- 21 November 2018
- 8 min read
I chose mental health nursing in the face of growing pressures
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.
Working in any healthcare role, particularly in the current climate, is challenging.
The funding that we, as nurses, are receiving simply isn't enough. The ratio of resources to nurses doesn't match at all.
And yet we, as healthcare professionals, are expected to deliver better and better care with less and less funding.
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 work closely with these people, and by the time I've stopped working with them they are usually in a much better place. The support I give means they are able to get back to doing what their version of their normal life entails.
The smallest of improvements means the world to these patients.
However working with people when they are in such a difficult place makes us as professionals vulnerable.
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.
It's hard to listen to the things that my patients have gone through without it having an emotional impact on myself.
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
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.
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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