Adult or MH nursing retraining advice

[TinaBlue21]

Hello everyone, this is my first post, although I have followed the forum for years.
I have decided to retrain as a nurse. After a few years pursuing a different career, I want to change for several reasons and believe nursing is the right path for me. Partner and family are supportive (nursing is probably what I should have studied in the first place, it took me years to understand it but my previous experience will be relevant). Ideally, I would choose a double registration degree to study both adult and mental health nursing as I like both fields, but there isn't one near home and I can't move for family reasons. Many of my close relatives work in either mental or physical health so I appreciate how different the two fields are and what they entail, but I still can't choose as I really feel I would enjoy both and be good at both. I am attracted to the talking therapy side of MH nursing and mental health in general, but I also really enjoy being very hands on and the physical health side. I guess this would make me a good nursing student as physical and mental health are of course connected, but what to start with now? Any MH or adult nurses here - what do you do in your day to day and how much is physical (if you are a MH nurse)/ mental (if you are an adult nurse) health part of your job too? And do you feel prepared / properly trained for that?
It seems to me that in the end it really all depends on what one then specialises in and where one works. Personally, I would enjoy working with adults in any setting, with women in particular, but not with children, for personal reasons. I don't mind working in shifts or doing nights and I don't mind busy environments, I can generally handle pressure and emergencies well. Any suggestions about any work settings or specialist fields that may be more 'hybrid' or 'in-between' physical and mental health, if that makes sense? What are the progression and further training possibilities in your field?

Just throwing in Learning/Intellectual Disability nursing as well - lots of the mental health side of things, but also some of the physical healthcare elements as well - particularly in terms of management of conditions like diabetes, sexual health promotion etc... and we bloody well need them! One of our local patches is down to a one-woman band of community ID nursing and, while she's bloody awesome, we need more of her!

Also ID staff tends to be so much more laid back, problem solving in nature and embracing the more "interesting" elements of life as well - I love ID work - albeit in a different AHP field.

Have you gone any HCA work? I’d really recommend you do that in a variety of settings to gain an idea into which branch you want to study.

I second doing some HCA work first, also do you have the entry requirements to go straight to uni? In Scotland it’s SCQF level 5 English and maths unsure of englands entry but imagine it will be something similar

There is a huge amount of documentation in mh nursing now and much less talking…much of it duplication risk assessments etc.

I gather for general nurses the HCAs are the ones who are more hands on.

If I was going to retrain now I’d think about OT

where I work what clinical stuff MH nurses can do varies e.g. we got called out (community nursing team) to the mental health hospital to replenish a syringe driver, the nurses there couldn’t do it and neither could the doctors!

@AlaskaThunderfuckHiiiiiiiii that’s interesting - I’ve never been trained to do a syringe driver, not sure if it’s covered in mh training in some areas?

I would second OT. They are dual trained in mental and physical health and there are loads of roles in non traditional places such as working with refugees or domestic violence support.

@onepieceoflollipop it probably is a more of a specialised thing perhaps, we do them a lot in the community but it wouldn’t be drugs they weren’t familiar with etc and it wasn’t as though they just wanted shown how to do it and then take it over we went in every day until the patient passed, you don’t get special training as far as I’m aware it’s only been shown to me on placements

Eating disorder unit.
Huge physical aspect as well as the mental health side

In the current version of nurse education both Adult and MH student nurses have the same skill competencies to achieve in their placements. There's lots of arguments whether this is a good or bad thing - but it should mean that in the future the situation outlined above shouldn't occur

Have you considered paediatrics? It's fab!

although mh nurses are in demand it's an area of work that is very draining as it takes people a long time to recover. although some find it satisfying it's rare to find a nurse working in that field long term (30 year career). they are also at higher risk of assault. i also believe some of the medications that you work with administer are known to have toxic effects (you will be taught precautions but it's worth knowing).
adult care can be harder on your back (physically assisting people with limited strength) but more often than not they do heal and return to home/family/other facilities (only you mean long term care settings in which they pass on).
thank you; working in mh i have never had family or a patient say thank you which in itself can be demoralizing. working with adults you tend to be appreciated more.

I agree also look into the Allied Health Professions. Tend to be better hours.

Roles such as mental health practitioner and care coordinator can be open to OTs

Depends what area forensics not so much , LD , old age , yes. I do agree it's a lot slower for people getting better or maybe not at all but I find you get to know the patients really well because it's not a revolving door outside of acute. To answer your question OP Brain injury rehabilitation might be the perfect job for you , lots of physical skills and lots of behaviours of concern.

Another vote for occupational therapy

I work as a MH nurse on acute admissions ward. It's true that there is a lot of paperwork to be completed each shift, I feel that I don't spend enough time with patients due to this and it's hard sometimes to find time to do meaningful therapeutic work with patients, especially if the ward is busy...
Regarding physical side of nursing, on day to day basis I do things such as basic physical observations: checking BP, pulse, temp, etc. We also do basic wound care and diabetes management (checking blood sugar level). I've also done additional training in taking bloods (venepuncture).

Regarding talking therapies, if you're in England, you could further train in CBT as a high intensity therapist [b7]. But as a previous poster suggested, I would also look into OT training.

From MH side of things a lot of crossover with physical health care is in care of the elderly, such as dementia wards/care homes, but i know it's not everyone's cup of tea...

I tend to think that adult branch offers more in the way of variety, once you qualify. There are dozens of different areas an adult branch nurse can work in, compared with mental health nursing. Just to name some, A & E, intensive care, outpatients, theatres, medical wards, surgical wards, district nursing, occupational health, practice nurse. My friends I trained with have a variety of roles. One is a community renal nurse, one works as a research nurse for the school of nursing, another is the lead nurse for haemochromatosis, one is a sickle cell nurse specialist, another works as a matron covering the gynae wards, the opportunities in adult nursing are endless.

Thank you everyone for your suggestions! I will definitely look into LD/ID and OT/AHP too, I hadn't really considered them but as many of you say OT may have the right balance of skills I am looking for.

Yes I can go straight to uni as I have the grades and relevant experience and qualifications. I am in Scotland too.

Thanks, this is very useful to know. I think this is a field I'd like to work in. Is this something you have experience with? If so, how is it as a work environment?

MH nursing is full of paperwork, I felt like I hardly got any time with patients/clients. If working on a ward, it involves managing support staff and students almost straight away at band 5 and holding the keys, i.e. being in charge of the ward and being accountable for everything that happens. It is very stressful and not really at all what people may imagine nursing is actually like.
In the community you may have a high caseload of very unwell people and the risk levels may be high again with most of the time spent on paperwork or in meetings.
Adult nursing has much more variety. Either way if on a ward be prepared for last minute rotas coming out and not being able to plan things very far in advance.
I would definitely look at Occupational therapy too.

I'm a Speech and Language Therapist - in adult LD work (which is not at all where I thought I would end up - I initially wanted to go into Pediatrics). I love it - retrained and started last year in a very large community and predominantly MH trust and we've got a fantastic team, plus a lot of autonomy in terms of managing our diaries and caseloads. Our caseload is generally roughly 50/50 with communication based work and dysphagia (eating, drinking and swallowing) assessments and reviews and there's that option to go into the more medical-based areas as well.

Friends who work in the MH wards are continually amazed with the massive range of ways their patients can attempt to find to self-harm - not quite sure I'd be up to dealing with that on a day-to-day basis, but again, I have other friends who work in medium and high secure hospitals and they love that area of their work too.

Potentially I'm at a fair risk of assault in that I lone-work within the community and I have the patch to work where every single fucking one of the breakaway trainers horror stories seems to come from - but I think I've felt potentially wary once - and that was not unmanageable.