Calling all mental health nurses - I have posted before. I have finished my degree (I know shocker) and now need to make a decision - please help?!

[Lillycake]

Hello
I have posted here as a student desperate for advice (wanted to finish mental health nursing as it was impacting on my own) and also before starting my management placement (absolutely no confidence and filled with anxiety). I had such support here that helped me more than I can explain. Here I am again hoping for the same outcome. I managed to complete the degree and I am now a registered mental health nurse. However, I have zero excitment about that. Of course I am so proud of myself for passing as a mature single parent. It was a hard course and a very hard emotionally and financially 3 years of work/study.
I have a job lined up and it's in a male low secure ward (about an hour away from my home). It's not a setting I would have chosen (still unsure, it scares me a little), a job was available and I have heard many stories of nurses going into the profession without support. This place appeared to be supportive (at interview). I have no clue yet as I haven't started. I have however started a few days of training and it appears less friendly, and when I have explained that I am nervous, haven't had any real comfort from them.
Anyway - for the whole 3 years I have not know what area to go into as I haven't particularly liked any. I have had advice from nurses explaining training is difficult and I would feel different once it's over. I don't.
Someone I know has mentioned a job as an assessor for mental health and disabilities with colleges. I'm now qualified for this role and it's the same pay as a nurse (although will not expand as a nurse can). Do I apply? It's assessments as I am going to be doing within a nursing role. Not so much any therapy work. This means I won't be on the register at all. So therefore if I do not practice, will not be able to in the near future as you have to work so many hours to keep your nursing pin. I can't bank (to keep within those hours) as I have no experience and to be honest wouldn't feel confident for at least a year or so.
I feel if I took this job I would be letting myself down as I wouldn't be a nurse. However, I haven't had my heart set on it throughout training and it does impact on my mental health (but question if that was the training). The hours would be easier as nursing hours are difficult. However nursing hours can be sometimes changed to your needs.
Please help!
What would you do?

I think there are many different options within mental health which will allow you to maintain your registration. A low secure unit can be a god starting point as admissions tend to be planned and patients stay for a lot longer than a straight forward acute ward. I worked in secure services for years and really enjoyed it and learned a lot. I wouldn’t have considered 3yrs training and then not working in a field or taking a job where I couldn’t maintain my registration...

It's a difficult one. I think if you have felt all through your training that nursing isn't for you, then you're probably right (I felt the same!) I was paediatric rather than mental health though. Everyone kept saying to me that I'd feel better once I was actually qualified and doing the job, but that didn't happen for me. I was also filled with anxiety, and used to feel physically sick at the thought of going to work. It was ruining my mental health and, long story short, I gave it up very quickly, then felt guilty that I wasn't using all my training and hard work so did a return to practice course. I still had the nagging doubts while doing the course but stuck it out, got my registration back and started as a nurse again and.... Still hated it! I'm now in a job with family friendly hours and much less stress, for better pay and I couldn't be happier with my decision.

I would say that you shouldn't feel pressured to take the nursing job just because you've worked hard for your PIN. You've still got the degree, and experience which as you say will stand you in good stead for this other role. Do whatever you think will make you happy and to hell with what anyone else thinks. Nursing is really hard, and to me it just wasn't worth the risk to my own health, just to say that I was using my qualification. Your quality of life has to come first.

Good luck with your decision

RM here. One of the main things that I found was that being qualified was so, so much better than being a student. You’re getting paid, you’re not having to jump through random hoops at college and you can just be ‘at work’ for 37.5 hours a week not ‘37.5 hours plus assignments and part time work while worrying about money’. I’d say take the RMN job and give yourself a mental time frame- maybe 3 months? To settle in and see how it is. Then reevaluate and see if you feel differently.

It doesn’t sound like you’re quite sure about giving up yet. But if you do get to that point, there’s no shame in it, you’ve just tried something and decided it wasn’t for you. Good luck with whatever you decide, there’s no wrong answer, but qualifying is a big achievement and you should be proud of yourself whatever you choose in the long term.

Are you sure you wouldn't be able to maintain your registration? If you're doing mental health assessments would that not count?

I know a nurse who does disability assessment for PIP type stuff and stays on the register.

General nurse here and now I recruit nurses to work in the UK from overseas.

I would consolidate your training for atleast 6 months in a clinical setting, most jobs ask for at least 1 year post grad experience. Like pp said being a trained nurse is different as a student, for one you feel much more part of the team. Once you have done some clinical time (it will fly by believe me as you are learning so much), then look at roles which maintain your pin.

And I can maintain my registration even though I am not clinical, because I am in a teaching role also, so working as a mental health assessor you will be able to maintain your pin. Other routes you could think of are things like aesthetics (giving botox etc), medical legal nursing, or academic (like OU). But all would like you to have some experience clinically.

Well done for sticking with it and congratulations for becoming a nurse :) If you need more advice, happy for you to pm me.

Or Medical Sales is a good one too.

aweedropofsancerre - thankyou, yes I have been told that a rehabilitation ward is a good place to start and also been told it's not easy and you are either built for this position or you are not. I have seen so many staff members being attacked throughout my last placement which wasn't always mental health related. I'm not sure I'm 'built' for that. I guess i am just being honest in saying it scares me. I really have enjoyed the therapy side though.
user1498549192 - thankyou, good for you. You did well for persevering (twice). I don't think I have even given it a chance. I just feel quite strongly that I haven't enjoyed and my mental health has been at it's lowest over the past few years. Can I ask, what is it you do now?
Iwouldlikesomecake - thankyou, yes this is what I jave been told. I just thought I'd feel some excitement now as I have finished and starting a new job etc. I feel dread and fear. It's normal to be slightly anxious but it all feels a bit upsetting to me. I should give it ago, you're right. I just want to be fulfilled in 'a role'.
NicoAndTheNiners - thankyou, yes I have heard of a PIP assessor however this is assessing disability and mental health to award funds for specific equipment to enable a person to study comfortably. Not too sure if I could maintain my PIN. I know you do not need a PIN just a professional qualification.
pudding21 - thankyou, and thankyou for the offer of asking for further advice, really appreciate it. Yes, I feel I need the experience. I'm just terrified. Not sure if it's the setting, however an acute setting worries me too. I know it's normal to feel anxious but I have no excitement and I feel so much pressure to take this job (start next week).

So lilycake start the job and give it a while to see what you think. Make sure you get a good mentor, if you don't feel supported speak out. If you ever feel unsafe, speak out. Keep a log/reflection on all your clinical days to give you some perspective how things are going. How acute is the ward? Is it a locked secure unit?

I work with a company at the moment that provides child and adult services for eating disorders, would that be an area you might consider? (Im not touting you for a job, just suggesting other areas).

For a few years at least if I was you, I would maintain your PIN. Your PIN means you can access so many other sectors. Without your PIN and not much experience your options will be more limited.

Lillycake happy for you to PM if you need to. I have been a mental health nurse for over 30yrs and was a Ward Manager for a long time too and supported a lot of staff. I work for NHS ENGLAND now which is rather different but I can offer advice if you need any.

pudding21 thankyou, I was offered a job in camhs, on a ward. Camhs is the area I wanted to go into as I worked with young care leavers before my training. Yes, that would interest me but its very difficult to get into with no experience. I decided not to take the job as it was too far away to travel and they couldn't offer long days. I struggle with childcare also. I still don't know if that was the right decision. I would love to work in primary care but again no jobs out there. Or with young adults (not on a ward). I started to feel better yesterday after posting but today woken up with such dread again. I wish I could be positive.
aweedropofsancerre - thankyou, that would be great. I emailed the ward yesterday explaining my feelings of anxiety starting at band 5 and asked what the plan was. Nobody got back to me. I'm off with my dc's this week and can't relax. I'm trying to enjoy my time but its such a horrible feeling I have. So much pressure to pay my mortgage but feel so unhappy with my choice.

Hi Lillycake, just popping in to say congratulations for completing your final placement and getting your degree and registration. What an achievement for you :)

I can't help with any good advice and you've already had lots of that above but can I just say congratulations on getting through your degree, well done!! I've read several of your threads over the last year or two and I'm really impressed with your tenacity. As a university course leader in times gone by, I know how easy it is for people to give up, and you didn't!

OP consolidate your learning by completing your preceptorship for a year and rethink then.
Secure units can be grim, the one I worked at had burnt out staff, empathy fatigue, high assault stats etc, (sorry - just being honest) but was actually an OK place to work. Strong team working, flexible shifts as they were desperate to keep staff etc.
I left after a year and got a band 6 role, the key is getting a good base to build on.

RMN here

I'd be hesitant about low secure as a first job. It wouldn't scare me, but it would likely be the same cohort of patients for a long time.

I'd try for a job in a local services acute ward. You'd get a bigger range of experience and a chance to work out which client group you enjoy working with. You'd also do much more liaison than in LS and interact with services like the CMHT, crisis team and liaison psychiatry, so when the time comes to move on you'd hopefully have a better idea of what interests you. Jobs get more varied and interesting at B6 IMO (although I'm definitely an inpatient nurse )

I'd definitely give nursing a go before abandoning your registration. You can always do 6mo for your preceptorship and go. It would be hard to come back, and honestly I didn't have a clue what the job was like until I did it. I only enjoyed 2 out of my 6 placements, but I've been a RMN for 8 years and I love it.

OP I'm dual qualified RGN/MH now in education . You do sound very anxious which is a shame as most graduating students can't wait to start their professional career. You've done amazingly well to finish your course given how you feel- what an achievement- so it would be a pity if you couldn't consolidate and stay on the register- if the assessing job you are thinking of doesn't require registration, it sounds unlikely you will be able to maintain your MH nurse status. There are so many "other" type MH jobs that might suit you better - charities, advocacy, counselling, dementia services etc. - but many of these will require experience. I think you really need to think long term as getting back on the register is a pain in the ass and expensive.

It's also very common to feel that lack of confidence at the point of registration- and not necessarily a bad thing - I worry more about the over confident students as it usually means they lack insight into the importance and significance of their professional role.

I would not recommend PIP assessing - i had students who felt a bit like you try that and they hated it with a passion as the system was so weighted against the clients.

Good luck.