Strange anniversary.

It was 5 years ago, December 19th 2001, that I quit nursing. At university I gained a Bachelor of Nursing degree having studied to become a qualified mental health nurse and a qualified community psychiatric nurse. The last year of the four year degree was a year of community nursing, holding a caseload of patients. It was varied, it was challenging, and above all it was rewarding. By 1999 I was working on an acute psychiatric ward with 22 patients, some detained under the mental health act, and working with 2 other staff each shift. In 2000 I moved to a locked ward (I spent much of my training in a similar environment) of only 6 beds where the patients were at the height of their illness, either suicidal at the peak of depression, or continuing to attempt to leave the hospital, refusing treatment, or being a danger to themselves or others. The patients lives were often in ruins. Their illness had lost them friendships, frustrated their families and in many cases left their lives in a static state or worse, in a downward spiral. Due to their illnesses, many patients were more vulnerable than ever, behaving sexually or aggressively, or often living their lives in fear of the delusions and voices that haunted their every waking moment. As a nurse it is your duty to protect these people. To protect them from exploitation and promote their own dignity. Often you are protecting them from behaviours brought on by their illnesses, and frequently you have to work in a team of nurses to stop one patient's aggression affecting others' recovery in hospital.

To do this you need the support of management. You need adequate staffing and you need appropriate training in techniques to safely restrain and manage violent and aggressive behaviour. You need the best tools available to try and give the patient the best care possible, to try and help them through the acute phase of their illness without them having to face aggression, intimidation and fear. You need a team of staff who feel empowered to work as a team to bring the best to the patients.

This is why I left nursing. I worked alongside some brilliant staff, particularly in my last year. Mismanagement from above the ward level continually undermined what we were doing and it often felt like we were being bullied and harrassed. For large periods of my time there, a demoralised staff felt unable to offer patients the best possible care. In the end, I had enough. I went on holiday in November 2001. On the train from the airport I thought long and hard. I wasn't happy. I'd felt harrassed by management for close to two years (I took one sick day in 18 months and they told me they wanted me to move to the community as I they thought I wasn't happy) and having been assaulted by patients in September and October, I decided it was time to leave that hospital. And then, on the 13th December, in my last week there, I was in charge of the ward when three patients became aroused, distressed and two of them quickly became aggressive. Despite our setting off the unit-wide alarm system, only three staff came from other wards to help, of whom only 2 were trained to manage aggression and violence. The result was that I and another staff nurse were assaulted (I was dragged backwards down a hallway, punched repeatedly and kicked when I eventually fell to the floor) and I was powerless to make the ward safe for the patients or the staff. This could have been avoided. The outcome should have been better for the patient and the staff. I had personally spent two years voicing my concerns to the management. And so on the 13th December I decided to leave nursing. On the 19th December it was over.

I think about returning frequently. It wi a rewarding job where you can really help people out in times when they can least help themselves. But to do that you need the system to help you. And with Mental Health Care being mismanaged so badly it frequently doesn't help anyone.