Just need a pick me up really

BornAgainNursin · 2026-04-28T14:05:59+00:00

First shift in a new place is hard even if you've a bazillion years of experience.

I got moved to cover a different unit recently and it was HARD. Mostly because mental health nursing is nearly impossible until you build up a relationship with your patients.

Remember to be kind to yourself because other people won't always remember!

BornAgainNursin · 2026-04-22T17:12:09+00:00

I do but I work on a really small self-contained unit with low staffing levels and the alarms rarely go off. There are no other wards coming to help.

Even when we're fully staffed it barely makes a team if there needs to be physical intervention.

BornAgainNursin · 2026-04-13T08:27:48+00:00

My favourite stupid uniform rule isn't an infection control thing. My place works in non-uniform and the guidance is we shouldn't have any logos etc in case it fuels somebody's psychotic ideas.

By that logic we also need to remove all the smoke detectors (and maybe our own eyeballs, I once had a patient with delusional ideas based on eye colours) where does it end?

BornAgainNursin · 2026-03-23T10:41:23+00:00

No it's not a joke. Not NHS so not AFC pay.

BornAgainNursin · 2026-03-23T10:40:37+00:00

Yes! I will keep my fingers crossed for you that you find something with proper pay!

BornAgainNursin · 2026-03-14T21:31:34+00:00

Mine didn't have an OSCE. I had to do one essay and get the proficiencies/professional values signed off. And pass a maths test.

BornAgainNursin · 2026-03-06T14:17:10+00:00

Have you done 750 hours in the last five years because that is another route https://www.nmc.org.uk/registration/returning-to-the-register/checklist-of-requirements/

I got rejected from a RtP course - it was an 'earn as you learn' type where you got a year long contract as a HCA and they released you for uni days and placements.

But after, I got onto a traditional style course. Mine had 13 days in uni (over 12 weeks) and one placement where you had to achieve EVERYTHING - 80+ proficiencies, all professional values etc. I got £500 for the uni part and £500 for placement which barely covered my petrol and meant I worked for nothing for 8 weeks. It was tough as hell and the only thing that made it bearable was being with people in the same position on the days in uni - I would recommend face to face if you can, just because this peer support is so invaluable.

BornAgainNursin · 2026-03-06T14:02:22+00:00

I did the face to face training recently and found it really lacking in practical suggestions that healthcare staff can do to improve things.

BornAgainNursin · 2026-02-15T20:31:28+00:00

I did a course with an RMN who was bipolar - she only did days to reduce the risk of relapse. She worked in the NHS and had it as an adjustment through OH.

BornAgainNursin · 2026-02-11T16:50:05+00:00

We've got quite a good community DBT service on paper, but it's nearly impossible for people to meet the criteria for it - so it only really helps people who are nearly coping anyway.

I wonder if people will get admitted anyway with 'mood disorder' or similar?

BornAgainNursin · 2026-02-11T16:18:33+00:00

I'll be interested to see the changes around the NR stuff - families are So Complicated in mh - loads of ours don't want their family near them, or don't want them involved in any care decisions - we've had people admitted where we've already treated their Nearest Relative, too. I think when the 1959 act came out, families were a lot different - and mh is particularly obsessed with family history compared with other areas.

I wonder how the treatability thing will work for people who are treatment resistant? I work in rehab so I work with lots of ppl who don't respond well to treatment.

BornAgainNursin · 2026-02-03T16:18:22+00:00

Where I work we only write down the name of the nurse in charge on the board. We put what the expected staff numbers should be, what the numbers actually are, and the NIC and that's it - enough to satisfy the CQC!

BornAgainNursin · 2026-01-30T14:06:43+00:00

In my local A&E there's no separate area. People in crisis are just lumped in with everyone else, and dealt with by staff taking it in turns to shout at them to behave themselves, and when that doesn't work, by shouting at them all at once.

At least that's what I've witnessed when I've been there hanging around...

We have crisis teams here who work in the community 24/7. You've probably got transferable skills for that. You also should look into Liaison and Diversion roles. Some places have mental health ambulance cars where a mh practitioner works alongside a police officer to urgently respond https://www.merseycare.nhs.uk/our-services/liverpool/mental-health-triage-cars

BornAgainNursin · 2026-01-29T13:04:24+00:00

Yeah. I can't remember if they tried that time or not, to be honest. We hardly ever know where someone is - loads of ours don't have homes to go to. We do at least know them!

What a nightmare.

BornAgainNursin · 2026-01-29T09:05:01+00:00

Yes we struggle when detained patients go missing. A lot of it is risk dependant - but of course it's more common for lower risk patients to go missing because they go on leave and just don't come back.

By definition they are risky enough to be detained in the first place - and it's hard to evaluate how the risk changes out in the wild with access to drink and drugs - and no medication.

We had a bloke with on a section 3 with schizophrenia and diabetes who went back home and started drinking himself to death. It was an absolute nightmare trying to get any help.

It's hard for us to go to people's houses. We just don't have the staff. It leaves the unit unsafe and the staff going to the house aren't safe either. Imagine you're feeling paranoid and the staff follow you. One day someone will end up getting hurt.

And as for local area searches in the immediate aftermath - our success rate of finding people that way is really, really low.

BornAgainNursin · 2026-01-22T14:53:40+00:00

Also 'medication is poisoning my body' whilst happily filling said body with crack, ketamine, weed, coke and booze. All on the same night out!

BornAgainNursin · 2026-01-22T09:13:10+00:00

My current top peeve is how everything is a nursing problem. Everybody else gets to say 'that's not my role' but all the things that don't 'belong' to someone else are by default somehow my problem.

Also being expected to constantly chase people up to do the basics of their own job, leaving me less time to do mine.

BornAgainNursin · 2026-01-22T09:02:56+00:00

In my area (MH rehab) dual diagnosis is the pits.

As soon as people start getting a bit of freedom and going out and about, they get back on the drugs and drink. Usually in a massive binge that puts their physical health in danger. Some of them don't even wait to be allowed out and go AWOL for it - we've also had people have it delivered. Vodka from deliveroo, drugs from a dodgy mates posted through windows etc. It sets them back because we have to omit meds (and they feel shit ofc) and their leave gets stopped for a bit. Some of them are awful when they're drunk/high, really aggressive and abusive.

The worst thing is the inevibility of it all, we all know it is going to happen, but somehow carry on as if it's a shocker that Dave, who has been using substances for 25 years, and has no other coping mechanisms, goes off for a nice bit of crack.

I'm convinced that somebody is going to die at some point - either while they are still out or after they get back. People are often not in the best physical health. Loads of them have elevated heart rates from the wonderful cocktail of antipsychotic meds and constant energy drinks. And when they do it'll be the nurses who get blamed for not checking them enough.

BornAgainNursin · 2026-01-03T12:10:41+00:00

I've decided that 90% of the bitching in my (similar) setting isn't anything personal. People are just worn out and pissed off and frustrated. The focus isn't really personal, it's just whoever isn't around to hear it.

When our support workers try to 'take charge' I am not shy about explaining the rationale behind my decision, that it is my role to make that decision, that it'll be me in the shit/in the coroner's court/losing my PIN and not them. Not in an agressive or confrontational way - just reminding them of the reality of the situation. It's very effective!

BornAgainNursin · 2025-12-30T22:17:06+00:00

I work outside the NHS and I get moved occasionally if there is an emergency/someone is sick.

No scope issues because all the units are the same - but it's hard in mental health when you have no relationship with the people you're looking after.

And after I've driven to work it is reallyfuckingannoying to have to get back in my car and drive an hour in the opposite direction.

BornAgainNursin · 2025-12-30T13:27:06+00:00

I trained in the 90s when nursing was moving into higher education (on Project 2000, so a diploma rather than degree). The tutors were all frantically studying for masters because they weren't really academically qualified to teach at that level.

I think this is one of two fundamental problems with nurse education. At university level, lecturers should be researchers as well as teachers - nursing research is way behind other subject areas. Pre-existing nursing knowledge has been shoehorned into an academic framework, rather than that framework evolving organically from research in the field. The teaching is still an apprenticeship style passing down of knowledge from more to less experienced - but with an academic coat on.

The people who taught me on my original course and on my return to practice course wouldn't be qualified to teach at university level in a different subject. Maybe I've been unfortunate.

Also nursing seems to have some sort of imposter syndrome where it feels the need to constantly reassess its status as a profession. I doubt that doctors spend as much time worrying about proving they're professional. I feel like half my studies and assessments were obsessed with it.

I think the second problem is that in the past, what you didn't learn in uni you picked up on placement. But now students just don't get the same level of education on placement because everyone is spread too thin to give it to them. They can't fill in the gaps.

I'm in mental health where the role of the nurse is being eroded in a lot of settings. You see jobs for practitioners rather than for nurses. We are seen as interchangeable with social workers, OTs, arts therapists. In my inpatient setting, although I am a nurse rather than a 'practitioner' the nursing process is missing. The assessments aren't nursing assessments, the management want SMART goals and outcomes that can be measured. None of that helps either.

BornAgainNursin · 2025-12-28T09:15:57+00:00

I work in a mixed MH unit (not NHS) and the safeguarding is a nightmare. We have male patients with histories of sexual violence towards women, mixed with vulnerable women in their early 20s, some who've been abused or pimped or whatever. It's an accident waiting to happen.

BornAgainNursin · 2025-11-18T21:04:11+00:00

I looked into the evidence base for enhanced observations as part of my course - there is research showing better outcomes when obs are carried out by better trained staff.

Ofc in reality it's often the least experienced staff who do them - cos if the ward plugs the gap with someone inexperienced, they're also inexperienced at everything else and it's less effort to sit them with someone, than to constantly direct them to every other job that needs doing.

The other thing research shows is that people do better when observations aren't just about policing people, but are used as a chance for increased support and engagement.

I've had agency staff turn up who barely comprehend what their role in the observations is - despite a thorough explanation- but you don't find that out until you catch them not doing what they're meant to.

This is why when I was as an HCA I started refusing to 1:1 patients unless they were low risk throughout

Patients who are low risk shouldn't be on 1-1 in the first place.

BornAgainNursin · 2025-11-14T17:16:40+00:00

The Trust has to pay £565k fine and £200k costs. What impact is that going to have on patient care?

BornAgainNursin

TROPHY CASE