Matron/Clinical Lead/Clinical Education Associate

Sheffield Children’s Hospital Trust/NHS England/ NHS Elect.

Matron/Clinical Lead/Clinical Education Associate 

Sheffield Children’s Hospital Trust/NHS England/ NHS Elect.

Where and when did you start your nursing journey/What field of nursing did you qualify in ?

Native to the North East of England, I travelled to Sheffield University in 1995 to begin my Mental Health Nurse training. Whilst immersed in all aspects of student life, I relished that this course allowed for vocational ‘real world’ placements alongside academic students. Experience is somewhat downplayed by comparison to academic studies, but the experiential learning ‘on the job’, has been invaluable to my development as a nurse, and is a continual reflection point to my practice today.

I had such a broad range of experiences; it was hard to contemplate how all those areas fit under one umbrella of mental health. My experiences ranged from adult mental health acute wards, drug and alcohol detoxification to community CPN involvement with the post-natal mental health team. It was very rewarding to be alongside new mums in their most vulnerable state, to recognise their condition had a name, it wasn’t their fault, they were not a bad mum, and bear witness to their successful recovery and bonding with their child.

One of my favourite aspects of my training was that you were able to select ‘any’ elective placement, as long as you could self source this. I went to Kilkenny in Ireland to work alongside a drug and alcohol counsellor in the community. What stood out to me was the impact of culture and the power of psychosocial interventions in relation to mental illness and addiction. This also really endorsed a long-held view that mental health nurses have an eclectic tool kit to wrap around the individual patient’s needs.

As with all of nurse training at that time, the end placement was the ‘management’ placement. This was the pinnacle point of nurse training met with intrepidation. Could you manage the ward, could you hold the keys, could you keep patients safe and meet their needs. This was it, the final hurdle and an auspicious one in the world of nursing. As luck or fate would have it my final placement was in child mental health in patient services, with children from 5 to 12 years old. I remember the day I walked into the building with a child heavily involved with letting down the tyres of the consultant psychiatrist, not so secretly…

This was it, the area of work I wanted a career in. I viewed it very much as working at the preventative end of adult mental health, in trying to address chronic adversities that may pave the way for serious, and enduring mental health difficulties in the child’s late life. Systemic engagement with the whole family and education appeared to me to allow for further reaching interventions and recovery. The range of difficulties and potential solutions also appeared limitless, and of course working with children was delightful, funny, emotional, challenging but ultimately most rewarding.

Needless to say, it wasn’t just me that had been enamoured by Camhs. Placements and posts were of a high premium in this area. As it was known then ‘everyone wants to work in camhs’.With a clear goal in mind I was delighted to be interviewed and offered my first nursing role in Camhs at the end of my training.

 What came next?

I am still in Camhs 24 years, post qualifying. What came after qualifying as an RMHN was a rich and vast experience within Camhs, so much so that this has allowed for my retention and commitment.

I had the opportunity to develop quickly in management initially in my career. I managed both an in patient child and adolescent unit. They were delightful experiences enriched with a sense of therapeutic community, developing staff and paved the way for my curiosity to branch out clinically.

I joined a community camhs team and I quickly built a caseload, integrating into the community and multi agency approach, allowed for speedier recovery and sustainable change for the CYP and their families.

My passion was ignited by the desire to provide mental health interventions early and so I join what was the first primary multi agency support team. Alongside police, social care and education I was able to offer advice, guidance an intervention into individual and whole populations, delivered in community settings.

I was proud to start the first Camhs consultation clinic based in local schools, providing instant access to specialist support and advice. This role also extended to providing Camhs clinics within GP clinics, however, was the main service to be cut in the round of NHS austerity measures. Needless to say this was narrow sighted and the need was so great, such initiatives returned in the form of healthy school minds.

Alongside this I also had a desire to develop clinically, feeling pigeonholed somewhat into a solely management career progression. This is a sentiment I have heard other nurses express over the years. I completed and delivered Carolyn Webster Stratton- behaviour modification, specifically targeted at young people with ADHD, conduct disorders and oppositional defiant disorders. This work also allowed me to work alongside parents and carers. I completed my BSci in Child and Adolescent mental health practice, CBT training, Clinical Supervision MSC training, as part of CYP IAPT and finally my nonmedical prescribing training.

This extensive training not only allowed me to be holistic in my care and treatment, in that the CYP did not have to visit multiple clinicians – like a ‘one stop shop’, but also provided me with frameworks for skills I had acquired much earlier in my career, but now had a ‘academic peg’ to hang these on.

It was also at this junction I was able to work with parents and CYP as partners in co production and co design of services. Working in this way allowed me to adopt humility for my practice and understand the multiple perspectives needed to provide the NHS services of today.

Latterly, I became a Matron for Community and In Patient Camhs, which was actually a new learning experience funnelling all my knowledge and experience into quality, patient safety and risk. I was able to be very visible, have oversight and influence high levels of change.

With a brief stay in Australia as a newly qualified nurse with the New South Wales board of nursing, I feel I have had the opportunity to experience nearly all aspects of Camhs, and much more so in the sense that I have had these experiences as a mental health nurse.

Today, I am working at a national level in CYP Quality and design of digital resources to support other colleagues in helping CYP and parents cope with mental ill health on acute and paediatric wards. Although in neither job description is a prerequisite to be a mental health nurse, I am very much still a mental health nurse, and would be ill equipped to carry out either role without being a mental health nurse and the knowledge and experience this has allowed me to access.

What were the challenges?

• Navigating ‘imposter syndrome’ as a mental health nurse. It was often reported that nurse was a ‘Jack of all trade, and master of none’. What made us unique, eclectic, and holistic was also extremely difficult to articulate, advocate and evidence.

• Pushing against a narrowed career development route and advocating for clinical, education, research parity alongside other MDT colleagues.

• Creating the opportunity for the patient’s voice to be heard with equal power.

• Movement of nursing from silo ‘branch’ trained model into humanistic, skills around the patient model.

• Harnessing a single a clear voice from within the rainbow of views in mental health nursing.

What were the learning points / would you do anything differently?

• Remembering the goal, bigger picture, worth realised in patient recovery as a professional protective measure than is held by the nursing profession.

• Supportively challenge the status quo with little steps- change from within.

• Recognise early the worth of reciprocal relationship of co- production with CYP/Parents and impact upon recovery.

• Advocate early for multiple career pathways in mental health nursing.

Next steps / Where do you want to go next in your career?

I am very clear in my passion to enhance quality of mental health care and I am sure this will guide any future career decision.

My experience to date as a mental health nurse has intrinsically led to this passion in quality, as this is the area of most concern to the nurse. Is my patient comfortable, are they treated well, are they recovering as they should……

We bear witness to the daily challenges of our patients, being alongside them – understanding, listening, advocating for their rights. Uniquely, we are rewarded with a relationship based on quality, evidence base and integrity. This experience and perspective in totality has only been possible because I am a mental

 health nurse. My hope is that the pendulum will swing back a little from the pressured, under resourced and

  sometimes ‘business’ environment of mental health, to recognise, retain and celebrate the impact of mental health nursing.

What advice would you give to others?

Instincts, intuition, and self-awareness are the under reported skills of the mental health nurse. Use and

trust in this skill set.

Practice with integrity and by example and support your nursing colleagues irrespective of professional branch/core training. Remember we share the same patients.

A must-read book recommendation when you struggle to know you can make a difference; On Playing a Poor Hand Well: Insights from the Lives of Those Who Have Overcome Childhood Risks and Adversities 1997. Mark Katz.