‘I think of what Simon taught me every day of my working life,’ says Richard. Looking back on this relationship, he recognises how invaluable it was to the clinician he has become. ‘I’d really like to thank him and the programme.’
‘Mental health was the last placement I wanted.’
In 2016 he wasn’t very keen on the idea of doing a mental health placement. ‘I told everyone that it was the last place I wanted to be. But when my placement came to end,’ he says.’ I was like a kid kicking his toys out of the pram. I did not want to leave! So much of that was down to having the support and insight a LEC gives you.’
‘I realise now I didn’t really know anything about mental health - or rather, I had a misunderstanding about it. I’d worked as a health care assistant in an A&E department and had seen people come in at crisis point – and then after a couple of hours, when they had seen a mental health nurse, they were able to walk out as if nothing had happened! This made me think they were wasting our time – rather than realising the skills of the mental health nurse!’
‘I thought I knew what it was like to be a patient.’
‘So, when I had to do my placement in mental health, I thought it would not be my cup of tea. The day I had to meet Simon I also had my doubts. I must admit I questioned the value of a LEC. I had been in hospital myself, so I thought I knew enough about what it was like to be patient. But after talking to Simon I realised that it was a very different experience, with different needs. I knew about Simon’s mental health condition and that he had been a patient. But he was fantastic from the start – giving me the courage to ask the right questions and very open about his experiences. It all started to make sense. The penny dropped about what it is like for someone experiencing a mental health issue. It’s not as visible as a broken leg, but it is just as real.’
The big shift from working with my LEC was to take a holistic approach
‘The big shift for me, working with Simon, was from my previous very task-orientated experience as an HCA to being able to take a holistic approach to patient care and seeing the person, not the condition. Like offering someone a cup of tea and sitting chatting with them. Simon told me that it’s not about waving a magic wand. Sometimes it is as simple as saying to someone, ‘Tell me your problems’. Many people just want to be heard and a listening sympathetic person can help them come down from a crisis.’
When Richard went on to another placement, he was asked to improve his time management and realised it was because he was taking time with patients and talking things through with them.‘There was pressure to become more task-oriented again, but I felt confident enough to challenge this and continue supporting my patients in this way.’ Since qualifying in January 2019 and joining the NMC Register, Richard has been working in community nursing, but is still able to bring his experience and knowledge to support his patients’ mental wellbeing.
It's about really getting to know the patient
‘An important thing I learned from Simon is about really getting to know your patient. Even if I am doing diabetic foot care it involves building up a rapport and getting to know the patient. I will ask about the family and how they are doing with eating and sleeping,’ he says. ‘Then I can see if they are in a low mood and I can dig a bit deeper. So I may need to signpost the patient to other support if needed – referring to other local area co-ordinators, for example, if they are housebound or refer them to the GP for a mental health check, or making sure the medication is sorted out. It’s the same whether you are working with someone with a stoma, or with leg ulcers – asking how they are and how they are feeling. When I first started in the community, I was working with a patient who was insulin dependent so it would have been easy to focus on the injections, but I realised he was having suicidal thoughts.’
My LEC experience gave me the confidence to ask the right questions
'I was grateful my LEC experience gave me the confidence to ask the right questions and it emerged that he was feeling lonely and isolated. I made sure he was safe and explored what protective factors were available.'
Richard’s experience in mental health services has also inspired him to explore and research more about certain conditions. ‘I have become geekier,’ he confesses, even though he is not required to do any more formal academic work. ‘Many patients we look after have depression, schizophrenia or have attempted suicide, so I want to find out not just about their medication, but also about the background and what might have brought this situation about, to give me more insight into how we can help them.’
All students should have this opportunity
‘Working with a LEC gave me confidence in so many areas. I think all student nurses should have this exposure to mental health and getting the other side of the story. This way we can bring this rounded experience of both physical and mental health skills to support our patients.’