Looking at Life Through the Eyes of a Mental Health Nurse

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July 17 2023 - "As a little child, I used to love pretending to be a nurse," recollected Chloe, a mental health nurse working in the UK. She is one of the many psychiatric nurses who believe they had it in them since childhood and were destined to be who they are.

However, what catapulted her inner nurturer was the life of Florence Nightingale and the way she revolutionized nursing during the Crimean War. Watching documentaries on mental illnesses around her teenage years led Chloe to her ideal area of interest - psychiatric nursing.

Nevertheless, this may not be every nurse's journey out there. No matter the turning point that pushes a person onto the path of mental health nursing, it is a rewarding experience. One vast difference between other nursing specialties and psychiatric nursing is the stigma surrounding mental illnesses. Many nurses take baby steps with the goal of helping minimize the demonization of people with mental illnesses.

Let's understand what life as a mental health nurse is like and how it makes a difference in others' lives.

Most Common Responsibilities and Duties

Over the past few years, there has been a massive dearth of mental health nursing professionals across the US. Nearly 158 million people still reside in areas with no access to mental health nursing services. Online MSN-PMHNP programs are offered to encourage more nursing professionals to take up advanced psychiatric nursing and fill the workforce gaps.

Once trained through such programs, a mental health nurse will need to uphold the following daily duties and responsibilities:

• Attending a mandatory meeting with head nurses to discuss the referrals for the day
• Visiting patients in their respective wards or homes
• Conversing with patients about their mental health condition and taking down notes
• Administering the required medication
• Conducting risk assessment tests that are based on a patient's health needs
• Preparing for one-on-one or group therapy sessions
• De-escalating heated situations by talking to patients in a calm and non-threatening manner
• Developing care plans and maintaining accurate patient records
• Working together with a patient's family or caregivers to give them a clear idea of the patient's mental health condition

A Day in the Life of a Mental Health Nurse

No fixed start and finish hours can be provided because a typical workday in psychiatric nursing vastly differs across countries, workplaces, and nursing roles. Often hospitals need to stagger shift times to ensure there is no staff shortage throughout the day.

According to Marymount University, most psychiatric nurses work in clinical settings like hospitals, but recently it is also common to find these nurses involved within the community. This would include visiting patients in their homes or other care settings.

In a nutshell, the role is pretty challenging since many mental health nursing patients suffer from complex and debilitating conditions like schizophrenia, bipolar disorder, self-harm, etc. In addition to empathy and compassion, mental health nurses require resilience in abundance.

Now, let's take a closer look at life from the lens of a psychiatric nurse - Eleanor is a mental health nurse working with a National Health Service (NHS) Community in London. Each nurse on the team, along with 26-year-old Eleanor, holds a caseload of at least 25 to 30 patients. Here's a glimpse of a run-of-the-mill day at the office -

• 7 AM - Eleanor wakes up, finishes her morning rituals, and prepares a light breakfast, followed by getting dressed for the day.
• 7:45 AM - Twice a week, she meets up with other nursing friends for a quick coffee break before work. This has been a practice since the pandemic to stay connected with others within the community.
• 8:45 AM - She bids her friends goodbye and cycles off to the clinic, where her day starts with preparing for the morning meeting.
• 9 AM - Eleanor's clinic has the practice of conducting an hour-long meeting every morning where nurses, psychologists, social workers, and physicians get together to discuss new referrals from the day before. This is also a session to talk about 'cases of concern,' gain necessary direction and advice from the seniors, and prepare for the day ahead.
• 10 AM - During this time, she usually checks her emails and often leaves with some surprising news that alters the course of her week. For instance - If she receives an email that says one of her patients just had a baby, Eleanor schedules a special visit during the week to check up on the patient and their newborn.
• 11 AM - This is the usual hour for her to drive off for community visits. Eleanor states that a considerable portion of her week is spent in paying community visits where she meets with patients having diverse conditions - schizophrenia, psychosis, bipolar disorder, etc.
• 2 PM - This is the time for a lunch break, and Eleanor cycles back to her office to see what's on the canteen's menu. She also likes to walk a bit after lunch, which again gives her the opportunity to meet patients within the facility.
• 2:30 PM - She is back at her desk to check emails and think about ways of improving her patients' physical health. Eleanor mentions that people with mental illnesses usually have 10 to 15% lower life expectancy rates, and taking care of their physical health is of utmost importance.
• 3 PM - During this time, she has a one-on-one with her supervisor to discuss her caseloads. This session also allows the supervisor to check on Eleanor's mental health.
• 3:30 PM - Official meetings are usually held at this hour in case something new springs up. However, some days are more unpredictable than others. For instance - On a particular day, she received a call from the police saying that one of her patients was under custody due to acts of violence.
• 4:30 PM - This is the time when she checks up on the last appointment of her day.
• 5 PM - After attending the last appointment, Eleanor gets back to her desk for some last-minute admin work before wrapping up for the day.
• 5:15 PM - She picks up some supplies she or her patients may need. Sometimes, she pays a special visit to a patient on the way back home.
• 6 PM - 10 PM - After cycling back home, Eleanor spends some much-needed self-time. As a way to decompress from the day, she enjoys cooking, watching here favorite TV dramas, and chatting with her boyfriend for a while. At around 10 PM, she prepares for bed to get an early start for the next day.

Do Psychiatric Nurses Work Night Shifts?

Mental health nurses working in the public sector are often required to work three shifts - early, late, and night shifts. While the early and late shifts last for 7.5 to 8 hours, night shifts are typically longer, extending anywhere between 10.5 and 12 hours at a time.

The UK Therapy Guide featured a story of a young female psychiatric nurse working 12-hour night shifts once every three months. A typical night shift began with taking rounds of patient wards, doing paperwork, checking medication, and keeping a careful eye on specific patients listed on the suicide watch.

Besides the tedious and monotonous paperwork, no two nights in a mental health facility are the same. The nurse recalled a particular night when one of the patients under her care held a knife to her throat (an eating knife, but alarming nonetheless). Other nights were surprisingly calm and uneventful. Mental health nurses are well-trained to handle hazardous situations like these, in case a patient is to get out of control.

The young nurse also mentioned the precarious state of mental health nursing despite tremendous efforts to employ a skilled workforce. Some common challenges facing the psychiatric nursing sector include funding cuts, hierarchal shake-ups, and large-scale reorganization. No matter how challenging, the vital truth is that mental patients need proper assistance and care from empathetic nurses willing to meet them where they are.

Tips to Handle the Demands of Mental Health Nursing

If you're planning to pursue a career in the field of psychiatric nursing, listed below are the top three tips to follow -

1. Develop a Deep Understanding of Your Patients

The foremost tip is to begin your mental health nursing career through an inpatient unit. This will give you the precious opportunity to understand the different conditions a patient goes through, why they are in the facility, what medications need to be administered, etc. Taking this into context, you will be ready to work in a proper clinical setting or community.

2. Always Stay Focused

The truth about mental health nursing is that a nurse often comes across gut-wrenching scenarios, especially when patients act out of fear, illness, or impulsive anger. The best thing to do is to keep an open mind and a strong stomach. Only with resilience can you stay true to your core values and focus on the patient's recovery over the chaos they create.

3. Prioritize Self-Care

In some studies, nurses have shown a major decline in mental health than physicians. This makes it extremely important to prioritize your health, both physical and mental. It is not possible to pour from an empty cup.

Connect with senior clinicians whenever you get the time just to catch up and get some advice. Additionally, make time to relax and exercise your body regularly to keep it fit. Eat healthy and spend time on hobbies you love the most.

Parting Thoughts

Have you ever wondered whether psychiatric nursing is more challenging than regular nursing? The answer is yes. The Saudi Journal of Nursing and Healthcare published a report discussing the difficulties experienced by psychiatric nurses in clinical settings and how it is linked to their work performance.

As many as 15 nurses across Iran were chosen as the test subjects. It was found that mental health nursing required much more effort and time in light of the patient's illnesses, exposure to unpredictable patient behaviors, refusal to take medication, emotional exhaustion, and increased risk of anger and violence.

If the centers did not offer adequate facilities and support, nurses themselves were vulnerable to suffering from anxiety and depression. However, for those who are passionate about making a difference in a highly stigmatized field, there are rewards hidden in the form of crisis intervention, building a therapeutic rapport, and literally transforming the lives of those who may have a minimal chance otherwise.

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