Is mental health nursing the easy option?

A comment on this post at Mental Nurse got me thinking. Jessa had asked what happens to well meaning professionals. DeeDee suggested that:

"Unfairly, mental health nursing has a rep among general nurses as an ‘easy option’, thus leading the lazy to decide to work in it, so you get a larger number of lazy fuckers on the job than elsewhere "

Mental health undeniably does attract some unpleasant people. People who get off on the potential for power that the job can involve, for example; an RMN has the ability to detain patients and administer medication against their will. Because of this, it does attract some freaks. The uni's job is to try and filter out the crap, which frankly they have mixed success with.



And yes, it probably does attract people who want an 'easy' career. It's percieved as being less demanding than general nursing, and in many ways it is. The jokes about drinking tea and playing pool all day started with a pretty firm basis in reality, although these days it's more likely to be the HCA's playing ping pong* while the nurses sit in the office swearing at the computer and cursing the crashed 'uncrashable' electronic records system. You are much less likely to be on your feet for a full 12 hours than a general nurse. There seems to be a lot more 'liasing' (read: spending hours trying to get hold of the Crisis team on the phone whilst simultaneously trying to type up a comprehensive risk assessment for the possibly suicidal patient who's just gone AWOL) in mental health, since MH care consistently broaches numerous spheres.



I would argue though, that they are both damn hard jobs. General nurses have people's lives in their hands, and are often on the recieving end of a whole load of abuse for their troubles....as are MH nurses. Take an example from my night shift: two of our patients tied ligatures round their necks and did a very good job of almost killing themselves. Luckily observant staff were able to intervene quickly. During the second incident, whilst the nurse was trying to hack through the bra strap with the ligature knife, another patient decided she wanted some attention too and, after shouting abuse at the response team for a while, decided to trash the quiet room so we had to attend to her. Then, once the previously suicidal woman had gotten her breath back, she decided she didn't want any help and that battering us would be a good way to proceed. There's nothing like being physically assaulted by a person who's life you've just probably saved to really piss you off. After several hours of us vascillating between one room and the other they both finally wore themselves out. I filled in five incident forms for that 3 hour period. 3 hours of constant adrenaline - wondering if you are going to get kicked/smacked/a tv hurled at you/ stabbed with a pen, or which other patient you might find dead after you finish dealing with the tv wielding maniac, and who is going to get fired when it inevitably happens - is not my idea of the 'easy option'. Add in another 9 hours of heightened awareness, waiting to hear the scream from the bedroom that means the voices are telling her to put her head through the window, or staring in through an observation window holding your breath while you try to work out if the figure in the bed is breathing so you don't have to go in and risk getting abuse for waking them up...and is it any reason people burn out quickly?



I'd like to say this was a fairly extreme example of a night shift at work, but recently it's been every night. The womens ward is going through one incident report book a month.



And those are just the big incidents. Every day we work with people who have tried to do horrendous things to themselves and/or others. The bloke who self harms by trying to gouge out his eyes with sharpened pencils. The woman who bites chunks out of herself. The man who raped his sister. The woman who drowned her baby in a bucket. The man who believes 4 year olds can consent to sex. The 5 stone anorexic girl who was raped by her uncle as a teen. The serial killer. The men and women who have suffered horrific physical, sexual and emotional abuse and are understandably, justifiably traumatised and damaged by it. These are examples from secure units, but these people usually start out in acute services and can be found at varying stages of severity in most MH arenas. Of course, they also pass through medical and surgical wards...briefly. A nurse on a general ward doesn't have time to sit and hear about how their patient was abused as a child. For MH nurses, it's our job. Most people's initial reaction to hearing this stuff is I don't know how you do it....I couldn't.



So all I'm saying is, anyone who thinks mental health nursing is the easy option, it's not. It's just hard in a different way.



*Not suggesting the HCA's have it easy of course, they tend to get the bulk of the hand's on care these days....