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Today is to be celebrated for many different reasons, especially when looking at the history of nursing. It is 21 years since the very first intake of nursing students to the University of Stirling, 50 years since the University itself was created, and soon will be 70 years since the creation of the NHS. Not just that, but it’s recognised as Mental Health Awareness day. With all this to celebrate, I thought it provided an exciting opportunity to look back on the history of mental health nursing, and views on mental health to see how it has changed and developed. But just how much progress has been made from the conception of the role of the mental health nurse?
For almost two centuries, mental health nurses have struggled to win recognition for their unique contribution to the health and wellbeing of those in their care. Nolan (1993) has well documented the historical timeline of mental health nurses, as well as how they have been viewed by society. From very early on nurses rarely had access to resources which would have enabled them to fully care and treat those suffering. It was the doctors who employed the nurses that taught, trained, examined, and decided what their role should be.
Because of this and the constant development of theory and practice, nursing experienced frequent therapeutic shifts over the decades causing even nurses themselves to feel confusion about their own role and name. During the 18th-19th centuries, they went by the term ‘keeper’, and had a small role of domestic duties, caring for ‘patients’ and keeping them manageable for the doctors. It wasn’t until after 1845 with the emergence of the asylum systems and implementation of the medical model, which attributed all mental illness to biological errors, that they then shifted to ‘attendants’ to seem more humanitarian and gained more responsibility.
From the mid-19th century, the term ‘nurse’, widely recognised today, began to be used. This helped to push for ‘mental nurse’ to become an official title in 1923. The model of practice then shifted to the new field of psychology, bringing forward interventions that are still used, such as psychoanalysis and behaviourism. The medical model remerged later in the century when famous treatments like electro-convulsive therapy became popular. It wasn’t until the late 20th century that models pushed for treatment to be done out in the community thanks to the NHS Care and Community act (1990). At this point nurses were encouraged to be autonomous in their profession and develop their skills to lead and solely deliver care and treatment, with the aim to re-skill and empower those with mental illness.
Despite all this growth, development, and therapeutic shift, this is not how mental health nurses were seen by the general public or even some health professionals. Nolan (1993) commented that the historical view of mental health nurses is that they are lazy, lacking in motivation, compassion, and intelligence. The stigma that clouds mental illness has fogged public perceptions of those who suffer from it, and those that try to ameliorate those suffering.
An early example of this is obsessions with witchcraft, which developed during the medieval times. Countless numbers of people (mostly women) were executed as they were believed to be witches. In 1682, Temperance Lloyd was the last person accused and executed in England, but recent research suggests that she suffered from dementia (Wright, J. 2010). The stigma fed into the fear and paranoia of the supernatural, leading to the deaths of too many. Just think, if these ‘witches’ had been alive today, how would they be treated? Would they still be ‘witches’, or people needing help for a mental illness?
Today, mental health nurses aim to work alongside those experiencing mental ill health while promoting independence, advocacy, and person-centred care. Mental Health Nurses are a caring constant for those in need during the lonely and enduring experience of mental illness; supporting their recovery, providing the essential aspects of treatment not many realise are vital: support, comfort, and presence.
Today’s nurses work long, hard, hours to help a person feel themselves again. But yet both are faced with the same dark cloud fogging perceptions. The stigma looming over mental health is still very much present, and can be an obstacle to accessing care. The historical view on mental health nurses remains to be held by many, including health professionals. The amount of comments like “they’re not real nurses” for example I have heard is disheartening for a 3rd student nurse like myself.
However, it is not just the staff that this view effects. Wright (2010) found that when the NHS Care and Community act (1990) came into place the public protested against those with mental illness living and being treated in the community, in fear for public safety. Yet, it is 6 times more likely that those with mental illnesses are to be murdered than commit murder. Such views like this create a vicious cycle leading to discrimination, low treatment effect, or high relapse rates which reinforce stigma (Sartorius, N. 2007). This could be detrimental to those experiencing mental health, and could possibly be linked to the rise of suicides in Scotland in 2016 (728) from the previous year (672) (ChooseLife. 2017). To me, this highlights the importance of further work being done to raise awareness of mental health with the aim to eradicate stigma, but is this enough?
Improvement is always possible; Wright (2010) suggested bringing in mental health nurses to schools as a potential opportunity to increase awareness and knowledge, and for possible early intervention work. Evidence on the impact of mental health nursing is at its strongest in decades, with a drive for more nurses to be recognised for being a key resource in effective delivery of services (Barker. 2009). More is being planned to tackle these issues too, but this is something anyone can help with. Charities supporting mental health are out there offering fund raising events and education, so anyone can help, even if it’s just through being open minded.
Devon Buchanan, Student Nurse, University of Stirling
10 October 2017
- Barker, P. (2009) Psychiatric and mental health nursing : the craft of caring. 2nd ed. London: CRC Press.
- Chooselife.net. (2017). Chooselife -Statistics suicide in Scotland. [online] Available at: http://www.chooselife.net/evidence/statisticssuicideinscotland.aspx [Accessed 6 Oct. 2017].
- Nolan, P. (1993) A history of mental health nursing. 1st ed. London: Chapman & Hall.
- Sartorius, N. (2007) Stigma and mental health. [online] Available at: http://search.proquest.com/docview/199002822?pq-origsite=gscholar [Accessed 4 Oct. 2017]
- Wright, J. (2010). A history of mental health and wellbeing, part 2. British Journal of School Nursing, 5(8), pp.458-459.
“As a mental health professional, how do you deal with a struggling family member? Mental health student nurse Leanne describes her experience.
“Today, the Scottish Association for Mental Health (SAMH) launched the Going To Be campaign that raises awareness about the number of children affected by mental health problems and how lack of support impacts their goals, dreams and ambitions for the future. ”
For the full post, published 11 May 2017 please visit Leanne’s Nursing Times blog online.
15 May 2017
Starting as a student nurse can be pretty scary and nerve wracking but it’s full of excitement and surprises. You might even find that it is the best decision you make. After two years as a student nurse, having never looked back, here are a few things that might help you get through first year. If not the whole of first year, at least the first few weeks!!
- Introduce yourself to as many people as you can. You might not know everyone in your class, and you might not see them every day, but your cohort are your colleagues. The friends you make here will get you through the good and bad and they can last for life.
- Attend all classes, and attend on time! You’ll no doubt hear rumours that it’s OK not to go to all the classes but it isn’t. They are for your benefit, you’re learning and it really does help with placement and exams. Also, try turn up on time, it’s just rude if you don’t.
- Talking of exams and essays, prepare in advance!! Don’t leave them till the last minute, take advantage of the study time, the student support and the lecturers’ knowledge. Remember to proof-read your work too, as it can make a difference in the marks. You can always get help from friends, they provide the best support (and the coffee)!
- Take advantage of the skills groups and sessions, including the communication ones. These are where you might see equipment for the first time, experience a skill or work as a team. You will do all sorts in these groups, so make the most of them. Use the time and take advantage of the knowledge of the lecturers, doesn’t matter if you make an error here, they will show you how to correct it and learn from your mistakes. You can often get a good laugh at these sessions, trying out a leg bandage for the first time is always interesting!
- Placement. This is 50% of the course. The best advice here, make the most of it. Ask millions of questions, get hands on experience, research what you do, speak to other students, share your experience (without breaching confidentiality of course!) and enjoy it. You’re only in placement for a few weeks at a time so do what you can. You will be surprised how much you will learn in a short space of time. And remember to always act professionally, both in and out of placement.
- Everyone gets a Personal Tutor; they are there for you for the three years you are in university. So why not get to know them. You’ll see them every semester after placement anyway, but nothing is stopping you speaking to them. They are not only there for your placement sign off, but a whole host of things, could be study-related or it could be personal, you don’t have to worry alone, they will listen and give the best support available.
- So, this is your school for three years, your home if you like, then why not get involved? There are always opportunities to be a part of what the nursing course has to offer. From helping trial new interview styles to promoting your school to others there is plenty to get involved with. Offer to attend conferences and present your work – take them – great for your CV! There is no better way to show your passion for nursing than helping others.
Well, that I think covers the most important areas to think about and consider when joining us on this amazing journey. Make the most of these three years, ask questions, get creative, be inspired and be inspiring. I hope everyone enjoys their time at University just as much as I have and I wish you all the best.
© Kimberley Blues, Student Nurse (Adult), University of Stirling
29 August 2016
I have always enjoyed helping people, in every aspect of life therefore nursing is something I have always considered. However it wasn’t till after my travels to South Africa – witnessing poverty and severe illness – that it was made clear to me that I wanted to strive and work to the best of my ability to become a successful, compassionate nurse.
I went out to South Africa with a charity called GAGA (Goodwill And Growth for Africa) volunteering constructing a vegetable garden in a pre-school. Here we worked as a team to plan and put it all together – this was not as easy as we had first thought. With solid, dry ground and just the basic tools we did our best. But we worked together and finished it within our 2 week visit. We involved the children who attended the school along with some of the teachers, allowing them to learn new skills.
We also had the opportunity to visit other projects that the charity were funding which was fantastic. We went to see another pre-school, a medical centre and a home/family that looked after and cared for people of all ages that suffered from disabilities, illness or children who were left abandoned by their parents. Such amazing work that goes on in this country and they are so grateful for the very little they have.
These projects were all difficult things to see, the poverty that they live in and put up with on a daily basis is unreal. People don’t understand until they witness this first hand. What a massive eye-opener this trip was, it has showed me that I want to make a difference and help in anyway I can. I feel that by becoming a nurse this would be possible. I would love to go back and do more volunteering in this country!
Caitlin Urquhart, 1st year Student Nurse, University of Stirling
19 June 2016
I had the privilege of attending the Florence Nightingale Foundation Students day this year, which was an extremely enjoyable experience. It was a great opportunity to meet fellow passionate and enthusiastic students and to discuss some of the issues that our facing our profession currently and in the future.
The day commenced with a panel discussion with four inspirational nurse leaders within their own individual fields. There were a number of great discussions had around nurse education, leadership and research. The panel provided some interesting insight into all of these areas. I found that the members of the panel were encouraging and inspirational speakers, in particular the areas of leadership and management, encouraging all of the students to be the nurse leaders of the future.
There was some interesting discussion regarding nurse education with a particular focus on generic training of nurses and the proposed cuts to the student nurse bursary. I feel though however that some of the comments where misunderstood by the panel in these areas. For the generic teaching aspect the questions were answered and reflected on about a generic course for all nurses however the question was framed at not reducing specialised nurse courses but including more content from all fields within each student’s specialised field of nursing.
In regards to the bursary I feel that the panel where generally supportive however when I asked about the concerns I had for the students nurses of the future wellbeing, particularly in relation to workload, that this question was not addressed. I feel that this was an opportunity for an organisation as respected as the Florence Nightingale Foundation to take a stand with Student Nurses and help stop a series of cuts that will have a serious effect on future nurse numbers and the wellbeing of student nurses. The panel where very knowledgeable and extremely encouraging however and reignited my passion after a long three years of training.
The only addition that could have been made was more input from the devolved nations on the panel. Each member was based within England and I think a broader discussion with all parts of the health services in England, Wales, Scotland and Northern Island being represented within the panel could have given more in depth discussion around national issues.
The next part of the day included a tour of the older part of Guy’s Hospital and Florence Nightingale Museum. It was fascinating to see and hear the changes in nurse education, practice and hear stories of nursing from the Second World War within the hospital. The museum itself was fascinating to me as I did not know a lot about Florence Nightingale and I discovered why she is such an inspiration to many nurses around the world. I particularly enjoyed seeing her famous lamp which was not how I expected it to look and to see her stuffed owl that she had as a pet during her time nursing in the Crimean War.
The final organised activity was a commemoration service for Florence Nightingale at Westminster Abbey. It was a beautiful service in the most beautiful of settings and the sound of the choir singing was utterly memorising. At the service we had the chance to meet various influential people within nursing, be that NHS, government or unions. One of the most interesting parts was watching Jeremy Hunt leave the service quickly and I am sure that many of the Student Nurses would have loved to have had a conversation with him!
One of the best experiences of the whole day was having the chance to meet such fantastic student nurses from all over the UK. It was great to see such enthusiasm, commitment and passion from the future of the nursing profession.
During my time training to be a Mental Health Nurse, I have taken every opportunity given to me and I have tried my best through many roles to make the experience of Student Nurses within my University a pleasurable and empowering one. Admittedly as I approach the end of my studies my passion has waned slightly, probably due to tiredness and the continual work of a nursing student.
The chance to meet similar minded students who were continually striving for the best results for their patients, colleagues and fellow students filled me with inspiration again and has helped me build networks that hopefully in future can help improve the services we deliver throughout the UK.
Robert Murray, Student Nurse, University of Stirling
16 May 2016
To mark International Nurses Day 2016 we asked our nursing students and staff what inspired them to nurse; this is what they said:
“For me, a role that matters and allows me to contribute to the society I live in.”
Ric, second year student nurse
“Circumstances saw me having to support myself through education from the age of 16, I always persevered, knowing my aim was to become a nurse one day. Life and motherhood saw ten years pass. I knew then that if I want to truly encourage my daughters to become whatever they want to be, it was through doing it myself. An HNC, years of work experience and a year of night college later I am exactly where I know I should be! My daughters are proud of me, and I am proud of myself. Nursing is where my heart is.”
Sandra, third year student nurse
“What motivates me is the opportunity I have to make a difference and to improve the quality of life for others, which for me is more of a calling than a career.”
John, second year student nurse
“I wanted to make a difference, sounds corny but it’s true! I never wanted to do anything else, it may have taken me a few years longer than most, I’m now 37 but now I’m finally making that dream become a reality.”
Hazel, first year student nurse
“I was inspired to go into nursing while working in a high school, I witnessed so many young people struggling with their thoughts, feelings and emotions, not knowing how to manage these. I want to be able to help them make a difference in their lives so they can mature and grow into confident individuals who are ready for adulthood.”
Pamela, second year student nurse
“I worked with a lovely probationary teacher last year who went into teacher training later. She inspired me, it’s never too late to achieve your dreams.”
Liz, first year student nurse
“I worked in a dementia unit for nearly 4 years, to begin with it was ‘just a job’ (I was 19 at the time and didn’t know what i wanted to do career-wise!) but as the months progressed and I received additional training and learning regarding the job. I realized how much I deeply cared for the well-being of all the clients and their families and loved how the feeling of providing care, support, comfort and compassion to each client was like receiving a personal reward on a daily basis. My experience of working as a Care Assistant prompted me to start my training, broaden my skills, expand my knowledge and continue onto a career of more person-centred care.”
Kirsty, first year student nurse
“Helping someone when they cannot help themselves even by just making them smile, nursing is such a rewarding career”
Lindsay, first year student nurse
“When I was 17 other people kept telling me that I should go into nursing. They said I had a strong value base, caring and compassionate nature and an ability to influence people. I always wanted to be a teacher, but didn’t apply as I could not spell! Who would have thought I would end up being a nurse teacher!”
Janet Smith, Teaching Fellow
“I’ve always been interested in the science behind the human body, but witnessing the care and compassion shown by nurses when my Granda was dying made me realise that nursing was the dream career for me – I wanted to make an impact on someone’s life like those nurses did for me and my family.”
Holly, second year student nurse
“What motivated me to choose nursing was the never ending possibilities nursing offers, as well as being able to make a difference in someone’s life. I also wanted a career, and not just a ‘job’.”
Michelle, third year student nurse
“When I was young (3/4), I spent a lot of time with my granny around nursing homes and would often help the nurses with tea, biscuits and bingo so I was around the environment from a young age. When I was 16, unfortunately I got ill. Although this allowed me to see all the different departments of the hospital I was in. I always had an interest for some science-based jobs, but personally experiencing the kindness of the nurses on the ward made me decide that it was what I wanted to do. I really wanted to give something back, to make other people experience the high level of care and compassion, like the care I had received. And well, here I am!”
Ryan, second year student nurse
“Seeing several family members working in mental health services, and the public’s perception of mental health issues, inspired me to train as a Mental Health Nurse.”
Sophie, first year student nurse
“I wanted to be a nurse because I care about other people’s health and well-being. Whether that be children or adults. I am a mature student and sadly have lost my own parents and my children are more independent. I suppose there in a need in me to nurture and care for other people and I want to make a difference, however small.”
Liz, first year student nurse
“The film Patch Adams.”
Sandra, third year student nurse
What motivated me to become involved with research was the awareness that when someone is in the same position for too long they can stop questioning, they become too set in their ways and are resistant to change. I didn’t want to become complacent. I was questioning everything and I needed to be involved with finding answers.”
Gaylor Hoskins, Clinical Academic Research Fellow
“I have always enjoyed helping people, in every aspect of life, therefore nursing is something I have always considered. However it wasn’t till after my travels to South Africa – witnessing poverty and severe illness – that it was made clear to me that I wanted to strive and work to the best of my ability to become a successful, compassionate nurse.”
Caitlin, first year student nurse
“I saw nursing as a challenge, a changing challenge and I’ve never looked back. Can’t wait to qualify!”
Kim, second year student nurse
“The reason I went into nursing is because my aunts are Mental Health Nurses. Initially it never really appealed to me. I was always complaining of how bored I was getting in my job. My aunts said they knew I would make a great nurse and to give a shot. I applied to work as a Rehab Assistant to see if I liked it. I did! I then put my application in to Stirling. The thing I like about it is that you’re always busy, no two days are the same, it is very rewarding and there is job satisfaction. I wish I did it earlier. I have never looked back since!”
Blair, first year student nurse
“I have always had a great amount of empathy for others, I chose mental health nursing to utilise this and have a career in which I care for people every day.”
Ela, first year student nurse
“What motivated me to get into nursing research was the opportunity to use my skills in technology, decision making and interventions to support care delivery, and make a meaningful difference to patients and those who care for them.”
Dr Julie Cowie, Lecturer
“I chose to nurse for the opportunity to make a positive impact on people’s lives, no matter how big or small.”
Kourteney, first year student nurse
“I am constantly inspired by patients and I love the feeling I get when I help others, it is so rewarding, the difference you can make to a person’s/family’s life is incredible and to be in a privileged position to do this is so humbling.”
Nicola, first year student nurse
“The idea of nursing being a rewarding career with so many areas that one can work in and the fact that I love working with people inspired me to get into nursing.”
Davinia, first year student nurse
“My mum and older brother work as nursing assistants in our local mental health wards and always talked about how rewarding it is as a career. They have inspired me to become a nurse from their experience and my want to help others.”
Fionnuala, second year student nurse
“I chose nursing because I liked interacting with people and thought it would be an interesting job – I was so right.”
Dr Susanne Cruickshank, Reader in Cancer Nursing
“I always wanted to study at University and, eventually, at the grand age of 46 I started my nursing degree. Now 2 years into my studies I am loving every aspect of it and looking forward to joining the nursing profession. It was definitely worth the wait!!”
Jane, second year student
“As I was born with a heart defect and went through a heart transplant at the age of 8, I have spent a lot of time in the hospital. The people that supported me the most, held my hand through different procedures and was always there for me when I was scared and vulnerable, was the nurses. They inspired me every day through their hard work and always with a smile around their faces which made me look at life in a more positive way even though that wasn’t always the case. That’s why I want to be a nurse, I want to give something back and help other people as they helped me and my family through the hardest times of my life”. Emilie, second year student
And the last word from Hazel:
“Complications after my surrogate baby was born meant an emergency trip to theatre. I will never forget how I felt a nurse suddenly hold my hand, I never saw her face but that hand ‘spoke’ a thousand words.”
Hazel, first year student nurse
Many students are not keen on undertaking an away placement – they may think it’s inconvenient, expensive, and that it won’t really add much to their learning or contribute to their future practice. But it’s not at all, it’s a great experience that everyone should try, if they can.
I was lucky enough to be able to rent a room for the duration of my placement from my mentor who runs a guest house as well as being a district nurse. My room was lovely, I got breakfast and dinner, and had access to everything I needed including the washing machine, ironing board etc. I really couldn’t have asked for better accommodation and hosts.
Travelling from Stirling to Barra is quite a long journey, around 10 hours, if you go by train and ferry, which is the cheapest option, around £25 single. The ferry journey can be quite boring so I would advise taking a book or something to do. I’d also recommend taking a blanket and pillow so you can sleep because the seats are also quite uncomfy. When you arrive at Castlebay one of the nurses will probably collect you and take you to your accommodation, otherwise there are buses and taxis which can be pre-booked.
The other option is to get the plane from Glasgow airport to Barra, it is quite expensive between £30 and £75 single depending on how far in advance you book from Flybe, but it only takes about an hour. The plane is tiny – seats around 20 including the pilot. It is a really good experience though as Barra has the only tidal airport in the world – the beach is the runway!
The Island has a 5-bed hospital called St. Brendan’s. The hospital includes 3 single rooms and 1 twin room, a treatment room, a physio room and a dentist. The community nurses are also in the same building and have their own room upstairs.
There is one doctor who is on call 24/7 and is based in the GP surgery which is around 0.5 miles from the hospital, though new plans are currently being developed to build a new hospital which will house everybody together to make working as a team easier.
Within the hospital everything is nurse led as there are no other health professionals which are constant on the island. All Physio therapists, occupational therapists, dieticians, speech and language therapists etc. are all mostly based on the isle of Lewis in Stornoway which is the main hospital for the western isles, and they visit Barra occasionally. There is also only 1 midwife on the island, who only works 7 hours per week, and only 1 health visitor who is very willing to take student nurses on visits and also to baby clinics – I even got to go on the ferry to the Isle of Uist to visit a few new born babies!
During my time in Barra there weren’t many patients, but I got to spend time with lots of different healthcare professionals – health visitor, midwife, diabetic nurse, practice nurse, community nurses. There were also lots of training days whilst I was there – management of the acutely ill patient, psychoactive substances, continence management and advanced life support. So, although it might be quiet compared to Forth Valley there are plenty of opportunities to keep you busy.
The island itself has very few shops and amenities, so if you do go to Barra I’d recommend bringing everything you need. The islanders are very friendly and welcoming, but during the winter there isn’t much to do. There are, however, many events during the summer such as a festival and various fetes/open days, and the beaches are lovely as well, even in the winter.
Overall, I’d definitely recommend going to the Isle of Barra for a placement, to experience how it’s done in a remote and rural area.
Holly McMurray, 2nd year Adult Student Nurse
University of Stirling
Published 13 April 2016