Nursing personal statement (6)

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27th September 2018

Section 1 personal statement and external evidence

In the past six years, I have worked in various mental health care setting including NHS hospitals and community setting and I hope to RPL 500 hours from the previous experience I have acquired. I worked as a healthcare assistant and community support worker (appendix: timeline).

The most recent role I worked is as a volunteer support worker at ‘The revivalist ministries world outreach’ (TRMWO). It is a community-based setting and various people with different mental health condition come to seek help. I provide service user with mental health social needs relevant information needed to assess the various type of help available to them and how to assess it. I volunteer for 5 hours in a week from 2016 till date (appendix; letter from employer). Aside from this, I engage the service user in a therapy session, take their physical observation when they arrive at the centre and occasional home visit.

At Jasmine ward in Kent and Medway NHS and Social Care Partnership Trust (KMPT), I worked as an agency staff from pulse nursing agency. I worked as a healthcare assistant while on the ward between July 2014 and October 2014, a total of 202 hours (appendix pay slips). Jasmine ward is an acute admission ward that provides inpatient care with intensive support for the service user in the period of acute psychiatric illness and end of life. The nature of my work involves providing physical and psychological care to service user while on admission on the ward.

During my training between 2012 and 2014 where I got a qualification in health study, I was privileged to work at various mental health unit within West London mental health NHS trust ‘WLMHT’ (community early intervention, forensic, intensive psychiatric unit, acute ward and recovery ward), and I acquired a vast knowledge and understanding of mental illness and transferable skill needed to work as a mental health nurse. (Appendix: certificate from university and copies of placement hours). My duties included, service user enhanced physical checks (temperature taking, blood pressure, a finger prick blood test for glucose level, pulse, height and weight measurement), medication administration under the supervision of an RMN and service user regular psychological observation.

Holistic aspect of health and wellbeing

2.1 Physical care

In my role as a student with WLMHT, I received training on how to carry out physical checks on service user with the use of relevant equipment, interpreting the result and documentation. The physical checks training I learnt are; taking blood pressure with the blood pressure monitor machine, the use of the thermometer to take temperature, use of blood glucose monitor machine and how to calibrate the equipment to have an accurate result (Nash, 2014). Before I commence any physical check on service user I seek their consent first except in a situation when the patients cannot decide, and it is in the best interest of the patients (NHS.UK, 2016).

In my role as a healthcare assistant at Jasmine ward in KMPT trust, I assist the service user who has no capacity to carry out their personal hygiene alone in their daily personal care. Personal hygiene care is an important part of human life and needs to be delivered appropriately, with respect and dignity (Delves-Yates, 2018). Also, I seek the consent of the service user before proceeding, having the service user consent before proceeding gives them the autonomy to decide what they want and safeguard them from abuse and neglects (NHS.UK, 2016).
On each occasion when I assist the service user in their personal care, I ensure they are involved in their personal care whenever they can and if they are capable to do so (Nursing and Midwifery Council, 2015). On the other hands, those who are unable are assisted in their care. I document the support done to the service user after the personal care is done. Recording keeping is vital and it provides information for another member of the team to know what has been done (Nursing and Midwifery Council, 2015).

Hand washing is of high importance during personal care. I endeavour to practice regular hand wash before and after personal care and I used appropriate personal protective equipment such as apron (yellow or white), gloves and mask if needed due to infection control (World Health Organisation, 2009). Diseases are easily transferred when proper hand washing is not done regularly, and this often leads to service user staying longer in the Hospital (World Health Organization, 2018). The world health organisation in 2018, identifies five major moments of hand washing and two among it include, before and after having contact with the service user. Others are, after having contact with service user surrounding, after having contact with bodily fluids and before and after an antiseptic procedure. If this is done effectively, it will reduce service user prolong hospital admission, reduce the spread of bacteria and thereby save the cost of treatment (World Health Organization, 2018).

2.2 Spirituality

Spirituality is seen to be beyond the faith of an individual ‘religious people’ in a supernatural being, but it encompasses beliefs and the values of a person (Cook, Powell and Sims, 2009). It does affect everyone and not just a set of people who are religious. In a situation when service users are on admission in the hospital, they want healthcare professionals to know their beliefs and values. This can be through the type of food they eat, some request to go to the mosque or church and others might request to speak with a chaplain. KMPT trust and WLMHT trust that I worked with made provision for Halal meals and vegetarian foods. The service user who is Muslim is given the preferred halal meal to eat, also those that are vegetarian. As a healthcare assistant, when the kitchen staff brings the food to the ward, it is my responsibility to ensure service user meal are served according to their needs and are severed their preferred meal. Ability to address the spiritual needs often reassure the service user and it does improve their wellbeing (Culliford, 2005).

Research has shown that spirituality, helps prevent physical and mental illness, reduces relapse in mental health and speed up recovery process (Royal college of psychiatrists, 2018). As a volunteer support worker with the TRMWO, I was involved in the care of a service user with post-natal depression. Her Christian believes affected the presentation of her mental health and she refused to accept medical help. Being a Christian, I made myself available for her to speak with and I listen attentively to her (ref). In the process, I was able to identify the issue why she refused treatment and I responded to the issue in a systematic approach (ref). I provide her with relevant chaplain information and encourage her to contact and speak the chaplain. By doing so I wanted her to express herself to someone who has a same religious belief with her and can identify the needs for medical help (ref). According to WHO, religious belief is seen as a major healing process to those suffering from mental health disorder.

In addition, I understood that most of the service user often have their own beliefs and value and therefore, I ensure my preference is not made known to them. I gave everyone an equal opportunity to express their faith, beliefs and values (ref).

2.3 Psychological aspect

The psychological aspect is crucial to care, and its effect cannot be underestimated if done appropriately. There was a time at TRMWO, I cared for a service user who is not medication compliant because of fear, anxiety and worry. The service user suffered from depression and is afraid that the medication will make her feel less active and sleepy all the time. She needed someone to reassure her that the medication she was given was to make her feel better and control her depressive symptom. I had a one to one session with her, engage her in a conversation by asking her reflective questions, to get a full understanding of her fear and worry. I listen attentively to her and I let her express her fear and concern. Active listening is vital for service user psychological wellbeing and recovery (ref).

I appreciated her for expressing her worries and fear and I reassure her that the medication she was given was not to make her feel worse off but to make her get better and recover from all form of a depressive symptom. Reassuring the service user is vital for their wellbeing and recovery from any form of illness they suffered, be it physical or mental health (ref). I discussed her concerned with the community mental health nurse who oversaw her treatment. The nurse gave her detailed information about her medication and why it is good for her to take it regularly. She consented to take her medication accordingly afterwards and was fully involved in her treatment and was encouraged to discuss what works better for her recovery.

According to (ref), effective psychological tends to reduce prolong hospital admission and unnecessary hospital admission. More so, the government aim is to treat mental health service user more in the community than having them admitted to the hospital ward (ref).

2.4 Social aspect

At TRMWO centre where I volunteer as a support worker, I engage with various people from a different background; education, ethnicity, religion, age, gender, socio-economic and sexual orientation. At the centre will have a group session where will discussed social needs that are available for service user having mental health issues. Some of the discussion is about how they could assess financial help, basic educational training (maths and English), vocational training and counselling about going back to work after recovery from their illness (Mind, 2018).

After recovery from illness people with the mental health-related issue often feel they cannot cope with work and are afraid of relapse (ref), as a support worker it is my duty to reassure them and give them the relevant information they needed. Referrals are often made for a service user who decides to volunteer in the field they want to work before starting a paid job. This has helped some of them to gain paid employment and it builds their confidence. A service user who is not in suitable accommodation and needs accommodation are often referred to the social service in the local area for support.

At the centre, I was engaged in the support of a service user who was recovering from mental illness due to lack of job and needed to work but has no relevant experience for the job she applied for. I encourage her to do some vocational training and do some volunteering alongside. Referrals were made for her by the social worker to some organisation where she could be volunteering. She engages the services provided for her and afterwards, she got a paid job. Soon after she started a job, there was a great improvement in her wellbeing and her recovery (ref).

Conclusion

In my role as volunteer community support worker at TRMWO, healthcare assistant (KMPT) and student (WLMHT), I took various responsibility in taking care of service user physical, psychological, spiritual and social needs at various times. I assisted service user in their personal hygiene, engaged in regular hand wash, active listening, communicating and liaising with other members of the team in a professional manner, documentation of physical observation appropriately and providing useful information needed for their wellness. I have acquired transferable skills that are relevant for nursing practice.

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