Amy usually sleeps for around two to three hours during the afternoon. However, if she has any sleep at all prior to this then she classifies this as her afternoon nap and refuses to attempt sleep until at least 7:30. For example: today we went to the garden centre, went to see my dad at his workshop, then took the dogs for a walk. On the way back in the car she fell asleep just as we pulled into Slaithwaite. It took us around five minutes to get home from there, but in Amy’s mind those few minutes counted as her nap for the day and she point blanc refused to go to sleep when we got back. Each time I put her into bed she was up within ten minutes shouting “Hello Daddy, I’m awake!”.
Normally this is not too much of a problem, I’d just write off my “me-time” for that day and get back on with the joy’s of fatherhood. Today however is Pancake Day and two year old children and flinging hot batter around the kitchen do not mix. Fortunately Amy has recently discovered the delights of Mary Poppins and so I was able to distract her sufficiently in order to get a pretty respectable pile together.
Hey there. Thank you for replying to my post about The Tidal Model at Live Journal.
It’s a real pleasure to have someone, who is obviously quite knowledgable and experienced within the profession, to comment.
My background studies lie in psychotherapy. Although not a professional, I have managed to retain some of the qualities within that area, thinking that I could transfer such skills within mental health nursing. Certainly with my [limited] experience of working within the Assessment Ward, I too, have seen some of what you have written about. There are quite a lot of newly qualified nurses who work within Acute settings who seem to have been caught up with mere clerical work (something which non-qualified staff could do). It’s very difficult to create a therapeutic milieu within such a fast-paced environment and, yes, the tidal model will be just another one of those paper exercises. It is this same Philip Barker who continues to assert that Acute Psychiatric Wards do not create therapeutic community; while it is he who is pushing for his model to be utilised! It’s almost farcical.
After spending four or so months at the Assessment Ward, it has certainly taught me that it is not the place for me when I eventually qualify!
Again, thanks for you post. I shall see you around, hopefully!
Could you recommend a specific area that I could pursue when I qualify?
I started off by going into rehab, but I was lucky in that the ward I chose wasn’t your typical rehab ward - i.e. long stay ward renamed as “rehab” but not particularly interested in moving anyone on.
The ward’s model was based around psychosocial intervention (or PSI.
It’s a model that’s been devised for treating schizophrenia, heavily reliant on a CBT base, but really it can be pretty much adapted to fit other diagnosis.
As someone who’s background is in psychotherapy it might be a bit stark and practical to you - certainly more paternal (although you could argue that all therapists are paternal, at some level you are generally saying “what you think is distorted and I’m going to show you how you really should think” - CBT is just more honest). I personally am a big fan of CBT like therapies. I just think they get stuff done rather than just gaze at your navel. That’s not to say I don’t rely on humanistic listening methods, I certainly do. I think mental health nursing is all about having a toolkit you can dip into rather than “I’m a humanist†or “I only do CBTâ€. We’re jack-of-all-trades really, which can be useful. Someone once told me they read an article that showed that all the different schools of council ling are equally effective, it’s the genuine human contact and warmth that really counts – that and the therapists belief in hope for the client (which they probably get from their model).
Anyhow, that wasn’t your question. As I said I started on a rehab ward that was quite focused on theory-backed therapy – we had a mixture of long term chronic clients and people who were coming in for some intensive therapy. Non of us were officially trained in CBT, but a fair few had a good working grasp of the model and three members of staff had masters degrees in PSI.
I stayed there for three years and honed my skills in a reasonably calm and settled environment where I had enough time to actually spend time with my clients. Then when I started to get a bit lazy I moved. I moved to a crisis team, I imagine you have them where you are (where are you?). They originate from Newcastle (doesn’t everything) and I guess are the answer to the whole “acute wards are untheraputic†problem. Basically we try to keep people out of hospital (they shut one of the two wards down as soon as the crisis team was created – so keeping people out of hospital is pretty important as there are zero beds). We assess the risk, and if they are safe to be left at home we do home treatment (intensive support, maybe visiting once or twice a day for about an hour which – lets face it is more dedicated 1:1 time than you would get on an acute ward). There are pretty major flaws in the crisis team model though, but I’m going on enough as it is. If you’re interested I’ll let you know my opinions.
Nurse training is pretty good; don’t let people tell you that “your training is too theoretical†(ok, let them tell you because they are probably your mentors, but just don’t believe them). It’s good in that 80% of the people training probably won’t ever go back to do theory again, aside for the bare minimum needed to keep up registration. It’s true that you don’t really have enough experience in practical nursing when you leave, but you have all your career to get that experience so you might as well stock up on theory while you can.
I don’t think there’s anything wrong in starting on an acute ward, most people do. I only started where I did because I was on placement there and I loved it and they loved meJ. I think if you do start on an acute ward though be wary of the cynicism that creeps up on you. It’s a paradox but usually the acute wards have the most unwell and challenging patients and the least experienced staff. In order for the ward to be therapeutic then it first has to be safe. That’s great experience, will stand you in good stead, and sometimes you will be able to snatch chance to do some quality work with people too. But always remember there’s more out there, you just need to get a couple of years experience first.
I don’t know what services there are where you are, but there is probably somewhere that does some reasonable therapeutic work. Make sure you don’t box yourself in though. My friend is working at a specialist mental health unit for deaf people. When she wants to move its going to be more tricky persuading employers that the skills are as transferable as a more generic nurse.
The best tip for getting a good position I can give you is every single service is only half as good as they say they are. If when you get shown round as a student you are told all these really wonderful things, then it’s likely that’s only half true and it’s a good rather than fantastic service. If you get shown round and you get told a load of mediocre things, then its probably going to be a bad service.
I’ve yet to come across a service that is fantastic, they have all been good in points and bad in others. You certainly are always going to have crap nurses as well as good ones. At the end of the day you can only control what you do yourself.
Hope that’s of help, let me know what you think. I apologise for prattling on but Kerry is watching some reality show fashion thing so I’m at a loose end.
Hmmm…there’s certainly a lot there to be digested…
Do you mind if I add you to my blog-roll? I’m at Nottingham by the way, but my family and I live in Derby. I WILL send a reply…but mate, you’ve covered way too much about such a HEEUUOWGE subject; first: some much needed sleep!
You are more than welcome to add me, although i’m not really intending this blog to be about work - its more abouit my family.
i think there is a real gap out their for a mental health nurses blog similar to random acts of reality but I’m not sure how it would be done due to confidentiality issues. I certainly wouldn’t be comfortable doing it.