This month marks two years since I qualified as a mental health nurse, and I’m almost at my 10 years NHS service!
I often get questions about how to become a nurse and what it’s like, so I thought I’d do a little Q&A post about it.
How do I become a mental health nurse?
To be a mental health nurse you need to have a degree. There are currently two routes to do this: either the traditional way of going to university, or through the new nursing associate route. All universities have different entry requirements so you would need to check with the ones you are interested in to see if you meet them. As a general rule, you will be required to have your core GCSE’s at grade C or above and either A-levels or an access course. I personally did an access course. The course is three years if you choose just one branch of nursing, or you can take a dual field course over four years which means you will be qualified to work in an additional field of nursing (either adult or child depending on which course you choose). Only a select few universities offer dual field training. You can also study a post graduate diploma if you have a previous degree, which takes two years. I’ve known of people to be accepted with all sorts of previous degrees but usually it is preferable if it is in a related subject (psychology is a common one for example). Throughout your degree you can expect to have 50% theory and 50% practice over a variety of different placement settings. When you qualify, you will enter as what is known in the NHS as a Band 5 nurse.
The second route is fairly new, which is through the nursing associate programme. This is vocational course that takes place predominately in practice rather than split evenly across university and placements, though you will still be expected to complete some academic work. Upon completion you will be a qualified nursing associate, which is a Band 4. Following this, there is the option to top up your qualification by completing part of the nursing degree.
What are my options once I qualify?
So many! Inpatient, community, crisis. Older people, adults, children. Eating disorders, specialist personality disorder services, liaison teams. And if you don’t want to be clinical, you can also go down the management, research or teaching routes. There’s also options to do further training in therapies, for example lots of CBT and DBT therapists have mental health nursing as a core profession.
What are your tips for applying for a mental health nursing degree?
Firstly, make sure you have all of the qualifications you need – very occasionally universities will accept lesser qualifications than they list in their entry requirements so if you are only a few points off it might be worth contacting your university of choice directly to enquire about this. However, what is really going to put you in good stead is your personal statement. Make sure you cover why you want to be a nurse, the skills you have that would make you suitable and any previous experience you have that could be transferable.
What skills do I need to become a mental health nurse?
Remember that even if you don’t have any experience in health care, you will learn all your clinical skills at university. What they are really looking for at the crux of it is your character and whether you are passionate about the role.
Do I need experience working in mental health before I apply?
No, you don’t, although it is desirable and it will help you no end to have some previous experience. I would always advocate for working as a health care support worker or volunteering if possible prior to applying to university although this isn’t essential.
Can I be a mental health nurse if I have my own mental health problems?
You will likely find that many of us have either had our own mental health difficulties or have a family member/friend who has, as that’s what inspires many of us to join the field. With that said, it is important that your mental health is stable enough to meet the demands of the course and to be able to complete the clinical work.
Do I need to be academic to complete the course?
In a word, no. However, it is important to remember that this is a degree and that you will be expected to have basic levels of English, maths and science in order to complete essays, drug calculation exams and your anatomy and physiology modules. Although nursing is about caring, it is also about evidence based practice and critical thinking, and it is important that you are able to do these things.
Were your university supportive when you had difficulties with your mental health?
They were very good actually. When I was diagnosed with bipolar disorder in my second year of the degree, I had to take a bit of time off. I was quite heavily medicated and really struggling to attend lectures, and as a massive perfectionist and high academic achiever I was so worried about it impacting upon my grades. They gave me the option of completing my assignment and then being able to retake it uncapped if I didn’t achieve to my usual standard, but thankfully I did.
What do you think most needs to be fixed in the system given that you see it from both sides?
Good question! There are many things wrong with the mental health system currently: high thresholds, long waiting lists, lack of staff, the list goes on. Ultimately, every single one of this issues boils down to money, and until funding is improved, services will continue to struggle.
How do you manage your own mental health working as a mental health nurse?
Pretty well generally. I try to keep my own difficulties out of work, ask for time off when I need it and try to keep myself well by taking my medication, getting enough sleep and generally trying to look after myself.
Do you find that your job impacts your mental health?
Not particularly. When things are stressful obviously that has an impact but I don’t think it has any more of an effect on me than it does on anyone else. With that said, I choose not to work with people with eating disorders because I think I would struggle with that.
Do you think that being a user of mental health services has advantages or creates difficulties?
Both in different ways. It helps in that I understand how it feels to be on the other side of the system and the power imbalance that creates, and I hope I am able to try and minimise that as much as possible. I know how important it is for people to be involved in their own care regardless of their age. It has created practical difficulties for me in some ways, for example accessing services where previous colleagues of mine work, or feeling unable to do group therapy in case there are patients I have cared for attending.
How do you cope with shifts and make sure that you keep a good routine with enough sleep?
I’ve done shifts for years so I’m pretty used to it. In terms of getting enough sleep it basically varies day to day – some days I get more and some I don’t get enough, but generally I think it evens itself out. I always say to people that you don’t ever stop feeling tired you just get used to it!
What do you do to prioritise your own your own self care and wellbeing?
I try and do things for myself outside of work – socialising, horse riding, arts and crafts. The occasional bottle of wine. I try not to think about work if I’m not at work.
How do you cope with the challenging aspects of your job?
Regular supervision, leaving work at work where I am able to, talking to my colleagues. Spending time doing activities completely unrelated to work.
Do you have a good support network at work?
Amazing! I have the best managers and some of my most wonderful, supportive friends are from work.
What have been your best, most positive experiences?
I can think of a few specific cases that will stick with me forever, but most of them are having breakthrough moments with patients and seeing them be discharged or move on to lower level services. I have some lovely cards I have saved over the years from patients and parents.
As a student, winning my scholarship to travel and do a placement in the Philippines was probably the highlight of my course. Also, non-clinically, I have since been back to my university to deliver a lecture which I was really proud of.
Do you find your experience of being a patient makes you more inclined to challenge poor care when you see it?
I hope so yes, although I am generally fairly assertive when I need to be anyway so I’m not sure if that makes me more likely to address poor care anyway.
What do you think the service will look like by the day you retire?
Gosh, that’s a big question. I certainly hope it will be receiving equivalent funding to physical health care, better staffed, shorter waiting lists. If I’m being really realistic, I think there is a very high chance that the NHS won’t exist and all services will be private.
What is your go to method for calming people during anxiety attacks?
Grounding techniques are one of the most recommended strategies for managing high levels of anxiety, along with breathing strategies.
How do you respond to people who have been harmed by mental health services and see you as a representative of the profession that harmed them?
This is difficult but fortunately is a situation I come across very rarely. There isn’t a lot that I can do except validate those experiences and try to be the best nurse I can be in the hope I can change that narrative for them.
Do you treat many patients who have a chronic illness and is their health care team dismissive or supportive of their health concerns?
Actually I don’t come across this very often although I think it is more common in adult services. Although I had placements in adult services I have been in CAMHS for 9 years now and it’s not something we have to manage too frequently.
How does having a mental health diagnosis affect you whilst studying and working in this particular field?
I think by my very nature I am a perfectionist and always want to achieve as highly as I can. This undoubtedly affected my mental health throughout university as I felt a huge amount of pressure to be the best at everything. Since qualifying that has relived a little. Other than that I think I just have to pay a little more attention to my wellbeing than others do perhaps, as I don’t want any of my difficulties to impact on my work. I try to be as honest as I can with my managers about my mental health so that I can make sure I get the right support when I need it.
Do you have any more questions you’d like to know the answers to? Let me know in the comments!