Dementia, a Nurse: "I don't feel equipped to treat patients with mental health problems"

From the Guardian Healthcare Network a new post about problems with training for nurses in special mental health care

From Guardian Healthcare Network: Nurses qualify with little training in mental health. Is it surprising that sometimes care falls short as a result?
(THE GUARDIAN) – I once heard a nurse tell a patient, who was half dressed and standing in a corridor screaming, to stop acting like a child. I wondered how somebody committed to caring could show such a lack of empathy to somebody so unwell. After years of working in and around the NHS and having qualified as a nurse, I am no longer surprised that the care of people with mental health problems in hospital sometimes falls short. I know that I too have fallen short.

I look after the same people in hospital now whom I met working untrained for mental health support groups. People struggling to cope with poverty, people without support networks, people with chronic illness, people who have lived through awful things. According to Mind, one in four people experience mental health problems each year. This statistic covers a complex range of problems which are as varied and profound as physical illness.

My nursing course, which I think was excellent, contained no more than three days’ structured education on caring for patients with mental health problems. The Nursing and Midwifery Council says nurses “must be able to deliver care to meet essential and complex physical and mental health needs”.

But there is a lot to cover on our newly degree-level syllabus. With the exception of dementia, which has a uniquely high profile, nurses qualify with little training in mental health.

Specialist mental health staff are an expensive, overstretched resource and they are often not available. In the ever-shifting hospital environment, the nursing staff of a ward are the closest thing a patient will experience to a constant presence. We could improve what we offer. I still find myself struggling to care for mentally unwell patients despite my best efforts, and despite my previous experience. I get frustrated and tired. Sometimes I am not as kind as I would like to be. I know that I have colleagues who feel the same; doctors, healthcare assistants and other nurses. Additional training would be helpful.

Our failure to have a proper public conversation about mental health perpetuates prejudice. People conceptualise people with mental health problems as difficult. “They are a difficult patient” is something we say far too often when faced with aggression or refusal of treatment. I have said it myself, and the sentiment comes from a lack of education and understanding as much as from pressure and lack of resources.

Many of the behaviours that make caring for patients hard are not inherent but are the understandable result of an alienating environment and loss of autonomy. Basic strategies for engagement and communication would help. We urgently need to be listening to the stories of people who have suffered poor mental health, and such listening could be part of our training, both initial and ongoing.

Services are being cut and are fragmenting. The incoming president of the Royal College of Psychiatrists has described a crisis of care in mental health. Properly funded community services are absent. We are going to be looking after patients who are both physically and mentally unwell, and we should be empowering them to look after themselves. We should know what support is available for them, their families and their friends outside of the hospital. There could be more training for this. We need to take it more seriously, as healthcare professionals and as a society.


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