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'Are general nursing students ignoring mental health?'

On the adult branch we’re mainly guided by a medical model, patients’ physical care needs are at the forefront of all interventions and conversations.

The question I think is, are we missing something?

By prioritising physical care needs do we ignore the impact of mental health? I believe it is worth considering that exacerbation of physical symptoms may have a root cause in the mental health of an individual.

Students worry that if they ask a person if they are ok they will suddenly explode with emotions

I have often found that mental health is kept distinctly separate from physical care and I wonder why this is?

Sometimes I think there is element of fear within the adult branch, people worry that if they ask a person if they are ok they will suddenly explode with emotions.

We too often use the excuse that we are adult branch, we aren’t trained and the individual is only there to be treated for a physical ailment.

It is within our NMC code of conduct to not discriminate against an individual, to treat people as individuals, and to treat them kindly and considerately. To me the most important aspect of care I can deliver to a patient is asking ‘are you ok?’ or ‘how are you?’.

I make sure that the first questions I ask are not guided by what they rate on a pain scale or how their nausea is - it means that the person feels you are genuinely invested in them.

This helps develop a relationship where the patient may feel comfortable enough to say  that ‘no I’m not ok today’ and as nurses, and compassionate individuals, we are then in a position to be able to support them.

Stigma is as rife within the nursing profession as it is the general population

What I find disappointing is that stigma is still as rife within the nursing profession as it is the general population.

This is not always expressed explicitly, but avoiding a patient or sending a student to go see the ‘difficult patient’ – who has come into the hospital environment to have their medication altered without consultation, their independence dampened – adds to this issue.

Mental health is not something to be afraid of, or to be emphasised inappropriately. We have all experienced the whisper in handover when the handover sheet says past medical history of depression, and especially suicide attempt.

What gives us the right to judge someone on the basis of a snapshot period of their life? It may not even be relevant anymore, and nurses are meant to provide care without judgement.  

A suicide attempt could have occurred twenty years ago, and the only way to gauge its significance is to have an open honest discussion with the individual.

By spending time with patients I have been able to gain a deeper understanding of their lives, and therefore provide higher quality physical care, alongside the psychosocial support everyone requires.

As adult student nurses it is crucial that we acknowledge that mental health is an area that we could do better in.

If we are not taught about how to provide non-judgemental care then we need to fight to be taught this to decrease the stigma within health services. We need to challenge our colleagues and peers, to acknowledge that mental health is our area to address.  All patients deserve the best care possible; the way to achieve this is by recognition that there really is no health without mental health.

Natasha McVey is a third year student nurse studying adult nursing at the University of Nottingham.

Readers' comments (2)

  • excellent article outlining points of great importance in the care of people with mental health problems.

    in order to deliver holistic and individualised care and offer the highest standard of service to patients mental health has to be fully integrated in adult nursing and medical care. better education and training should help to stamp out such judgements as mentioned above and the catalogue of them I have experienced throughout my long career from staff at all levels which never cease to surprise and shock me. Somehow those making such judgements and remarks seem to think it is clever but maybe it is covering up a feeling of powerlessness in not knowing how to deal adequately with the problems a patient may be facing.

    As a student on I was told by the sister in charge of a medical ward that a newly admitted young girl semi-comatose after a suicide attempt was just attention seeking and we should only give her basic care and we were called away if we prolonged our stay at her bedside. Another patient with borderline personality disorder, without being offered any further explanation, we were told just to carry out basic care but not to enter into any conversation with him as he could be aggressive. I could go on!

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  • Well said Natasha. As a adult nursing student I did a mental health nursing placement - I remember being more nervous about it that 'normal' pre-placement nerves. What I learnt about being alongside someone, listening to their story, trying to empathise/understand why they had acted as they had etc. were all lessons that stayed with me through the rest of my career. & they're all skills relevant to adult nursing too - even if 'only' relate them to general nursing issues such as health promotion, people with alcoholic liver damage etc etc.
    As well as the code of conduct re: discrimination and the mantra about holistic care, there's the current focus on compassion, the need for every patient to feel safe etc. It seems far easier for general nurses to reclassify the 'challenging behaviour' of a patient with dementia as 'understanding their stress & distress', but I have found very few nurses able to offer the same to patients (or colleagues) given a mental health diagnosis.
    Within the last week I have witnessed an A&E nurse refuse to help a patient who had attempted suicide who had called out for painkillers as the nurse went past (not calling out otherwise) be told to "shut up as we're busy with patients who are really ill" - hmm, compassion/being non-judgmental at its best??

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