Pre mental health nursing

You can read the backstory About Me to give you an understanding of how I got to here………. how I loved mental health nursing – then I got sick
I was on the road to recovery from my own mental illness when I realised I wanted to study. I wasn’t sure I was clever enough and I wasn’t sure what I actually wanted to study.
Studying massage part-time
I thought I’d start small so took evening and weekend courses in Shiatsu, followed by Swedish Massage, Seated Massage, Aromatherapy and finally, Indian Head Massage. I loved it and so too did my family and friends, who I practised on.

I had the massage table, the massage chair, the fluffy white towels and a full kit of aromatherapy oils. However, despite passing all my exams with distinction, I couldn’t ask for money. I just loved providing massage, but I realised it would never be a paid job.
Studying to become a mental health nurse
In February 1997 I’d seen a large advert looking for General Nurses to study at my local University and Hospital. This didn’t so much interest me but, right at the bottom of this ad, there was a few lines about becoming a Mental Health Nurse. It just felt so right and I knew my own experience of mental illness would help to make me a good nurse.
So, during my own recovery from, what I learnt was, a lengthy psychotic episode, depression, anxiety and anorexia (which you can read here), I applied to train as a Mental Health Nurse.
On becoming a mental health nurse
After three long years of study, I worked successfully as a Mental Health Nurse in various settings before eventually becoming a Ward Manager. I was already working more than double my previous hours but now earning half the salary but I didn’t care — I’d found my purpose, my reason to get out of bed.
However, despite being a qualified MH nurse, I still felt that I just didn’t know enough, that I was a fake and I’d soon be found out. This drove me to attend further specialist courses including the one-year Thorn Nursing programme which taught nursing interventions for schizophrenia and a Cognitive Behavioural Therapy (CBT) course for psychosis.

Outside of the NHS, I also trained to become a Mental Health First Aid (MHFA England) Instructor, a Mental Health Awareness Trainer, Mental Health First Aid Youth and Mental Health Armed Forces Instructor.
Working in various mental health settings
I was enjoying every aspect of my job and had the honour of working with some amazing people; patients, families and their carers, together with colleagues from lots of different disciplines. I spent time working in the community, visiting patients in their own homes and seeing how they lived when they were ill and well.

I worked on various acute in-patient mental health wards where patients could be extremely unwell, distressed, chaotic, occasionally angry and aggressive towards staff and others. Unfortunately some had to be restrained for the safety of both patient and others. Whilst it can look quite alarming, nurses tend to take the brunt of the drops to the floor, ensuring patient safety at all times. Our patients were acutely unwell, experiencing:
- panic attacks, depression and/or anxiety disorders as well as obsessive compulsive disorder (OCD), borderline personality disorder (BPD) and post traumatic stress disorder (PTSD)
- severe mental illnesses like schizophrenia, bipolar disorder and schizoaffective disorders
Acting as ward manager for three years with the elderly was definitely an experience but it wasn’t always easy as many patients had both mental and physical illnesses. The lack of family or visitors on this ward saddened me and of course, often patients had to be transferred to general wards, where sometimes they’d pass away – which always broke my heart.
I’d worked in A&E which was fast-paced and never a boring moment; working with disturbed patients, the Police, distressed families and community colleagues. Then with the Home Treatment Team (HTT) and in the Mental Health Emergency Department where we’d see patients in various stages of illness who needed support, perhaps admission or to go home with the HTT.
Duty Senior Nurse
From Band 6 (Charge Nurse) upwards you’re on the rota to carry out two shifts a week as Duty Senior Nurse (DSN), which could be early, late or night shift and you have responsibility for the whole mental health hospital.

to hospital — image by
Huffingtonpost.co.uk
Despite The Mental Health Code of Practice saying a patient in crisis should only ever be transferred to hospital by an NHS vehicle, quite often an extremely psychotic and aggressive patient arrived in a police van, in handcuffs. It was always great when the patient recognised you, calmed down and agreed to walk in with you, rather than being practically dragged in by the police.
Unfortunately I’ve been on DSN shift when the police come to tell you bad news such as they’d found a body somewhere, it would be one of our missing patients. Or they came to ask you to identify a missing patient who had died by suicide. Once they came to tell me of a double suicide and I was raced off to the scene to identify the patients.
Favourite mental health settings
One of my favourite places was the Day Hospital (despite a bully of a manager), where we saw up to seventy patients each day, who all came to attend various therapies and activities. This was part of their recovery and they might been referred from an in-patient ward in preparation for their discharge.
I loved being able to use all the knowledge and skills I’d gained together with my own personal experiences to support our patients. Part of my role was training less senior staff from both the day hospital and the ward, something I got a lot of satisfaction from. And of course, I enjoyed the positive feedback.
Another favourite and sadly my last post was as ward manager on an all female acute in-patient ward. It was an absolute nightmare when I first arrived, the ward was in chaos! It was initially managed by three male staff, the ward manager and two Band 6 nurses. The patients had previously been allowed to yell and swear at staff; they’d tried to attack them, thrown dining table and chairs around and generally behaving badly.

Some of the nurses were said to be worried about my arrival and chose to transfer to other wards, which saved me the job of managing them on the Capability programme. Some had attitude problems and didn’t like that I’d adhere to Company policies regarding the Trust Dress Code; no inch long nails, no big dangly earrings, wearing id, their inappropriate dress like tight leggings and vest type tops. If I hadn’t already known the staff, I would have wondered who were nurses and who were patients.
My Personnel Management skills came in handy as I was well aware of the need to know company policies and procedures. I was able to use them to guide me through how to manage patients abusing our staff and the ward. During my first year our team was able to reduce the number of violent incidents on the ward by 74%, something we were all very proud of and actually gained recognition for it.
We were to present our ‘work’ at Head Office, after which I was asked to present it to all Ward Managers within the Trust. I was so excited and even more so when our Nursing Director suggested that in the future, I become more involved in training staff from Band 4 – 7.
The onset of my physical illness
Within days of that presentation I was struck down with a rare disorder – idiopathic (cause unknown) Transverse Myelitis (TM), which is normally caused by a virus but, despite the hundreds of tests, mine wasn’t, hence the idiopathic.

According to Mayoclinic.org, TM is an inflammation of both sides of one section of the spinal cord. This neurological disorder often damages the insulating material covering nerve cell fibers (myelin).
TM interrupts the messages that the spinal cord nerves send throughout the body. This can cause pain, muscle weakness, paralysis, sensory problems, or bladder and bowel dysfunction.
Due to my physical disability and ongoing mental health problems I am no longer able to work in the job I loved and even after nine years I still miss it terribly.
I became physically disabled overnight and though the NHS paid full salary for six months and half salary for six months, they still ought to have kept my job open. However, they needed a Ward Manager and after around nine months they replaced me.
Medical retirement
It was then that the snotty young HR dogsbody decided that medical retirement was the best option. I was devastated at losing the job I loved but I was too exhausted both physically and mentally to fight — in hindsight, I wished I taken them to a tribunal — just to wipe the smirk of the HR dogsbody’s face. You know that look, when someone thinks they got one over you, which she did in this case.
I often reflect on some of the most amazing and inspiring patients, remembering some of their journeys and the extremely difficult changes they made on their personal road to recovery. I’ll never forget how humbling it was working in mental health — and I like to think I made a difference during the course of my nursing career.

As mental health nurses, we see people at their lowest point, emotionally, which makes us very significant, not only in their survival, but also their growth. Along the way, sometimes our lives are even changed because we feel their struggle, so it sharpens our emotions as well as our skills, and sometimes in rare cases, it can touch our lives as well — Anon
I hope this might help and inspire both students and nurses alike — aim high and be the best nurse you can be.
Mental health nursing really is an amazing line of work.
Transverse Myelitis looks very painful. Had I not known what this condition looks like by you explaining, I would have thought abuse.
An excellent post I think to give students and nurses insight on wards, with the experience you have.
I know, it’s difficult to explain to people how TM affects you but this picture is excellent and this only shows the top half lol.
Thank you for your lovely comment and I hope others enjoy this post.
Caz x
Just on what you say about the elderly, it seems to be a fact of like, unfortunately. It makes me wish I had been a better son, closer, at least. Through my Age UK work, I see people with very large families – children, grandchildren, great-grandchildren, none of whom ever think on even to pick up the phone.
With death, I am somewhat more relaxed, I have had a couple of clients die and the deaths have been a release from some awful-sounding health problems. A word I often hear is “tired”.
I know with my own health scare, it made me think about death and so it is not that big a deal as a result. I suspect your average 90yo will think the same!
I always try to be a good daughter, keeping in touch with my parents regularly, visiting them, have them visiting us – tho’ they’re both only 76 (they had us young).
For myself, I’m pretty relaxed about death but I find it distressing when others pass. I had over a dozen die by suicide when I was a nurse and most of them were so young – they just couldn’t live with their diagnosis – often schizophrenia. When it’s my time to go, I’ve told the boys, just let me go.
Although suicide is the ultimate example of somebody taking control of their life, when medical issues probably leave them feeling very out-of-control. I think death is almost always harder on the people left behind, though.
Yep, we been here before lol. And I agree, it’s always harder on those left behind. Although I have had one or two families say that they’re glad it’s over as they’ve spent a lifetime watching their son or daughter in emotional pain.
I have a cousin, we’re only friends on Facebook, but she had an ex-husband and a child. The ex- committed suicide, they all said exactly the same.
Sometimes, it may be the only way to end their suffering.
I’m so sad that you suddenly got ill and couldn’t be a MH nurse anymore, because you sound like a great nurse! I’m so impressed, reading all this, how ambitious you were to learn all this stuff, and what a great job you did working with people. Go you!!
Aaaww, thanks Meg. I really have to try hard not to think about it too much otherwise my mood changes and I get really low. I have to try to remember all the good things I gained from my time as a nurse. Caz x
Well, yeah, you should hold onto that. It’s not your fault you got sick. I haven’t been nearly as successful as you, but I did work at a local residential treatment facility for three months. There was a girl who got angry (she didn’t want to get out of bed) and tried to bite me, after taking out my eyeglasses with an over-the-head swing that she wasn’t even monitoring (because she was still in bed facing the wall). It was like a whole morning of violence and bloodlust, and my eyeglasses were broken beyond repair, so I wasn’t in any position to cope. I got her back in her room and told her she wasn’t going to school. Anyway, I gave my two weeks’ notice at around that time for unrelated reasons (I was unable to work all the back-to-back shifts they demanded, among other things). And apparently, one of my coworkers told this girl that she–her bad behavior and her trying to bite me–was the reason why I was leaving the job. Gracious saints. Another girl told me, and thank goodness, so I was able to pull that girl aside and say, “You aren’t the reason. I understand. I really do.” And she started to cry. And I cleave to that one moment of good karma in a world where I can’t do much good (not nearly as much as I’d like) due to my own mental illnesses and especially my inability to handle stress or normal social interaction. Sometimes that memory is all I have to hold onto when I’m just messing around on the computer all day, writing my novels and that sort of thing. One thing I know, or strongly suspect, is that good karma can never be canceled out by an inability to keep creating it as we’d like to do.
Aaaww, what a lovely response Meg. And like you said, you were able to tell the girl she wasn’t the reason for you leaving, bless! Of course it was a tough job at times but fortunately I was never bitten, beaten or hit in any way. One young guy spat in my face one evening for what seemed like no reason – I was just passing. I was horrified and so upset. I had to clean up my face and write up the paperwork etc before I could leave. Next morning as I said my hello’s and nice to see you’s, I offered him the same greeting with a smile. Ten minutes later, he came to my office and said “I’m really sorry nurse. I was just angry cos I’m here and you were smiling like you were laughing at me. I’m really sorry. It melted my heart 🙂
Caz x
This is a very inspiring post as is your back story on your About Page. Having just started a blog to recount my experience of living with psychosis, I often contemplated beginning a career in the mental health field. But like you, I thought I would be a fraud and that it was ridiculous to consider working in a field that dealt with issues with which I was currently being challenged.
Most recently, I moved from blogging anonymously to advocacy through public speaking and it has been a life-changing experience. I realized that removing the mask and showing my face and telling my story publically was a very powerful and positive thing to do for myself, and more importantly, for other people.
After every talk I have people come up, thank me for my openness and sharing my story, sharing their own heartbreaking tragedy feeling they had found a kindred spirit.
I am now working to turn my advocacy into a career of some type. And your story is serving as more convincing inspiration that I can do it. Thank you!
Thank you for your kind comments. Wow, well done to you — it’s quite scary opening up at first isn’t it, but I do understand that people coming up to you sharing their own often heartbreaking experiences.
Coming from your own personal experiences, you’ll be a terrific advocate; kind, compassionate and empathic. Good luck and keep me posted. Caz x
A dresscode enforcer? I had no idea you were the devil, Caz!!! LOL.
I am truly sorry your physical pain cost you a career you loved so passionately. It is the patients’ loss as well as your own, you sound like you’d have been an awesome nurse.
Hopefully at some point-even if it is a one off- you will do a post for the community, or cowrite one with me, at least. Your experience and insight are priceless. <3
Hey listen, some of them looked like they were shaking their booty out on the dance floor, the way the dressed. And others, well – they looked like they just got out of bed!
Thank you for your lovely comments, as always Morgs. And I’ll deffo keep that in mind 🙂 Feel free to re-blog any of my posts on the community blog 🙂 Caz x
The most lonely need to let others know they are not alone……oxymoron of a life to be lived? It takes heart and not book smart to heal the mind from abuse be it mental illness or induced sickness….things inflicted on a conscious that didn’t know how to protect it….My therapist was a no nonsensical ethically bound intelligent open being ….I was privy to ‘issues’ he’s had to manage his lifetime which helped assure me that he wasn’t a book read theory query of a quack….lol…I believe it takes first hand experience to grasp the depths and not all can. Glad you are in forum still to help & share w/those along the way…ty
Thank you for these lovely comments ‘Willow’, much appreciated. It’s these small things that keep me going when I’m feeling down.
Patients often looked at me, got that lightbulb moment and knew — I’d been there, right where they are. Often, just by the empathy shown or the questions I asked. Like you said, books are nothing without the ‘knowing’ and ‘feeling’.
If I hadn’t been there, I might not have known the right questions to ask or how to ask them sensitively and not just reading from a checklist.
Thank you once again. Caz x
yes…the “i got/get you’ is not heard but felt!!! There is so much language exchanged w/out a word said….thank you for sharing as you have through your years! mental illness is a scary place to visit and live….my sister was paranoid schizophrenic & passed at 42….Those, when she was lost in psychosis, that knew her where a god send in the tough situations….the light of recognition means the world in some situations.
I’m so sorry to hear of your sad loss. Your sister was so young to die. I’m really glad to hear both you and her had support during tough times – by people who just ‘felt’ and ‘knew’ how to care fore her.
You’re incredible.
You’re too kind 🙂
You deserve so much kindness, and I greatly admire your accomplishments <3
Thank you for reading and again, your kind comments. Caz x
you have done very very well .people never see the every day effects ,there views/judgements are very Snotty Nosed ..i
am not able too work. i have ,m.e . migraines carpol tunnel syndrome .the list gets longer
my blog.http;//mark-kent.webs.com
twitter,supersnopper
i am co-Author of a book about,Disability and Sex.can give you a link if you would like
mark
Thanks for your kind comments and your insightfulness Mark. Yes, of course, please send me the link 🙂
Link,
https;//www,igi-global.com/book/cases-teaching-sexuality-education-individuals/239396
look for,marks story
mark
Great, thank you Mark. Do you have a blog too?
my blog,
http;//mark-kent.webs.com
mark
have you been able too find my blog.
mark
Hi Mark, I did manage to your your chapter 11 in the book but I haven’t had a chance to look at your blog yet. Unfortunately been busy trying to get hubby out of Spain and then France just before they both went on lockdown. He’s home safe now so I might get a chance to do some catching up 🙂 Caz x
you got a copy of the book … there are different stories in the book
it does cost ..i am UNAWARE if say you can buy A COPY FOR EACH STORY
i have a copy ware ALL STORIES are there . as I was one of the Victims who took part i did NOT
Pay for a copy of the book ..big good luck with your husband
mark
Glad you got it for free Mark. I read your article which was thought-provoking and definitely worth reading. And hubby’s home safe, thank you.
Caz x
very good news for YOU lot lot less worry for you
be interested in your views/what you think of the book
mark
Thank you Mark. Will get back to you soon x
chat any time
my e.mail ,mkentdad12@outlook.com
mark
Thank you Mark 🙂
What an amazing journey! A 74% reduction in violent incidents is an incredible achievement, though I’m sure the impact of that change on patients and staff is beyond numbers to explain. I’m so sorry to hear that your illness cost you that job. It’s clear you did a lot of good work over your nursing career.
Thank you for your lovely comments, as always, much appreciated.
Worth a read for everyone!
Thank you for stopping by 🙂 Caz x