“I enjoy the challenge of joining new services and making sense out of the chaos,” specialist clinician, Shirley Nicholls tells me with a laugh. As we talk, it becomes clear that becoming involved with new projects and services has sparked her interest throughout her nearly 30-year nursing career.
“That’s the good thing about nursing,” Ms Nicholls explains. “You can diversify and pursue special interests and learn new things all the time.”
Coming from a family with deep roots in general nursing, Ms Nicholls has always known a career in health care was for her. “But I wanted to be a bit different,” she explains.
“Mental health nursing attracted me more than the physical side of things”
While working in a role supporting elderly people, she applied to be a nurse, but quickly realised that the profession wasn’t solely confined to helping those with physical conditions. She was drawn to a career that assisted with bettering mental health as well. “Mental health nursing attracted me more than the physical side of things,” Ms Nicholls explains.
She has worked in various nursing roles throughout her career but is currently settled at Cynnwys Therapy Service in Cardiff as a specialist clinician where she’s making her mark on services for people with complex needs, including personality disorders.
At Cynnwys Therapy Service, Ms Nicholls works within a team helping people with complex trauma and personality disorders. One day each week, she helps facilitate a therapeutic community called Ymlaen, a Welsh word meaning “forward” that could also symbolise Ms Nicholls’ innovative approach to health care.
She was part of a pilot group that used DBT (dialectical behaviour therapy) and introduced the concept of positive risk taking with clients. Ten years ago, she worked with five other people to look at an alternative way of treating people with personality disorders. Impressively, Ms Nicholls was only one of two nurses in the group.
“I’m attracted to new services,” Ms Nicholls says. And it’s as simple as that.
Meetings are once a week for those who have difficulty in relationships due to a personality disorder. Staff and service users are group members of Ymlaen, but both parties are seen as equal in the group to ensure a balance in power. Members share in all decision making, such as voting on who enters the group and who is ready to be discharged.
While traditionally services tend to assume an “expert” role when treating people with personality disorders, Ymlaen allows service users to provide their own expertise on living with their difficulties. Group members support each other and behaviour is managed in the community, rather than by hospitalising the individual. People learn to become their own therapists, rather than relying on professionals to have all the answers, she explains.
“It has been a bumpy ride at times, but it’s moving in the right direction”
“People often do much better in this setting than the traditional way of treating personality disorder,” Ms Nicholls says. But she is reluctant to take sole credit, Ms Nicholls emphasises how her whole team plays an important role in improving the patients’ outcomes. “It has been a bumpy ride at times, but it’s moving in the right direction,” she says. “We were recently finalists in the Wales NHS Awards in the ‘Citizens at the Centre of Service Design’ category. All the group members are contributors to that success.”
The challenge of her work as well as her commitment to developing new services allows Ms Nicholls to keep learning and stay motivated. “Seeing the change in how people with personality disorders are treated now and contributing to that — that’s been a real high point,” she says.
But she realises that being able to have such a positive impact on services is a privilege with many services under pressure. Clearly, her drive to learn and excel despite difficult circumstances is key to Ms Nicholls’ progress.
“Try not to stand still too long … When you get comfortable, it’s tempting to stay there and just do the same old thing” Ms Nicholls says. “The job is much more fulfilling if you challenge yourself, keep learning and keep moving.”