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STUDENT EDITOR BLOG

How open can I be with my mentors and other staff?

  • 8 Comments

Katie was shocked when a mentor warned her not to tell staff members about her own mental health problems, surely fellow nurses would be the most understanding?

Katie Sutton_SNT

Katie Sutton

As student nurses, we have the NMC Code drilled into us pretty regularly.

I remember looking through the statements towards the start of my first year and thinking “I’ll never remember all this”, but also “Well, this seems like common sense…”

Of course, as with many things, when you actually devote some time to thinking about it, it starts to get complicated. And there is one thing from the Code that comes up again and again in conversation with mentors and other students alike: professional boundaries.

I’m pretty open about how I’ve struggled with my own mental health, both recently and in the past, and it usually comes up in the first day or two of my placements. At some point during the placement, my mentors so far have asked some variation on the question “So why do you want to be a mental health nurse?”

I’m always quite candid when I answer; I don’t go into the gory details, but I do say that I’ve battled anxiety and depression in the past, but managed to overcome my difficulties with the help of the NHS. I’ve been taught skills I can re-use over and over again to overcome setbacks like the one I faced heading into my second year, and that this is my way of giving back.

Their reply is invariably something like “Oh, that’s nice” followed by a short pause and “Be careful how much you tell the patients.”

My mentor on my most recent placement went a step further, and warned me of being too open even with staff. “People talk,” he said, and I was kind of shocked by that. I understand why we can’t be too open with patients: while chapter four of the Code talks about honesty and transparency, chapter one talks about professional boundaries. As much as it might help some patients to know that their named nurse has some personal insight into what they’re going through and has experienced similar themselves, when I’m at work, my focus must be on my patients, not me.

My most recent placement began a few days after the Student Nursing Times Awards, where I’d been having a very similar conversation with Rachael, the SNT Children and Young People’s branch editor, and Fran, Nursing Times’ Acting Online Editor. I’d spoken about a different (but similarly personal) situation, “I don’t tell the staff on my placements everything, even when I’m welcomed as part of their team. They’re still the ones teaching and assessing me, and I don’t want my personal and professional life to mix too much”. I likened it to being friends with a manager.

And yet, I was genuinely surprised by mentor’s words – while I wouldn’t share the intimate details of my personal life with the staff, the idea that nurses working on a mental health ward would talk about a student (or anyone) who had disclosed a history of mental health issues behind their back shocked me.

It really got me wondering, is there really any benefit to being open about our history for those of us with experience of being the patient (or their family), or could it do us more harm than good?

There’s a definite suggestion that patients appreciate nurses being open with them, that for some people it could improve the bond, the therapeutic relationship – but is there any good in being open with the staff who aren’t mentoring us themselves?

Should we be scared that those assessing us might be talking about us when we’re not listening – and is this just one ward, or was my mentor simply the only person to tell me it happens?

What have you experienced? What do you think?

 

Katie Sutton is Student Nursing Times’ mental health branch student editor

 

  • 8 Comments

Readers' comments (8)

  • This is a topic which has fascinated me for decades. and in my almost 30 years of experience in mental health nursing, I would echo your mentors words of caution. Although we would like to think otherwise, people are judgemental and I have seen many a situation where self disclosure to staff about personal mental health reflects on how they are perceived as part of the team and their abilities. The dynamics within nursing in general can be difficult (there have been many debates about this alone) and throwing in too much deeply personal information adds fuel to the fire. In my opinion, it is definitely better to separate personal and professional lives in respect of personal health issues.

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  • Anonymous | 16-Jun-2014 9:37 pm

    excellent comment with which I totally agree and would recommend the same unless there are issues which seriously affect somebody's work and where they need understanding of them and the support of their mentor in order to carry on.
    the student-mentor relationship is a professional working one and it is easier all round and for you protection that it remains so, at least during the assignment and until such time that a professional relationship with them ceases.

    as you say even though we do not wish to be judgmental in our work and we develop good strategies to avoid being so it is part of the human condition to and the way our brain functions, and from which we cannot totally detach ourselves, and designed to ensure, historically, we are operating in a safe environment and in the absence of any predators/enemies.

    Once you have disclosed personal information you can never retract it and may later regret it. people may use this knowledge about you which you have offered voluntarily and also singly you out and treat you differently as a result.

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  • "I have seen many a situation where self disclosure to staff about personal mental health reflects on how they are perceived as part of the team and their abilities" - Anonymous | 16-Jun-2014 9:37 pm

    I'm a registered mental health nurse and qualified only within the last 18 months. I've had my own experiences with mental illness and though I have opened up to one or two members of staff who have been in a similar position, I can't help but echo the above sentiments. And it's a shame. Patients/service users can find comfort in knowing they're not alone and that the nurse they're speaking to is on the same level as them. And despite nurses, in particular mental health nurses, supposing to be non-judgemental and stigmatising, one will always find people who will continue to judge someone's ability and practise on their health rather than from an objective point of view.

    I think your mentor, Katie, was realistic in what they said to you. I guess though that it's up to you to judge how each area is in terms of supportive and welcoming staff and how comfortable you feel in disclosing. Personally speaking if someone judges me negatively based on my experiences then screw them! :)

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  • "Personally speaking if someone judges me negatively based on my experiences then screw them! :)"

    Anonymous | 18-Jun-2014 0:31 am

    that is also very true. people with good self-awareness and confidence know themselves with their strengths and weaknesses far better than does anybody else and should be open only to constructive criticism so they understand their effects on others to help them develop.

    one needs to weigh up any criticism for its validity very carefully. judgement and destructive criticism often has more to do with those delivering it than anybody else and one should always be very wary, open and attentive.

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  • I can sympathise with Katie completely. And have found out the consequences of revealing too much the hard way.
    I am a male, mid 40s, first year mh student. On my first placement, I was pressed into giving information about my reasons for entering the field. I am not ashamed of my past and thought that being open and honest would stand me in good stead. After all, my diagnosis was four years ago and I have worked hard to overcome the problems. And let's face it, I have been accepted for nursing training.
    However, only a couple weeks later, I had to deal with some personal issues. My mentor used this opportunity to recommend that I BE REMOVED from training! He considered that I was vulnerable and be likely to cope.
    I made a complaint - this made things even worse. My mentor then refused, point blank, to sign my PAT. He would not even acknowledge my hours! This has all been very stressful, over and on top of the issues I had to deal with.
    My advise is to very very careful. Mentors have the capacity to severely hinder your advancement. I am currently pursuing the matter further, but it's a situation that could have been avoided. I don't know what the outcome may be and my progression is uncertain.
    As you say, there is a call for transparency and openness. And within the mental health setting, one would think that would come as standard. But, it is not so.
    I hope this can be a warning to others - regardless of the message projected, be very careful of what you disclose, especially to fellow colleagues. Not all of them are as empathetic as we would like to believe!

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  • Katie Sutton

    Thank you all for your comments; it's really insightful! To the last commenter - I do hope your university are supporting you and that you get a good outcome from the situation with your mentor. Don't forget to contact your Students Union, student rep, or whatever system your university has, if you need support!

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  • Anonymous | 20-Jun-2014 10:53 pm

    I am uncertain how your mentor can prejudge you are vulnerable and may not be able to cope. He is making a value judgement based on his own assumptions which he is not entitled to make. Unless you have proved otherwise (and we are all vulnerable, students and staff career long and outside of it alike and all have our own levels of resilience and are all affected by very different things).

    It sounds more like an issue which has more to do with your mentor than yourself and maybe even a lack of self-esteem and a need to assert himself by showing his superiority by diminishing another which verges on manipulation and bullying. Bullying comes in very many guises and can at times become so subtle that it is imperceptible until it is too late.
    there are many staff at all levels who have been affected in this way and somehow the bully comes out top (or at least to all outside appearances). these are the ones who often get promotion and climb the career ladder because they have cultivated the 'art' of appealing to those above them and an ability to suppress those below them. they can be very charismatic individuals but often cut corners to the detriment of the care of their patients and very often lack compassion, empathy and a genuine ability to care for others and put their self-interest first. There needs to be a lot more information and discussion about this and different personality types and how they all fit together in teams and inn the organisation and how to deal with difficult behaviour such as this as well as conflict of interests.


    I am a great believer in openness and transparency. After all why should one have to hide part of who one is and how can one function normally as a fully functioning human being if this is the case. It is difficult to give your very best when you are always under the added stress of having to be on your guard with certain individuals about what it may not be safe to disclose about yourself although obviously we all have to do this under certain circumstances.

    Unfortunately we do not live in an ideal world or a wholly empathetic profession as we would like to believe (and in fact far from it) and have to learn at times we need to defend our own interests and hold back. You have sadly learned the hard way early on in your career which must have been a significant shock for you and a needless and added stress.

    "...a situation that could have been avoided. I don't know what the outcome may be and my progression is uncertain."

    sadly, you could not have possibly predicted the reactions of others and the outcome of your disclosure but it will make you far more wary and less trusting of your colleagues in the future. Disclosure to patients is also another highly sensitive issue and needs careful weighing up of what and how much you choose to disclose. In nursing, and especially mental health, you are a therapeutic instrument where interpersonal relationships form a significant part of the therapy. you are often perceived as a role model for your patients and a small amount of self-disclosure shows the human side of the healthcare and sharing similar experiences can often be of help, support and comfort to patients breaking down the 'them and us' barrier which often exists between the carer and the 'being cared for'.

    I do hope, as Katie above says, you can talk it through and get all of the support you need and even with trusted family members and friends. I wish you every success. you are right to bring your case forward and please remember, if this one insignificant mentor does not need you, all your future patients do! It is the mentor and not you who is the sad loser in all of this.

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  • Anonymous | 21-Jun-2014 10:06 pm

    I am so sad to read your story and that this is happening in the nursing profession. it most certainly paints those who managed to qualify and enter the professional register in a very poor light and all students can do is learn from it and make sure that they become strong leaders who can lead by their own example gained from these very negative experiences. I sincerely hope, unpleasant though it is, that you get through it and find more positive experiences on other wards as it is not like this everywhere and there are some excellent clinicians around as well.

    Such negative behaviour is something that needs debating in university to see what can be done to stamp it out.

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