21st Feb 2019 marks the first ever UK Mental Health Nurses day. The point of the day is to to gather together voices and experiences from across the UK to celebrate, describe and promote Mental Health Nursing. To mark this Mental Health Nurses Day, we asked a number of our friends, Fellows and Queen’s Nurses to write blogs on various aspects around being a mental health nurse. We have three to highlight during the day. Our first is a reflective look at a long and varied career in mental health nursing from our Fellow, Derek Barron, Director of Care at Erskine.
Everyone has mental health, some have good mental health for others their mental health can fluctuate. Today is an opportunity for us to recognise the contribution of mental health nurses in supporting people who at times struggle with their mental health.
On this, the first mental health nurses day, it seems like an appropriate time for me to reflect back on over thirty years as a Registered Mental Nurse (RMN).
Having been in nursing since 1984 when, as a student nurse I took those first few steps, through my registration in April 1988 (with the UKCC) up until today I can say that mental health nursing has a dynamic and rewarding career choice. It has also proven itself to be a field of practice that continuous to evolve and touch the lives of people it serves.
In 1988, when I qualified, mental health nurses were predominantly based in asylums; large hospital often set away from communities, where a huge number of people lived, often for many years. Leverndale Hospital in Glasgow, where I had my first staff nurse post, had over 1000 people there, and that was a downsized version of the hospital from the 2000+ capacity it used to have – it even had its own onsite golf course!
In 1993, when I moved to the community, we were among the vanguard of new mental health nurses, around 15 of us joined the existing three CPNs along with a consultant psychiatrist. We adopted a different, community facing focus, where inclusion was a belief and approach we tried to embed in our care delivery. We also introduced health care support workers to our approach before extending the model to have occupational therapists and psychologists as core members of the team. I don’t think we always got it right, but what excited and motivated me was that we constantly strived to learn, to develop, to be open to change. Mental Health Nurse were at the centre of this new community focused service.
On a personal, professional level the adopting of clinical supervision into my daily practice was the biggest influencer in how I developed. While I had regular, monthly three way supervision with two other nurses, I also had reflective practice supervision sessions with a psychologist, with a medic and (in those days) most strangely of all, two way supervision with a senior social worker. Our team set up preceded ‘integration’ by many years, however the ethos and practice of the team delivered a practical integration for those people we served, while not letting management structures and finance get in the way.
Trust in colleagues was paramount. In supervision, my practice, approach and my underpinning beliefs were challenged in a supportive, growth and professional development way. I like to think that I also supported colleagues in their growth and development. There will be lots of time when you are ‘too’ busy for supervision, I’ve heard that said a thousand times, each time the person’s potential growth is stunted, an opportunity to learn, to care for themselves (and their colleagues) and to provide better care input is dented. And yes, in case you think the above is a little ‘holier than thou in approach’ there were times when we postponed supervision, when we were too busy – delayed by a crisis, or still out on a visit, but we valued supervision so much, we never delayed it by more than a day or two.
On this, the first mental health nurses day my small piece of wisdom to share is to anyone reading this, a newly qualified nurse, an experienced nurse/practitioner, who wants to grow in their practice and career, find someone (some people) who will challenge and support you, make and protect time for clinical supervision as a time to care for you as well as to grow, and ensure it is an embed aspect of your practice.
Right, Relationships and Recovery – Refreshed (https://www2.gov.scot/resource/doc/924/0097678.pdf ) guides is that reflective practice supervision should be at a minimum two monthly (preferably more frequently) for at least one hour.