My first morning as a student nurse on a mental health placement
So, what happened on my mental health nursing placement? I mainly remember how my anxiety levels went through the roof even before my first day. I’d almost forgotten the sickening thud of palpitations that indicated the onset of a panic attack. Breathe Nancy, breathe…..
It all started after coming across the Scary security guard who let me into the acute inpatient mental health unit. If he was anything to go by, now I really was afraid! However, I followed his scant instructions to my allocated ward… and I breathed my way through the anxiety.
Beyond the ward door, people were milling about in all states of undress. One lady baring her breasts, as she had a hospital gown on backwards and the ties were undone at the front. Fortunately, she had knickers on, albeit they were large white paper ones, which covered her modesty.
Others had on what looked like hospital-issue pyjamas, tho’ some male patients were bare-chested, and barefoot. While some had their own dressing gowns, clothing and footwear on.
The ward on the first of my mental health placements
mental health placement
More dusky-coloured walls lined the long narrow ward corridor. The old artwork that adorned the wall on the left was curling at the edges and hanging precariously with tattered tape.
A large perspex-covered board with photographs of unsmiley people (staff) wearing nametags hung on the right. Maybe someone had had a fallout because they’d scribbled over one particular nurse’s face.
Alongside the board was a wonky shelf with “Welcome” leaflets and other ward-related information. Some were ripped or scrunched up, and others were way past their sell-by-date. To one side grubby windows were bare, the lino looked like a dried sanwich curling at the edges and a lone dining chair sat against a long wall.
Which one is the nurse
Heart still pounding, I pressed the buzzer and watched as this man-mountain sauntered lazily towards the door. He unlocked it with a key from a large bunch and nodded me in, smiling. As I entered, he locked the door behind me.
Other than those in pyjamas, it was difficult to identify who was a patient and who was staff. Man-mountain was wearing jeans, a sweatshirt and trainers and could have been anyone, but for the keys and lanyard round his neck. The staff badge itself was concealed within his clothing. He introduced himself as Adeola and nodded me toward the nursing office, a small room surrounded by perspex windows.
The door to the office was locked so I tapped lightly on the perspex and waited. I stood for some 30 seconds, hoping one of the three people in there would let me in. And quickly, as a small crowd was beginning to gather round the ‘new nurse’, some leering and making rude gestures. One had his hands down his pyjamas and was grunting unpleasantly. However, a few patients smiled at me and asked whether I was a nurse or a student. My anxiety levels began to stabilise.
The nursing office
Yay! The door opened and a young man with a bald head and geeky but cute round glassed bounded towards me. “Hello. You must be Nancy, our new student. Come in now, come sit. Moreblessings get up and give this wee lady a seat now, will ye?” This young Northern Irish guy also in jeans, with a t-shirt and trainers raced on “I’m Derry, that’s Moreblessings and there’s Abimbola, Nancy.”
Without coming up for air “Would ye like a wee cuppa tea Nancy, would ye? Give us a wee minute and Moreblessing will get ye one, eh?” I loved him already and despite some humphs and tuts together with eye-rolling from Moreblessings, I knew I was going to like it here.
Moreblessings was dressed in a neat flowery jumper, a calf-length polka dot skirt with thick black tights and flat black shoes. The poor thing huffed and puffed her bulk out of the chair in the far corner, between the filing cabinets, to give up her seat. Derry slid into her empty chair, leaving his for me.
As I sat I took in the rickety desk with some stacked filing trays, a telephone, and some office paraphernalia on it. Two battered-looking four-drawer filing cabinets stood opposite each other, crammed into the corners. An ill-fitting formica top stretched along one side of the office and held a fax machine, the photocopier, and few loose files. Above that was a couple of flimsy shelves holding lots of precariously balanced lever-arched files and some nursing books.
Start of early shift
Just at that, the office door burst open and in bungled two others, out of breath and laughing as they attempted to get their coats off in the tiny space. “Yer late again Alison, Fadhil. Come on now. Hurry up,” shouted Derry pleasantly above the din.
“Keep your hair on, I’ll just grab some coffee.” giggled Alison as she winked at me.
“You’ll just not. Come on. Some of these folks want to go home this morning.” said Derry. “Anyway, this is Nancy, our new student,” he added. Alison smiled and Fadhil nodded at me.
Morning handover on mental health wards
The heat from the six of us soon steamed up the office window and I was getting a whiff of body odour, badly covered up with strong but not unpleasant cologne. Alison sat her neat bum on the table edge closest to me and her sweet, floral scent helped mask the icky smell. She too was wearing faded jeans with a striped t-shirt and trainers. Fadhil wore white jeans, a red shirt with an unusually ornamental tie and shiny black mock-croc shoes.
Derry looked towards Abimbola who started to read out names from a large whiteboard on the wall. “Helen, slept all night, no problems. Peter, he’s okay, just waiting to go home. Isaac, restless and sat in the day area most of the night.” Abimbola went on, discussing the twenty patients on the ward that morning. This was called handover and it happened at the beginning of each shift. It was brief and didn’t give me too much information. However it was enough to begin with as I also had to memorise staff names.
Finished, Abimbola snatched up his coat and heaved his large frame through everyone and left the office, waving wearily as he went. The other two night staff also made a mad dash for the front door.
“Coffee Nancy?” Derry asked over his shoulder as he went next door to the kitchen, so I followed, and said yes. A toaster, cereal bowls, plates and coffee mugs clattered onto the stainless steel worktop as staff began preparing breakfast for the patients. As they worked, they helped themselves to hot toast dripping with yellow axle grease (aka, cheap margarine) and runny jam.
Smoking rooms on acute in-patient mental health wards
Derry made two coffees and handed me one asking “Do you smoke Nancy?” As I nodded he made cheeky eyes at me to follow him and we crossed the narrow hall to the smoking room. As we walked in, clouds of yellow fog surrounded us and the pungent smell of too many lit cigarretes hung in the air. Two filthy windows were open by half an inch so the smoke had nowhere to go.
Several pairs of lifeless eyes turned towards us, others stared blankly at nothing in particular.
The floor was littered with fag ends, empty crisp packets, screwed up plastic cups and old cola tins. Derry sat on one of the chairs, inviting me to sit next to him. As I did I noted the stains, the cigarette burns and other unidentifiable debris so perched myself lightly towards the front end of the chair. Smiling nervously I offered my introduction “Hi, I’m Nancy and I’m a new student on the ward.”
“Alright Nance. I’m Pete” one guy mumbled flatly, “I like students,” and I sighed in relief, then “You got a spare fag Nance?”
Derry interrupted, “Pete, the wee lass just started today. Leave her alone.”
“No it’s okay.” and I offered the pack to Pete, who took two! Then I watched as others eyed the box, willing me to offer them one too. I didn’t feel I had a choice, so I was five ciggies down already, and it was just gone eight a.m. However, I could see that ciggies were going to be great currency for getting patients to engage with me.
Breakfast and Medication on a mental health ward
At that, there was a loud rattling of the kitchen hatch going up and Moreblessings yelled out, “Breakfast time, breakfast……” as she loped along the hallway.
“Time to move,” said Derry. “I’m your mentor for this placement Nancy, but bear with me and I’ll catch you up in a wee bit. I’m coordinating the shift today. Have a wee seat, chat to a few patients and see how you get on, eh?”
Moreblessings was still yelling and now Fadhili had joined in, “Medication,” he sang and I watched as he went down the hall, knocking on bedroom doors “Medication…… Break……fast…….. Med…i….cation………”
Patients trickled out from rooms, heading in various directions. Some shuffled to the hatch between the kitchen and dining room for breakfast and others towards the queue for medication. One or two just flopped on chairs in the living area and gazed vacantly at the blank t.v. screen.
I thought I’d be best in the kitchen helping with breakfast, as there wasn’t much I could offer on the medication side, being a new student. But to be honest, I was glad of the counter between the kitchen and the dining room. It put a barrier between me and a slightly aggressive young female who was eyeing me up and down, glaring. However, it didn’t protect me from the stale morning breath and rancid bodies of one or two who hadn’t seen a shower for weeks. I retched when I saw ingrained dirt under one patient’s fingernails as she scrambled to pick up toast.
I was out of my comfort zone
There was no queue as such and patients just leant over each other to reach for cereal, milk and sugar or the unevenly toasted bread. Green plastic cups of hot water were being handed out so that patients could add either tea or coffee.
Drinks and cereal sloshed around as patients shuffled to small tables in the dining area, leaving sticky puddles everywhere. Afterwards, vacated tables were dotted with crumbs, slops and spills, so I went round the other side of my barrier to wipe them down.
I practically flew back when Mandy screamed, “Fucking lesbian. Stop fucking staring. You fucking ugly white bitch.” This was the young lady who’d had her nightgown on back to front.
“Oh, ignore Mandy. She harmless really.” said Mrs Wilson, this tiny, sweet domestic lady in her Jamaican twang “She just having a bad morning.” Which didn’t do anything to abate the dry mouth and dizziness my anxiety was causing.
Supernumerary on mental health placement
Breakfast was almost over and the last of the dawdlers stood heads down in the queue for medication. I popped into the office to see that Derry had allocated patients to the four staff on duty; two qualified mental health nurses being Derry and Alison, while Moreblessings and Fadhili were the two nursing assistants.
I had Supernumerary status which means that student nurses are additional to the clinical workforce and undertake a placement in clinical practice to learn, not to be used as members of staff.*
Feeling like a spare part and quite out of my depth, what with Mandy following me, I asked Derry what I could do to help. He said to just shadow one of the staff and not to worry about Mandy; she’ll be fine after her medication. Alright for you to say, I thought as I bumped into Mandy when I backed out of the office. I turned with a wobbly smile to say “Hi, I’m Nancy, a new student here. Is there anything I can I do to help you this morning Mandy?”
Patients love student nurses on mental health placements
“Ah, you’re a student, I thought you was one of the Doctors, I fuckin’ ‘ate Doctors. Ask if I can have leave, will ya? It ain’t ward round today and that’s the only time you get to ask for leave, but I ain’t fucking waiting ’til Wednesday. I need some clothes, look at me in this fucking dirty ‘ospital gear.” she ranted. And while she ranted, I relaxed — a little.
I asked where her clothes were, what did she come in with and whether we could perhaps find them together. “They ain’t here. Someone nicked them in the night. Jealousy, that’s what it is. Jealous cos I’m a model and I get given good gear to wear. And that’s why they nick it. Fucking poofs and lesbian, all of them. And the staff, they’re at it too. All of ’em,” she rambled.
I didn’t know what to think so I offered to help find her clothes but she wandered off, still cursing and muttering. Quieter now though.
“Go and have a wee break Nancy, you deserve it.” Derry grinned. Not a bad introduction to my first mental health placement.
Over to you
Have you ever been on or visited a mental health ward? What’s you’re experience of mental health wards. How does your experience differ from mine? Maybe you’re a student nursing and wondering what it’s like on mental health placements?
