As a student, the thought of clinical placements conjures many thoughts and emotions. They vary between excitement, joy, intrigue, sadness, stress, anxiety and uncertainty, to name a few.
We can become caught up in the emotion and pressure of achieving set skills or searching out learning opportunities that we run the risk of missing what is most important: patient care.
We know that we can become a better nurse and provide high-quality care through our learning, practice and development. But what about the unplanned stuff?
Something I am truly interested in is the physical and mental wellbeing of patients and staff, and their impact on one another.
I often wonder how I can influence my ideal vision of high quality provision of care. I make every effort to get the best out of each placement, even if things are not quite as I expected, and never miss an opportunity to learn – whether it is hands-on or observing patient interventions and interactions.
Reflecting on my first year and my placements among the many learning opportunities, one statement comes to mind: no health without mental health. I had not really given it a great deal of serious thought, but that soon changed.
”Why couldn’t the teams work together while the patient was in the ward?”
Some of what I saw in practice revealed the true impact of such a statement, whether positive or not mental and physical health or co-dependant attributes of a person can greatly affect their recovery. Several examples of this with regards to patients, health professionals and students are summarised below:
- A mental health patient with physical health needs not receiving input from an appropriate physical health professional. Later in another placement, the same patient required urgent intervention in the community from adult nursing services. Why couldn’t the teams work together while the patient was in the ward? Surely recovery could have been more successful with combined input?
- A nurse I worked with on placement was very stressed most the time and constantly plagued with headaches or a poor appetite. How long can they continue like this? A quick fix for the headaches each time would not be sustainable. There could be many considerations, such as reviewing workload, hours worked and ways of reducing stress, perhaps access to coping strategies (e.g. mindfulness, yoga, exercise, healthy eating). Why the reluctance? Does mental illness stigma still really exist in the profession? If we carry the shame ourselves, how can we help our patients?
- Many students have often expressed or shown signs of mental and physical health problems, such as anxiety, stress, sleeplessness, poor diet and depression, particularly on placement. In each situation, it has been clear that each had an impact on another. Health is not always our priority. If we were looking after at least one element, we could positively influence the other.
“Physical and mental health are interdependent in recovery”
My own personal experience on placement has been enough that when I stopped taking care of my own diet, exercise and sleep, it led to a serious health concern that also impacted my mental health, causing anxiety and depression.
Thankfully those close to me noticed when I did not. With the right treatment, I improved quickly – a stark reminder of the impact our mental and physical health can have on each other. What I have learnt from all this is that there most definitely is no health without mental health. Physical and mental health are interdependent in recovery.
How can I influence change? I can demonstrate a culture of considering a person’s mental health as part of their physical health recovery journey, in my training and future practice and I could also lead by example.
I cannot eradicate the stigma but I can work hard to positively influence the patient’s recovery journey.
Cheyne Truman is an adult nursing student at the University of Essex