This is the final post in a mini-series that’s looked back at my past. This post is a bit different because I don’t have any photos to capture my mental health nursing career. I became a nurse in 2004. It was my second health professional career; the first was as a pharmacist. This is a quick overview of where my career has taken me.
I realized while I was in nursing school that I wanted my career to focus on psychiatry, and I had requested to do my final preceptorship experience, which is the last bit of school prior to graduation, on a psych ward. The school was limited to the placements that they were able to find, so I ended up doing my preceptorship on a surgical ward. That meant that I really didn’t have a lot of psych experience when I started working, although at least knowing the meds wasn’t an issue.
Job #1: Inpatient
My first nursing job was on an acute inpatient psychiatry unit. It wasn’t a locked unit, nor were any of the other inpatient units at that particular hospital. That was mostly a good thing, but certainly posed some challenges given how easy it was for patients to AWOL.
Unlike a lot of hospital units, our shifts were 8 hours long. I had a day/night line, working mostly days and then a stretch of 6 nights in a row every 6 weeks or so. By night number 6 it felt like my IQ had dropped by half. On day shifts, though, I was on the ball and soaking everything up like a sponge. I learned a ton from my colleagues, both in terms of what to do and what not to do.
It was almost 2 1/2 years after I started working that I ended being hospitalized as a result of my first episode of depression. After I went back to work, I waited for the conditions to be taken off my nursing license (which took a year and some-odd) and then started looking for another job.
Job #2: Community Mental Health Team
The job I ended up taking was as a nurse case manager at an inner-city mental health team. I absolutely loved it. I had a caseload of regular clients, and there was quite a bit of outreach, like chasing people down for their regular antipsychotic injections. I was at that job for four years, and got to know most of my clients really well. I would see people anywhere from daily to every 3 months.
Our office was smack dab in the middle of skid row, and it was quite the eye-opening experience. Open drug use, prostitution, atrocious living conditions – it wasn’t just about anonymous social problems, it was about my clients and their community, and it was the world they lived in. I learned a great deal working in that neighbourhood.
I found that nurses in the community setting tended to have more say in the overall treatment plan than they did in the hospital, and there wasn’t the same kind of hierarchy among the different professions. I had great relationships with all of the doctors at the mental health team, and if I asked a doc to make a change to someone’s medication, they’d almost always do it without hesitation.
That was my favourite job and I would’ve been happy to do it for many, many years, but once my manager had decided that my illness aligned with the stereotype of dangerousness, I knew it was time to move on.
Job #3: Crisis Team
Next, I worked for a crisis stabilization team, helping to keep people out of hospital or providing added support at home so people could be discharged sooner. All of our work was outreach-based, seeing clients in their homes. Depending on who did the referral, the first meeting might be in a hospital. We got a lot of referrals from ER, so I got quite familiar with the two main ERs in the city.
It was interesting to see such a wide variety of different clients, but also going into different homes, ranging from skid row to multimillion-dollar homes. It was also nice to have the freedom of not being stuck in the office all day.
The schedule was great, too; 9am-9pm, with 4 days on and 4 or sometimes 5 days off. After I’d been there for 2 years and a bit, some major organizational changes happened and it all went to hell in a handbasket, which I won’t get into here.
Job #4: Concurrent Disorders Transitional Program
My current job (although I haven’t worked for several months) is at a transitional program for people who have been through a concurrent disorders (addiction plus another mental illness) treatment program. All of the clients are reasonably stable and preparing to move back into the community.
As a casual nurse picking up the odd night shift, I hand out the odd Tylenol or sleeping medication, and that’s about it. On rare occasions, someone might be really unwell or need to be transferred to hospital, but the vast majority of the time, it was just Tylenol or sedatives. Nothing fulfilling about that, but it’s what I was able to manage, at least when I was still managing to work.
And there you have it, a quick wander back through my nursing career. Up until the current job, which I’m in only because it’s what’s feasible, I really enjoyed the work that I did and the clients and colleagues that I learned so much from.
Missed the previous “this was me” posts? You can find them here: