I'm a mental health nurse - ask me anything

[toadabode]

Hi, I'm a mental health nurse working in an extremely challenging and volatile inpatient setting. My patients have very complex needs ranging from self-harm and attempts at suicide to challenging behaviour and substance misuse. It struck me when meeting my friends today how little they understand about what I do, mental illness and the mental health system. If you're at all interested, ask me anything :)

Apart from the disgraceful lack of funding & support, what is your biggest challenge?

I have no idea how I've posted this under 'relationships'...

What are your views on The Priory?

What does a typical day look like for you?

In your opinion are patients discharged home sooner than they should be?

Have asked for it to be made bed for you OP

A new low for texting,that was typed as moving not made bed!

Relationships may not be the worst place for this AMA, OP.

How much of the mental health issues you see is inborn (e.g. genetic/neurodevelopmental) and how much is related to trauma from dysfunctional family of origin and/or abusive relationships?

Do you think any of your patients could do more to help themselves?

How do you look after yourself and your own MH?

@iklboo there are so many! Day to day I would say it's attempting to find a balance between managing risk without being overly restrictive. Generally my patients need to get to a point of being able to take responsibility for their own safety in order to progress with their recovery, which means a lot of positive risk taking. Every day I have to make countless life/death decisions, often under pressure. Should I allow this person out of the hospital today? Should I allow this person to bath on their own? Is this person safe to use a knife and fork? I only ever feel one wrong decision away from being stood in coroner's court, on the front page of the newspaper under the headline 'failure in care'...

How often are people misdiagnosed?

@TinyMystery the day always starts with handover from the nursing team on the previous shift. We discuss each patient, their presentation and how often they need to be observed (some every 5 minutes). Then as a team we read out their written risk assessments/ crisis management plans. My day then typically revolves around providing patients with support sessions, continually reviewing our risk management strategies and making changes as needed, dealing with significant incidents (of which there are usually more than one every shift and can often involve police/ paramedics etc.), administering medication, sometimes by injection under restraint, liaising with the local pharmacy and GP and continually touching base with the Dr, psychs etc in our team, attending (lots of) clinical meetings, attending tribunals for patients challenging their detention, writing reports/ care plans/ risk assessments, meeting second opinion doctors/ solicitors/ local funding teams, running health promotion groups, running debrief sessions for staff, supervising support staff (they tend to need a LOT of support - sometimes more than the patients), sorting out the rota and trying to cover shortages oh and documenting, documenting, documenting(!!!), then trying to remember all that has happened during my day to handover to the next team

@ComeTheFuck0nBridget yes, all of them

How much of the 'average' in patients problems are due to past events in their lives rather than a sudden illness affecting them.

OP we've moved your thread now as it seems you didn't mean to post in Relationships.

Do you think some diagnoses have become more common recently? I feel like in my personal and professional life I keep coming across a certain diagnosis but I don’t know if it’s just me!

Are there any demographic groups that turn up more than others?

This is a big question but to what extent do you think modem life impacts mental health, in particular diet, working practices, cost of living, social media etc?

@Scruffalicious mainly by having a sense of humour, possibly one that could be considered inappropriate by someone looking in, though is never intended to be offensive. I don't think that as a team any of us could turn up and give our best day in day out while putting up with the shit we do if we didn't laugh. It took me a long time to learn how to leave work at work and there are days that it does still follow me home, but on those days there's always wine...

@Summerfalls we often see patients with multiple diagnoses that they've picked up over the years and sometimes we'll rediagnose after assessment. It's sometimes difficult to provide a definitive diagnosis as presentations will fluctuate and people don't tend to fit neatly into the box of just one disorder. As a team we often disagree about a patient's diagnosis but always work collaboratively to manage distressing symptoms in hope of improving their overall quality of life

@OhMyGodTheyKilledKenny sometimes yes, though far more detrimental than that is the number of patients discharged home without an appropriate package of care in place invariably leading to readmission and 'revolving door' patients

@PicsInRed It's impossible to provide a definitive answer to the root cause of an individual's mental health problems but from my own experience most (as in almost all) have suffered some form of trauma, often in early life. My experience is that those who have suffered neglect at a young age are particularly difficult to treat. Generally illness becomes compounded by poor life choices (chaotic relationships for example) often combined with alcohol or drug use. It's worth bearing in mind that I'm not talking about your typical run of the mill 'anxiety and depression' but complex, enduring mental health problems

@R44Me almost all of them

@TinyMystery Yes - personality disorder