I was 27 when I began nursing. I had a degree in philosophy, and lived in a low-rent social housing flat. I actually applied for mental health nursing, speech therapy and social work all at the same time. I felt it was time to do something ‘useful’ and get out of my head, which was full of nonsense and easily distracted by stories and songs
In truth, I have never felt that mental health nursing is characterised by a single approach, belief or set of attitudes. I have known nurses who exist to service psychiatry and others who can barely tolerate the industries that coalesce around acute distress and simply see their job as skilled companions. They are all on the register, they are all called nurses, they have little in terms of philosophy, politics or sense of purpose in common.
In fact, I would go so far as to say that the title mental health nurse has become so diluted, ubiquitous and generic that it does not in itself mean anything other than common regulation by the Nursing and Midwifery Council and some legal responsibilities. Given the pressure on services, that is perhaps the point: there are thousands of nurses holding responsibility for risk. I do know those branches of nursing attract all sorts of people for all sorts of reasons and, traditionally, it has attracted slightly older candidates.
Perhaps the alleged proposal in the overdue NHS long-term plan to offer mature students in mental health and learning disabilities £5,000 ‘earn and learn support premiums’ or what we might call, ‘sweeteners’ makes sense. Recruits to nursing are down (32%), recruits from more mature applicants are even more down (40%), fewer people are being drawn to mental health and learning disability nursing programmes. Why wouldn’t we encourage recruitment if we can?
Granted, it doesn’t quite cover the £28,000 fees that students have to pay now, or even the first year of the bursary that nurses don’t get anymore, but it is better than the original proposal, which amounted to 20 minutes a month on the communal foot spa and all the pickled eggs you can eat.
If you were 24 and thinking of becoming a mental health nurse would you wait a year now? If you were 23 and planning to become a learning disability nurse would you wait two years? Or would you think ‘I’d best get on, the way things are going we won’t have a health service in two years?’
More pressingly, is this proposal a halfhearted, shrugging response to the abject failure the removal of nursing bursaries has been? Or might it be an attempt to state the special value attached to those particular branches? If so, perhaps they might like to back that up by getting quotes from existing mental health nurses – the ones with the really big caseloads – talking about how valued they feel? Alternatively, might this policy simply be despair. A sort of ironic pre-NHS plan illustration that there really is absolutely no plan.
Personally, where recruitment is concerned, I think reason left the building some time ago. And it was riding a unicycle. I am never going to say that it was better in my day. It wasn’t. But it was easier, much easier. I worry that underpinning our attitude to nurse education is an unreflective masochism, not only is the course hard, the work hard, the services massively under resourced but you must also be hungry and in debt. We are unkind and our policies are abject rubbish when it comes to students. Wouldn’t it be nice if this year nurses took charge of those policies and looked after their young?
Mark Radcliffe is author of Stranger than Kindness.
Follow him on twitter @markacradcliffe