Qualified RMN Chloe answers questions about studying mental health nursing

In this 18 minute video Chloe answers questions sent to her by people wanting to know all about studying a mental health nursing degree course. Watch and learn!

What would be your advice for nursing students who are living in halls with people from different courses? The nursing degree is structured so differently to other degrees, for example English. I find that in comparison to my friends I can't go out as much or be as carefree with my social and personal life I just wondered what your tips are for balancing a professional degree with life as a typical student?

I'm just gonna come right out with it and say you are not a typical student.

If you're a nursing student we don't have as much freedom as everyone else and it’s something you've kind of got to accept, however that doesn't mean you can't have a social life.

My advice is just to make the most of it when you can.

You're going to have blocks at university where you're going to have a little bit more free time, and of course even when you are on placement you're gonna be working shifts so there's no reason why you can't have a social life.

You just need to be clever about it time management is key when you are a nursing student.

For example, at the moment I'm on at my sign off placement which is my final placement before I become a nurse and I have two assignments to write so at the moment my social life is on hold but before I started this placement I had a little bit more free time so I was you know doing more fun social things.

So I would say make the most of the free time when you've got it because then when you don't have as much of it it's not as frustrating.

In regards to placement, how do you go about asserting your authority when it's needed?

I find that as a student people are mainly staff and sometimes patients don't really take me seriously or listen to me when I tell them something important or request that they do something for me.

How do you manage to break that barrier when needed?

The most important thing about this is how you come across, especially when you're asking someone to do something for you.

If you come across as quite nervous or unsure when you're asking them they're not going to take you very seriously.

I know it can be quite tricky but it's just something that you get better at as you get more experienced, and generally I've found that people take you more seriously as you get further along in your training.

When I would ask people to do things I used to apologize and be like I'm so sorry but do you mind doing this - do not apologize.

At the end of the day they're there to work just like you are you shouldn't apologize for asking someone to do something.

Also don't say ‘would you mind…’ because if they're trying to be difficult they could turn around and say no.

You want to be polite but be direct in what you're saying so ‘can you please go and do this’.

You just kind of have to accept that as a student there are gonna be some people that just aren't gonna want to listen to you.

I've been quite lucky and this has only ever happened to me a couple of times where people think ‘you’re a student, why are you telling me to do something?’ but you will generally find that the majority of staff will respect you for who you are, irrelevant of whether you're a student nurse or a qualified nurse.

I'm currently enrolling on an access course so I can get the qualifications to become a midwife. I'm worried about how to juggle the course working and looking after my daughter but I am so determined to do it if you have any tips on how to juggle life inside and outside of uni?

For starters, I really admire people that go into a degree whilst they have children.

It certainly isn't impossible and a lot of incredible people on my course have managed to juggle a uni placement and children.

My biggest advice would be to do as much research as possible to make sure you are getting every penny that you are entitled to.

Child care and low income, everything you can possibly get take it because you're just gonna be shooting yourself in the foot if you're not.

Second piece of advice is to take all the help you can get. If somebody offers to look after your children or offers to give you a little bit of money each month, obviously I don't know what your financial circumstances are, then take it.

I have made my life so much more difficult than it needed to be because my parents offered me a bit of money every month but I was being really stubborn and I didn't want it - well I wanted it but I didn't want to take it from them.

So I would say just take all the help you can get, whether that be financially or in terms of support because at the end of the day it’s going to be a difficult three years but then once it's over you're gonna be so glad you've done it, and then you'll be able to return the favor to all the people that helped you out while you were training.

Don't do what I did, don't be stubborn.

With your placement, do you choose the shift patterns and where you go or are you assigned?

In my experience I had absolutely no say over my placements whatsoever. The University randomly allocated us I don't know if this is the same in all universities but I imagine it will be quite similar because obviously they want you to have a wide range of experiences, whereas if people choose their own placements they might only choose certain ones.

In theory the reason that the university won't give you much choice is because they want you to have a variety of experiences from community to ward based, different client groups etc however if you have a major issue with your placement then we were allowed to swap amongst each other and so that was quite helpful for people.

For example if you were placed somewhere quite far away from where you live you were able to swap with someone who lived closer to it and things like that. In general we didn't have a lot of say in where we were going and then ask for shift patterns that is gonna vary depending on what trust you are training in so my trust operates on a system of earlies, lates and nights so that means our shifts are 7 a.m. till 3 p.m. or 1 p.m. until 9 p.m. or 8:30 p.m. until 7:30a.m. and you do a mixture of all three whereas some people's trusts will operate on twelve and a half hour shifts you might do like 8:00 a.m. till 8:30p.m. or up the 8:00 p.m. until 8:30 a.m.

Obviously there's pros and cons to both so but that will vary depending on where you're training.

If you're in a community placement chances are that's gonna be Monday to Friday 9:00 to 5:00 and or some of them are slightly different they might be like 9:30 till 5:00 most days, and then one day they'll stay open slightly later but generally community placements on Monday to Friday 9:00 to 5:00 obviously when you're in community there is kind of no flexibility over your shift you just have to be there when the place is open.

But I've generally found that on wards they're quite flexible with you as a student because you're considered something called ‘supernumerary’ which means you're not counted in the numbers - you're not like a proper member of staff, you can essentially be there whenever you want to but again this is gonna depend on the ward and how flexible they are.

You'll be assigned a mentor and you need to work with them as much as possible because they're going to be the ones that are signing you off for stuff and obviously if there's lots of students all on the same placement then it's a bit trickier because they don't want too many of you on shift at the same time. In general I think they tend to be pretty flexible; if you need to do shifts at certain times or need a day off for whatever reason they tend to be okay.

Every single one of my placements has been brilliant about working around what I want to do, and at the moment on my placement I'm the only student which means so long as I make sure I work with my mentor a couple of times a week I pretty much choose my own shift so that has been a great benefit, but obviously they haven't always been quite that flexible.

I want to be a mental health nurse but my family are worried that I will be attacked by patients has this ever happened to you on placement? I feel like they're being quite stereotypical but maybe it would put their mind at rest if you could answer this and help to end the stigma.

I have been assaulted on two occasions and it's just one of those things.

I mean the majority of my classmates have gone through their entire training without it ever happening to them but there are a few of us that have been assaulted once or twice.

Again, it's the same in practice you'll meet some nurses that have been assaulted you'll meet some people that have been doing it 20 years and they've never been assaulted it's one of those things where when people are really really distressed.

Quite often they're taken against their will or put in a hospital, they're not allowed to leave, they want to smoke but they're not allowed to smoke, people can get angry.

When I have been assaulted it was purely because they were very very unwell which is why it kind of didn't bother me because I didn't feel like they were personally attacking me - it was just a case of wrong place wrong time.

The first time I got assaulted was actually by a gentleman with dementia but also a whole host of other physical and mental health conditions that meant he couldn't communicate.

I asked the nurse in charge what will he drink and she said I'll just give him a cup of tea and as I put down the cup of tea in front of him he just went smack punch me straight in the face but you know it's it's not his fault at all which is why it just doesn't bother me.

And then in the other case I got hit in the face with a Bible and but you know it's just it's just one of those things.

On neither occasion was I seriously injured it was more just kind of like a shock. I can’t tell you it will never happen because it can, but as I said a lot of people go through their whole career without it ever happening, and as I said in my case it has happened on two occasions but on neither occasions have I felt targeted and my experience is very very rare that someone will assault a member of staff.

Don’t let it put you off going into nursing because it does happen, but it's not very common and there are a lot of things that are done to protect staff, for example everyone will carry personal alarms they're called different things in different places but it will be a personal alarm that you can trigger in some way which means if you're in any danger you can press the alarm and other staff will come to help you and obviously if somebody's really really risky then they would be in an environment that's more secure with more staff and less patients, and things are put into place to keep staff safe.

I have a borderline personality disorder a completed DBT two years ago so I'm stable. I have been an inpatient and I know that some staff can carry a stigma with BPD as I was treated terribly by some staff. I'm worrying that when I'm on placement if a service user has BPD they might say something that's unhelpful. Have you ever experienced this issue while on placement and do you have any advice around it please?

I can't give you sort of specific advice because I'm not in the same situation as you. However I do have friends and I do know people that have had prior experiences of mental health issues, some to the point where they've needed hospitalization and yet they are still incredible nurses.

It doesn't stop them doing their job at all, in fact in certain elements of their job I think they're even better at it than some people that haven't had mental health problems.

My advice to you would be to speak to your university about it right from the get-go, let them know your situation and even though that might seem really scary it should enable them to put extra support in place to make sure that placement is a positive experience for you and in the future mention it to your employers as well.

For example if there is a patient with BPD they might try to make sure that you're not their primary nurse, just to reduce the likelihood of it impacting upon you; obviously they're not going to stop you working with that person but just sort of reduce the amount of direct therapeutic intervention you have with them if that's something you'd find helpful.

Obviously it's gonna depend entirely on what you feel comfortable with but I would just say take all the support that is out there and prioritize your own mental health as well, so if there's something going on that you find is really distressing speak to university, speak to your mentor, ask for a little bit of extra support because you need to be in the best place possible to be able to help other people.

If you've had a personal experience of mental illness are you allowed to choose not to do a placement on that ward if yes when is the best time to bring that up ie a piece or interview for university or when you start placement?

You can bring it up in your interview, if you think it's relevant you know if you're talking about a certain scenario you might say ‘this is my experience and this is what I learned from it’ but I would say the best time to you inform your university is when you actually start the course.

Don't wait until your first placement has been allocated because then they might not be able to change it.

If you make them aware right from the start they will tell you what their policies and procedures are - the likelihood is that you will not be allowed to do a placement on a ward that you have been a patient on, but that might vary from university to university and it might vary on your preference.

If you're happy to do that they might allow you to, it all depends on the policies of your trust and your university.

My personal opinion is that if you have been a patient somewhere I wouldn't recommend going back there as a student nurse, simply because a lot of nurses stay in the same place for years and years and years so the chances of there being a lot of the same staff there is quite high and I personally just don't think I would feel very comfortable going in somewhere as a student nurse when those people are going to already know quite a lot about me.

But again that is entirely up to you and if you would feel happy going to a ward that you've been on and the university will let you then that's fine but if you're asking for my advice I would recommend against it just so that you're gonna get the best out of all of your placements rather than feeling a little bit awkward.

Making university aware and allow them to give you all the support.

Do other people's issues ie the patient's get to you and how do you deal with this? How do you stop emotions getting in the way of your job?

It's difficult. I've met a lot of people that have gone through horrific life experiences that I wouldn't wish on my worst enemy, and when you sit there and you listen to them talk it can be quite emotional and sometimes it is hard to leave work at work.

I do sometimes come home feeling a bit like I've got a lot of emotional baggage so to a certain extent it’s gonna happen, whether you've been in this job for ten minutes or ten years people will always say that there will be a certain person that will just get under their skin and really really hit them in the heart.

My advice is that the best way to handle this is to talk about it, whether it be to your mentor, whether it be to a colleague on your course, your friend, your partner, because if you just bury everything then it's just gonna build up and up and up and up and then end up affecting your mental health and you're not going to be in the best position to help other people.

I would say be aware of it happening because there's a very good chance it will. Speak to people or if you're not comfortable speaking to people maybe just keep a diary and things like that.

I always try to think ‘why is this affecting me so much, is it because I relate to the person or because I relate to the situation that they've been in?’ What is it that's really making this person get to me?

It’s going happen so just make sure that you have the right kind of support around you to help you deal with it because otherwise you're just gonna get into a state where you're just emotionally burnt out and you just can't do it anymore.