I'm a jaded mental health nurse working with very high risk individuals - as me anything

[Meadow90]

Ask me anything...

[Keepmewarm]

@Meadow90 yes I think I would still be nursing. Obviously I don’t enjoy every day but I can’t imagine doing anything else.

[InkyToesies]

Hello Meadow90.

Thank you for the work you and your colleagues do. I'm sorry but not surprised to hear that you've just about had enough. I hope you find a different type of work before too long.

My question is about anti-social personality disorder / sociopathy / psychopathy. Laypeople like me are always being told that a percentage of the population - 1%? - has this condition. And that while some come to the attention of health professionals or the criminal justice system, the great majority don't. Although the incidence of the disorder seems low, it's actually not. One in a hundred means we must all know, or work with, someone who's wired so differently and is potentially very bad news.

My question is, have you developed a 'sixth sense' about such people, and can you pick up on cues that most of us wouldn't notice? So while I'd be none the wiser or even thinking how great they were, you'd be thinking " Woah - need to be careful with this one / avoid"?I

Thank you.

[housinghelp101]

Have you ever found someone after they have taken their own life?

I read a case of a young girl in a psychiatric unit who was on suicide watch (not sure if that is the proper term) and she was only allowed a paper robe to wear. She reported that she had her period but as she wasn't allowed pants it literally just dripped down her legs. As someone with very heavy periods the thought of this terrified me, is this something that happens?

[Hepsibar]

How do you offload from the stress of the day, bearing in mind you confidentiality restricts you so much?

[nearlyfinished1moreyear]

@Schmoozer I totally get where your coming from and I have spoken to nurses who say the exact same as yourself. It seems a common theme within the NHS where staff are far stretched. There is a lack of placements for patients who have been in hospital wards for years with just no place for them to go I.e lower secure, grade 5 areas.

To the poster above I am no way naive @Loopytiles. I worked in challenging behaviour for 10 years before doing the course. Maybe I should have worded my post better. But you see a lot of nurses who are only there for the money.

[howdyhohoho]

My dream job post woman 😂 even in the rain as I would only have brief interactions with people and get to meet lots of dogs and be home by 2.30.

[Loopytiles]

To the PP studying to be a MH nurse and on placements “ I just don't understand why you go into a career if it's not what you want to do” Perhaps many of those people you’re judging were like you, before their experiences at work. Understandable that it’s hard for you to read about and witness people who’re “jaded” and sometimes negative, when you’re studying for that job. But your post seems naive.

[RhinoskinhaveI]

'Man hands on misery to man it deepens like a coastal shelf'
people who were traumatised by their own upbringings are now traumatising their own children

[Stooshie8]

I think that the Human Rights act, giving everyone autonomy, is a good thing. But it means you cannot just dope aggressive patients as in One Flew Over The Cuckoos Nest. Then someone has to pay for all the extra staff reqd.
Fascinating that chidhoid trauma is a major cause. There is much more intervention than in the past eg 50 yrs ago, but numbers aren't falling. Perhaps more self confidence building and less pressure to succeed in schools might help.

[Meadow90]

@AgeLikeWine

How do you deal with people who are so dangerously violent that they cannot safely be approached?

We'll try to keep a team of people around them (perhaps up to 4 staff), so that if they make any attempts to assault then intervention is fast and co ordinated. If even this is too dangerous, then seclusion

[Meadow90]

@RhinoskinhaveI

I would also be interested to know what you see as being the chief causes of mental health problems?

Primarily trauma (inclusive of neglect) particularly in childhood.

[Schmoozer]

And less pay !!!
With agenda for change, pension changes, NMC costs, a lack of full time positions, no to little pay rises, mean I earn less now than I did 15 years ago

[Schmoozer]

@nearlyfinished1moreyear I can understand how it would appear to you at the start of your career .....
However, I’ve been RMN for 25 yrs
I DO value my job, and it is so rewarding at times, the problems come from pressures in services to patch people up and send them on ASAP, a lack of joined up services, a lack of community support, community OT, day services / hospitals
Over the last 20 years we have seen massive positive shifts in awareness and acceptance re metal health, but alongside that, the destruction of comprehensive services.
Especially for the serious and enduring.
Less staff, less services. More demand, higher expectations, more beaurocracy, shorter interventions, more risk adverse, ........
I’m afraid mental health services survive on staff goodwill, I would not recommend it as a career. Sorry.

[TheLidoOfThighs]

nearlyfinished they probably did want to go into it when they started. All careers have the potential to look somewhat different several years down the line.

[Mandatorymongoose]

@Meadow90 I'd do something better paid!

Other than the pay, I do really love my current job. I get to make a real difference to people and they only see me if they want to which helps a lot!

I wouldn't go back to the wards I don't think, even CMHTs are very stretched and dealing with a lot of risk they never would have been expected to before.

[nearlyfinished1moreyear]

I'm currently 3rd year MH student nurse. Some of the posts and responses on here are quite depressingI have so far had 5 practice placements and each variable only 1 I would describe as awful. Nurses at the end of their career with the "I can't be arsed with you" type of attitude is prevalent on some wards (I also work bank shifts). I just don't understand why you go into a career if it's not what you want to do.

[Mandatorymongoose]

@Egghead I can't answer for Meadow but from my own experience, in most places staff care a lot. They do their best to treat people with compassion. I know I always thought about how I would want a friend or family member to be looked after and tried to provide that level of care.
That said, resources are often very stretched. When there is no time, lack of staff and you are trying to balance competing needs sometimes risk management has to come first for everyones safety. That's not great because it demoralises staff who want to help as well as impacting on recovery.

Wards have their place in some peoples recovery, sometimes they are the least worst option, especially to manage short term crisis. For forensic wards they are certainly better than prison. They could be better.

[Longfacenow]

Sorry hadn't clocked your earlier reply

[Longfacenow]

Do you have access to clinical supervision, reflective practice with your team psychologist and Schwartz rounds?

[TheLidoOfThighs]

Thanks Meadow for answering my question about clinical supervision. Does it work ok when it’s your line manager or would it better if it was someone removed From your chain of command, if that makes sense?

[staydazzling]

How do u deal with the issues of inappropriate placements i. e adults with autism being on MH wards?

[Egghead68]

Sorry - these questions are not meant to sound loaded!

[Egghead68]

Do patients get treated with compassion, sensitivity and understanding or just risk-managed?

If you developed serious mental health issues would you feel that a psychiatric hospital offered you an appropriate environment in which to recover?

[SuperLoudPoppingAction]

What training did you receive in relation to autism?
Was it designed or co-designed by autistic trainers?
Do you feel it was helpful?

[TheLittleBrownFox]

Thank you for doing a very difficult job that many (most?) people wouldn't be prepared to do.

I would like to ask do people working in your field have a higher level of ill health from sickness and/or injury than the average in nursing?