Posted by: ayrshirehealth | January 20, 2016

The Accidental Nurse? by @jonnybaldy

The careers officer

I think I must have been in third year at high school when our year met with the careers officer that I first had to really start thinking about what my chosen profession might be.  SPSP MHGrowing up wasn’t on my agenda then, perhaps it still isn’t now!  I suppose my options were to become an apprentice plumber in Aultbea with Dad or, like many others from Wester Ross, hit the A9 and head south.  That interview with the careers officer certainly didn’t indicate a career in mental health nursing and definitely didn’t suggest my current role in the Scottish Patient Safety Programme.

Interestingly, the signs were there.  My Grandfather, having been demobbed after the second world war worked in Craig Dunain in Inverness, my Great Aunt was one of the district nurses covering an area from Achnasheen to Gruinard in a series of inadequately powered three door Ford Fiestas and a couple of other cousins are nurses.

Ultimately, I decided that I wanted to be a PE teacher, but after six months into my first year I realised it wasn’t going to work out. After a couple of chats with friends and relatives I had my NBS Catch form filled out, a bursary rather than student loan, and in to the Lothian College of Health Studies to study mental health nursing.  I had no idea what I was doing; I truly was an accidental nurse.

I saw people ..

I spent the first couple of terms getting to know some wonderful classmates, some really interesting lecturers and working out if the islets of Langerhans was a place or not!  Then it happened, a placement on an acute mental health admission ward.  MH WardI don’t remember being particularly nervous and indeed I don’t think I could have been because I had no idea what to expect.

I looked around the ward and I saw people.  I saw people talking, sleeping, eating, laughing and crying.  I saw people struggling, I saw people getting angry, and I saw, for the first time, restraint.  Now I was nervous and now I was more than a little bit scared.

How was I supposed to help when I was the one out of their comfort zone, out of their depth?

So what do you do when this sort of thing happens?  I think I’ve always been compassionate and a bit of a thinker.   So, I think I was okay on that front.  But, as a student, as an observer, how do you learn to engage, interact and support somebody to recover?  You become a sponge for what is around you and you absorb some good and some bad, but through inexperience and naivety it was sometimes hard to tell the difference.

Growth – change

Fast forward 20 years, and with the ability to reflect on that moment and my time from student to Charge Nurse to the Scottish Patient Safety Programme, I realise and recognise I have been more than fortunate to have been able to play a part in caring for some wonderful people.  SPSP JourneyI have also been incredibly privileged to work with some incredibly talented, skilled and compassionate people too. Let’s be clear here; I learned from both groups.

These are the people that continually help us all to develop.  They will help you keep that degree of curiosity around challenges to custom, practice and culture to make you constantly improve.

I know these are the folk that keep me passionate about being a nurse, something that is essential to me since I left day to day clinical contact.

From restriction to recovery

And, I keep meeting these people, much like the team from Intensive Psychiatric Care Unit in NHS Ayrshire and Arran I met when pulling together a story for the recent Scottish Patient Safety Programme Conference.  SPSP leadersAcross all grades and disciplines in this team I witnessed a belief and indeed a need that person centred and safe care is the only thing that matters.

To move an IPCU from control to greater compassion and from restriction to recovery isn’t straight forward and the shift in culture shouldn’t be underestimated.

I see a service, with evidence, continually looking to improve and a team developing a comfortable relationship with data, even when sometimes it isn’t going in the preferred direction.

Reduce harm

Person centred thinkingIt’s this that motivates me.  I didn’t become a Nurse to restrict people, or to use strong chemicals to control them and when I see and hear of work around the country across all professions from service users, carers and third sector groups I am comforted by the fact that I am in the majority.

It’s this desire to reduce harm that drives the work of the Scottish Patient Safety Programme in Mental Health forward.

So, 20 years since I started my training, am I still an accidental nurse?  Definitely not!

This week’s blog was by @jonnybaldy (Jonathan MacLennan, Programme Lead, Scottish Patient Safety Programme – Mental Health, Healthcare Improvement Scotland.

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