Posted by: ayrshirehealth | April 29, 2015

From CPN to Supergran! by @craggyirene

Dear diary

I have been a Community Psychiatric Nurse (CPN) for 16 years and I have decided the time has come for me to take early retirement. NHSaaaThis has given me the opportunity to reflect on what is a CPN and why have I stayed in the same team without venturing out to pastures new.

A CPN or Community Mental Health Nurse, as the job is now known, has numerous roles and I wondered if my job description would accurately describe what I do on a day to day basis.

So I have looked back at my diary over the past month or so to remind myself what I have been doing as each day if often so different.

Phased retirement

We have caseloads of around 30 patients but this can vary depending on the number and urgency of referrals received, mostly from GPs.  As I am getting close to starting my phased retirement I have been considering carefully my input, along with my patients, and whether they require longer term CPN input and thus require to be transferred to a colleague or if we are able to complete our work and discharge them from my caseload. retirement

My week usually consists of brief meetings every morning to keep us, as a team, up to date with any concerns regarding our patients overnight or from the previous weekend.

I also attend a multi disciplinary clinical meeting each week where patients with complex needs or where there are increased risks can be discussed with the Consultant Psychiatrist and other team members.  Consultants are readily available throughout the week for advice if required.

My patient group either has severe or enduring mental health needs or are in crisis where the risk to self or others has increased. I would usually see patients either at home or in clinic settings depending on need or risk identified. I would assess their needs and ascertain whether they are suitable for input from the Community Mental Health Team (CMHT), be signposted to other services or discharged back to the care of their GP.

A range of interventions

As a CPN I would be able to offer a range of interventions to my patients i.e. supportive counselling, psycho-education, relapse prevention, anxiety management, administration of intramuscular antipsychotic depot injections, monitoring efficacy of medication and identifying side effects, obtain blood samples as part of Clozapine therapy, care managing support packages, care planning, advocating and be able to offer support to their carers. I would also help my patients to access appropriate services for assisting with debt management, maximising benefits, volunteering, college, work placements, housing etc. This list seems endless which at times it feels like it is. The most rewarding part is preventing relapse and seeing how recovery has helped patients lead more fruitful and meaningful lives.

FACEAll these assessments and interventions have to be electronically recorded on FACE which is time consuming but hopefully this system will continue to improve. We are currently piloting the use of iPads to make it a more portable and user friendly system for community workers thus leaving more time for direct patient contact.

As a Charge Nurse I supervise a Staff Nurse and I am supervised by my Team Leader. I also have days where I am on Duty and respond to any crisis that develops throughout the day for our team. These calls can come from GPs, other health professionals, Social Workers, colleagues, patients or their carers. I am also on a rota to work weekends covering Ayrshire wide again dealing with any crisis that may develop. On Duty or at weekends we work closely with our colleagues in our Crisis Team.

Sleepless nights

On a normal day my diary management goes according to plan until any of my patients relapse. This can lead to longer visits, introducing my Crisis colleagues to offer additional support, contacting my Consultant for advice, arranging informal hospital admission, escorting to hospital or being involved in a detention under the Mental Health Act.

I have had the odd sleepless night worrying about my patients in the hope that I have done my best for them in assessing risk to keep them safe. I have had that stomach churning moment when we hear of an untimely death and wonder if I was the last person to have contact with them.

So what is it about my team that has kept me in there for 16 years? We laugh, we cry but ultimately we support each other as this job can be very stressful at times. They say laughing is the best form of medicine and we do plenty of that! We recount memorable things that have happened in our careers and in our personal lives.

Alice CooperI can recall many funny things that have happened in my career. I have helped to put out a kitchen fire during a routine home visit and came out looking like Alice Cooper with black tears running down my face and soot sticking to my hair and clothes.

I will never forget the time my colleague and I were visiting a patient and her elderly mother. They made us tea and used their best china, only tell us half way through eating the delicious doughnuts offered that they found them sitting on their garden wall!Doughnuts

Another time we were taking a patient to hospital in my car and we had her cat in the boot in a carrier as we had to drop it off at a cattery. Unfortunately the poor cat must have been stressed by the journey and urinated numerous times in its carrier. The smell was awful and we travelled the rest of the journey either holding our breaths or with our heads out of the windows.

I, like many others, have numerous stories that lead to fond memories of working in my team.

Supergran

SupergranSo how will I fill my day once retired?  That won’t be a problem as I will be looking after my baby twin grand children to let my daughter return to work fulltime for NHS Ayrshire & Arran.

I keep active with regular hillwalking and cycling but I am also looking for some voluntary or paid sessional work.

I feel interaction between adults, whether with patients or colleagues, has been an essential part of my life and that is what I think I will miss most.

This week’s blog was by @craggyirene (Irene Cahill), Community Mental Health Nurse, North Ayrshire Community Mental Health Team, NHS Ayrshire & Arran

 

 

 

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Responses

  1. Irene, a heart warming reflection reminding us of the complexities of day to day life of a CPN – but also if the importance of that role.

    Good luck with the next chapter of your life.

  2. I read your ‘work examples’ with amusement and you really did make me laugh out loud as I read them. But I do think it’s all too easy for us ‘not’ to fully appreaciate the challenges you face as CPNs.

    Good luck in your retirement x

  3. Really enjoyed reading your personal blog. All the best in your future challenges.

  4. Enjoyed reading your blog, you will be missed by all you colleaugues in the CMHT when you retire. All the very best in your retirement and enjoy every precious moment with your twin grand children, different challenges lie ahead for you now Irene. Good Luck.

  5. I enjoyed your blog Irene – it was interesting to read your reflections on the role of the CPN. I wonder how it has changed since you started?

  6. Thanks everyone your your kind comments, its really appreciated. I hadn’t realised how many people would have read my ramblings from NHS Ayrshire & Arran, Facebook and Twitter. Feeling a bit overwhelmed 🙂

  7. HI Irene, a real interesting read it is good to remind ourselves what we are here for the patients. I hope you have a long happy retirement. If you get bored the Gaiety Theatre is always looking for Volunteers either to sell the tickets or work in the front of the house. Myself and some of my colleagues do this and it is so rewarding.

    • Thanks Jessie for suggesting the Gaiety. Would have been interested if I lived nearer Ayr.

  8. […] by Irene Cahill  certainly seemed popular judging by the number of retweets, and which was called From CPN to Supergran!    In this blog, Irene, a soon to be retired Community Psychiatric Nurse, recalls some of her […]

  9. You truly are SUPER Irene xxxxx


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