Rachael Holmes
Full name: Rachael Holmes
Place of work: Living Well Salford
Job title: Mental Health Practitioner (Band 6)
Rachael Holmes
Mental Health Practitioner
Provide an outline of your career Journey to date: (Where did your career start and how did you get to where you are now?)
• Dental Nurse for 10+ years
• Lived and travelled abroad
• Mature Student – started Mental Health Nursing Degree at a London University at the of 28
• Completed elective placements whilst at University with The Red Cross in Iceland and National Centre for Mental Health Research facility in Cardiff
• After qualifying I worked in a 17-bed Medium Secure Forensic Mental Health Unit in East London as a Staff Nurse (Band 5)
• After 6-months as a Staff Nurse I was promoted to Clinical Practice Lead (B6). I was the nominated lead for Physical Health and Quality Improvement on my ward
• My Physical Health lead role involved audits, running joint clinics with the medical team, personalised care plans, HDAT monitoring, healthy lifestyle groups and responding to covid-19 outbreaks and medical emergencies. I was a Covid-19 Vaccinator for staff and service users
• In this role I led on several ward QI projects for ‘improving the experience of enhanced observations as well as local and national collaborative QI projects to ‘reduce Sexual Violence and Aggression (SAV)’
• I worked in a forensic setting for over 2-years before returning to the Northwest in November 2021 to work in a Community Setting for Living Well as a Mental Health Practitioner
What inspired you to become a mental health nurse?
• I have always worked in caring roles and value helping others
• I initially applied for Adult Nursing but after much reflection thought I would be better suited to a role as a Mental Health Nurse
• Mental Health Nursing aligns with my core values of empathy, compassion and being non-judgemental
• As Mental Health Nurses we have the opportunity to make a positive difference to peoples lives during some of their most difficult times
What are you most passionate about in mental health nursing? (What values and principles guide your approach to your work and how do you put these into practice?)
• Reducing stigma and being an advocate for service users - I value lived experience and believe that peer led support and collaboration is powerful in supporting delivery of services that are shaped by the experiences/feedback of the people using them. I use a solutions focussed and strengths based approach
• Parity of esteem – I value the importance of mental health and physical health being given equal priority. I believe that people with complex mental health needs should have the same access to health care services and support as people with physical health needs. I liaise with GP’s regularly to flag physical health concerns. I have recently started developing a Football Group collaboratively with VCSE sectors to promote the importance of a healthy lifestyle
• Research/Innovation/Quality Improvement (QI) – I am passionate about nurses being involved and leading on research studies. I believe that research and QI in nursing is vital to generate creative interventions that improve outcomes for service users and inform evidence-based practice. I have led on several QI projects in my previous role and within my new role, I am involved in an intervention kit development project. I am also a GMMH Research Advocate – this role involves sharing information about research studies that are currently recruiting to promote better access to research participation for our service users
About your role
Please provide a summary outline of your current role: (Why is your role important? Is your role a new or innovative role in mental health nursing? What impact does your role have?
• My current role with Living Well is as a Mental Health Practitioner working between Primary and Secondary care.
• Living Well is a new innovate community mental health service, delivered in partnership between GMMH, Mind in Salford, Six Degrees, Wellbeing Matters and START
• We do mental health support differently, with a focus on people’s skills, aspirations and experiences. We put peoples strengths and lived experience at the centre to help them recover and stay well as part of your community
• We provide support for people who’s mental health needs are too complex to be managed by their GP but do not meet the threshold for a Secondary Community Mental Health team
• I believe that my role has a positive impact on service users lives as we are providing a service to those that otherwise would not have been offered any support before our team was piloted
What are the key priorities for your role?
• Promote trauma informed care, strengths-based and solutions focussed approaches
• Undertake a key worker role, alongside an assessment and formulation role
• Use knowledge and expertise to strengthen the Living Well multi agency team
• Offer advice and support about mental health profiles, evidenced based interventions and crisis and safety planning
• Build strong relationships with partner organisations and use the strengths across the VCSE system to ensure community connections are accessed and maintained
What do you like most about your role?
• Autonomous working
• Partnership/Collaborative working with VCSE sector
• Peer joint working
What have you achieved in your current role?
• Football Project (in development) – integrated working with VCSE sector
• Places and Spaces Primary Care Scoping Exercise – researching, identifying and seeking out available spaces to see people within the local community
• Developing Partnership Huddles – between VCSE and Statutory Services to support with liaison and advice on mental health support/advice and appropriate pathways
What do you hope to achieve in your current role?
• Continue to develop links in the local community to support service users
• Continue to expand my knowledge and understanding of research nursing as a GMMH Research Advocate
• Continue to support the development of intervention kits and promotion of healthy lifestyle through the football group
Inspiring others
Why should mental health nursing be considered as a career option?
• Throughout my time at University, working on in-patient wards and within the community I developed special interests in Physical Health, Quality Improvement and Research
• I have been fortunate to be able to access additional training courses that align with my interests in order to improve outcomes for service users
• I recently completed a Level 6 module for Physical Health in Mental Health
• After being offered my Band 6 role I applied for a HEE funded Florence Nightingale Academy Mental Health Nursing Leadership Course. This involved completing a Quality Improvement Project poster for ‘Improving the experience of enhanced observations for service user and staff’
• ELFT Quality Improvement Leaders Programme – Wave 10 and QI projects (SAV, observations) – because if my interest in Quality Improvement I was able to enrol on QI training to support me to take the lead on 2 x QI projects on the in-patient ward on Observations and SAV (sexual violence and aggression – adult care plans)
• GMMH Research Advocate – I recently became a research advocate for GMMH. This role involves promoting and raising awareness of the importance of research within GMMH
What advice would you offer mental health nurses at the start of their career?
• I would recommend that you seek out and engage in a varied learning opportunities. This gives you the opportunity to explore what suits you best
• It can be helpful to have special interests that align with your values
• Your career aspirations might change over time based on your experience of each workplace so be flexible to changes
• Be open to new ways of working and think creatively (think outside of the box) in your ways of supporting people, it can help to break down barriers and enhance engagement
• Seek out training and new learning opportunities – you don’t know what interests you until you try it!
How do you maintain your health and wellbeing, achieve a good work life balance, and develop resilience?
• Practice being self-aware and recognise signs of burnout and compassion fatigue in yourself. Make use of your supervision space and ensure this is protected time
• You could look at arranging peer supervision which is beneficial
• Don’t be afraid to seek help if you are struggling - try and try to be solutions focussed, if you feel you have knowledge gaps in some areas then raise this with your supervisor
• Flag your worries if you feel are unsure of something and don’t attempt to do something outside of your scope of competence
• Over time you develop personal resilience
What advice you would give to someone thinking of taking a similar career path as you?
• The job requires insight, careful judgement and the ability to engage in both analytical and creative thinking.
• It is an incredibly rewarding job – you are able to make a difference to someone’s life when they are most in need
• It certainly is not always be easy but we remember can always make a difference
Are there any useful websites/books/podcasts/videos that you would advise mental health nurses to refer to?
• Mind
• Rethink
• Headspace
• Oxford Handbook of Mental Health Nursing
• Art and Science of Mental Health Nursing (Norman and Ryrie)
• Psychiatric and Mental Health Nursing: The craft of caring (Chambers)
What is your favourite quote and how does this relate to you as a mental health nurse?
• “An important question in mental health shouldn’t be “What’s wrong with you?” but, rather, “What’s happened to you?” - Eleanor Longden
• Acknowledging someone’s trauma is very powerful and should be considered in every contact you have with someone
Have you been nominated for or won any awards?
• University of Greenwich Merit Award for Outstanding Achievement
• Florence Nightingale Foundation – Winner for Quality Improvement Project (improving the experience of enhanced observations for service users and staff)
• ELFT Staff Awards Nomination – Extra Covid Mile Award Going (nominated by colleagues)