Shocking ugly truths about our Mental Health Nurses
Have you ever been an inpatient on a mental health ward? Have you come across washed out nurses who’ve either lost the ability to care, or they never cared in the first place? I wasn’t a patient. I was a nurse. And unfortunately, I witnessed many shocking ugly truths displayed by some of our mental health nurses. More appalling however, was the response (or lack of) of their managers and their modern matrons.
Our Nursing and Midwifery Council’s (NMC) The Code (2018) contains the professional standards that registered nurses must uphold. This is a nurse’s bible, whatever your faith or religion, and all standards ought to be reached by the end of your three years pre-reg training. Moreover, you should be committed to upholding these standards throughout your nursing career. Essentially, through revalidation, nurses provide evidence of their continued ability to practice safely and effectively.
“The Code provides a clear, consistent and positive message to patients, service users and colleagues about what they can expect of those who provide nursing care.”NMC, 2018
Who oversees our mental health nursing standards?
Now, I’m not sure the above-mentioned patients and services users ever get to see this Code; it’s not given to them on admission. Therefore, I don’t believe they do know what to expect. Okay, imagine for a second that they’ve seen The Code and the standards of care provided don’t match up. Do you think patients are in any fit state to ensure nursing staff uphold these standards? No? Me neither and I think it’s up to the profession itself to effect, maintain and monitor these standards.
While I agree patients ought to be able to expect certain standards, they’re often too unwell to notice. Many of our inpatients suffer from a wide range of mental illnesses including bipolar, schizophrenia psychosis, personality disorders, and depression. They might be confused, drowsy due to the effects of medication and sometimes angry because they’ve been detained. Expecting anything might be too much!
Most inpatients are on a section of the Mental Health Act (MHA 1985). This is a law that requires patients to remain on the ward for assessment and also treatment. Some patients are informal, which means they gave consent for admission and can come and go as they please.
Nurses should be doing more
As a new nurse I was excited and couldn’t wait to uphold the standards and expected the very same from my colleagues. Patient care and safety were, as expected, my (our) main concern. It was up to me (us) to ensure patients’ needs were recognised and assessed. However, how can patient needs be recognised if staff don’t actually spend any time with them?
While well aware that our wards were often oversubscribed and our patients could be chaotic, it p’d me off seeing how little time nurses spent with their allocated patients. Moreover, their half-hearted attempts at engaging with patients were sadly reduced to the odd casual nod or fake smile.
No wiggle room to meet everyone’s every need
Each shift, we’d be allocated five patients to look after, on top of which, one nurse would coordinate that shift. One nurse might be in Ward Round and one nursing assistant (NA) would hold the Rapid Response radio (attending to crises elsewhere). The fourth member of staff, an NA, would be on the floor, and completing the hourly checks (ensuring patients are safe).
Obviously, this didn’t make it easy for nursing staff to spend long periods of time with their patients. However, we were fortunate when we had good nursing students to help out by chatting to patients and feeding back to nursing staff. Or they’d help coordinate the shift, releasing the coordinating nurse to spend time with their patients. Students would be answering telephones and constantly unlocking the door to let people in or out of the ward. Patients loved having good students on the ward because they usually had the time to chat.
Nurses could work smarter
Staff ought to have allocated tasks to students which would then free them up. They could have used that time to spend with a patient and to document more than a line or two in their notes.
Still, even with time to spare, we’d see staff flicking through patient’s magazines or settling themself in front of the t.v. Then you’d see a one line entry in patients’ notes saying “Mary had a quiet day. Stayed in her room throughout the shift.” Did this nurse speak to Mary? Had they asked if she wanted breakfast or lunch? Did they ask Mary how she felt or whether she needed any support? Who knows, because if it’s not documented, it didn’t happen. So — not only did they not speak to that patient, they obviously didn’t
give any care either.
Not every day you get to see such sights
I think because I was older than your average new nurse, I got away with tongue in cheek remarks directed at lazy staff. “Are you on shift today Monica?” when she was clearly organising her whole year’s holidays on the only nurse computer we had. Or “There’s beds to be changed if you’re bored Ade?” I’d say with a grin. That got them of their backsides, and their tutting or heavy sighing never deterred me, “…….. and Sidney needs support with his toileting when you’re done,” I’d chuckle.
Harsh? Maybe, but like I said to my colleagues, if I’m cleaning up shit, so are you! I wouldn’t expect staff to do anything I’m not prepared to do myself. And for the nurse who said of a patient who’d spent her night rolling around in her own excrement, “No, she didn’t do it deliberately.”
And like, “Just to get attention and pee you off?” Duh! Evie had faeces up her nose, in her ears, dangling from her eyelashes and under her nails. Safe to say, she was covered poo. I’m certain this unfortunate young female would have been horrified to know she’d been rolling around in her own mess.
“No, I’d never seen a sight like it either but you didn’t have to yell at her. The girl didn’t know who or where she was. Yes, I also gagged as I donned plastic bags over my feet and hands before rolling Evie onto a sheet. My back hurt too as we dragged her out of the bedroom, into the shower room. But I didn’t make it obvious by heaving dramatically in her face every five seconds.”
And to our manager “Nice of you to retch theatrically then walk on by when you came in late that morning, for the millionth time.” Ha! Now that’s another post — what’s the point of ward managers?
You might be interested in the following posts too:
- Poor nursing in mental health here
- Bad manned nurses on mental health wards here
- Should we report our mental health colleagues here
Over to you
As a new nurse, what would you have said or done? Would you feel able to call out your colleagues? What might a new nurse learn from this post? I look forward to hearing what you think and any questions are welcome.
This is a true account from my perspective and all names have been changed to protect the lardy arsed staff and save them from any embarrassment.
“If you’re looking for a hard-hitting evaluation of the mental health profession with a sharp wit, please stop by Caz’ blog. She writes pieces revealing the challenges and problems in mental hospitals from first-hand experience as well as examining different mental health diagnoses and taking on the myths around them. Not the kind of myths I cover, the kind that hurt. Thank you, Caz. You are an amazing, courageous person.”Kindly written by Ceridwen at Illuminating the fools mirror, 2020.