A call to arms

Tracey Sheehan, who has experienced the chronic under-resourcing of mental health first-hand, welcomes the Federal Government’s 2.2 billion dollar budget boost as long overdue.

After working as a ground-level nurse at Rozelle Hospital and then for five years as a Clinical Nurse Consultant at St George Hospital, she felt stuck. “We were always understaffed so I really couldn’t get in and make a change, and that’s what I’m hoping to do now,” she says. 

For the last year, Sheehan has been working in the Mental Health Nursing Professorial Unit of South Eastern Sydney Local Health Network under the mentorship of UTS Professor Jane Stein-Parbury. “It was an advertised secondment position open to all qualified senior mental health nurses. By coincidence, the unit was being led by Jane, who taught me at UTS 17 years ago.”

Together they’re developing a new program for 2012 and delivering a 12-month Transition to Practice Program for graduates and experienced nurses new to mental health. The nurses attend structured study days once a month and take part in active-learning workshops designed to support them in their workplace.

“Many of the nurses feel like they’ve been thrown in the deep end. Knowing they can come to an open forum where they feel supported and can debrief with one another about the situations they’re dealing with means a great deal,” says Sheehan.

With a Bachelor of Nursing degree from UTS, a Master of Public Health from the University of Wollongong, and seventeen years’ experience, Sheehan says she definitely knows where the nurses are coming from.

“What’s most important is that you receive good support from your place of employment; whether it’s through debriefing sessions, supernumerary time or ongoing education. You should feel like you’re practicing safely and know where to go for answers if you’re unsure of something. The transition year is always the hardest – but it gets better.”

In the unit’s most recent study day, the role-plays involved managing phone calls from mentally ill patients in crisis situations. One of the scenarios concerned dealing with a highly suicidal caller.

The nurses need to think, how can I manage this situation effectively over the phone under duty of care?” says Sheehan. “This person is telling you they’re going to hang themselves. They‘ve got the means, they’ve got the intent, so what do you do?”

Real-life situations are also discussed. “One was a suicide on an inpatient unit. The other was a patient who was discharged from care and committed suicide.”

Sheehan says the nurses involved felt they needed more support in dealing with these situations, and she plans to address this.

“When these issues occur, hospitals often run large formal debriefing sessions with all staff involved in the critical incident, which feels impersonal. In fact, the nurses found debriefing in this way more disturbing.”

“I’ve been through it myself as a nurse on the ward and what’s useful is being able to deal with it in your own time, with your own colleagues.”

Sheehan is constantly researching case studies, conducting literature reviews and benchmarking to improve work conditions to keep nurses motivated. The recruitment and retention of staff is the biggest issue for the sector and by supporting ground-level nurses through the transition program, Sheehan hopes to improve the figures.

“Despite the challenges, I love my work. I find it so rewarding and varied.”