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‘Carers, along with patients, should be at the heart of care’

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Helen Croft wants carers to become involved in co-designing services

I am a newly qualified mental health nurse. I suppose that means that, like driving a car, I have passed my test and my real learning starts here. However, although I am an inexperienced nurse, one thing I have a lot of experience with is being a carer: it is a term I don’t like but, for want of a better one, it will do.

I am a daughter; my mum has a severe and enduring mental health problem that has affected my whole life. Because of this, when I was asked to be the carers’ link nurse at my place of work, I said yes. Why? Well, I became a nurse as a result of the care and compassion of some dedicated nurses who not only transformed my mum’s life but mine too. They inspired me to embark on this wonderful path, where we are in the privileged position to care. It is from this first-hand experience that I also understand the valuable source of support and information carers can provide.

I also appreciate that, while caring is a rewarding experience, the responsibility of supporting others can take its toll: indeed, people who provide substantial care are at 50% greater risk of experiencing mental health problems themselves. The burden of caring can be objective (when the carer must make changes to daily routines, to support activities like attending appointments) and subjective (when carers can feel an emotional response to the burden and experience anxiety and social isolation). For carers to fulfil their roles and feel supported doing so, it is essential for nurses to be empathetic and compassionate, and provide information, as well as offering a carer’s assessment.

I wanted to increase carer participation in care planning and develop a coproduced service that meets people’s needs. I wanted to develop a service that is carer centred. Only 34% of carers are actively involved in care planning – I am fast learning that it is often not easy to involve patients, let alone carers, in the nursing process – but I believe we must try.

Designing services in partnership with patients and carers is at the heart of my aspirations for a service that meets people’s needs. I saw a quotation that said coproduction is not only about involving people in rowing or steering the boat – but in building it too. I think that about sums up my whole philosophy, not only in increasing carer participation in the nursing process but in supporting the building of a carer-centred service too.

Our carers’ link strategy is based on two main themes: involvement and individual or peer support. It encourages open and honest discussion, in which consent is given by the patient, and promotes a collaborative and participatory approach at every stage of an individual’s journey when using our service. It means we, as nurses, can support our patients and their families, despite the many challenges in our way.

Through individual and peer support groups, the strategy allows us to attend to people’s individual needs – not everybody likes going to groups and it is important we recognise that a ‘one size fits all’ approach does not work when we think about carer-centred support.

However, for many people groups are a valuable source of support. Peer carer support groups allow nurses to understand people’s needs and ask “what do you need?”. People may just want to feel that they are not alone, that others are experiencing the world in the same way; they may want more information or to be signposted, or they may just want a cup of tea.

I don’t want our carers to just be boat builders, I want them to be captains too.

Helen Croft is registered staff nurse at Derbyshire Healthcare Foundation Trust.

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