In my late twenties I decided to go back to university to study mental health nursing. I am now several months into my first position as a qualified nurse in an acute psychiatric hospital. There are days I question my decision and think: “What the hell have I done?” I sometimes feel trapped in a position I have worked so hard to achieve and I wonder if this is to be my life from now on.
Before I became a nurse I was a support worker looking after people with learning disabilities. I supported a service user who had physical and communication difficulties and she would fight, bite and scream at staff. However, when we were together we would laugh for hours and we developed an amazing relationship. I realised I had a knack for caring for people who were considered challenging and the whole nursing business escalated from there.
When I first started studying to be a nurse, I admit I was naive and unaware of exactly what the role entailed. I was frustrated having a minimum wage job with no hope of climbing the financial or academic ladder and I wanted a future. I wanted to challenge myself intellectually and expand my education, but also be able to afford nice things without stressing about money. Nursing sounded good and I wasn’t getting any younger.
I had visions of helping vulnerable people and making a difference – supporting challenging patients who are hard to care for and who no one else wants to look after. I knew I was entering a challenging yet rewarding career; I just never anticipated how tough it would be.
The reality is so much harder than I expected and I often leave work feeling like I want to cry. I do cry. My job can be beautiful and wonderful and so rewarding. Some days I leave work and my face hurts from smiling. I can’t sleep some nights as I am replaying the fantastic conversations I have had with the exciting people I have met. I think about the people I have helped and the little conversations or actions that make such a massive impact to a patient’s life. I get to save lives and make a difference, no matter how small that difference may be and I am so fortunate to be able to do that.
The contrast is the tears, the stress, the lack of staff and the inability to help those who desperately need me the most. The loudest patients often get the most attention and the quiet ones who are suffering sometimes get neglected. I wish I could spilt myself into 10 and have 30 hours in day to do what I so desperately want and need to do for my patients but it’s not possible.
In any one day I may have a patient swallow razor blades and have to be sent to A&E, only for them to self-harm when they have passed them. I have had patients headbutt walls until they bleed. Psychotic patients attack staff and scream at other patients because they can’t control their mania. Depressed patients cannot leave their bed and have neglected their personal care for days, sometimes weeks. Patients are consumed by their hallucinations and delusions, unable to communicate what their needs are. Staff are exhausted and defeated but we carry on. The staff are amazing but what we have to deal with is unimaginable and there is not enough of us to do it.
The cuts have made a dramatic impact on the quality of care we provide. There is never enough staff to effectively care for the patients and both the patients and staff suffer as a consequence. The horrible thing is, the patients see how stressed, tired and busy we are and some don’t like to bother us. It is our job to care for them but they don’t want to burden us with their problems and they see we just don’t have the manpower to care for them.
The staff are incredible. We work as a team and support each other because we are going through the same stress together. In the hospital where I work, the support goes right up to the matron and ward managers but their hands are tied. They cannot give us the additional staffing we need as the budget does not allow for it. It feels like it is not safe sometimes. And this is not just in my hospital. Every nurse, healthcare assistant, junior doctor, occupational therapist and social worker I have spoken to says the exact same thing.
There are times I feel burnt out. I reflect on what I have to deal with on a day-to-day basis and question whether this is what I want for my future. I have been told I will get used to it, but I don’t think I should have to. I have fresh eyes to mental health nursing and it doesn’t feel right. Some nurses get burnt out in their careers and they quit, move jobs or develop mental health problems of their own. I am in my first-ever post and some days I feel I am drowning. But then there are days I leave work beaming, my heart is singing and I know I made the right choice. A patient once said to me: “You can’t work in a paint shop without getting paint on yourself”. The question is, how much paint will that be?
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