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

[Meadow90]

Ask me anything...

@orangeisnotmycolour

I work by a locked forensic psychiatric hospital. What do they do in there? Is there a risk to me as a passerby?

Most of the individuals they treat will have encountered the criminal justice system as a result of mental illness or will have become unwell following a conviction. Some will be there because their risks cannot be managed at other hospitals. The individuals there will likely pose a significant risk to either themselves or others. More often than not however the primary risk is to others. Many will be subject to legal restrictions.

They will be undergoing assessments, particularly in relation to risk, and will be receiving pharmacological treatment and therapy (though many won't engage).

Before being allowed any leave from the hospital extensive risk assessments will have been conducted. I doubt you're any more at risk where you work than you would be out and about in our towns and cities!

Do you enjoy your work?

Yes and no. Mostly no.

@TheLidoOfThighs

Do you get decent clinical supervision or the opportunity for work discussion groups? Not sure what you’d call it in your context, but the opportunity to make sense of the stuff that kind of work brings up.

Yes, we have one to one clinical supervision with our line manager. One of my main responsibilities is supervising support workers and newly qualified nurses. We also have group supervision/ debriefs inclusive of support workers/ nurses/ OTs/ psychologists/ psychiatrists. We'll also meet as a team as soon as we can after any serious incidents (of which we have many!) The sessions are invaluable

@flippinehh

Do you wish you had chosen a different career? More money fir less stress?

Yes

Blood in urine - test sample = UTI... treat with antibiotics.
Deformity on arm following fall - x-ray = fracture... apply cast and give pain relief.
Lump in breast - scans, bloods, samples = cancer, treatment varies.

Does mental health diagnosis get investigated the same way?
Are all treatments the same for the same diagnosis or is it patient specific?

What will you choose as your next career?

Hi @howdyhohoho @Schmoozer @Mandatorymongoose @Tiredemma @Keepmewarm 👋🏻

Here's a question for all you fellow mental health nurses - if you could do anything, what would it be? Would you still be nursing?

@Echobelly

Are there satsifying times when see you someone getting better or coping better?

Yes, definitely. Though progress often isn't sustained for any length of time amongst the individuals I work with which is very discouraging

Hello OP, I worked briefly as a psychiatric nurse many years ago, mid 1980s
there seems to be a strong theme here that psychiatric nursing is just too much for most people to handle (?) so what, given the rise in mental health problems, are we to do?
I would also be interested to know what you see as being the chief causes of mental health problems?

@BobLobLawLLB

I am a HCA, in hospitals but lately on forensic units. The MH nurses are bloody amazing. They manage to liase between all the agencies,managers,families,patients and medication rounds, yet manage to be right beside you when when situations are potentially dangerous. Hats off to you!

They couldn't do it without support from great HCAs

In your opinion and experience, do you think mental health issues are created through trauma etc or do you think people are born with them?

Do you think hormones and nutrition contribute to mental health problems or no significance at all?

@colouringinpro

Thank you
a) how do you keep going?

I'm fortunate to work with an absolutely fantastic team. We all really work together, particularly in times of crisis. Sense of humour (dark at times). Wine.

b) how much are mental health staff aware of the impact caring for someone with severe mental illness? I'm asking as a spouse of a bipolar partner who's now suffering with ptsd.

Sorry not sure I understand what you're asking.. impact on who?

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

@Meadow90 thanks, that's informative.

Think you do amazing work, not sure I could do it.

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?

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

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?

Sorry - these questions are not meant to sound loaded!

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

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?

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

Sorry hadn't clocked your earlier reply

@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.

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.

@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.