Life on a Mental Health Mixed Acute Ward

It’s a roller coaster ride

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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!

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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!

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A Day in a life of a Hospice Nurse

Today I am delighted to bring you a guest blog post from a Hospice Nurse.

After qualifying as a children’s nurse about 2 years ago I worked on a neonatal intensive care ward. Although palliative care was an integral part of the role, I felt that I wasn’t using my specialist paediatric skills so decided to apply for a nursing role at Haven House.

I was lucky enough to be successful and a few months later, I can honestly say I love my job. The encouragement from staff and the hands-on-experience has already helped me progress and develop as a nurse.

The work here varies on a day-to-day basis which makes my job really interesting. At the start of a shift all staff receive a handover from the nurses on the previous care shift. We discuss all aspects of individual care and then a lead nurse allocates each child to a nurse and one of our fantastic health care support workers. This ensures continuity of care and gives everyone a sense of security throughout the day.

Depending on the care plan we bath or shower each child in our luxurious sensory bath that has lights and music. Most of our children attend school, so if it is a weekday we ensure they are dressed, fed and ready for school by 8am. This can sometimes be a challenge but good team work and staff management helps ensure we are usually on time. Haven House has fantastic complementary therapies for children and families to benefit from such as therapeutic yoga and music therapy. When children attend these sessions we usually have the pleasure of providing day care to them as well as attending the therapy session. We also have paperwork, care plans, documentation, audits, research and meetings to attend so it soon comes round to 3:45pm again. The beeping sound of a vehicle in reverse informs us that the school bus has arrived! Each child’s detailed care plan informs staff on shift how, when and exactly what to feed them. After a snack or feed its playtime. Many of our children can’t eat solid foods so are fed through a tube in their stomach.

Next, the children have some down time. Haven House has a sensory room with an interactive floor and walls. Music and lights, sensory toys and games and books for all ages are available in the activity room. Our lovely play co-ordinator ensures there are always activities and crafts set for children to immerse themselves into, whatever the weather. We often spend time in our wonderful grounds or our cinema room – the children love this as it often gives them a feel of family time and time to develop interpersonal relationships with staff and other children. Breaks in play time have to be had when children need changing, medicines or a feed.

Dinner time can’t come soon enough and we either have food ordered in or we whip up a healthy meal ourselves for the children who can eat. After dinner we have a good tidy up and then take the children to their bedrooms to get them prepared for the evening. It’s bath time or showers for those who require them according to their care plan or based on how actively engrossed they were with their messy play and crafts during playtime! Medications are given throughout the day at specific times to each child based on their individual prescriptions.

Once the children are washed, they are dressed in their pyjamas, teeth brushed and settled into their rooms. It’s either story time or a bedtime programme to help children wind down. At 9:45pm the handover process begins again with a fresh team of staff ready for the night shift. I can honestly say it’s a complete privilege to do my job every day. Our children have complex and rare life-limiting conditions and require a great deal of care and attention. I draw my strength from the knowledge that parents and carers look after them on a daily basis without any complaints. Their strength becomes our strength and this translates into brilliant care for each child at Haven House.

Despite the long hours, intensive work and heavy case-loads; I wouldn’t exchange the job satisfaction that nursing gives me for anything else in the world.

Muryum Khan, Pediatric Nurse.