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You Have No Choice But To Cope: A Day On The Ward With A Student Nurse
Date Posted: 31/Jul/2017
It’s exhausting and sometimes distressing, but Chantelle Brooks, on her final placement at a mental health hospital in Blackpool, wouldn’t work anywhere else
 
Inside the Harbour, Blackpool’s mental health hospital, a patient is anxiously eyeing up the student nurse who is taking another patient’s blood pressure. When it comes to her turn, the woman begins shouting insults. On the acute woman’s ward, it’s easy for things to escalate if one patient becomes upset. For nurses on placement, it can be a stressful introduction to life on the wards.
 
Chantelle Brooks has learned to cope by now. This is her final placement on a three-year degree course in mental health nursing at the University of Cumbria. Despite the occasionally distressing nature of her job, she can’t imagine doing anything else.
 
Her shift started at 7.30am today. Although she admits to having had a hard couple of weeks, Brooks is all smiles. She has been working 37.5 hours a week as part of her placement, while also managing university assignments and shifts as a bank support worker to earn money. Her nursing bursary – now a thing of the past – amounts to just £77 a month, but she’s lucky enough to be able to live with her parents. Still, she regularly forgoes the student nights out and hasn’t seen her friends properly for months.
 
All her hard work has paid off though: she’s just found out that she has earned a first in her degree and a job at the Harbour starting in September.
 
“It has involved a lot of time management and planning,” she says. “It’s been knackering, especially in the second year. It all hits you at once. I’ve had to make a lot of sacrifices, but it’s been worth it.”
 
The ward Brooks is working on has 18 beds and the patients have a range of severe mental illnesses, including schizophrenia, bipolar disorder and personality disorder. It’s always full; demand never ceases and there are never enough beds.
 
After a handover with the night team, the nursing team is up to date with their patients. These meetings ensure important information about individual patients’ state of mind and the general mood of the ward is passed on. “With 18 patients to get through, it’s sometimes hard not to go over the half hour,” says Brooks.
 
A little later, nursing and support staff meet the consultant doctor to review treatment plans. Patient observations are pulled up on a big screen using new software called Nervecentre. Gone are the days of leafing through hefty patient files.
 
On the ward, each patient gets their own bedroom, which is similar in size and design to those seen in student halls of residence. By 9am, there aren’t many patients left in bed – establishing a routine is an important part of their recovery.
 
Outside in the garden, a woman attempts to feed a pigeon perched on the high perimeter wall. Inside, a patient is lying down on some seating in the TV area, and an activity coordinator begins to set up in the arts and crafts room. Another patient in a tracksuit approaches Brooks and asks about her upcoming leave – unaccompanied time away from the hospital.
 
After informing a senior nurse about the patient’s request, Brooks sits down with her mentor, the ward’s deputy sister, for a chat. Having a good mentor is crucial for student nurses, she believes. “I was nervous before my first placement as I didn’t know what to expect. I quickly realised how important having a mentor is, especially when you’ve had a tough day.”
 
Her advice to nursing students starting their first placement is simple: “You get out what you put in. Decide what you want to learn and make sure you work closely with your mentor so you can achieve your goals.”
 
Back in the nurse’s office, her colleagues are busy completing paperwork and reviewing risk assessments. The whiteboard is divided up into different levels of supervision, with the highest being two support staff to one patient. There is currently one patient at this level and she can be seen walking slowly back to her room with two support workers.
 
The risk of self-harm, violent behaviour and suicide is high, and even those on the lowest supervision levels need to be monitored for the signs – something Chantelle says only comes with experience and getting to know patients as much as possible. “Sometimes you see a patient sauntering off and you just know. You get used to their early warning signs. You have to activate your alarm and get help quickly. It is scary and you can be a bit shook up after.”
 
Brooks says that experience has also allowed her to deal with the sights and sounds she has witnessed. “Stuff that bothers you in year one doesn’t as time goes on,” she says.
 
When one patient becomes violent, it can often have a knock-on effect on the others. Prior to her first placement, Brooks wondered how she would cope. “I have realised it’s just one of those situations where you have no choice not to. Adrenalin kicks in and you go on autopilot.”
 
A new admission has arrived so Brooks must introduce her to the ward and go through the paperwork. She also takes baseline observations, including height and weight, and informs the doctor and mental health act administrator that the patient has arrived.
 
This makes for a busy few hours but the rest of the day runs fairly smoothly. A patient is granted overnight leave so Brooks updates her risk assessment and makes contact with the family. Some of the patients go to the sports hall for organised activities.
 
At 3.30pm, her shift ends. “It’s been a positive day, all in all,” she says, before heading off to the gym to unwind.
 
By Nicola Slawson @nicola_slawson
Supported by Bucks New University, Source: Theguardian

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