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  • 21 November 2018
  • 8 min read

I chose mental health nursing in the face of growing pressures

  • Chloe Lawrence
    Registered Mental Health Nurse

I have only just graduated as a mental health nurse, but my placements throughout three years of training have been an indicator of what is to come in my new profession. It’s going to be rewarding, and the challenges and pressures are likely to increase.

Play video: "Listening is the one skill I couldn't do without"

“I couldn’t do that, I don’t know how you do it” is usually the first phrase out of someone’s mouth when I tell them what I do.

Working in any healthcare role, particularly in the current climate, is challenging.

Between 2009/10 and 2020/21 the budget for the Department of Health will have grown in real terms by 1.2% in total, this is significantly less than 4% per year increase in spending required according to The Kings Fund (2018).

Thus we, as healthcare professionals, are expected to deliver better and better care with less and less funding.

Enter the Nurses.co.uk 2018 Mental Health Nursing Survey - win £100 Amazon voucher

We’ve devised a quick survey to gather information about YOUR concerns as a Mental Health Nurse. We hope to highlight the challenges that you face in your profession. Responses will be collated (anonymously) and shared with our audience of health and social care policy makers, hiring managers, and the general public. All respondents will be entered in a prize draw to win £100 worth of Amazon vouchers.

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Outside and inside pressures

The number of nurses working in mental health services has decreased by around 7,000 since 2010 and the number of mental health beds have fallen by 30% since 2009.

However, this is an issue felt throughout the health service with almost 40,000 nursing vacancies in England alone and the NMC consistently losing more members than it is gaining.

But for me, the role of a mental health nurse comes with its own set of pressures, some of which relate to the general pressure on the health service but others which are quite specific to the role we carry out.

Why I chose to take the pressures and challenges

I see being a mental health nurse as a privilege; when I meet people they are often at the worst possible place in their life.

I get to work closely with them and usually by the time my working relationship with them comes to an end they are in a much better place.

Things might not be perfect, but maybe now they can go back to work, or start working on repairing their relationship with their partner, so even something as simple as completing daily activities without support.

No matter how small the improvement may be perceived to an outsider, to the person in question it can mean everything.

However working with people when they are in such a difficult place makes us as professionals vulnerable.

The importance of being a good listener

Learning how to listen

If you were to ask me what is the most important skill for a mental health nurse to have I would immediately say listening, and I mean really listening.

It’s easy to listen to what someone says to you but often our patients and service users tell us a lot more than what they literally say.

Despite being considered a ‘soft skill’ by many, I would argue that it is the one thing in my metaphorical tool belt that I am guaranteed to need on every single shift.

If you are familiar with the American TV series ‘House,’ you’ll know that he often solves the medical mysteries by noticing one small thing that others have overlooked which reveals the answer. That’s often how I see my role as a mental health nurse, particularly when working with so-called ‘revolving door patients’ i.e. people who are frequently in and out of services.

For me, that means that we as services have missed something, otherwise these people would not frequent services as much as they do. Sometimes it only takes noticing that missing piece of the puzzle that enables you to develop a better plan with someone that will really enable them to improve their life.

Mental health nursing may impact my own mental health

In my role of a listener I have certainly heard some harrowing things.

While it is my job to listen to people who choose to disclose information to me, I am only human.

It is a difficult balance because on one hand I felt honoured that someone feels comfortable enough with me to share with me what are often awful things, but on the other hand I am not a robot and these issues can impact upon my own mental health too.

Whereas most people would discuss a bad day at work with their family, friends or partner, it’s a lot more difficult when you are a mental health nurse. Walking through the front door saying “hey honey, guess what happened at work today” often feels really inappropriate when dealing with some of the emotive topics that we do on a daily basis.

I have supported those I work with through divorces, miscarriages, relationship breakdowns, deaths, every kind of abuse and more.

To be able to sit and listen to someone who abuses substances talk about the spiralling path that led them there or a child talk about the horrific abuse they have experienced and walk away at the end of my shift without breaking down into tears is a difficult thing to do.

It’s also a terrifying thing to do, constantly worried that I’ll say the wrong thing or be unable to stop the horror showing on my face and make an already difficult situation worse for someone.

All people are individuals and I never really know how someone might react when they have made themselves so emotionally vulnerable to me. Having supported numerous people before often doesn’t make the situation any easier. Each person is a unique experience.

(The only thing harder than sitting and listening to someone pour their heart out to me is trying not to check my watch while they do so. Mostly, I’m desperately short on time but don’t want to person to feel that their conversation isn’t important to me.)

People versus paperwork

I chose a career as a mental health nurse to work with people, not to do paperwork. While I realise it’s an important part of the job, it seems to often be an overwhelming requirement.

There are care plans and risk assessment and so much more and it all needs to be done, no matter how short-staffed you are.

And if it isn’t done I’ll receive abrupt e-mails from team leaders and managers. It would seem to impact the time I’m able to spend with patients.

But all the while the service is under such pressure it’s not going to get any easier. Nurses will continue to work under immense emotional pressure, with very little time to process what it is they’re hearing and doing.

Yep, all that and I still LOVE my job

I feel very lucky to absolutely love my job.

Sure, when people tell me they couldn’t do it, I can certainly understand why.

For me nursing is in my bones. I’ve gone into this straight out of school and I genuinely couldn’t imagine doing anything else.

It does however sadden me when I feel like I’m not giving patients my all through no fault of mine, or theirs.

Being a mental health nurse certainly takes an emotional toll on me as I imagine it does for many others, and I genuinely do wonder how long I will be able to do this for, particularly if working conditions don’t change.

For me, good supervision is the key to dealing with the emotional pressure that we are put under.

It isn’t an easy job, and it is made difficult by the political and economic situation within the health service.

Ultimately patients will be the ones to suffer most. This is hard for me. I am someone who cares and want to give people the care they need. But I will continue to do the best I possibly can with what is available to me.

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Enter the Nurses.co.uk 2018 Mental Health Nursing Survey - win £100 Amazon voucher

We’ve devised a quick survey to gather information about YOUR concerns as a Mental Health Nurse. We hope to highlight the challenges that you face in your profession. Responses will be collated (anonymously) and shared with our audience of health and social care policy makers, hiring managers, and the general public. All respondents will be entered in a prize draw to win £100 worth of Amazon vouchers.

Find Out More

About the author

  • Chloe Lawrence
    Registered Mental Health Nurse

I qualified as a Mental Health Nurse (RMN) in August of 2018 and started as a newly qualified nurse shortly after. On top of nursing I juggle creating content for both my YouTube channel and blog.

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