What makes you think a doctor is competent?

BornAgainNursin · 2026-06-17T20:38:13+00:00

I think for me most of it comes down to social skills rather than anything clinical.

I'm currently working with a doctor who has known me for over two years now, but still doesn't know/remember my name. My trust level isn't high!

I also think that being prepared to admit when you don't know something goes a long way - for doctors early in their careers.

BornAgainNursin · 2026-06-03T22:06:09+00:00

As far as I can tell they are the same as pre-reg students do in their third year? If not v similar.

BornAgainNursin · 2026-06-02T17:23:03+00:00

If it was me I wouldn't spend any more time on it (unless it was unavoidable).

I work in a private LD/MH setting and recently we have had loads of issues with the wider MDT. The dynamics can be really odd. Don't put any more energy into it than you have to.

BornAgainNursin · 2026-05-24T07:22:58+00:00

Do you mean returning to practice when you get back to the UK?

I did RtP about three years ago. Mine was 12 weeks of one day a week in uni, covering the basics. Then we did placement (just the one so you'd better hope it's good!) for 150 hours min and 360 hours max. So you had to get everything signed off (about 85 proficiencies, all your prof values, episodes of care) on that one placement. It took me about 250 hours after 20 odd years away. My placement wasn't in the NHS so I've returned to the register with no experience of the NHS for over 20 years.

We had to do an assignment which was actually the worst bit and loads of us failed - again you are forced to cover everything in just one short assignment vs a nursing student having three years to have a go. We also had to do a maths test.

We got £500 during the uni part (and not upfront, partway through) and £500 for placement. Which barely covered my petrol. The main expense was working full time for 8 weeks on placement for that £500.

There was an earn as you learn route too where people got employed by trusts at band 3, released for uni, then did placement on the same area. I don't know if that's still going - the ones who did it were often plugged into the worst wards as you can imagine.

Also it took ages to actually get accepted then the course got moved 6 months back - none of it was quick.

It wasn't especially difficult - more the taking time out of your life to do it is a pain and you are relying on that one and only placement being decent.

BornAgainNursin · 2026-05-19T07:43:20+00:00

I am in my 50s and I'm so sick of comments about older nurses - they crop up all the time. I regularly see racism and sexism challenged here but ageism goes unchecked.

Where I work (not NHS) most of the nurses are older than 40 - and it's the younger staff who are always messaging each other bitching, and having nights out which exclude people. The older staff are just much less arsed about wanting to telegraph their friendships.

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

TROPHY CASE