Tell me about being a mental health nurse?

[Red Cat]

I once had a conversation with one of the team looking after my ex, and they said much the same thing. They also implied that it was about the only thing going for the job, because the conditions were shit, and the money pretty bad unless you were a charge nurse or ward manager. They described the profession as a "Cinderella", which seemed only too accurate to me: there is something of a recruitment crisis for psychiatric nurses (there was at this time, anyway), which meant that a lot of the people were not-very-good bank staff, or students, mostly with English as a second language, which makes working with the patients very difficult - for patients AND staff. And, with morale often being low, attitudes could often be pretty dodgy, too - there was quite a lot of hostility and negativity towarts patients, especially ones who were perceived as being "difficult". And, I have to say, quite a lot of overmedication - I had to intervene a couple of times when it seemed to me that they were being a bit free with the Largactyl. In fact, the chap I remonstrated with was later recorded in a TV documentary boasting about how he'd take bets on which PRN (patient request) medications he could persuade patients to take...

This was in a particular area of London, though, and the ward in question was known as a particularly bad one to work on - they had a very high abscondment/suicide/assault rate on the ward, poor ward management, a Trust that was on its knees with various high-profile cockups, and all the rest of it, so this may not be a typical picture.

Again, this is not accurate for CAMHS, which is what the OP was asking about. Not to say it has no place on the thread, but its not that helpful if someone is thinking about working with children.

We used to get students like you describe and they were awful, really frighteningly bad. No sense at all of someone's distress having meaning. It was "but what about meds?" when they were told to go get to know the children. Their experience had only been of adult acute and it made me very angry to see that old-fashioned psychiatric technique is still very much out there. These students just didn't get that our approach was talking and thinking and even if they had, their English was often simply not up to it. On the other hand, we get paeds student nurses on placement who are invariably excellent, love how we work, and get jobs with us after qualifying.

 

[Red Cat]

Re control techniques:

Bill Thorpe's 'Approach' stuff should be rolled out nationally in various environments imo. I trained to be an Approach instructor, and was hugely impressed with Bill, his philosophy, and the methods he's developed. They work too. Bill's a former high-security prison officer; he knows about dealing with violent, strong people.

Some stuff here:
http://www.tes.co.uk/article.aspx?storycode=311474 (bit old)

I think the stuff we got trained in is this. It has different names depending in part on the org who runs the training, so it can be quite confusing. Ours was excellent and really stressed the role of appropriate force as a last resort, de-escalation techniques and the legal aspects of restraint. All restraint training should be in compliance with human rights law etc.

In my workplace training we are always joined by senior paeds nurses who often find themselves in potentially violent situations with parents. Also, children sometimes have to be held for painful and invasive procedures. When we first received the training the emphasis was on our work until they realise that they encountered far more of these situations and far more potential violence than we do. And if you work in A&E...

Just to point out that nursing of all kinds can be potentially difficult in this sense. Trying to keep people alive can be an ethical minefield.

 

[berniedicters]

Again, this is not accurate for CAMHS, which is what the OP was asking about. Not to say it has no place on the thread, but its not that helpful if someone is thinking about working with children.

Oh, whoops, my bad. I didn't notice the reference to CAMHS.

 

[Red Cat]

Oh also money is an issue for me too, I can't afford to pay more fees, I'm not sure how much NHS bursaries are though.

I've been trying to get volunteer work in youth projects and stuff but it seems to be harder to get into than I thought.

Its not easy at all getting work with young people without a professional qualification. I'm on a pre-clinical child psychotherapy training and people on my course without social work or teaching qualifications tend for this reason to work as teaching assistants, which is very badly paid. I also did this.

For the nursing diploma, your fees will be paid for and you'll receive a bursary of approx 6k depending on where you live. You'll need to check this as its a while since I looked. Its non-means tested. If you're not already a graduate you'd be encouraged to do the nursing degree for which you don't get a bursary, but the usual loans. Nursing in the future is expected to be a graduate only profession.

The social work bursary is part non-means and part means-tested. Not sure if it amounts to the same as nursing. Fees are also paid for, or they were.

As with teaching, it changes all the time with a new org running it every year it seems. Hard to keep track of.

 

[Red Cat]

Oh, whoops, my bad. I didn't notice the reference to CAMHS.

Well the OP said children but didn't mention CAMHS, so it was easily missed. And I've been talking about CAMHS without thinking that not everyone knows what CAMHS is Child and Adolescent Mental Health Services for those that don't.

 

[weltweit]

When I was last a client most of the nurses, well at least 50% were Africans.

 

[Corax]

When I was last a client most of the nurses, well at least 50% were Africans.

Were they? Where from, SA? And... so?

 

[weltweit]

Were they? Where from, SA? And... so?

From all sorts of places, there was a white woman from SA but most of the black Africans were from other places. They were fine, all had excelent english etc ..

And so? I poped it in because there was a comment above somewhere about recruitment of MH nurses being low, so and? in my hospital they did fine because they imported them from Africa.

 

[Corax]

And so? I poped it in because there was a comment above somewhere about recruitment of MH nurses being low, so and? in my hospital they did fine because they imported them from Africa.

Fair enough. It wasn't immediately apparant (to me) what you were responding to.

 

[berniedicters]

Well the OP said children but didn't mention CAMHS, so it was easily missed. And I've been talking about CAMHS without thinking that not everyone knows what CAMHS is Child and Adolescent Mental Health Services for those that don't.

I know who CAMHS are CAMHS are the people who won't take any onward referrals I make because they're up to their eyes in caseload, so I end up managing Tier 3 clients whom I shouldn't really be managing because they're officially beyond my level of professional competence, but if there's not me there's nothing, and anyway we often manage to do some quite good work

 

[berniedicters]

From all sorts of places, there was a white woman from SA but most of the black Africans were from other places. They were fine, all had excelent english etc ..

And so? I poped it in because there was a comment above somewhere about recruitment of MH nurses being low, so and? in my hospital they did fine because they imported them from Africa.

I think it was me who made the original remark. My experience was that what the ward ended up being staffed with were students and trainees, many from African countries. There was a definite language problem, which was probably exacerbated by the fact that the ratio of such nurses to trained native English speaking staff was so high (the ward was an unpopular posting, so permanent staff leaped at vacancies elsewhere the moment they came up). Add into that a higher-than-average level of racism from the patients (and, I suspect, quite a few of the staff), and it wasn't a helpful picture.

 

[weltweit]

I think it was me who made the original remark. My experience was that what the ward ended up being staffed with were students and trainees, many from African countries. There was a definite language problem, which was probably exacerbated by the fact that the ratio of such nurses to trained native English speaking staff was so high (the ward was an unpopular posting, so permanent staff leaped at vacancies elsewhere the moment they came up). Add into that a higher-than-average level of racism from the patients (and, I suspect, quite a few of the staff), and it wasn't a helpful picture.

Oh, in my case I did not notice any racism from other clients.

 

[Red Cat]

I think it was me who made the original remark. My experience was that what the ward ended up being staffed with were students and trainees, many from African countries. There was a definite language problem, which was probably exacerbated by the fact that the ratio of such nurses to trained native English speaking staff was so high (the ward was an unpopular posting, so permanent staff leaped at vacancies elsewhere the moment they came up). Add into that a higher-than-average level of racism from the patients (and, I suspect, quite a few of the staff), and it wasn't a helpful picture.

I would agree that this is a problem. Good mental health work is about talking, listening and being able to contain the distress of the patient/client. By contain I mean in the psychoanalytic sense of trying to understand..not to control. This requires a certain linguistic proficiency and an understanding of psychological theories of distress. Mental health nursing is therapeutic work, or it should be. If there is a language problem then you can't really work therapeutically.

It also shows that mental health nursing is low status. As is psychiatry amongst doctors. Paeds nursing, for example, is very competitive and IME very white, middle class British. Mental health nursing just isn't and the fact that it relies in part on immigrant workers who wouldn't be accepted on a more competitive training shows that.

Before anyone suggests otherwise, obviously, I'm NOT saying that black Africans can't be good mental health nurses.

 

[berniedicters]

I would agree that this is a problem. Good mental health work is about talking, listening and being able to contain the distress of the patient/client. By contain I mean in the psychoanalytic sense of trying to understand..not to control. This requires a certain linguistic proficiency and an understanding of psychological theories of distress. Mental health nursing is therapeutic work, or it should be. If there is a language problem then you can't really work therapeutically.

It also shows that mental health nursing is low status. As is psychiatry amongst doctors. Paeds nursing, for example, is very competitive and IME very white, middle class British. Mental health nursing just isn't and the fact that it relies in part on immigrant workers who wouldn't be accepted on a more competitive training shows that.

Before anyone suggests otherwise, obviously, I'm NOT saying that black Africans can't be good mental health nurses.

Last point first: absolutely, neither am I!

But in my line of business, which is talking therapies, it's generally accepted that it is usually difficult-to-impossible to do this kind of work in a tongue other than your mother tongue. You simply cannot manage the nuances and subtexts of a client's presentation, not to mention cultural aspects, if you are not more than just totally fluent in a language.

Of course, RMN's aren't therapists, so the bar probably isn't as high, but I'd still argue that they need fluency to be able to deal sensitively with (say) a distressed patient whose own communication skills might not be at their best.

And the cultural thing is really important, too. Shortly after I had a major health emergency, I went to my GP's, where I was seen by a Nigerian locum. He was clearly a good doctor, and perfectly pleasant. But his manner was brisk in the extreme, and he was almost shouting at me to do this and that in my lifestyle. I was really taken aback by this, even though I told myself this was probably a cultural thing. On later reflection, I decided it really was a cultural thing, because his apparent bossiness was at odds with his obviously engaged and caring side. And, having spoken to a few staff at that surgery since, my impression wasn't a unique one - some patients had complained about him, which is sad, because I am absolutely sure he's a fine GP.

Transfer that kind of cross-cultural disjoint into an acute mental healthcare setting, and things are going to be awkward. Not insuperably so, but enough perhaps to make the experience for everyone a less positive one. And perhaps also likely to exacerbate any latent racism or other prejudices, on both sides.

 

[weltweit]

It was my experience that clients helped each other, after all we had very little to do apart from spend time with each other. Staff while perhaps willing did not have the actual experience of the illness and so could not empathise like another sufferer could.

 

[Red Cat]

It was my experience that clients helped each other, after all we had very little to do apart from spend time with each other. Staff while perhaps willing did not have the actual experience of the illness and so could not empathise like another sufferer could.

I think you'll find that there are plenty of people in the mental health field who have experience of mental distress and illness. I'm not sure that its vital in order to work helpfully or therapeutically though.

The therapeutic community model actively encourages the patients to help eachother and to not rely on staff to 'help' them. I work with children so its not really a therapeutic community, but some of the ways we work are influenced by that practice, including an emphasis on the children's healthy part of the personality as opposed to their 'sick' part, their ability to work to get better, and to help the other children get better also.

 

[Upchuck]

I have only had one brush with mental health teams, and in that there were Africans. I was lucky as I got this young withit Greek woman who really helped me. The couple of dealings I had with African staff left me feeling quite desperate as from the tone of their voice I felt they did not understand not so much what I was saying, but what I was trying to say and where I was coming from. Perhaps if I had been African it would have been different. Personally I did not take to the African workers.

The other thing I found bad about mental health work (this was a community centre) was that it liked like little or no money was spent on the building the staff operated from. It was dark and delapidated and few of the staff had computers which shocked me. Also I once met one of the managers and she was dressed like a hobo despite being on what muct have been a good salary and this made me depressed and despondant. Mind you this was in Haringey and they seem to have a problem getting rid of shit staff that have been there ages, same as many other Councils I imagine. The only way to get rid of them is to promote them. Disgraceful.

 

[Pingu]

my mate works on something called "acute admissions and assessment" and last night he had nothing remarkable happen to him

 

[Red Cat]

In terms of cultural understanding, the training of high quality black African mental health workers in London would be a real bonus, I think, given the immigration to the UK from African countries and the mental health problems suffered in this group of people. They tend not to seek help for these problems though.

 

[berniedicters]

my mate works on something called "acute admissions and assessment" and last night he had nothing remarkable happen to him

Was last night remarkable for this, then?

 

[Pingu]

Was last night remarkable for this, then?

the fact that he mentioned it would suggest that it was an unusual occurence.

tbh he enjoys his job, apart from the being kicked in the nuts bit, and he does say its satisfying when you get someone you can help

 

[Thimble Queen]

thanks for the replies everyone...

I've been thinking alot about this over the last few days and i dont think this is for me.

I definately want to work with young people helping and i definately want to be able to use my creative skills... I thought about art therapy before and im thinking about it again. The training is really expensive tho

 

[Red Cat]

thanks for the replies everyone...

I've been thinking alot about this over the last few days and i dont think this is for me.

I definately want to work with young people helping and i definately want to be able to use my creative skills... I thought about art therapy before and im thinking about it again. The training is really expensive tho

I think its a real shame if you make up your mind based on what has been written on this thread because I believe it gives the wrong impression entirely of what mental health nursing is about with regards young people.

We have an art therapy group on our ward. Used to be art therapist led until her retirement but is now led by a nurse and a volunteer. We did have a music group but that stopped when the musician nurses left. We cook with the children and involve them as much as possible in the running of the ward, we have community meetings 3 x week to try and discuss anything that effects the staff and patient group. The children and staff are going on an activity type holiday this year for the first time (since I've been there anyway... )

At the same time we would be trying to think about the meaning of the childrens' behaviour and generally trying to get to know them and understand what's going on for them, to encourage them to try and put into words conflicts which are acted out through their bodies...

If I were you, I'd get in touch with hospitals where they have an inpatient unit and see if they have a bank of temp staff you can apply to. Then you can do a few shifts and see for yourself what the work entails. I have heard of young people's units where the nurses are in the nursing stations and its the support workers who actually spend time with the children but its not like that at my place nor in many other places.

Of course, it may be that you want to work with children who are less distressed or ill than those who end up as inpatients.

So perhaps try getting in touch with ThePlaceToBe who do volunteer counselling/play therapy in schools or Kids company. You can volunteer with them and I was told recently that they are developing their own schools counselling training. It'll be affordable and needed. Have you heard of these?



http://www.theplace2be.org.uk/p2btraining/default.aspx?menuid=46

 

[Thimble Queen]

I'm not put off solely by what people have said here....

It's just that actually I really want to be an art therapist, but i was put off that by the fees cost. I've already borrowed loads for my first degree

If I'm going to spend another two years of my life getting training into a profession, then it should be one that I really want to do... I've spoken to my partner and he has expressed that he'll support my decision. If I decide that thats what I'm going to do. Thats one less worry

Cheers for the link you provided. I had a look at the foundation course, it's nearly two grand.

I have heard of Kidsco, they have a centre just round the back of my house... they do good work

 

[innit]

An old housemate of mine used to volunteer at Kids Company as an art therapist, just a thought

It didn't sound like she was a match for the kids though.

 

[Saffy]

Oh also money is an issue for me too, I can't afford to pay more fees, I'm not sure how much NHS bursaries are though.

.

They're pushing people to the degree children's nursing now but when I did mine I did the Diploma and topped it up to degree afterwards. I got a non means tested bursary of about £600 a month, though I think i got a little more as I was over 25 and had children.

For what it's worth I really wish I did adult nursing then specialised. If you do adult nursing the world (in nursing terms) is your oyster. If you do adult it's only 18months or so afterwards to get other types of nursing under your belt.

 

[Red Cat]

Cheers for the link you provided. I had a look at the foundation course, it's nearly two grand.

Didn't realise it was so expensive. Someone told me it was affordable compared to the psychotherapy training they initially wanted to do with Islington Arts; I didn't actually look at the costs

Basically, the world of therapy is an expensive one. Whatever you decide to do.

 

[Serotonin]

Ive not worked in CAMHS but I am a registered mental health nurse of nearly 14 years experience now. I have had a wide and varied career so far from working in a University research department through to working ona Psychiatric Intenive Care Unit. (PICU) Ive also done some NHS management in that time and am now working as a CPN and am training to be a Dialectical Behavioural Therapist and in the process of setting up a new DBT service for the treatment ofr clients with borderline personality disorder.
Its a good job, the pay is pretty good (Im on around 33k and I get a lease car). It can be hard work physically and mentally, but its also very interesting and rewarding and a priviledge to meet and work with people in hugely vulnerable and distressed states. Im glad I made the choice to do it ( I was very nearly an architect!)

 

[Red Cat]

It can be hard work physically and mentally, but its also very interesting and rewarding and a priviledge to meet and work with people in hugely vulnerable and distressed states.

Those are my thoughts also. The children and young people I meet really blow me away sometimes and the work is always really interesting. I've also felt really privileged to work with some of the nurses I've met and I've loved being part of the nursing team and having an identity as such, rather than the wannabe therapist I started out as when I began my current job. I may still train as a therapist, but I love the group work of inpatient nursing - its powerful stuff for staff and patients alike. In this respect, I'm not sure that I ever think of it as 'helping' people. I tend to think of it as working with or alongside..

 

[Celt]

I work for a mental health charity as a support worker. There is a certificate of mental health course you can do, and our charity will support you to do the qualifications. We have a work based day centre, where we have tried to set up social businesses, run my our clients supported by people like me. I am not involved directly with nursing care,more social care. Love the client group and know that our project has helped a number of people make the steps from inpatient care, back to working, we run a cleaning service, a busy station cafe, an outdoor catering service, and art glass sudio and an IT section. Our clients are usually referred from the community mental health team.

I'm rather proud of our work