Caring for patients with complex mental illnesses ranging from schizophrenia to drug induced psychosis is no easy feat. And this work takes on a whole new dimension when patients are ex-offenders or admitted to a mental health unit by court order.
For Michaela Share, a band 5 nurse working with mentally ill patients at St George’s hospital, part of South Staffordshire and Shropshire Healthcare NHS Foundation Trust (SSSFT), there’s no such thing as a typical day. While there are some constants: each shift begins with a handover to bring incoming staff up to speed and involves writing reports on patients’ progress, there are also plenty of things that you can’t plan for.
It’s not unheard of for patients to have violent outbursts. They often get frustrated by the restrictions placed on their freedoms that sometimes differ to those they had in prison – smoking, for example, is prohibited. But Share says these things don’t characterise the role. “On some occasions [patients] get angry, like everyone does, but it’s not something that’s a constant in the job.”
Despite the intense and unpredictable nature of her work, Share has no regrets about choosing to work in the unit. “I picked the forensic ward because a lot of the time our patients are in here for a long period of time so we have the chance to build up a good therapeutic relationship with each patient.
During her shifts, which alternate between day and night, Share manages the responsibility of 13 patients with one other nurse and two healthcare assistants. It’s a role that requires an organised and dedicated person. She says the workload can be challenging if you don’t plan time for tasks in advance.
And when it comes to looking after the patients, Share says it’s vital for nurses to be able to separate them from their criminal activity. “Some people [have committed] quite horrific crimes and if you can’t block that out and still communicate with the patient, then there’s no point coming onto this ward.”
As well as looking beyond people’s criminal pasts, nurses need to be patient, understanding and exercise compassion. Share says that having staff who really care makes a real difference to the way a ward is run, and to the patients.
One former patient who Share worked with for around seven months was discharged from the unit recently, a rarity on a ward where patients can stay in treatment for years. He had drug abuse-related mental health issues and was anxious about life outside the unit, having spent a considerable amount of time in prison. To allay his anxieties, Share accompanied him on public transport, on shopping trips to the supermarket and helped him plan activities that would occupy him on release, and help him avoid the people who introduced him to drugs.
How the trust supports its staff
To manage such a demanding workload, healthcare staff need great training and support. These are two things which are on hand to employees at the trust, Share explains.
“I feel you’re quite well supported. My manager’s really good, very approachable [and] so are the band 6 [nurses].”
During her preceptorship – a learning development programme for newly qualified nurses – Share was given a mentor who she shadowed. And this peer guidance isn’t only available to new starters.
Theresa Shaw, the trust’s head of learning and development, has built a pool of qualified coaches over the last few years who can support colleagues across the trust facing particular challenges or aspiring to change roles. An online database of mentors has also been set up to give all staff access to one-on-one mentoring.
And the process is made simple and accessible with staff having the autonomy to seek out a mentor. “[They] can easily find somebody in the organisation who’s offered their services as a mentor without having to go through formal application processes.”
Shaw says it’s all part of the trust’s strategy to “create an environment where staff feel supported and engaged and have opportunities to discuss their development”.
Share, who previously worked at the trust as a temp, didn’t hesitate to apply for a full-time role with SSSFT, largely because of the atmosphere created by the staff. “They make you feel like you’ve been working here for years, even though you’ve only probably been working here for a couple of weeks.”
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Content on this page is paid for and produced by the South Staffordshire and Shropshire Healthcare NHS Foundation Trust.
