Life on a Mental Health Mixed Acute Ward

It’s a roller coaster ride


Some people like them some people don’t but life on an acute ward is often up and down. Some days are busy some days are – dare I say the word…. Quiet!


But no two days are the same, which for some people is what attracts them to work the acute life.

Acute wards in mental health are designed to be a place for assessment and or treatment for people experiencing a severe episode of mental illness. Admissions can come at any time in the 24 hour period and with varying degrees on urgency.

Some patients are informal and choose to be admitted as they may recognise they are unwell, others are brought in on a 136 section from police custody due to concerns for their welfare or that of others. All will need risk assessing and care plans put into action straight away.

On top of the new admissions there are the often another 20 or so patients on the team-upward (depending on the size of the units). These patient’s presentations may vary day to day depending on how their treatment is going and how they feel it is going. Whilst mentally unwell, patients may have little or no regards for others on the ward so balancing out everyone’s needs can be hard. Team work is essential.

Some patients may be restless all night so keeping the disturbance for others to a minimum is another challenge. Flexibility and thinking on your feet for solutions is another necessity for a mental health nurse.

However there is nothing more rewarding than escorting a discharged patient calmly off the ward knowing they are now thinking  and feeling a lot more clearly and will hopefully be able to manage their illness out in the community and regain their place as part of  their family or community.

As a student nurse a mental health ward is one of the best places to really understand what someone experiencing a mental health illness can be like. Every kind of illness could be admitted, from depressive or manic behaviour, thought disorders and post-partum psychosis to severe self-harm and aggressive behaviours. To match the variety of illnesses you may encounter there are the medications to match.

The medication trolley will be your nemesis as a student nurse. Trying to remember your anti-depressants from your mood stabilisers and your anti-psychotics becomes stressful as you are under the watchful eye of your mentor as well as the patient themselves. You probably won’t remember them all so don’t try too.

Always ask if you are unsure – the patient is an expert in their own medication usually as well so there is no harm in asking them if they are stable in their presentation to assist you. This also helps to check the patients understanding of what they are taking their medication for; which is part of the NMC Code.

Talking to the patients can seem daunting at first but just being around canbe helpful for some as a piece of mind that someone is there is they need them. As a student nurse you may often find during your shift you have more free time than the qualified nurses so you can become extra support and provide more vital one to one time with a patient. Just don’t forget to document it afterwards.

Love it or loathe it acute wards can throw anything at you at any time of your shift they really are a roller coaster!