeted at you is crucial as a result.

For many within the Forensic Mental Health pathway there have often been some awful experiences and traumas and as a result they may be mistrusting and wary of your own intentions.

What Does A Typical Day For A Mental Health Nurse Look Like

For a Mental Health Nurse no two days can look the same, and will depend on how not only your patients are feeling that day but how your staff are feeling.

There are some routine tasks that have to occur however.

The first thing that happens when I start my shift is checking there are enough staff to safely run the shift and make sure that patient care can be met.

I start the day as do my colleague having a handover from the previous shift, making note of any particular aspects that need focussing on.

I then plan the shift trying to match skillset and ensure no one staff member has too much to manage appropriately.

It is important to recognise as well that at points we may all make the wrong judgment call, and this is why having a good team is so important.

If you are managing a particularly distressed patient, seeing them potentially causing harm to themselves, can be distressing for all and looking after your colleagues is paramount.

Another aspect you may find is making positive risk decisions for a patient to progress and finding that your colleagues are more anxious than the patient.

Managing the anxieties of the team and supporting colleagues to understand that this is their anxiety, and the patient should be given a chance to show they can cope without any adverse effects is crucial.

Throughout the day as the Mental Health Nurse you spent the shift negotiating patient and staff distress, problem solving and putting patients at ease, managing high distress situations and keeping patients and staff safe.

As a Nurse in Charge you are required and expected to plan and ensure that everything runs smoothly, patient care is met, conflicts are dealt with (both staff and patients).

This can feel particularly pressured if you have a very agency heavy team on shift or you find yourself as the only qualified nurse.

Ensuring you can talk to someone about how you are coping, or struggling with something is important.

Compassion burnout is very real and staff quite often may not recognise the early signs themselves.

As a result you need to be able to recognise when your team are struggling and make sure they are supported.

We quite often forget our own wellbeing as nurses, something that I have become even more aware of in the last 2 years nearly burning out myself.

Having excellent and caring support within the team and my team leaders greatly helped me manage this and become more self-aware.

What Kind Of Settings Do You Work In?

I recently transitioned to a Deputy Ward Manager role within a non- forensic acute environment around 3 months ago.

This did make me feel anxious initially as I was changing trusts, role and starting this amidst covid19.

When starting a new role it’s important to get a feel for the team, settle in and use support available.

I am still learning as a new band 6 and feel excited to have a new challenge.

Coming from a forensic background there are a host of varieties you find within an acute setting.

You become accustomed to managing risk in structured manner far above that of non-forensic services.

For example when you work in a forensic environment there are security standards that have to be met, Ministry of Justice approval for hospital visits or any patient movement outside of the hospital, household items being high risk/prohibited items.

Trying to build therapeutic relationships with the patient group and ensure quality care alongside forensic restrictions is quite often a significant challenge.

In my new role I work with a patient group that have approved time off the ward to see family and do shopping amongst other things.

My role now is ensuring the patient has the right treatment to help them be able to cope outside of hospital.

I have to consider a plethora of factors in supporting them to be able to return home.

This is a particularly different experience amongst COVID19 with routine swabs being conducted on admission to any ward, daily temperature and physical health monitoring and managing the patients’ own anxiety around COVID.

How Do You Deal With The Emotions Of The Job?

Self-care is the most important tool in ensuring your own mental health and ability to practice as a Mental Health nurse.

Having regular supervision, trying to have a healthy amount of rest time to reflect and process the day, ensuring you take care of your own physical health (diet and sleep) and talking to someone if you feel overwhelmed are all so important.

I cannot emphasize enough how many nurses I have worked with who have found themselves feeling burned out and needing time out for a period.

Due to the complex nature of our patient’s needs, as nurses we take that pressure for them and as such it is important that we recognise our own mental state.

Developing an awareness of your own emotional intelligence and awareness is the biggest skill for any nurse to manage their own health and be able to support their own colleagues as well.

Let me know in the comments your thoughts on Mental Health Nursing and what I've said about my journey - let's chat there! You can also read about PICU mental health nurse.

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