Night shift on a Mental Health rehab unit

Night Shift on a rehab unit

I was working a bank shift which means I am on the Trust’s bank of staff who are available to cover shifts on the various wards if they don’t have enough staff. Because I was a student I could only work as a nursing assistant (N/A).

In comes Ayo with her big bag and her big blanket, tutting as per usual before slumping down into a chair, moaning, “Oh Lord, I don’t need this, I worked early bank shift on Jasmin (ward).”

Working a night shift then a late shift is not standard practice. Long hours, fatigue and lack of rest breaks or time to recuperate between shifts are associated with an increased risk of errors. However it’s very difficult for Ward Managers to keep track of, if staff members do extra bank shifts on another ward, which many of them do. Is it any wonder they’re tired and burnt out when they’re working three to four bank shifts a week elsewhere?

Handover

Lisa arrived just in time as Clare was about to start handover at nine pm “Mandy’s not coping with the titration of her Diazepam and continues to scream at medication time. Sasha remains bright in mood and went out with her nurse to buy new underwear today. She asked when Nancy was working next……..” and this made me smile as I’d taken a shine to her too. “Elsa messed herself again today and her clothes were found in the shower floor.” Clare briefly covered all patients on the unit and said her goodbyes. That left left Lisa, Ayo and me working as a support worker.

Ayo was coordinating this shift but before she could even allocate patients and any tasks Mandy was banging on the office door “I need my medication. I need my medication……” and as I went to speak to her Ayo cried out “No. Let her wait. Everyone have to wait.”

“Ayo, I just want to let her know that she will get her medication soon. It’s not nice that she’s crying and upset. I ………..”

“No!” muttered Ayo and she kissed her teeth. Ayo then allocated four patients to me, including Mandy and Elsa. As much as I loved working with all the patients, cos they each brought their own joys with them, I noted how I was always given the more difficult patients to work with. Unfortunately, lots of staff did this but, by rights, they ought to have taken these patients because they were trained and qualified.

Lisa would be doing medication this night and I was to prepare supper of toast and hot chocolate; no coffee or tea because patients weren’t allowed caffeine before bedtime. Mandy was given her medication first then she tottered through to the kitchen, wringing her hands and muttering to herself. “Hello Nancy. It’s nice to see you again. I’ve had my medication but they’ve cut it down and I can’t cope Nancy. Honest, I can’t. Can I have three slices of toast nurse and will you cut it into quarters for me?” before shuffling over to the large table. I took her hot chocolate over as she was trembling and I could see her ending up with half a cup if she was to carry it.

Edward was next at the counter and he too shuffled away happily with his toast and jam and cup of chocolate. Edward was forty years old but could have passed for fifty plus as he was always unshaven, his face was weatherbeaten and his grey hair had receded. Edward had a diagnosis of schizophrenia and since he was seventeen he heard many voices and saw people who were not visible to others. Unless you saw him at mealtimes, you wouldn’t know he was there; he was so quiet. I had to seek him out each week for games night and he came along willingly, as he was actually really good at scrabble and we both enjoyed the challenge.

Bedtime

With medication and supper over I went to check on my four allocated patients. All bar Edward were in their rooms and in various states of undress. Mandy wore a long floral flannelette nightgown and ancient slippers and I watched as she carefully folded the clothes she’s just taken off into neat piles. Her room was spotless if not a little cluttered as she collected china tea pots of all size. and colours. “Night, night nurse. Will you close my door for me?”

Sasha was in bed and snoring lightly. Elsa was struggling with her bra straps so I offered to help. “Fuck off me, you. I don’t need you.” she spat and turned her back on me. “Go on, fuck off.” Then she gave me another of her toothless grins. I think she just liked to test the nurses’ responses. She always made me smile and I told her I’d be back in five to see she was okay. I did go back because if you say you will, then you must. So many patients are left waiting when nurses tell them they’ll come back and I think it’s cruel. That left Edward. He was watching a film in the shared living area, chuckling away to himself. I wasn’t sure if he was laughing at the television or the voices he heard but he looked happy enough. I was going to go over to sit with him for a while when Ayo called “Bedtime Edward.” and switched the lights out.

I said “He’s watching this film, let him see the end. It’s over in twenty minutes.”

“It’s eleven o’clock and it time for bed. Come Edward. Come now.” Totally ignoring me, she watched as Edward struggled to get out of the chair and shuffle over to the door. Once everyone was in bed Lisa checked all the downstairs doors and windows then returned to the office. I asked why Ayo wouldn’t let Edward finish watching the film and she said “Eleven o’clock, lights out.” I couldn’t believe it because I’m sure everyone has a different body clock and bedtime and had Edward been at home, he would have watched the end before going to bed. I was going to make sure that I documented this in Edwards notes and flag it up at the next team meeting.

Staff bedtime too

It was eerily quiet, pitch black and unnerving as I went to the kitchen to get drinks for myself and Lisa. On my way back to the office, all I could see in the living area was a pair of eyes peering out at me from underneath a blanket. I whispered “Hello,” but got no response. I crept forward so as not to startle what I thought was a patient but Ayo shrieked “My Lord. Girl, what you doing? You frightened the life out of me.” There she was, feet up with her slippers lying on the floor, curled up on the sofa. “I havin’ my break. Go. Foolish girl,” and she kissed her teeth.

Off I went with the drinks, shaking my head, stunned. I asked Lisa whether this was normal practice, for staff to sleep while on duty and was told that we each get two hours break but Ayo just sleeps all night. “So that would leave one of us on the floor?” I enquired. If both Ayo and Lisa were on a break that would leave me, an N/A, to be responsible for the unit. “Yes, that’s what we do. It’s okay, Ayo always sleeps” she smiled.

“I’m sorry Lisa but I don’t feel comfortable with that. I’m working as an N/A and I’m not qualified if there’s any emergency.”

“Nancy, she’s done it for years. Even our manager knows.” said Lisa sighing and shrugging her shoulders. However, that night neither she nor I had a sleeping break. We both sat in the office, Lisa looking at holidays online and me reading through my patients’ notes. I really enjoyed finding out more about the patients and while it was quiet I could help update their care plans, number the pages in their files and generally complete paperwork that’s often difficult to do during a busy shift.

The time went quickly and I was so immersed I didn’t hear Ayo coming into the office. However, I heard her loud yawning and watched as she stretched upwards before dropping herself into the spare chair next to me. I caught a whiff of her stale morning breath and body odour! Offering to make us drinks allowed me to make a swift exit and by the time I’d returned Ayo had rolled her chair to another desk.

Six fifty five and the morning staff were starting to arrive. “Nancy, Lisa, you go on the floor, I do handover.” Which is normal for the coordinating nurse to stay in the office to give the handover, while the rest were outside attending to patients. However I couldn’t help but wonder how a nurse who’d slept all night and hadn’t asked her colleagues about the shift’s events could possibly give an adequate handover. Again, I asked Lisa who tutted and said “Nancy, you’re just a student. It really won’t do you any good to keep questioning your colleagues practices now. They won’t thank you and you’ll fall out.”

“I don’t want to fall out with them but as I’m a student, working as a nursing assistant surely I have an opinion? And I don’t think it’s safe for patients or staff if others are not doing their job.”

“Nancy, it’s just how it is, how’s it’s been for years and you can’t change it.”

The Nursing & Midwifery Council’s (NMC) Code of Conduct 2015, sets out professional standards of practice and behaviour for nurses, midwives and nursing associates. Point 3.4 states: act as an advocate for the vulnerable, challenging poor practice and discriminatory attitudes and behaviour relating to their care. Both Ayo and Lisa had completely ignored all the rules!

Would you be able to highlight where they’d gone wrong? Would you have reported them?

I would later talk this through with the unit Manager.

Note to self: “Folks who never do any more than they get paid for, never get paid for any more than they do”― Elbert Hubbard

Does Mental Health Rehabilitation really work?

Early shift

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As I parked up my first morning, even above Slade’s Noddy Holder screaming “It’s Chriiiiiistmass”, I could hear a female screeching “Medication. I want my medication. Where’s my medication? I need my medication.” The poor neighbours either side of the building must have been well p’d off. It was six forty-five, pitch black outside and the streets were eerily quiet — other than the high pitched screeching coming from the Mental Health Rehab Unit piercing the air.

Someone in the office by the front door pressed a button to let me in and I was greeted by this tiny little lady who grabbed both my hands and panted “Help me. Help me please. I need my medication. You’re new. Are you an Agency Nurse?” Will you help me? Please?”

I spoke calmly but firmly, “Listen to me, I can’t help you right now…” I was trying to placate her enough so that she could hear me and take in what I was saying. At the same time I was trying to get her to take a breath as she was panicking and was as white as a sheet. I really felt for her.

“Please, please. I’m begging you,” she continued to screech, now in my face, as I tried to disentangle myself from the tight grip she had on my wrists. The office door opened and a nurse yelled “Cindy, stop it, leave her alone. Cindy!” I’d now managed to get myself free but Cindy had grabbed the nurse and was pulling on her cardigan, all the while screeching “You’re a bitch. You’re a fucking bitch! Get my medication you fucking black bitch.”

The nurse eventually pushed me into the office and she followed, turning to slam the door in Cindy’s face with a kiss of her teeth “Oh Lordy Lord. That Cindy. She will be the death of me. I am Ayo. Who are you?”

I breathed a sigh of relief and introduced myself as the Student Nurse. “I don’t know. See how it is here. I pray to God for her sins,” humphed Ayo. “Hmmm. Take a seat. Ah! Here come the staff.” and I turned to see two females and one male puffing away outside, the ciggie smoke belching through the office window. “Tsk, Tut. I don’t know. Smokers, heh!” moaned Ayo as she reached to slam the offending window shut.

Seven o’clock on the dot the three members of staff traipsed in, throwing their coats on top of a filing cabinet. Lisa was first to introduce herself as the RMN, the shift coordinator and my supervisor, and said “That’s Lorna, she’s a qualified (RMN) and that’s Graham the NA (Nursing Assistant).” Where’s the fourth member of staff? I thought to myself.

Morning handover

“Okay.” started Ayo, above Cindy’s screeching. “The lady herself. Cindy, she slept and now she has been shouting before six thirty. Lord help me! Everybody still in bed. Only Sasha, she awakes all night but she stay in her room. Somebody needs to clear her room. I saw the mouse there.” My feet moved on their own, up off the floor as I sat on a desk, and I shuddered involuntarily when I was looking around for the said mouse.

Ayo continued and ended with “Moses needs to see a Doctor and his toenails need to be cut. It’s in the diary for this morning. Now I’m going home. Goodbye!” She pulled off her slippers and put them in her bag then huffed and puffed as she bent down to put her shoes on. She grabbed a large woollen blanket and shuffled out of the door.

Lisa went through the diary, handed out tasks to the other two and said she was doing medication and that I should shadow her. Lorna went off to wake up the other nine patients that lived in the ten bedded unit and Graham wandered off to the kitchen to prepare for breakfast.

Medication

With our coffee, Lisa and I went to the medication room, we were met with Cindy who was still gulping in great lumps of air, wringing her hands and saying “Thank you Lisa.” and “Thank you nurse.” to me. Yes, I could get quite used to being called Nurse.

“Right Cindy. You know we start titrating down your Diazepam today.”

“No, please Lisa. Not today. I can’t cope. I can’t cope!” Cindy screamed.

“Nought point five milligrams Mandy. You won’t even notice it.” Lisa tutted and turned to me. “She’s been on thirty milligrams three times a day for years and you can see it doesn’t reduce her anxiety. So we’re going to try titrating down while she’s in Rehab.” Cindy lived in a one bedroom flat and had apparently relapsed over a period of six months prior to admission to an acute ward. Once stabilised she was transferred to rehab.

Cindy had generalised anxiety disorder (GAD) which is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than one specific event. 

People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed. As soon as one anxious thought is resolved, another may appear about a different issue. Titration looked like it would go on forever, reducing her Diazepam by nought point five mg three times a day. However, Cindy eventually accepted the reduced dose and greedily swallowed down all her medication, followed by gulps of water, then scurried off to the dining room.

Breakfast

We continued until each patient had had their medication then joined everyone for breakfast in the dining room because, on rehab, we were encouraged to eat with the patients each mealtime. Lisa waffled something about nurses having a responsibility to role model table manners and eating with the patients was supposed to encourage healthy eating. I wasn’t sure that this was an evidence-based intervention but I went along with it anyway.

Coffee and toast with jam was just what I needed but as I sat to eat I was immediately struck by an offensive odour. One older lady to my left had obviously not washed or brushed her teeth, yet there was another disgusting smell.

Graham screwed his nose up and said “She’s just sat there and shit herself and carried on eating!” to nobody in particular. “That’s Elsa.” he whispered with an Aberdonian accent. “She normally goes to the toilet but she uses her clothes to wipe herself and then hides them down the back of the toilets, eh Elsa?” he now boomed. “Elsa, say hello to Nancy, she’s our new student.” Elsa’s face was buried in the huge breakfast she was picking up with her teeth. She raised her head and gave me a toothless grin.

None of the staff got up to help Elsa so I offered, but Graham told me “No. Wait til after breakfast!” And this is rehab? I wondered — does it really work?

Around the table, there was belching, farting and one young chap was trying to snort back the snot that was threatening to hit his top lip. He eventually gave up and wiped a huge glob on the sleeve of his t-shirt leaving a silvery snail-like trail.

Coffee finished and my toast in the bin, I helped clear the table and took my time in the kitchen. I was hoping someone would deal with Elsa, as I was already feeling queasy. Fortunately, she’d gone by the time it took me to do the dishes but she’d left wet poop dribbling down the chair legs. Gloves and apron on and ten minutes later the chair was scrubbed and left outside in the back garden to dry.

Activities of daily living

To the bedrooms on the first floor now where I tried encouraging patients to wash and dress before attending any appointments or activities. Oh my word! I’d knocked and opened the door to Sasha’s room and was aghast at the cereal boxes piled as high as the ceiling. At a guess I’d say there must have been over two hundred boxes and the only other floor space was filled by her bed and two or three black sacks.

“Get out of my room.” stormed Sasha as she pushed me and slammed the door. I stood for a few seconds, stunned, then knocked and called out “I’m a student nurse Sasha. Is there anything I can do? Would you like me to help you clean your room.”

“Get lost.” Sasha muttered. I went to find Lisa and asked what I could do to help Sasha. “Not a lot,” Lisa laughed. “Her room’s been like that forever. She won’t let us in.” That can’t be right. Surely we have a duty of care? I went to the office to look through Sasha’s file and her painstakingly completed but outdated care plans to see if I could find ways to engage her.

I read that she was single, had no children and had been in care since the age of eleven when her mother couldn’t cope with her chaotic behaviour. She was thirty one and was diagnosed with Schizophrenia at eighteen. Sasha heard voices and was often heard talking back to them when alone in her bedroom. Apparently Sasha had no insight and didn’t believe she had a mental health problem. She’d been on the unit for six months and was awaiting housing but it was proving difficult to find a place that would meet her needs.

I decided then that I’d be really firm with Sasha right from the start, telling her that we have a duty of care to ensure that her environment is habitable. If she wouldn’t clean it herself, then we would have to do it! It annoyed me that staff had let her live like this for months. Even if Sasha had refused to let them clean it, surely the staff could have come up with a plan between them.

It was exhausting and often thankless, but I worked hard with Sasha for the next twelve weeks, updating her care plans and engaging her in meaningful activities; things that would both interest and help her rather drum banging or painting by numbers. I appreciate that one of her care plans previously stated ‘Engage Sasha in activities.’ But, while these particular activities may help with dexterity and fine finger/hand movement, I wasn’t sure they would support her development. It was clear that certain staff had intermittently tried to push Sasha into any activities and wrote in her notes ‘Declined to attend.’ I wondered why!

I’d eventually learned more about Sasha, along with the other patients on the unit, and had managed to form a professional bond with each of them. As I got to know them better, often by engaging them in friendly banter, I was better informed about their likes and dislikes. It was easy to see they weren’t interested in particular activities and that they had their own ideas about how to spend their time.

Mark liked football so I’d have a kickabout with him in the gardens – he was quite good – so encouraged him to attend the local leisure centre where he could access different types of exercise and look out for a local football team to join.

Jenny loved knitting so we bought her knitting needles, a few patterns for baby clothes (that she requested), and some wool. She wasn’t great, dropping more than a few stitches, but that wasn’t the point. She enjoyed it. Other staff who could knit helped her unpick and start again. Eventually, with the help of staff, she started her own small weekly knitting group on the unit.

We also got a group of patients to go swimming once a week, with a member of the team. We also went to the local pub once a week so that some of the young lads could have half a pint and a game of pool. They’d never felt comfortable going into a pub previously, because they were worried about what other people thought. We quite often did get some odd looks but as a rule, the regulars were great – helping the lads with their game and showing them trick shots.

At the end of my placement I loved seeing Sasha and the others laughing, smiling, engaging and growing in self-confidence and once again, I was sad to leave.

I would later bump into some these patients in various settings i.e. in the community or on the wards and I was either saddened by their relapse or delighted by their continued improvement.

Note to self: “Public service must be more than doing a job efficiently and honestly. It must be a complete dedication to the people and to the nation.” Margaret Chase Smith.

Scary security guard at a mental health hospital?

This is it. This is what I was training for; my first Mental Health placement on a mixed Acute In-patient ward in East London.

I’m normally a bit of a snob about public transport but, unsure whether I’d find a parking space, I headed off towards the bus stop at an ungodly hour. I relaxed and actually enjoyed the ride, seeing places I’d not previously spotted when driving.

Your proverbial man in a not-so-grubby mac sauntered out of a  grimy massage parlour, picking his nose with his pinky and devouring the contents. Nail bars and lots of them, a more upmarket Gentlemen’s Club next door to a greasy spoon, where two young girls stood brushing their long ponytails into place, right behind the counter from where they’d be plating up their full English soon.

The journey was over all too quickly, as the hospital came in to view, and off I hopped, keeping my eye out for parking I could use tomorrow. Despite the brightly lit reception area just ahead, I could still feel the chill and the darkness surrounding me like a heavy black cloak. It didn’t get any better either!

If the reception that greeted me on arrival was an any indication of the day to come, I’d have turned on my heels – pronto. I arrived at the huge glass doors, where there were too many buzzers to comprehend this early in the day. I knocked my already freezing knuckles on the icicled glass and waved frantically at the obese gentleman who was wearing a white shirt that said Security.

However, after banging so hard that the icicles crackled and popped to the ground, behind his flexiglass screened reception desk, the man appeared be asleep – with his eyes open. Yet I heard a click and the huge doors opened inwardly. The said gentleman nodded me in, urging me forward with another tip of the head and he barked “Yes!” while I was still half a dozen paces from him.

The Scream, Edvard Munch

“Hello, Lavender Ward please, I’m a stu …….” Obese man with the bulbous nose harrumphs “Sign in. Along the corridor, left and left, in the lift, first floor.” Ugh. This man was ignorant, and scary so I didn’t dare ask him to repeat it. I got the corridor bit so off I went, my trainers squeaking on the lino, loud and lonely in the silence that pervaded the building.

The scuffed mint green walls were adorned with patient artwork, some almost childlike though many screamed of fear and desperation. I wondered if this was the right place for the display. Others may think differently, but if I was being admitted during my psychotic state and taken along this corridor I think I might have felt a tad apprehensive. Distressed and paranoid even.

I found the lift and when the door opened, the acrid smell of pee nipped the inside of my nostrils, and I gagged at the the freshley gobbed phlegm slithering down towards the buttons. I pushed the first floor button with a spare pen and as there was now no place for it in my bag, I cheekily I dropped it down the gap in the lift.

Outside the lift there were five wards and I eventually stood at the locked door to Lavender ward with its wire mesh glass window and yet another buzzer to press at the side. I’d arrived at my placement and just took a moment to do some deep breathing, which would calm my pounding heart.

Note to self: Must ask why the flexiglass reception and a rude security guard in a Mental Health Hospital? It certainly didn’t give off a welcoming environment.

Patients loved good student nurses

Patients loved good student nurses cos we had time to chat with them

Patients and nurses loved good student nurses
Everyone loves good student nurses

Good student nurses might not be as skilled or knowledgeable as the professionals, but they’re very much loved by patients. They’re a breath of fresh air. Most of them want to help, whether it’s plumping up your pillows or making you that longed for cup of tea.

Have you ever been in hospital, maybe bursting to go the loo and you couldn’t get the nurse’s attention? Or your chin was on your chest and your neck had locked because your pillows were skew-whiff? Hmm, me too, on more than one occasion. And I get that nurses are really busy, I know, because I was one. But manys a time I could see them huddled round the nurse’s desk, laughing and stuffing their faces with chocolates.

Seriously, some general nurses work really hard, running up and down their wards, trying to fit in everyone’s needs. And it seems impossible some days. But Hallelujah, several times a year, they get a group of student nurses, many of whom want to learn. Woe betide if you just want to hang around looking like a nurse. You had work to do, and nurses couldn’t be bothered with hangers on.

I’d wanted to become a mental health nurse and this general nursing wasn’t what I’d signed up for. However, if you were a good student, willing to learn and share the teams’ mission, they’d support you, which made it easier. You’d help them with most anything they asked, within your capabilities. Even the most dreaded tasks.

Me and patient’s bodily functions

General nursing student

I wasn’t looking forward to this particular placement because, not only did I dislike East London and that hospital, it was also a general male ward. And generally where you get all men, you get burps, farts, snot and phlegm, in no particular order.

I gagged when I was asked to collect mucus — just at the thought of it. But actually holding a sputum cup half-full with sticky green bodily fluid had me dry-retching and reaching for the ladies. I dreaded the day I had to hold male poo samples.

A lovely elderly chap called Derek was the first patient I saw. He had prostate cancer along with other age-related ailments. Derek chuckled and winked at me when he saw me screwing my nose up. I couldn’t help but show my disgust at the foul smells of half-full bedpans and commodes. I realised I was being unprofessional, and it didn’t take long for me to become accustomed to the odour on the ward.

Patients I adored

General nurses were always busy
General nurses were always busy

Derek loved telling me stories about his life during the war and how, once home with his lovely young wife, they’d never spent a day apart. He also told me that his wife was on another ward down the corridor and he missed her terribly.

Before I went off shift one day, I managed to get Doris’ bed wheeled right next to Derek’s for the afternoon, despite moans from the nurses. I got to see why they never spent time apart; holding hands, whispering and giggling like teenagers and dipping custard creams into each other’s tea. I felt so proud that I was able to help in some small way. I’d honestly never had such a humbling and emotional experience.

Ah! Derek’s bed had been moved the next morning. I asked a male nurse where he was. With a nod and eyes rolling upward, he said: “He’s gone upstairs.” Oh, I thought and before I asked anything more, the nurse said “He’s dead.” Just like that!

I dashed the ladies to dry my eyes before looking in on Doris and her family, to pass on my condolences. I wasn’t sure I was at the right curtains when I heard laughter. So, I stood for a while, then Doris noticed my tiny shiny shoes and called me in. The family thank me for the humanity shown the previous day, and told me how much it had meant to both parents. They’d had their final chuckles and they were both at peace in their own way now.

Students have the time to listen

Most patients love good students on the ward because sometimes they’re the only ones who have time to stop and chat. They’d ask patients about their needs and wants, and try to help. Sometimes patients just wanted someone to listen to them, and students fitted the bill. While nurses ran ragged. They’d administer medication and attend ward rounds, while writing notes, and updating no end of needless care plans.

Phones rang out, begging to be picked up. It might have been someone wanting to speak to a poorly patient, or results from other departments?

Patients had many needs

Nursing students supported their colleagues while learning

See, most patients had more underlying health problems than just the issue came in with. This tends to happen unfortunately, particularly in large cities like London. It then becomes difficult for care teams to discharge patients in a timely manner because:

  • patients who didn’t speak or understand English needed interpreters
  • some patients needed support with housing and benefit issues
  • other patients couldn’t go home because their accommodation had to be repaired of adapted prior to discharge
  • often we had homeless patients who required a lot of input
  • others — just didn’t want to go home either because they were lonely or didn’t have any family around them
  • we also had patients with mental health problems and were awaiting a psych assessment
  • at least 25% of general hospital beds are occupied by people living with dementia. On average people with dementia stay more than twice as long in hospital then other patients aged over 65, said the National Audit Office, 2016.

Bed-blockers (hospital speak) are a huge problem for the NHS, and I can’t see it being ‘solved’ any time soon. Patients still need care and support from our busy nurses, while multidisciplinary teams scratch their heads. They too have large caseloads, and no doubt it’s hard to put systems in place so that patients can go ‘home’.

In the meantime, nurses made hundreds of phone calls to the various support agencies and social services, while still caring for patients. This take them away from the very job they trained for; looking after patients. No wonder both patients and staff loved and appreciated good student nurses on their wards.

Over to you

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What’s your experience, if any, of student nurses? Do you think nurses have a tough time on the wards? I’d be interested to hear what you think, and I’m looking forward to your comments or questions.

3 years study to become a mental health nurse

Within weeks of starting Uni, I learned just how stupid some people are! How many lack personal insight and have no idea of personal space or people skills. I was able to study my fellow students as they shoved their way through the doors I was entering and jumping ahead of me to get the seats at the front of lectures or lessons.

Now, I know I was really skinny but trying to get two people through the narrow single doorways at Uni was nigh on impossible and, if they thought I wanted to bring attention to myself by sitting anywhere within a ten-foot radius of any lecturer, they were sadly mistaken. Those lardy arses who bulldozed past me, snorting, kissing their teeth or tutting were welcome to their prime seats.

Having only recently recovered from a lengthy psychotic episode, I still felt really shy, nervous even, and constantly prayed to someone who’d help me stave off the ever-impending anxiety attacks. I’d sit somewhere in the middle of the halls and quickly avert my eyes or pretend I was taking notes if I caught a whiff of a question coming my way from the attending lecturer.

I was so busy monitoring my pulse and breathing, I probably missed half the lectures anyway.  Still, most of the lecturers appeared to be reading straight from books, which meant I could catch up by going through the same book or reading any handouts during breaks or at home.

What I hadn’t bargained for was the seminars and classes, which normally lasted between one or two hours and, where we were expected to work in smaller groups, normally around eighteen to twenty students. We’d be further split up to around 2-4 people, to discuss some topic or other, then complete a written task before presenting our understanding back to the group

Or, because of the sweet packet rustlers, the stupid questions and other disruptors, we often had to complete the task at home then feedback to the larger group. Oh, my word! If I’d known that I would have to stand up. In front of everyone. And speak? I would never have applied for the course.

No way was I making an absolute arse of myself. I practised for hours in front of a full-length mirror at home, where I’d present my findings calmly and with a flourish, maintaining good eye contact and waving my hands theatrically. Cracked it; I could do this.

Huh! For all that, the first time I presented to the class, I dropped the acetates I was relying on to distract my peers as I spoke. Taking in huge gulps of air as I bent down to retrieve said slides, I could feel the heat rising up my neck and hear my heartbeat pulsating in my ears. Then I swayed and felt dizzy, increasing my anxiety tenfold. ‘Please do not let me have a panic attack’! Though not sure who I was asking. By now, I could see my heart leaping out beneath my clothes like Jim Carrey’s character in The Mask and felt sure everyone else could see it.

It felt like an age as I raised my head and saw my well-meaning contemporaries smiling, encouraging me, willing me to get over the finishing line, so I began. With trembling hands, a fake smile and what felt like a massive boulder in my stomach, I managed to stutter my way through my presentation and answer some easy questions.

There was no theatrical waving and no calm, just relief when it was over and I was able to watch my peers presenting. Not sure I should be glad but, I could see I wasn’t the only anxious student in the room. Those following me muttered, mumbled, lacked eye contact, had hives creeping up from their chest and for some, their presentation wasn’t even relevant.

Note to self: “Today I will not stress over things I can’t control.”

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