Shocking ugly truths about our Mental Health Nurses
I discovered many shocking ugly truths about some of our mental health nurses. What was more appalling however, was the response (or lack of) of their managers and modern matrons. I wasn’t a patient. I was a nurse, and a ward manager.
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 service users ever get to see this Code; it’s not given to them on admission. Therefore, I don’t believe they know what to expect.
Okay, imagine for a second that they’ve seen The Code and the standards of care they’d received 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.
Our inpatients suffer from a wide range of mental illnesses including bipolar, schizophrenia, personality disorders, anxiety, and depression So while I agree that patients ought to be able to expect certain standards, they’re often too unwell to notice or they might be confused or drowsy due to the effects of medication.
Many inpatients are on a section of the Mental Health Act (MHA 1983); a law that requires patients to remain on the ward for assessment and, depending on which Section they are on, for treatment. However, some patients are informal, which means they gave consent for admission and can come and go as they please.
Nurses could be doing more
As a new nurse, I was excited and couldn’t wait to work with patients while upholding the standards, and expected the 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 some 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 smiles.
It wound me up no end when I shared my concerns with my managers and all they’d say was “Oh, that’s just how they are.” Or “Don’t report it, you’ll just cause problems for yourself.”
No wiggle room to meet everyone’s every need
Each shift on the wards, 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).
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 kind, caring, and interested nursing students to help out.
Students had the time to spend chatting with 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 patients’ 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 actually 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 caught organising her whole year’s holidays on the only nurse computer we had.
“There’s beds to be changed if you’re bored Ade?” I’d say with a grin. That got them off their backsides, and their tutting or heavy sighing never deterred me. “……..and Sidney needs support with his toileting when you’re done,” I’d smile.
Harsh? Maybe, but like I said to my colleagues, if I’m cleaning up sh*t, so are you! I wouldn’t expect staff to do anything I’m not prepared to do myself.
So, to the nurse who said of a patient who’d spent her night rolling around in her own excrement, “No, she did not do it deliberately.”
And nor did she do it, “just to get attention and pee us 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, but I’m certain she would have been horrified to know she’d been rolling around in her own mess all night. The poor girl didn’t know who or where she was.
Yes, I also gagged at the smell as I donned my gloves and tied plastic bags over my feet before rolling Evie onto a sheet so that we could pull her out of the bedroom, and into the shower room as there was no other way. My back also ached but I didn’t make it obvious by heaving, huffing, and puffing dramatically in her face every five seconds.
As for managers
And to our manager “Nice of you to retch theatrically then walk on by when you came in late (again) that morning.” Ha! Now that’s another post — what’s the point of ward managers?
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.