NURSING

A day in the life of mental health nursing
MENTAL
HEALTH
NURSING
DECEMBER 2015/JANUARY 2015 • VOL 35 • NUMBER 6

No to the Trade Union Bill
What the Conservatives are calling the Trade Union Bill is in a
reality a threat to all of our rights at work.
If it becomes law it will make the lives of all working people a
lot tougher, giving a green light to bad bosses to behave badly
by undermining the right to strike.
The result? Every single one of us will have fewer rights at
work, and less power in the workplace as the government
stacks the scales against you.
However badly an employer may behave they will know that the
government is on their side, not yours.
The government wants to:
• Place extreme and severe restrictions on the right to strike.
• Strangle the most powerful way you have of protecting your
rights at work – your union – in red tape and costs
• Silence voices and stifle protest and picketing – for example,
having to tell your employer what you’ll post on Facebook two
weeks in advance or whether you intend to carry a banner.
This is threat to all our rights at work; the safety of the rights
we have now, and the rights we are still fighting for, such as
ending zero hours contracts.
To stop this attack on your union needs all of us to take action.
Visit www.unitetheunion.org/campaigning/no-to-the-trade-unionbill
to find out more.
References
Jones A and Crossley D. (2008) In the Mind
of Another: Shame and Acute Psychiatric
In-Patient Care: An Exploratory Study in
Progress. Journal of Psychiatric and Mental
Health Nursing 15: 749-757
Norton K. (2004) Re-Thinking Acute
Psychiatric Inpatient Care. International
Journal of Social Psychiatry. 50(3):
02

Editorial
Contents
Mandy Bancroft
Faculty director of widening
participation and student
success, University of the
West of England, and chair
of the Mental Health Nursing
editorial board
Telling your stories of
mental health nursing
Welcome to this ‘day in the life of mental health nursing’ special
edition. This was an embryonic idea that has grown and finally
come to fruition and is now in print.
The editorial board was keen to allow authors to paint a picture
of what a day looks like in 2015 for mental health nurses.
This would not have been possible without the support and input
of many of our colleagues, who have put pen to paper to share
their thoughts and views about how practice is for them right now.
I have contributed a short piece. When I sat to write my
thoughts it made me realise how many days in the life of a mental
health nurse I had completed – and calculator at hand, I worked
out it is somewhere around 7,000!
Yet when I think about each and every one of those days they
were never the same and never predictable, and I guess that is
one reason I enjoy the job so much.
It also gave me the chance to think back for a moment on those
people I have met in those days, the ones who have taught me,
challenged me and educated me to the person I am today.
I also know, however, that I will keep changing. I often feel that
every time I get a step closer to thinking I understand things in
mental health I realise I am actually further away, as questions
form as more new evidence emerges.
So in a time when austerity measures are being implemented
ruthlessly and it feels that everything is difficult, how refreshing it
is to see that many of you took the time to share your ‘day in the
life’ experiences.
Thank you for that – thank you for allowing people to share
in your day and your journey, from the fun, sad, reflective and
thoughtful, I hope that the combined and edited version has been
captured in a way that we have heard your voice.
This is a truly collaborative edition that would not have been
possible without you, so I hope you enjoy it, celebrate it and take
a moment to share others’ days.
We are stronger as a collective and if mental health nursing is
to survive and thrive then we need to be proud of what we do and
to shout about it to everyone who will listen (and sometimes those
who don’t).
Of course this themed edition is not the end of Mental Health
Nursing’s interest in your day-to-day life. If you have anything to
tell your colleagues, whether it’s about the pressures you face
or sharing examples of your practice or innovations, then let us
know. MHN
News
Cuts and service changes are harming patient care •
Safeguarding reference group to develop guidance for
members • Data shows ‘negligible’ public mental health
spend • Economic recession raised the risk of suicide
and mental illness
Unite/MHNA update
A round-up of activity by professional officer Dave Munday
No improvement seen in community
mental health care
CQC’s annual survey reveals a lack of progress in
community care in England in 2015
Disparity shown in emergency hospital
admissions data
Research of acute episodes finds that people with
mental illness suffer disproportionately
A day in the life of mental health nursing
A series of diary entries that show typical days in the life
of mental health nursing, giving a snapshot of how the
profession operates in 2015 and the pressures that exist
Website provides ‘day in the life’ stories
of service users
Donna Kemp reports on an online resource that helps
people to tell of their experiences
Reflections
Cover image: Mike Mozart (Flickr Creative Commons)
04
06
08
09
10
21
22
EDITOR Phil Harris – mhneditor@gmail.com
EDITORIAL BOARD
• Mandy Bancroft, chair of editorial board; senior lecturer, University of the West of England
• Terez Burrows, ward manager, Rampton High Secure Hospital
• Steve Hemingway, senior lecturer in mental health, University of Huddersfield
• Alun Jones, adult psychotherapist, North Wales NHS Trust
• Steve Jones, senior lecturer, Edgehill University, Faculty of Health, University Hospital Aintree, Liverpool
• Donna Kemp, care programme approach development manager, Leeds and York Partnership NHS
Foundation Trust
• Nicky Lambert, senior lecturer, Middlesex University
• Athia Manawar, practice education facilitator, Tees Esk Wear Valleys Trust
• Dave Munday, professional officer, Health Sector, Unite the Union
• Neil Murphy, lecturer, University of Salford
• Emily Prescott, student representative, Edge Hill University
• Mike Ramsay, lecturer in nursing (mental health), University of Dundee
• Hollie Roblin, student representative, University of Huddersfield
PUBLISHER Ten Alps Creative on behalf of the Mental Health Nurses Association © MHNA 2015
ONE New Oxford Street, High Holborn, London WC1A 1NU
ADVERTISING OFFICES Claire Barber, Ten Alps Creative, ONE New Oxford Street, High Holborn,
London WC1A 1NU • claire.barber@tenalps.com • 020 7878 2319
SUBSCRIPTIONS MHN is free to members of the Mental Health Nurses Association.
Annual subscription (six issues/one volume) for non-members £72.45 / £108.75 Institutions
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Orders (cheques payable to MHNA) to:
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TN32 5AD. Tel: 01580 883844, email: mhn@c-cms.com
ISSN 1353-0283 (online version ISSN 2043-7051)
03

News
Cuts and service changes are harming patient care
04
Cuts and large-scale changes
to mental health services
are harming patient care and
represent a ‘leap in the dark’,
according to a new report.
Mental health under pressure,
a briefing produced by The King’s
Fund, shows that the sector is
under a huge amount of strain,
with around 40% of mental
health trusts experiencing a
cut in income in 2013/14 and
2014/15. This is in marked
contrast to the acute sector,
where more than 85% of trusts
saw their income increase over
the same period.
The briefing shows that,
driven by the need to reduce
costs, trusts have embarked
on large-scale transformation
programmes aimed at shifting
demand away from acute
services towards recovery-based
care and self-management.
This has seen a move away
from evidence-based services
in favour of care pathways
and models of care for which
the evidence is often limited.
There has also been little formal
evaluation of the impact of these
changes.
One example cited in the
briefing is the merger of
specialist crisis resolution
home treatment teams (CRHTs)
and early access to psychosis
services into generic community
health teams. Evidence suggests
that these teams are often
unable to provide the level of
support required by patients,
reducing quality of care and
increasing pressure on inpatient
beds.
Drawing on a range of
sources, the briefing highlights
widespread evidence of poorquality
care:
Only 14% of patients say that
they received appropriate care in
a crisis.
‘‘
Mental
health
services have
often been
the first to
see their
funding cut
’’
There has been an increase of
23% in out-of-area placements
for inpatients in the year up to
2014/15.
Bed occupancy rates routinely
exceed recommended levels.
The briefing finds that, as their
financial situation deteriorates,
many trusts are considering
a further wave of large-scale
changes, which could further
destabilise services and reduce
the quality of care for patients:
More than two-thirds of
mental health trusts were or had
recently overhauled services.
Of those, more than half had
plans to reduce staffing levels or
the skills mix in its workforce.
A quarter were aiming to use
less qualified staff, by replacing
nursing with volunteers and
support workers.
More than 10% said they
would be further reducing bed
numbers.
The report calls on the sector
to focus on using evidence to
improve practice and reduce
variations in care, but says it is
essential that this is underpinned
by stable funding, with no more
cuts to budgets.
Helen Gilburt, fellow, (mental
health) policy at The King’s
Fund and author of the report,
said: ‘Historically, mental health
services have often been the first
to see their funding cut, so many
trusts felt forced to look at what
savings could be made through
transformation programmes to
pre-empt this.
‘Trusts looked to move
care from the hospital to the
community, focusing on selfmanagement
and recovery. Few
would dispute the intention and
rationale for this – the problems
arise with the scale and pace
of the changes, which lack the
necessary checks to evaluate
their effectiveness and the
impact on patient care.
‘Mental health trusts now need
the security of stable funding,
supported by a national focus on
evaluating the changes to date,
improving practice and reducing
variations in care.’
Paul Farmer, chief executive
of the charity Mind, said: ‘This
report lifts the lid on the true
state of NHS mental health
services. The government has
expressed its commitment to
putting mental health on an
equal footing with physical
health but it’s clear that there is
an enormous gulf between that
aspiration and the day-to-day
reality for many.
‘We hear every day from
people with mental health
problems who tell us that
support is getting harder and
harder to access as services
shrink while demand escalates.
‘Poor mental health can ruin
lives, destroy relationships, take
away people’s independence
and can lead to some taking
their own lives. But with the right
support at the right time, people
can and do recover or manage
their mental health in a way that
allows them to lead the life they
choose.
‘If people don’t get the help
they need, when they need it,
they are likely to become more
unwell and need more intensive –
and expensive – support further
down the line.
‘Failing to deliver the right care
isn’t good for people and it’s not
good for the NHS.
‘We echo the King’s Fund’s call
for more funding for NHS mental
health services; after decades of
neglect and five years of cuts,
services are in urgent need of
significant investment.’
Safeguarding reference group to
develop guidance for members
There have been many
changes in workplaces and
responsibilities recently and so
Unite in Health has decided to
reconvene the Safeguarding
and Child Protection reference
group to assess what this
means for practitioners and to
develop guidance for members.
If you are interested and
have appropriate expertise,
please contact Rosalind
Godson, professional officer,
via email to rosalind.godson@
unitetheunion.org for further
information.

News
Data shows ‘negligible’ public mental health spend
Local authorities in England spend
The charity argues that
mentally healthy and reduce
work to our physical health.
an average of just 1% of their
spending on promoting good
the chances of them becoming
‘The personal costs are
public health budget on mental
mental health and preventing
unwell.
immeasurable, and the wider
health, a freedom of information
mental health problems
Paul Farmer, chief executive
economic cost is huge.
request by the charity Mind has
developing is just as important as
of Mind, said: ‘Our research
‘Prevention is always better
revealed. Local authorities have
physical health.
shows that the current spend on
than cure and ignoring the
a remit to promote both good
The data on public mental
public mental health initiatives is
problem simply doesn’t make
physical and mental health in the
health spend was obtained under
negligible.
sense. We need local authorities
communities they serve.
the Freedom of Information Act by
‘The fact that local authorities’
to use their budgets to help
While local authorities spend
Mind, and this also showed that
public health teams are allowed
people in their communities stay
millions of pounds on physical
some areas plan to spend nothing
to file mental health under
mentally healthy and reduce
health programmes, most areas
at all on preventing mental health
“Miscellaneous” when reporting
the chances of them becoming
of the country spend close to
problems this year.
on it perhaps explains why. It
unwell.’
nothing on preventing mental
Responses from many local
sends a message that mental
Mind’s new guide to
health problems.
authorities also painted a picture
health is not seen as important
commissioning better public
Local authorities are required
of enormous confusion about
and not a priority for investment.
mental health can be downloaded
by the Department of Health
what local public health teams
‘It is not acceptable that such a
at: /media/2976113/mind_
to report on their public health
should do to help prevent people
small amount of the public health
public-mental-health-guide_web-
spending against a set list of
becoming mentally unwell.
purse goes on preventing mental
version.pdf
categories, including sexual
Mind is calling on the
health problems.
For more information on the
health services, obesity and stop
government to send a clear
‘One in four people will
‘Mental Health Challenge’, which
smoking services.
message to public health teams
experience a mental health
is an initiative led by the Centre
Currently, any spending on
to prioritise mental health by
problem every year, yet so much
for Mental Health to encourage
public mental health is reported
asking them to no longer label
of this could be prevented by
local authorities to champion
under ‘miscellaneous’, grouped
public mental health spend as
targeted programmes aimed at
mental health, visit www.
together with 14 other areas.
‘Miscellaneous’, and instead
groups we know to be at risk,
mentalhealthchallenge.org.uk.
This comes despite the fact
give public mental health its own
such as pregnant women, people
that it is conservatively estimated
category.
who are isolated, or those living
that mental health problems cost
The charity has also produced
with a long-term physical health
health and social care services
a best practice guide outlining the
problem.’
£21 billion annually, with a further
£30 billion lost in economic
output.
kinds of initiatives local authorities
could be commissioning to help
people in their communities stay
‘Having a mental health problem
can impact on all aspects of our
lives, from our relationships and
Images_of_Money
Economic recession raised the risk of suicide and mental illness
The economic recession of
David Gunnell, professor of
cuts, demotions, reduced hours
were not in contact with mental
2008 to 2013 was followed by
epidemiology at the University
or disputes over benefits – are all
health services or their GP.
increases in rates of suicide,
of Bristol said: ‘Prior to the
likely to be important contributors
Professor Gunnell added:
suicide attempts, and mental
recession, rates of suicide in the
to the rises.’
‘Ensuring the provision of
illness, according to new
UK were declining.
Other research has explored
adequate welfare benefits could
research.
‘Around the time of the
impact of the recession on mental
mitigate the impact of future
Researchers from the University
recession, this decline reversed,
health, and has found the most
recessions on suicide risk.
of Brisol used national mortality
and similar patterns were seen
vulnerable to problems such
‘It’s vitally important that staff
statistics, inquest reports of
in other European countries and
as job losses or debt are those
who come into contact with
people dying by suicide and
in North America. The greatest
with pre-existing mental health
vulnerable individuals whose
interviews with people affected by
rise in the incidence of suicide
problems or past psychiatric
mental health is affected by
the recession, including 19 who
appeared to be in young men.
illnesses.
economic difficulties are trained to
had made suicide attempts, to
‘The consequences of recession
The Bristol researchers
recognise and respond to risk, and
understand the ways in which the
on individuals – unemployment, the
found many individuals who
are properly informed about the
recession affected mental health
risk of losing a home, or financial
die by suicide in the context of
places to steer people affected
and suicide.
difficulties caused by debt, wage
employment or financial difficulties
towards for appropriate help.’
05

MHNA Update
Unite/MHNA update
Dave Munday
Professional officer
Unite the Union
(in the health sector)
dave.munday@unitetheunion.org
@davidamunday
Looking back
Revalidation
requirements in the pilot were
Secretary of State for Health
As I sit to write my last update
I am sure many of you will have
pegged at 40 hours over the
Jeremy Hunt.
of Mental Health Nursing for
heard that the NMC agreed
preceding three years.
A few days later, the letter
2015 I cast my mind back
the revalidation process at its
However, this was reduced
that did get sent had a change
over the last six weeks or so
October council meeting, which
back down to 35 – which
of heart and again said England
since I last put pen to paper
I attended.
matches the current
is ready.
(or more accurately fingertips
I don’t often go to the
requirement under post-
I did pick up a few members’
to smartphone screen), and
NMC council meetings as my
registration education and
unhappiness of our support for
consider what has changed
professional officer colleague
practice (PREP).
revalidation, this is however in
since last we conversed.
Jane Beach covers regulation.
However, there is the new
line with our discussion with our
I often review what I typed in
However, she was off on
requirement that at least 20
members.
the edition before and looking
holiday so I got to go. For the
of these 35 hours need to be
On that matter, by the end of
back I remind myself that in the
most part discussions were
participatory).
the year the professional officer
previous edition I covered our
positive.
With the final decision taken,
team will have spoken with over
Nursing and Midwifery Council
There was some disquiet
the NMC has produced the full
3,000 registrants across the
surveys of our Unite in Health
voiced in that the continuing
guide How to revalidate with
UK in our NMC revalidation road
membership.
professional development
the NMC. This covers each
trip events.
of the steps in detail, and the
As I offered last month, if
document is an easy read.
you want to host an event, get
Smoking and mental
health research – your
opinions are needed
We have also finalised our
briefing pages on each area
and you can download these
(and find a number of other
resources) at the website www.
unitetheunion.org/health/
in touch once you have ten or
more members interested. The
feedback from the events so far
has been excellent.
The terrible Trade Union Bill
nmcrevalidation.
This edition’s campaign page
Smoking is more common
among people with a
mental health condition.
Those with a
longstanding mental
health condition are, for
example, three times as
likely to smoke as those
without.
To better understand
these links, Action on
Smoking and Health (ASH)
is gathering data and
would like to know your
opinions.
The survey is for staff
who work with people with
mental health conditions.
The results of the survey
will feed into a report
that is being developed
in partnership with ASH,
the mental health charities
Mind and Rethink, and
the Royal College of
Psychiatrists.
It will be published in the
New Year.
The survey is available
at: https://www.
surveymonkey.com/r/
L8X6TX7.
Thinking after the council
meeting that all was settled,
it was a genuine surprise to
me when the Nursing Times
reported that Jane Cummings
(England’s Chief Nursing
Officer) was poised to write a
letter to the NMC’s Jackie Smith
to warn that England wasn’t in
fact ready, and to suggest a
delay of up to two years in its
full implementation.
We were quick to voice our
opposition to this possible
delay for a number of reasons,
which your national officers
Barrie Brown and Colenzo
(see p2) continues with the
focus on the Trade Union Bill.
It is interesting that at a
time when the government is
desperately trying to curtail
individual freedoms, the junior
doctors’ dispute has delivered
an exceptionally strong
mandate for strike action
following Jeremy Hunt’s bullying
tactics.
Our Doctors in Unite (Medical
Practitioners’ Union) association
is leading the charge in
supporting junior doctors in
their dispute.
We continue to highlight how
06
Jarrett-Thorpe laid out to
none of our members would

MHNA Update
ever wish to take strike action,
but when faced with a Secretary
of State who is keen to put the
public at risk by introducing
changes that are unsafe to
patients, strike action may be
the only way to force him to sit
down and talk reasonably.
Special edition: 24 hours in
mental health nursing
Regular readers will know that
this journal sets aside a couple
of editions every year to focus
on particular subjects.
We have had special editions in
the past on dementia, austerity,
the third sector in mental health
and student issues.
One of the ideas our editorial
board came up with was the
concept of focusing on the 24
hour nature of mental health
nursing, and that is the focus of
this edition.
Thanks to some great
contributions from authors
across the mental health
nursing field, I hope you will
agree that we have managed to
reflect on a small percentage
of the varied work you all do,
during every minute of the day.
We can only fit so much into
one edition, so if you read the
entries and think you could also
contribute then get out those
fingers and tap away!
Mental Health Nursing is a
great way to get published,
and there is an editor and
editorial board members who
are interested in helping the
authors of tomorrow.
If you do get chance to have
a few minutes’ rest during
the Christmas ‘break’ then I
hope they are relaxing, but I
wanted to finish my last update
of 2015 by wishing you all a
merry Christmas and a happy
new year.
I would like to thank each
and every one of you for that
24 hour care you provide, 365
days per year. MHN
MENTAL
HEALTH
NURSING
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closari
07

News feature
No improvement seen in
community mental health care
CQC’s annual survey reveals a lack of progress in community care in England in 2015
A survey of over 13,000 people
who were treated and cared for
proportion of people reported a
poorer experience compared to last
‘Community mental health
services play a vital role in
• Coventry and Warwickshire
Partnership NHS Trust (inspected by
in the community for their mental
health problems has shown ‘no
notable improvement’ in the last
year – 28% rated it as five or lower,
compared to 25% in 2014.
Also, a slightly higher proportion
supporting people with their mental
health problems without needing to
stay in hospital.
CQC in January 2014 – not rated).
• Leicestershire Partnership
NHS Trust (inspected by CQC in
year and in some questions, a
of people than last year reported
‘It is imperative that the NHS gets
March 2015 and rated ‘Requires
slightly higher proportion of people
have reported a poor experience.
The annual survey, which was
that they did not feel listened to by
staff (7%, up from 5% in 2014), did
not feel they were given enough
this right. We urge all NHS trusts
and in particular those that have
performed poorly to reflect on what
Improvement’).
• Lincolnshire Partnership NHS
Foundation Trust (to be inspected
carried out by the Care Quality
Commission (CQC) and published
at the end of October, assessed
time to discuss their needs and
treatments (11% up from 9% in
2014), and did not feel they were
the survey tells them about what
their patients think of their services
and act on the findings.
by CQC in November 2015).
• North Essex Partnership
University NHS Foundation Trust
people’s experiences of the care
treated with dignity and respect
‘We will consider the results
(inspected by CQC in August 2015
and support they receive from
community mental health services
run by NHS trusts in England, such
(7%, up from 6% in 2014).
While the survey did not show
improvement from last year’s
of this survey in our inspections
so that we can be confident that
people receive the safe, high-quality
– awaiting rating).
• The Isle of Wight NHS Trust
(inspected by CQC in June 2014
as in clinics and in their own homes
results, there were many questions
and compassionate care they
and rated ‘Requires Improvement’).
for conditions ranging from mild
that people responded to positively
deserve.’
The variation is also
depression to psychosis.
about their care and treatment. For
demonstrated by NHS trusts
The community mental health
survey represents the experiences
of over 13,000 people who
example:
• 96% of people reported that they
knew how to contact the person in
Trust performance
The survey also showed some
variation in performance between
whose survey results are ‘better
than expected’. Those that scored
‘better than expected’ for 10% or
received specialist care or
treatment for a mental health
condition in 55 NHS trusts in
England between September and
November 2014. The survey did
not cover care given by general
practices.
The charity Mind has estimated
that at least 1.6 million people
across the UK accessed community
mental health services in the last
year.
charge of organising their care and
services, if they have a concern
about their care.
• 70% reported they ‘definitely’ felt
listened to by the person or people
they saw (2014: 73%).
• 78% of people on long-term
medication reported they had had
this reviewed (the same as in 2014).
• 73% reported that they were
‘always’ treated with respect and
dignity (2014: 75%).
NHS trusts, with a small group
performing poorly across many of
the questions.
Those that scored ‘worse than
expected’ for 10% or more of all of
the questions were:
more of all of the questions are:
• Bradford District Care NHS
Foundation Trust (inspected by CQC
in June 2014 and rated ‘Good’).
• Cheshire and Wirral Partnership
NHS Foundation Trust (inspected in
June 2015 – awaiting rating).
• Mersey Care NHS Trust
(inspected by CQC in June 2015
and rated ‘Good’).
• NAVIGO Health and Social Care
CIC (to be inspected by CQC in
The CQC survey asked people
for views on aspects of their care,
such as whether they felt they were
Dr Paul Lelliott, the CQC deputy
chief inspector of hospitals (lead
for mental health), said: ‘Overall it is
January 2016).
• Tees, Esk and Wear Valleys NHS
Foundation Trust (inspected by CQC
treated with dignity and respect
disappointing that there has been
in January 2015 and rated ‘Good’).
and on whether they felt involved in
no notable improvement from last
For further information about
decisions about their care.
year’s survey.
the community mental health
When people were asked to rate
‘In particular, the fact that over a
survey, including results for all
their overall experience of their
quarter of people reported a poor
55 NHS trusts and the summary
08
community mental health care
on a scale of 0 to 10, a higher
experience of their care is worrying
and must be acted on.
report, visit: www.cqc.org.uk/
cmhsurvey. MHN

News feature
Disparity shown in emergency
hospital admissions data
Research of acute episodes finds that people with mental illness suffer disproportionately
People with mental ill health
had almost five times more
emergency hospital admissions
mental health needs.
• People with mental ill health
had 3.6 times more potentially
last year relative to people without,
preventable emergency admissions
according to a study.
than those without but slightly fewer
The vast majority of these
emergency admissions were not
explicitly to support mental health
planned inpatient admissions.
• For some common physical
health procedures, people with
needs, and a proportion of them
mental ill health were more likely
were potentially preventable.
to have an emergency rather than
People with mental ill health
planned admission, stay longer in
experienced 4.9 times more
hospital or be admitted overnight.
emergency hospital admissions.
For example, for people with
The findings, published by
mental ill health who had a hip
the Nuffield Trust and the Health
replacement, 40% experienced an
Foundation, suggest that people
emergency rather than planned
approaches are not widespread.
health and hospital use, authored
with mental ill health are not
admission; whereas for people
‘The challenge for national
by Holly Dorning, Alisha Davies
having their physical health
without mental ill health, just 8%
policymakers and local leaders
and Ian Blunt is the tenth ‘Focus
adequately managed, despite
of these admissions were an
is to find the will and resource to
on’ report from the Nuffield Trust
being known to the NHS for their
emergency.
support this innovation and improve
and the Health Foundation’s
mental health needs.
Holly Dorning, research analyst
care at scale and pace.’
QualityWatch programme, a joint
Drawing on analysis of over 100
at the Nuffield Trust, said: ‘It is
The Nuffield Trust and Heath
programme tracking the quality of
million hospital records per year,
striking that people with mental
Foundation study was published as
care in health and social care over
the research compared hospital
ill health use so much more
part of its five-year QualityWatch
five years.
use between two patient groups –
emergency care than people
programme. This offers a way to
This research examined 100
people who have previously been to
without, and that so much of this
measure progress towards parity
million hospital episodes in
hospital for their mental health, and
isn’t directly related to their mental
of esteem between mental and
England per year for five years,
people whose previous hospital use
health needs.
physical health.
looking at two groups: a physical
does not relate to mental health.
‘This raises serious questions
Focus On: People with mental ill
health cohort of 13.1 million
The analysis looked at patterns
about how well their other health
people, and a mental health cohort
of emergency and planned hospital
concerns are being managed. It
of 536,000 people.
use between 2009/10 and
is clear that if we continue to treat
Nigel Edwards, Chief Executive
2013/14. It found that:
• People with mental ill health
experienced 4.9 times more
mental health in isolation, we will
miss essential care needs for these
patients.’
at the Nuffield Trust said: ‘The
higher rates of unplanned and
preventable emergency admissions
emergency hospital admissions and
Felicity Dormon, senior policy
experienced by people with mental
3.2 times more A&E attendances
fellow at the Health Foundation
ill health are of national concern.
than people without mental ill health
said: ‘It is deeply unfair that the
‘But with austerity affecting
in 2013/14.
• Despite previous experience of
mental ill health, only a fifth of the
physical health needs of people
with mental health problems
continue to be poorly met.
both local authority and NHS
mental health services, achieving
parity of esteem between mental
emergency hospital admissions
‘Some areas are trialling
and physical health may remain
this group experienced in
2013/14 were explicitly for
innovative approaches to tackling
this pressing issue, but these
an aspiration rather than a reality.’
MHN
09

A day in the life of
mental health nursing
10
The pages that follow in
this themed issue of Mental
Health Nursing give a series
of diary entries that aim to
collectively show a typical
‘day in the life’ of mental
health nursing.
They give a snapshot of
how the profession operates
in 2015 and the pressures
that exist at all hours of the
day.
Images
Mike Mozart, Alexander Bolotnov, David
Michalczuk, Gloria Bell, Lee Haywood,
nathanmac87, oatsy40, Susana Fernandez,
zaphad1, Liam Clancy, openDemocracy, Anders
Lejczak, Craig Sunter, Katie King, liz west,
Nic McPhee, frankieleon, Joe Haupt, Karlis
Dambrans, Kayla Kandzorra, scott feldstein,
WayTru, Franco Folini, Helmuts Guigo and
Omarukai (all Flickr Creative Commons)
‘‘
Name:
Emily-May Barlow
Role/setting:
Staff nurse, intensive
psychiatric care unit, Scotland
’’
At 6.50am I arrive at work and
change into my nursing uniform
on the hospital premises.
My shift begins at 7am and I
attend the handover in the nursing
office. The intensive psychiatric
care unit has six inpatients in the
10 bedded unit.
The only female inpatient is
detained under section 52D of
the Criminal Procedures Act. She
is in the unit to receive a 28 day
assessment of her mental health,
in preparation for her upcoming
court date.
Patient N
physically
attacked a
member
of nursing
staff while
he was an
inpatient
The other five male inpatients
are detained under the Mental
Health (Care and Treatment)
(Scotland) Act 2003.
Three of these men are
from ‘out of sector’, and the
fourth is awaiting a long-term
private rehabilitation bed and
the final gentleman is awaiting
transfer back to an open general
psychiatry bed.
Psychoactive substance misuse
is a factor in four of the male’s
mental health presentations.
The night shift reported a
relatively uneventful shift, with
no major changes to any of the
patients’ mental states or care
and management plans since this
nursing team were last on shift
(i.e. the late shift of the previous
day).
I safety test my personal attack
alarm and log this out.
At 7.10am, as I have been
assigned ‘nurse in charge’ for this
shift, I am responsible for being
in receipt of the safe key (which
holds all inpatient funds) and the
controlled drug cupboard key.
Both the safe and the
controlled drug cupboard are
checked and counted before
these keys are signed over from
the night shift’s ‘nurse in charge’.
Two male inpatients are
currently prescribed constant
observations, i.e. a member of
the nursing team maintains a
constant visual whereabouts of
the patient at all times.
As the nurse in charge, I
am required to ensure these
observations adhere to the local
NHS observation policy.
The established team that are
on duty this morning have selfassigned
this responsibility. If this
hasn’t happened, I (as nurse in
charge) will designate appropriate
staff to this duty.
I then check the nursing
ward diary. Today’s priority is to
transfer a male patient (Patient X)
back to their local NHS trust.
The night shift staff have
organised all the relevant
paperwork, including the mental
health warrant for this transfer.
This is required due to the
different legislation operating in
England.
I wake Patient X and administer
the morning prescriptions.
His prescription chart is then
photocopied and filed with his

transfer paperwork.
This led to his transfer to the
Patient F, with the intention of
Patient N is very happy with this,
Patient X is understandably
IPCU.
relieving any agitation that the
and does not wish to appeal. I
anxious about the upcoming
I complete a general risk
objective symptoms may be
complete all transfer paperwork.
day’s events and I provide verbal
assessment for this transfer
causing him. He refuses this.
At 1pm the late shift staff arrive
reassurance and reconfirm the
(which is based on the Health
At 11.30am there is a 15
and I take care of the handover.
process ahead.
and Safety Executive’s five steps
minute allocated patient cigarette
This includes a report of all
At 8am it is time for the
to risk assessment). Due to the
break in the IPCU garden,
inpatients’ presentations and
medication round. All other
risks present, i.e. Patient N’s
which I facilitate. In order to
recent activities, a safety briefing
patients are administered their
mental state; the potential for
adhere to IPCU policies and risk
of current IPCU risks (two patients
prescriptions. No issues arise.
unpredictability and aggression,
assessments, no inpatients have
on observations, potential for
Fifteen minutes later the IPCU
and the immediate increase in
access to this area unattended
unpredictability and the pending
consultant psychiatrist arrives at
stimulation, three members of
and do not have access to fire
transfer) and a review of the
the ward and verifies that all of
nursing staff will escort Patient
starting equipment.
staffing levels for the upcoming
the transfer paperwork is correct.
N during this transfer. This is
I ‘check’ all inpatients in and
three shifts (to ensure these are
I sit with Patient X as the
scheduled for 2.30pm. The senior
out of the garden on the relevant
adequate for the current level of
consultant finalises the discharge
charge nurse will organise escort
checklist and wear a garden
clinical activity).
process with him. No issues
staff.
personal attack alarm, should any
A third student nurse has just
arise. Patient X then leaves with
At 11am the second patient on
issues arise.
started duty and I invite them
his escort nurses.
constant observations, Patient F,
At 12pm I liaise with all
to assist me with preparing the
At 8.30am I complete all
is highlighting concerns regarding
other staff on the ward before
medication for Patient F’s planned
discharge paperwork for
his mental state by repeatedly
documenting all of the morning’s
intervention. Both oral and
Patient X. I discharge him from
responding to unseen stimuli.
activities via the computerised
intramuscular medications are
computerised systems, complete
Patient F has a diagnosis of
system used by the trust.
prepared.
various recording sheets and
schizophrenia, which has been
This ensures a thorough and
At 1.30pm we have the
inform the local Mental Health
ongoing for much of his life.
comprehensive reflection of all
scheduled intervention for
Act office and Patient X’s named
He has not been taking his
inpatient’s recovery.
Patient F. He initially refuses
person that he has left the
regular prescribed medications
I discuss Patient F with the
oral medication, despite a lot
hospital.
while in the community. Patient F
senior charge nurse and a fellow
of persuasion and reassurance
At 9am I provide a handover
recently had a hospital admission
staff nurse on duty. Patient F
about the justification for
of the night report (of the
at his local English NHS trust,
continues to exhibit overt signs of
treatment.
remaining patients) to the IPCU
but two weeks after discharge he
psychosis but continues to deny
Patient F is made aware that
senior charge nurse and IPCU
travelled to Scotland aware that
them.
intramuscular medications have
consultant psychiatrist. There are
his Community Treatment Order,
We have a duty of care to
been prepared as an alternative.
no changes, at this time, to any
under the English Mental Health
relieve mental distress, as far
Because of this he accepts the
care or management plans. Then I
Act, would not apply.
as possible, and it is decided
oral preparations instead.
grab a 15 minute breakfast break.
I approach Patient F, and
that Patient F should receive
At 2pm a ‘psychotropic PRN
At 10am the senior charge
attempt to generate a discussion
‘as required’ pharmacological
audit’ is under way, which I am
nurse informs me that another of
about his current experiences. He
prescribed treatment.
actively involved in.
the out of sector males, Patient
is very guarded, and denies any
This will be administered
I complete the required audit
N, will be transferred today.
psychotic phenomena or mental
intramuscularly should the patient
tool for patient F’s administration
They have just received
distress; consequently it is very
refuse oral treatment.
of the required medication;
confirmation from Patient N’s
difficult to engage him in any
An intervention is scheduled
which identifies the medications
local NHS trust (within Scotland)
meaningful conversation.
for 1.30pm, when there will be
given, time and route, who
that a bed is available today.
I offer ‘as required’
additional staff on duty to assist
initiated the administration, and
Patient N is presenting as
psychotropic medication to
with this administration.
a reassessment of the patient’s
hypomanic and is prescribed
Approved prevention and
mental state 30 minutes after
constant observations to manage
management of violence
medication is given.
this. He is currently being nursed
and aggression techniques
This is filed in Patient F’s notes,
in his room within the IPCU, in
may be adopted as a last
the data from which is collected
order to minimise stimulation.
resort, to facilitate medication
weekly and compiled by the IPCU
Patient N physically attacked
administration.
lead pharmacist.
a member of nursing staff while
At 12.30pm Patient N is
I document the above
he was an inpatient in the local
informed of their transfer by the
intervention in Patient F’s
general adult psychiatry ward.
IPCU consultant psychiatrist.
computerised notes. At this time,
11

12
he is resting on his bed but it is
difficult to ascertain if the desired
effect has been achieved. The
following shift I learn that Patient
F has reported beneficial effect
from this medication later that
afternoon.
Fifteen minutes later I sign
over the safe and controlled drug
cupboard key to the afternoon
shifts assigned ‘nurse in charge’.
My shift is complete at
2.30pm, so I change back into
civilian clothes and make my way
home. MHN
Name:
Donna Kemp
Role/setting:
Care Programme Approach
Development Manager
‘‘
’’
With two meetings scheduled
in my diary, today is a day of
catching up on emails and
doing smaller pieces of work,
interspersed with the two
meetings.
Today is
a day of
catching up
The first meeting, from 10am
to 12pm, is with a group of
mental health clinicians who
together form a review group.
The work of the group is to
review a trust-wide procedure.
The second meeting of this group
is intended to be one where we
appraise progress since the last
meeting and agree next steps.
The procedure for review is
‘Procedure for the management
of adult service users with a
diagnosis of both mental health
and learning disabilities’ and
we have already decided that
the title was too long and more
importantly doesn’t have the
right ‘tone’ – we feel the term
management is outdated and
reinforces the ‘being done to’
rather than ‘with’ mindset.
We had agreed an alternative
at the first meeting but since
then, another alternative has
been suggested, so this is for
discussion again.
The new procedure needs to
reflect the changes to practice
and direction of travel for learning
disability services and mental
health services working together.
This is very current and outputs
from the national group are
emerging gradually, however,
we are keen to progress the
procedure and will aim to review
the procedure early if the content
is contrary to national directives.
Working in partnership across
both learning disability and mental
health services is agreed in
principle by all.
Joint assessment and
consultation are seen as
achievable and reflect current
practice.
However, shared contribution
to delivering the care plan is a
discussion point as generally,
beyond assessment, current
practice is that someone’s care
is with either learning disabilities
services or mental health, not
both, with finances being cited as
the barrier.
From this, it is agreed that
discussions should be held with
the service managers, to explore
the scope of joint working.
Discussions with the mental
health service manager are
positive, with the priority being
about meeting the person’s needs
in the best way possible rather
than demarking service turf.
A meeting with the learning
disabilities clinical director is
scheduled.
Further refining is needed to
the glossary – additional terms
such as ‘reasonable adjustments’
and ‘inclusion’ had been added
and these require explanation;
and some slight amends to
the wording are highlighted but
otherwise, the procedure is about
there.
The role of the care coordinator
and the lead
professional are clear and
specific as to their responsibility
and expectation.
Working on the procedure has
brought up a number of questions
that are not going to be resolved
by the procedures existence
– they are more strategic and
concerned with the organisation’s
culture.
For example, should teams
have both mental health and
learning disabilities nurses within
each service? We agree that as
a group we will collate these
issues as recommendations for
consideration within services.
Overall, the second meeting
is productive, although there are
more apologies than attendees.
The content is taking shape
and a clear next steps plan is
articulated.
There is an acknowledgement
that there could be indefinite
number of meetings but that
really moving this forward is a
matter of reading and discussion
– and this can be done by email
just as effectively.
In the afternoon my meeting
is cancelled at short notice, with
plans to reschedule to be made
on Monday.
This leaves me with two hours
to focus on the actions from the
morning’s meeting – and this is
my preferred way of working for a
number of reasons.
The information is still fresh
in my mind and I can recall
the detail. It helps keep the
momentum of the piece of work
going, and it means I am more
likely to complete the work in the
agreed timescale, and in taking
the lead role in pulling this work
together, it gives other members
of the group time to focus on
their contribution.
Also this approach just feels
efficient and means I can manage
my workload better – spending
less time worrying about what I
forgot to do or haven’t done yet.
MHN
‘‘
Name:
Hollie Roblin
Role/setting:
Second year mental health
nursing student placement
I prepare
to give
handover. I
am racked
with nerves
’’
I am on my final placement of
the year, with only three weeks
left until summer begins. My
placement is in a medium secure
regional forensic unit, on one of
the male wards.
My day starts at 5am with a
very large cup of coffee and a
quick shower before I catch two
buses and a train to placement.
My commute provides me
invaluable time to reflect, make
notes and mentally prepare

myself for the day ahead.
conflict as some take much
seconds between calls.
develop a rapport before I read
The official shift starts at
longer to wake than others.
I answer a host of different
about their index offence or listen
7.40am and continues until
Luckily, today everyone was
calls from concerned family
to any preconceived ideas from
7.30pm. The trust has recently
awake and ready for morning
members, scheduling patient
other staff members.
moved to a 12-hour shift pattern
medication and the first cigarette
visits and liaising with pharmacy
I always strive to practise in
in all inpatient settings.
of the day.
regarding medication stock.
a non-judgemental and person-
I walk into the unit, filled with
My mentor has asked that I
In between answering calls,
centered approach with all clients
anticipation as to what has
take charge of the shift today and
unlocking the kitchen and laundry
and patients, regardless of
happened over the previous three
complete the daily planning sheet.
for clients and taking trips to the
previous history.
days. I am the first member of
I start by double-checking levels
vendor, I take ten minutes off
Before I know it teatime
staff to arrive and I greet two
of observation and allocating staff
the ward in search of a doctor
medication is complete and the
patients who are eagerly waiting
to conduct the required task.
who can rewrite four medication
patients are either watching the
for their first cigarette of the day.
The ward had to lose one
charts before teatime medication.
soaps on TV or relaxing alone
Once inside the nursing office, I
male staff member as the acute
Luckily, a senior house officer
in their bedrooms, as the day is
check the diary and leave book to
admissions ward had an unsettled
was available and happily took
slowly drawing to a close.
see if there are any appointments
night and required a male for their
the scripts and returned within 30
This period is quiet and gives
or visits, or if a patient has
day shift. Therefore, we did not
minutes.
me chance to reflect with my
planned leave today.
have enough staff members to
I divide my afternoon by
mentor about managing the shift.
Handover officially starts at
facilitate a patient’s leave and a
spending time interacting
I have thoroughly enjoyed the
7.50am. The night nurse provides
family visit.
and getting to know the new
experience of assigning jobs,
a substantial handover and
I spoke with the two patients
patients and accompanying the
ensuring breaks are covered,
starts by discussing the two new
individually in the quiet lounge,
horticulture therapist to the unit
making sure the patients are ok
admissions.
only after I ensured my alarm was
gardens.
and most importantly thinking and
Every patient’s condition is
powered and my colleagues were
I make an effort to speak and
behaving as a staff nurse.
discussed, covering current
aware of my location.
try to develop a therapeutic
Fortunately, it has been a
presentation and behaviour,
One gentleman became very
relationship with the two new
relatively quiet day and nothing
mediation amendments, recent
upset and hostile, expressing
individuals and find out their
too chaotic has occurred.
ward rounds and if any risk
anger that this was the fourth
interests and personality traits,
However, just as we are speaking
assessments or care plans have
occasion where leave had been
and explain the ward’s culture.
the alarms are called for the
been altered or new ones added.
cancelled due to staffing levels.
I find these interpersonal
female ward.
The nurse discussed the Mental
I de-escalated the situation
interactions with patients an
One of the care support
Health Act status of each patient
by using distraction techniques
invaluable experience. I aim
workers whose duty is to attend
and that of the new admissions.
and insisted his leave would be
to converse with patients and
such emergencies is called away
Following handover, the two
facilitated as soon as possible.
nurses and myself check the
Together, we planned a day
controlled drugs cabinet. While
filled with therapeutic activities
on this ward, the only drug that
such as the gym, gardens and a
was classified as controlled was
game of bingo in the evening.
Tramadol.
I updated the patient’s notes
This drug can only be
with the recent developments
administered if prescribed by
and reflected with my mentor. I
the doctor and checked by two
expressed my concern, as this
qualified healthcare professionals
was not the first time leave was
before dispensing, which is
cancelled due to staff shortages.
challenging when there is only one
My mentor also agreed how
qualified nurse on shift.
periods of escorted leave are
I ask if I can assist with the
an invaluable mechanism for
morning medication round so
clients to reintegrate back into
I can practise dispensing and
the community and develop
reading medication charts.
meaningful skills that are person
The patients all smoke and
centred and aid recovery.
cannot be let out to the courtyard
The office phone continues to
until medication has been
ring throughout the morning and
completed, which can cause
into the afternoon, with barely
13

14
for 20 minutes, to help with an
antipsychotic medication by
injection by a restraint.
The night staff start to arrive
and I prepare to give handover. I
am racked with nerves and feel
my cheeks fill with colour when
all eyes are focused on me.
My handover is not substantial
as the team were all here last
night and this morning. I deliver
the handover and remember
to use effective wording that
describes presentations and
events of the day. I think it goes
well and I do not ramble.
My day shift is complete and I
cannot wait to return tomorrow.
I realise how forensic nursing is
rewarding, challenging and totally
where I want my first staff nurse
post to be. MHN
‘‘
Name:
Nicky Lambert
Role/setting:
Senior lecturer,
Middlesex Univerity
She writes
down
everything
we talk
about in
a small
notebook
’’
I am a mental health nurse who
teaches in a university setting
normally, but today I have been
asked to attend a community
meeting with older women
from Asian communities in
order to discuss mental health
awareness.
I have agree to come out to a
local community centre and do
an informal talk.
I do one-to-one work but
usually teach groups of between
40-60. When I arrive there is just
one person and she is looking
worried, as she had expected
more people from her group but
they were anxious about coming
so she has brought a list of
questions instead, and asks will
I stay?
I would always rather talk with
one person who is listening than
a room full of people who are
not, so I am soon settled in with
a coffee.
In the time we spend together
we talk about mental health and
illness, voice hearing, stigma,
the stress/vulnerability model,
personal experiences and our
different cultures.
She writes down everything we
talk about in a small notebook
and asks carefully considered
questions, such as ‘Why do some
people get sick and others not?’,
‘Can you hear voices and not be
ill?’, ‘What can we do to help if we
have someone in our family who
is sick?’
As we draw to a close she
shuts her book, thanks me and
says: ‘So to help someone with a
mind illness it’s like if they have
a body illness – you should listen
to them, be with them and love
them.’
I couldn’t have put it better
myself. MHN
Name:
Martin Bennett
Role/setting:
Clinical nurse, child and
adolescent inpatient service
‘‘
A staff
member
has found
a young
person with
a ligature
tied around
their neck
’’
I arrive at work at 7.15am, after
having the previous few days off.
I have been allocated the role
of ‘shift co-ordinator’ for the
day. While I have a fairly sound
awareness of this role and the
subsequent responsibilities, there
can be numerous unforeseen
challenges.
At 7.30am I have a handover
meeting with the night shift staff.
I am informed that there were
two rather significant ligature
incidents overnight.
This was managed effectively
by the night staff who placed
the young people on enhanced
observations. Aside from this,
they had a settled shift.
At 7.45am I plan the shift and
allocate staff members to various
roles, including a medication
nurse and a security nurse. I also
assign someone to undertake
enhanced observations. I then
check the diary for the day.
Friday is often the busiest day
as the multidisciplinary team do
not work over the weekend.
I have a meeting at another
ward followed by a supervision
meeting. I also have two
scheduled one-to-one sessions
with young people for whom I
am ‘primary nurse’. I then have
to consider potential observation
reviews and anything unexpected
throughout the day.
At 8.15am I take notes for
discussion at the morning
multidisciplinary team meeting.
These daily meetings consist
of the nursing team, ward
psychologist, education staff,
social worker, consultant
psychiatrist and outreach nurses.
Each young person is
discussed, with a focus on
safeguarding issues, medication,
engagement and (perhaps most
importantly) risk.
At 9.15am we have the
meeting. As mentioned, we
discuss the previous night’s
events, including the significant
incidents.
A predominant focus of
inpatient mental health services
relates to assessing risk, so we
spend some time discussing how
best to manage this.
At 10.30am I return to
the nurses’ office. Shortly
after the alarms are raised –
while undertaking enhanced
observations a staff member
has found a young person with a
ligature tied around their neck.
Due to the risk of asphyxiation
and following a period of support
and encouragement for the
young person to remove the

item, this then requires physical
interventions to secure their arms
while we remove the ligature
using the ligature knife.
The young person requires
further support following this. We
take her physical observations
and start to discuss how best to
manage this new risk.
We decide that removal of
risk items and an increase
in enhanced observations is
appropriate. Following this, the
young person is offered a debrief
to discuss the incident.
At 11am I return to the office
to document this incident. This
is a sometimes frustrating but
necessary part of my role.
Typically an incident like this takes
around an hour to document.
At 12pm I have a one-to-one
with one of the young people for
whom I act as ‘primary nurse’.
We are doing some work around
stress vulnerability.
Engaging a young person
requires some creativity at times,
and we conduct this session
whilst playing basketball.
It’s not the most
straightforward session but
successful nonetheless. We make
a plan to continue this next week.
At 1pm I have a meeting
scheduled at another ward to
discuss how to reduce restrictive
practice within child and
adolescent mental health service.
I represent our ward at these
meetings and we are hopeful of
making some significant changes
to how the ward operates, in
terms of restrictive practices.
This will hopefully reduce the
frequency of incidents of violence
and aggression. I plan to get
young people’s perspectives on
this before the next meeting.
I arrive back on the ward at
2.30pm. Just as I am scheduled
to take my break the alarms
are raised again. This time a
young person has self-harmed
using a piece of glass secreted
from home leave. The cuts are
superficial and are cleaned and
dressed.
I have a one-to-one with
this young person after to
discuss how best to keep them
safe. Along with the ward
consultant, we develop a plan of
enhanced support to keep this
young person safe, and I then
contact the parents, who are
understandably upset by this.
At 3.15pm I document this
incident. Again, this takes roughly
an hour.
After this, as part of my role I
facilitate clinical supervision for
support workers. I meet with one
of my supervisees for around
30 minutes to discuss current
concerns and issues.
At 5.15pm I have another oneto-one
session, this time with a
different young person for whom
I act as ‘primary nurse’. This
session focuses on distraction
techniques for preventing selfharm.
At 6.15pm I have just enough
time for a quick game of pool with
one of the young people.
At 6.45pm I start to prepare
for the handover to the next shift.
Again this is a time-consuming
exercise, requiring documenting
the same points repeatedly.
We generally find that just
before handover time is when the
ward is most unsettled. I can’t
help but think that my skills could
be put to better use at this point.
At 7.15pm I have the handover
meeting with the night staff.
This takes roughly half an hour,
depending on when the night staff
were last in work.
My shift ends at 7.45pm. My
drive home is my reflection time
because we don’t have time for
reflection at the end of the shift
as everyone needs to go home.
Any challenging shift can be
stressful given the responsibility
and accountability involved, and
I reflect on how I could have
managed situations differently.
I am fortunate to be able to
leave work in the car and when
I arrive home I can concentrate
on my personal and family
responsibilities for the rest of
the evening, as I am back there
tomorrow. MHN
Name:
Simon Hall
Role/setting:
Senior lecturer in
mental health nursing, Bristol
‘‘
We go into
nursing
to witness
and share
moments of
courage and
compassion
’’
I am actually on leave from
academic work but I still try and
support the football group that we
set up in 2009 whenever I can.
It also acts as a peer and
family support group and a place
we just think about having fun.
We also use some of the
service users from this group at
the university where I work to help
coproduce a programme that is
suitable and relevant for mental
health nursing education.
At 12.45pm I am helping
with pickups, and as Wiltshire
is such a rural county with poor
public transport, the start of the
group (and sometimes the most
important element) is the drive to
the sports centre to pick up the
lads and find out two important
questions – how they are and
what are their expectations of
today?
Everyone seems happy and we
spend our time catching up and
discussing the few past months.
At 2pm everyone is changed
into their kits and we have the
perfect numbers for a six-a-side
game.
There are two new faces and I
introduce myself. They observe
the other players’ actions to
meeting me and I reflect that it
must be hard meeting so many
new people in circumstances that
you wouldn’t choose.
I also reflect it is clear that
one is recovering from an acute
episode of psychosis and the
other appears more confident.
It proves to be a close game
and I have a period in goal in
which I feel like a magnet or a
target in a video game, so I am
pleased to hear the half-time
whistle.
During the break I have a chat
with a one of the guys who I
recently supported at his asylum
hearing and we are just waiting
for the outcome.
The anxiety is shared with the
whole group, but the support and
care provided by all is truly heroic
especially those recovering from
an acute phase of their illness.
It is why we go into nursing – to
witness and share moments of
courage and compassion when
faced with adversity.
The result of our football game
is always irrelevant, but the match
remains competitive to the end.
Then everyone shakes hands and
everyone heads off for a shower
15

16
and to get changed.
We meet up after the game
for a chat and I get to catch up
with the youngest member of the
group, – a beautiful six-month-old
daughter of one of the players.
His girlfriend comes and
supports the group and we get to
take turns to hold the baby.
I reflect it was just over two
years ago that life was very
different for this couple and it is
amazing how nursing can make a
difference with hope, medication
and a plan that can change lives.
We all say our goodbyes and as
I leave I hear people making plans
to catch up over the weekend,
which always pleases me greatly
as that is the whole point of the
group.
Mental illness can be lonely and
friendships often bring fun, hope
and engagement with a form of
reality that is not as scary as it
can be at times.
It also gives me a chance to
spend some time with some of
the service users to discuss the
next few months at the university.
The discussions on the way
home are filled with highlights of
the football, plans for the next few
weeks and, of course, the English
weather.
By 5pm my legs are tired,
which means it’s beer o’clock!
MHN
Name:
Janice Dunn
Role/setting:
Senior nurse, recovery team,
London
‘‘
She says
she wants
to thank
me for
being there
at such an
important
time
’’
I have been nursing now for about
20 years, all of that in London,
and mostly in community mental
health settings.
I often have to deal with
traumatic home situations
whereby a mental health condition
innately changes something within
a family context.
There have been lots of tears,
but thankfully also loads of fun,
and I hope many experiences
where patients and carers are
able to remember something
positive that came out of a crisis.
It is the late evening. My
daughter has come to meet me at
a local bus stop on my way home
from work. After the usual chatter
over kisses and cuddles, a lady
comes up and puts her hand on
my shoulder. She seems vaguely
familiar and this becomes clearer
as we speak.
She introduces herself,
explaining that I had nursed her
son through his first psychotic
episode about 10 years ago.
She talks about his life now
being difficult. He lives in a
supported project and has been
in hospital many times over the
years.
He has three siblings and they
appear to have been able to fulfil
a lot of Mum’s dreams.
She apologises for interrupting
us, but says she wants to say
hello and thank me for being there
at such an important time.
She says she can see the
closeness of my relationship
with my daughter as we met up
just now, and that she clearly
remembers the caring nature of
my time with her son.
We sit there for a bit as she
talks about her loneliness over his
illness, and how it has not only
affected him but also the rest of
the family.
She describes how she tends
to not have many friends now,
and has become socially isolated
herself. She feels unsure about
the impacts such an illness may
have on any new relationships she
would have.
I remind her that she
has managed to start this
conversation today, and how she
is socially able to talk with others.
What she says next profoundly
affects me. She describes how I
stood out as a practitioner.
She explains that nurses
don’t spend enough time with
the ‘problem’ and that they are
now too concerned about too
many things to give the patient
enough space for it to be really
meaningful.
She tells my daughter some
nice things about having such
a mother and our conversation
ends with a brief cuddle.
As we walk into a supermarket
my daughter reminds me about
all those times when I would
come home from work at such
crazy times in the evening/night
and feeling totally drained, yet I
never discussed the situations I
was involved with.
We reflect about how an
individual can do that, year after
year. She says it is only after all
these years that she recognises
that the nurse is probably not
someone who is taught how to
care, but someone who is taught
what to do with their caring
nature. MHN
Name:
George Coxon
Role/setting:
Owner, care home
for older people
‘‘
The role
is multilayered,
varied and
diverse – in
the nicest
possible
way
’’
The work of a mental health
nurse is multi-layered, varied and
diverse – and never more so than
when making the transition from
a traditional mental health nursing
role in an NHS setting to a social
care one.
Although having full
responsibility for the care of our
16 residents at Pottles Court
near Exeter, who are mostly
living with advancing dementia

and frailty, my role also includes
We repeat the quiz at regular
produces lots of response
a lot of ‘hands on’ direct work
intervals during the day with
and interaction – including a
with residents and our 24
large audiences in the lounge and
spontaneous birthday competition
predominantly part-time staff.
larger communal areas as well
for those eager to claim the title
Today my work is very varied
as with random small clusters
of our oldest resident.
and includes the following.
of residents, visitors, staff and
This demonstrates to other
I carry out a planned
several one-to-one discussions.
staff members that activities can
performance review appraisal of
While the event is geared
emerge from the most innocent
the home’s registered manager.
to be fun, there is very much
and innocuous items, providing
Then there are three separate
an evidence gathering and
what for many in care home work
investigatory interviews with staff
observational element to the
see as the most vital ingredient
looking into some concerns at
exercise too – the continual
to a good home, namely having
the home – none of which lead
assessment of each resident’s
fun.
to any disciplinary actions being
required, thankfully
I have instigated a ‘Glen
Miller Appreciation Day’ and
participating in this includes
leading the ‘low intensity’ and
very entertaining multiple choice
quiz about his life and making
sure we play lots of his music
throughout the day.
The skills required to facilitate
the involvement of people with,
for many, very advanced features
of dementia are subtle, carefully
constructed and sophisticated.
I use the mental health
nursing skill set to ensure
that any awkwardness from
slow or delayed responses
from residents, arising from
the progressing verbal ability
difficulties they may have, does
not cause embarrassment but
can be delicately drawn and used
in a light-hearted manner, and
helps to provide a stimulating and
validating experience.
Assessing and contrasting
capability for people with
dementia is a daily reviewable
part of a mental health nurse’s
work to promote a satisfying and
balanced daily life in 24/7 care.
It may seem basic to an
onlooker, but clinical judgements
are as much about monitoring
and intervening regarding the
person’s retention, responses
and reaction skills as they are
about motor and co-ordination
skills.
changes is part of what goes on,
sometimes tacitly.
Later I carry out some
resident bedroom audits and
staff briefings on how we ensure
safe, person-centred and ageappropriate
environments at
our home is always kept under
scrutiny.
Specifically we need to
examine how we provide ‘lovely
bedrooms’ for our residents that
protect dignity in not having ‘on
display’ personal care items such
as creams and pads for those
needing them in the night time.
This is another aspect of the role
I perform in an ongoing way in
our homes.
Next I have a meeting with one
of the district nurses, reviewing
the care she is offering on this
day to our residents and also
agreeing that she will run a
series of massage sessions
for residents, as she has just
qualified as a certified massage
therapist.
I then spend some time
playing an impromptu and totally
invented in the moment game
of ‘snakes and ladders’, using a
small blob of Blu-tac as a counter
and gently engaging as many of
our residents as I can, asking
for favourite numbers, dates of
birth, as well as randomly called
numbers to climb ladders and
slide down snakes.
This proves most entertaining
and stimulating for many, and
Later I have a meeting with our
cook to talk about the upcoming
‘Devon Care Kite Mark Cooks
Bake Off’ event, where all the
cooks of kitemark member
homes will present a Christmas
cake for judging at our annual
Care Kite Mark Jamboree in
December.
In between these actions I
make numerous cups of tea for
residents, staff and visitors at
regular intervals – as well as
having several made for me too, I
should add.
During the day there is
also time spent overseeing
mealtime routines and practices,
particularly where staff are
supporting and assisting
residents to eat.
I am often involved in leading
training on issues such as this
and role modelling what we
regard as best practice to be
replicated by all staff involved at
all times.
I also spend time with
our newest resident and her
daughter, and it is pleasant to
hear about how thrilled and happy
they are now to be part of the
‘Pottles Court extended family’.
The work in 24/7 residential
care is as rich and colourful
as in any mainstream mental
health ward or unit – paperwork,
documentation and the range
of recording requirements are
as much a part of how we
provide high standards of care
as achieving a strong positive
culture, atmosphere and ensuring
quality of direct care to residents.
Our recent ‘Good’ Care Quality
Commission inspection outcome
was an emotional experience
– we are always checking and
double checking our systems,
and ‘back office’ work such as
care plans that capture how we
ensure consistency and continuity
of care.
Some of my day is spent
checking how well our new lady’s
needs and wants have been
recorded and shared in records
and handovers – so I talk to our
new lady, her daughter and our
staff and cross-reference the
detail accordingly.
My usual method is to
approach her and say: ‘Hello,
how do you do? My name is
George, I’m one of the owners
here – what would you like us to
call you?’
Occasionally we discover
that some residents reinvent
themselves with quite different
names to those they have used
for most of their lives.
The rest of my day is taken
up with incalculable chats,
slipper monitoring, hairdresser
bantering, window cleaning
reviews and lobby poster
refreshing.
As said – the role is multilayered,
varied and diverse – in
the nicest possible way. MHN
17

18
Name:
Mandy Bancroft
Role/setting:
Senior lecturer, University of
the West of England
‘‘
’’
So what does a mental health
academic do all day, particularly
in the summer months? For those
of you busy in practice I could
forgive you for thinking we shut
up shop (in this case university)
and disappear for the summer.
This is not actually the case
(unfortunately), as many degree
programmes work over a 30
week year and nursing is 42
weeks – however, we can all feel
sorry for midwifery students and
staff as their courses last for 46
weeks.
I see
the new
generation
being full of
passion and
commitment
So we are pretty much
constantly doing something,
however I would say it does
ease up slightly in the summer
months.
So about today in particular?
As a mental health nurse who is
passionate about young people’s
mental health, for the last four
years I have been running choice
modules on this subject in the
Specialist Community Public
Health Nursing programme (in
other words, health visitors and
school nurses).
Due to a change in my
workload this is being handed
over, so I spend this morning
passing that on and discussing
ideas for the new team.
I am delighted that finally child
and adolescent mental health is
being integrated as an optional
module in the undergraduate
programme (finally, after 15
years of trying), so this feels like
an exciting time).
As well as planning new
teaching sessions I am a
personal tutor, so I am still in
touch with my students who have
just qualified and those who are
heading for their third year.
We have a large programme
where we have an intake of 120
students per year, meaning we
have over 360 students on our
books at any one time.
Today I need to sort out a
number of problems that
students have, including
registering with the Nursing and
Midwifery Council, childcare
issues, placement problems, and
helping those who are struggling
with their studies.
I believe the personal tutor role
is pivotal to the student journey
and, in much the same way as in
practice, supportive relationships
are often key to success.
We have resubmissions in
the summer for those who have
been unsuccessful at the first
attempt of an academic piece,
and retrievals for those who have
time to make up in practice or
an objective to achieve, so there
is always someone around to
support them.
Support for students is really
important, as the university is
judged on something called the
National Student Survey, and the
performance of each programme
reflects on where we are in the
league tables.
We have the same but different
pressures in practice to keep
up the league tables and we are
always looking to improve and
enhance the student journey.
In the world of academia we
are constantly looking to bring
in money for research, and I
also have a role for looking at
disadvantaged potential students
(this fits in well with the mental
health background)
Today I look at putting in a bid
for Higher Education Funding
Council for England money to
look at how we support children
in care.
Think about it for a minute –
‘‘
most students come to university
and go home for the holidays.
Many children in care do not
have that luxury so we offer 52
weeks’ accommodation a year.
Alongside this there is
research we have to publish, and
I spend some time writing up
three interventions we have been
trialling with nursing students to
go into a widening participation
directory.
Although I am a mental health
academic I always see myself
as a nurse first and an academic
second, something I think that
resonates with many in similar
positions.
The summer is still a busy time
and later on in the day I head off
to a ‘Well Beans’ event, which
is something that has come out
of the Time to Change initiative
to look at how we improve the
mental health for both students
and staff in the university.
On reflection not only have I
come a long way in 30 years but
so has the mental health agenda.
Would I change what I do or
what I have done? No, not in a
million years.
I have loved my career and I
see the new generation being full
of passion and commitment in a
world that is suffering from cuts
and constant change – yet the
students I come across still very
much want to be mental health
nurses.
I wonder what the next
generation of mental health
nurses will be writing about when
they describe a day in the life
of the profession in another 30
years from now. MHN
Name:
Kayleigh Orr
Role/setting:
Art therapist, London
NHS trust
At present
we are
exploring
family
relationships
and
childhood
experiences
’’
As an art therapist working in a
large NHS mental health trust
I provide groups for service
users in our inpatient services
as well as individual sessions for
outpatients.
Art therapy in this setting
aims to provide service users
with an opportunity to explore
and express their feelings and
thoughts using art materials in a
safe and containing environment.
Due to the differing mental
health diagnoses I have to adapt
my approach as an art therapist
to meet the needs of the client.
A typical day in this setting
consists of a combination
of clinical contact and
administrative tasks.
The first hour of my day
consists of administration,
collecting art materials and art

work together for sessions and
liaising with colleagues about
service users.
This is the perfect opportunity
to prepare for any clinical
contact I have arranged during
the day.
My first session of the day
is on the long-term ‘incomplete
recovery’ ward for service users
with schizophrenia.
Multidimensional perspectives
using pharmaceutical and
therapeutic approaches are used
on this ward, and art therapy
provides an important part of this
service.
Before I facilitate the open
group, I attend the service users’
plan for the day meeting.
This allows the service
users to be reminded that the
group is running and is also an
opportunity to liaise with other
staff members.
The group is held for one
hour in the activities room on
the ward. I provide a range of
materials including pens, pencils,
pastels, and paint, clay and art
books.
As the group is open to the
whole ward I use a non-directive
approach – service users are
encouraged to use the materials
but not given a specific task.
Due to the nature of the
service user’s complex needs,
often there are few verbal
interactions.
Individual members have the
opportunity to speak and think
about their art work with me
should they wish to do so.
I will comment on the use of
materials, process or marks
made to generate dialogues.
I would not be making
interpretations about the artwork
as this may be perceived as
intrusive and unhelpful.
Following the group I have to
tidy the room, put the artwork
away and provide a handover to
the nursing staff.
Straight after this, I see an
outpatient for an individual art
therapy session in the therapies
room. This is a long-term
service user with generalised
anxiety disorder and obsessive
‘‘
compulsive disorder symptoms.
She enjoys using watercolours,
pencil, clay and inks to
developing her own imagery.
Often I will create artwork
alongside her as she finds
the therapist’s gaze anxiety
provoking.
At present we are exploring
family relationships and
childhood experiences, and
thinking about how these impact
upon her behaviours and feelings
as an adult.
After a quick lunch, I head
over to the complex health and
dementia ward.
I have been developing an arts
therapies model for this ward,
running both an open group in
the main lounge area as well as
today’s ‘mobile’ service.
The mobile service is for
service users who struggle
to access the group because
of mobility issues, cognitive
difficulties or the need for one-toone
support.
This involves taking the art
materials to a service user and
working alongside them.
Together we explore a variety
of tactile materials including
textiles, sand, natural objects
and a light box.
Often these service users
have impaired communication
skills so I have to be sensitive
to their needs, verbalising their
experiences with the materials in
the moment.
At the end of the day I return
to my office for the final hour
or so, so I can write up clinical
notes onto the NHS computer
system, follow up any issues and
answer any final emails. MHN
Name:
Sandra Connell
Role/setting:
Lecturer and institutional
link, Middlesex University
I arrive at work at 8.30am to
get ready, go through my plans
for the day and check my notes
again.
I visit my placement areas
once a month usually, or as
often as needed beyond that.
I am already thinking about
how long I can allow for each
visit, as there is loads to do.
I am conscious that if there
are any issues to resolve, then
I might not make it to all my
areas, but sometimes there are
just no quick answers.
It is already on my mind to
make a concerted effort to try
to meet more mentors, not just
managers.
I see
myself as a
teacher now,
but being
in practice
connects me
to my roots
’’
While it is great to meet
the managers and build
relationships with them, I also
need to make sure the mentors
see me on the wards as a
resource who is there and able
to support them.
I am conscious of the
experiences of mentors – and
providing mentor updates
regularly in a practice situation
helps me with this.
I need them to see that I am
there to see them too and to
offer support, not just students
and managers. After all, it is
important that we all work
together.
It feels good to be out in
practice. Just being back in
clinical areas always helps with
reminding me of my focus.
I see myself as a teacher
now, but being in practice
connects me to my roots and
gives me extra motivation to
do this work to the best of my
abilities.
I am aware that the mentors
I meet with are hard pressed
for time, but it is great to be
able to meet them and to build
relationships.
It is also interesting to
spend some time talking with
students and supporting them
to access and process learning
opportunities – they can be
quite different in the different
settings.
Sometimes students who
lack confidence academically
can surprise me with their
practical skills, while others
who are buoyant in classroom
situations can be really anxious
in practice.
Students should see link
lecturers out in clinical areas
so that they understand the
collaborative approach to their
education.
I still like to drop by to see
areas, whether they have a
student or not, on the off
chance the mentors have any
issues or concerns they want
to raise.
If they can’t see me on the
day for various reasons I will
send an email offering another
visit if needed, but if not, I will
19

make set appointments for the
next month with these areas
to make sure I can meet with
someone on the team.
Relationships take a long time
to build but without the effort
the students’ learning really
suffers.
I hope the mentors will be as
pleased to see me as I am to be
here. MHN
Name:
James Nicholls
Role/setting:
Staff nurse,
Somerset
‘‘
’’
My day starts with the beep of
the phone alarm. I get up, get
showered and piece myself
together mentally but not so
rigidly that I won’t be able to
adapt to whatever the ward has
in store for me today. It is never
the same twice, let’s put it that
way.
Then it
suddenly
hits me that
there has
only been
one nurse on
shift today –
me
Then it is time for food, the
healthier the better. The fuel for
the engine has to be optimised
because every ounce will be
needed through the day.
Once the shift starts there
won’t be time to stop.
Cruise control allows my
commute to be used for
reflection from the day before
and gentle preperation for the
day ahead.
Anticipation starts to mix with
excitement as the journey to
work draws to a close, and my
mind begins to bubble.
What will today bring? What
will the service users need? How
will the team be? These thoughts
are allowed to pass like
clouds in the sky and mindfully
any ideas about the day are
released.
The moment and the ‘now’
is embraced and the speed at
which everything can change
is remembered as something
which cannot be controlled.
Suddenly I am buzzing onto
the ward, my NHS badges are
on and it is time to deliver the
best care possible with the
tools that are available, namely
myself, the team around me and
our skills and ability to adapt to
whatever is thrown at us.
Handover finishes with a
splash of humour and we go
onto the ward to start the early
shift.
Some service users are
up already and so we have a
relaxed catch up over breakfast.
Others are needing close
observation and are still
struggling. Staff rotation for
one-to-one observation is
discussed and the members
of the team take it all in their
stride. Someone says: ‘No
breaks again today.’
Then it’s onto the morning
round of medication. Some
service users come to the clinic
while others are still a bit sleepy,
but all the necessaries are taken
care of just in time before the
doctor’s ward review starts.
Any potential confusion
over daily notes is resolved,
outstanding phone calls are
dealt with, 48-hour follow-ups
are logged, and S17 leave is
rewritten and communicated,
then signed and agreed.
New medication plans are
revised, visitors are welcomed,
coffee and tea is prepared, new
care plans are devised, new
care pathways are created with
consent and multidisciplinary
discussion, and patients are
able to express themselves
freely and openly. Phew, the
ward review is done.
Then it is lunchtime – for the
service users at least, that is.
For me it is team catch-up time.
Wait a minute – it was 9am last
time I checked. Where did those
three hours go?
Luckily as always the
healthcare assistants are totally
on it and the ward is under
control with only minor issues to
be dealt with.
Thankfully the weather is good
today too, so some one-to-one
time in the garden allows a few
service users a brief distraction
from their troubles with a bit of
table tennis.
Meanwhile a few of the others
are enjoying an art and crafts
session with the occupational
therapist. The ward is feeling
sunny.
I realise there is only
30 minutes until lunchtime
handover, so it is speed typing
time.
Hopefully the phone won’t
ring too much either. I type up
patient notes and update the
handover.
Then it suddenly hits me that
there has only been one nurse
on shift today – me.
I check with the healthcare
assistants and they assure me
that everything is together and
that everything has been done.
A quick wander round the
ward confirms that everything is
‘ship shape’.
So it’s off to handover I go.
That was certainly a whirlwind.
Happily for me, the morning
shift ends with the feeling of
satisfaction and knowledge
that I have helped and changed
people’s lives.
The energy given to me
on this day has not gone to
waste. That’s a day in the life
of a mental health nurse – it’s a
challenge, that’s for sure. MHN
20

24 hours in mental health nursing
Website provides ‘day in the
life’ stories of service users
Donna Kemp reports on an online resource that helps people to tell of their experiences
The ‘A Day in the Life’ website
place as content is approved
change of medication.’
reflection and supports shared
was the inspiration for this
before publication, and any
Drawing out a concrete
learning and development.
edition of Mental Health
content contrary to the Equality
positive took more reading of
• The themes identified (health,
Nursing’s focus on a day in the
Act is deemed inappropriate.
diaries than it did for finding
people, things we do, home life,
life of mental health nurses.
The writing guidance is
negative content. That said, the
services, where we live, money,
The website provides a
thorough and written in plain
diaries are not a catalogue of
stigma and work) give us a
snapshot of what it is like to
English, and it encourages
negatives – they are reflective
clear ‘heads up’ as to what is
be a person with mental health
people to participate and seems
and descriptive.
important to people and as such
difficulties in the 21st century.
to have got the balance right
My impression of the diaries
can guide us in engaging with
You can find it at https://
between ‘do it’ and ‘don’t do it’.
is that they hold very personal
people.
dayinthelifemh.org.uk.
Searching the website is
accounts, not only of that day
• As nurses, we should note
Currently in its first year, the
straightforward as the content
but of life generally.
this as an example of how being
project has been made possible
of people’s diaries are put into
The brief is met. This is a
radical can yield results, bring
with the support of Public Health
themes of health, people, things
library of people’s experiences.
awareness to an issue or simply
England and is curated by Social
we do, home life, services,
But it is more than that. People
amplify a voice.
Spider, a community interest
where we live, money, stigma
have seized the opportunity
• If you find yourself
company.
and work.
to share their thoughts and
professionally conflicted,
Behind Social Spider are
Within these you can then
feelings, hopes and dreams
submerged in your organisational
Mark Brown and David Floyd.
search for reports that are
through writing.
mire, defending boundaries of
Mark is prolific on Twitter (@
positive, negative or neutral.
This is an example of
services, and rationing health,
oneinfour), commenting on
So taking a peek at ‘services’,
where contributors have
then read a diary or two and
mental health and social action.
an example of negative was: ‘I
created something unique and
remind yourself of the people
He speaks at conferences about
am desperately disappointed
collectively it has exceeded its
you serve. This will help you to
mental health, social media and
in the NHS. I know it’s not their
brief.
maintain your professional and
innovation and is leading on
fault but the waiting list to see
What can we learn from this
personal focus. MHN
several national workstreams.
a psychiatrist to review my
as nurses? Well, there are some
One day in each season is
medications is three months.
standout observations:
Donna Kemp is the care
selected and people write up to
‘I’m also on a waiting list for
• As nurses we should do
programme approach
700 words describing their day.
DBT but I don’t even know how
this more – sharing what we
development manager at Leeds
This ultimately builds a library
long that will take.
experience, what we do and how
and York Partnership NHS
of people’s experiences, painting
‘I have to wait for my
we do it is useful. It promotes
Foundation Trust
a picture of what it is like to live
temporary care co-ordinator to
with mental health difficulties –
tell me (I don’t have a permanent
what helps to make life better
care co-ordinator yet… But am
and what makes it worse.
on the waiting list! I’m sure you
There are guidelines
can start to see the pattern!”
for writing, which includes
Conversely, an example of
considering their own and other
positive was: ‘But now, I am in
people’s confidentiality, not
the mood for listening. I have
disclosing sensitive information
discussed treatment options,
and writing generally about
and specifically lithium therapy,
specifics – for example ‘a nurse’,
with my ever-patient care
‘my local community team’.
co-ordinator and with the NHS
Further safeguards are in
consultant who will oversee the
21

Resources
6317_DutyofCare_RecordKeeping A5_4_Layout 1 26/02/2014 12:07 Page 1
AVAILABLE NOW!
Books and resources
Record Keeping and Documentation
& Putting Patients First
Depressive Illness: The
curse of the strong
Tim Cantopher
Sheldon Press (2012)
ISBN: 978-1-8470-9235-9
128 pages
£8.99
Psychiatrist Tim Cantopher has
provided an insightful, concise and
comprehensible third edition to his
book Depressive Illness: The curse
of the strong.
The third edition provides the
reader with relevant, easy to read
and factual knowledge regarding
the condition.
Rather controversially he
states that depression is not an
psychological or emotional state
Contributor
Hollie Roblin
Student nurse,
Huddersfield University
but a physical illness, and makes a
comparison with pneumonia.
The audience may not agree but
the author provides a convincing
case.
Following the topical start, he
carefully guides us through the
nature of depression, history, and
triggers to the illness.
The author examines the
importance of research; awareness
of how to manage if one becomes
unwell and discusses the physical
and psychotherapies treatment
choices.
The later chapters provide
advice on managing and dealing
with the problem areas caused by
depression.
The author adds personal
commentary throughout book,
£15 each for members
£25 each for non-members
Special introductory offer;
buy both books, save £5!
Please see
www.unitetheunion.org/health/bookshop
for further details and how to order
which adds humour and keeps the
reader engaged throughout.
I would recommend this book to
anyone who suffers with or knows
someone affected by depression,
all allied health professionals and
student nurses.
The book provides an index,
suggestions of further reading
and a list of useful addresses that
specialise within the realms of
depression.
Hollie Roblin
Books, CDs,
DVDs or
websites relevant
to mental health
nurses
If you have been involved in the creation of a resource relevant to mental health
nurses, then why not send it to your journal for review? We are interested in
all materials that support the education, continuing professional development
requirements or practice of mental health nursing – from academic reference books
to CDs, DVDs and innovative websites. Don’t hide your achievements – communicate
and share them with your colleagues. To discuss a resource review, contact the journal
editor via email to: mhneditor@gmail.com
Social media and the MHNA
Stay informed online through the MHNA’s
social media connections.
Facebook: http://www.facebook.com/#!/UniteMHNA
Twitter: http://twitter.com/#!/Unite_MHNA
(@Unite_MHNA)
22

Membership
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wellbeing at work. Unite negotiates on your behalf with employers
and the UK and European governments to get you a fair deal at work.
Why join?
There are many benefits to joining Unite/MHNA:
• Free, 24/7 access to our online journal Mental Health Nursing
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• Online information and support at www.unitetheunion.org
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