A Day in the life of a Mental Health Nurse

Author Rotary eClub One Rotarian Roberta Porter

It is true that 2 days are never the same in the life of a Mental Health Nurse, however one shift I recall was very different. That’s because I was a Mental Health Nurse in Northern Ireland.

It was Sunday afternoon in 1987 and the Unit Manager approached me asking if I would complete a community assessment under the Mental Health Act. I agreed and after advising that the ambulance would pick me up at the front of the Psychiatric Unit at 2pm she added that I would be going to South Armagh. The patient was a male in his 50’s and was displaying psychotic symptoms.

My initial thought was umm that is a bit of a risky area to go into but it should be ok, I will be in the ambulance.

At 2pm as scheduled I met the ambulance officers and I jumped in the back of the ambulance. There wasn’t much conversation but I expect they had more awareness of what they journey might be like than what I did. As we left the hospital grounds and travelled towards Armagh, I realised that we now had a Police armoured vehicle as the lead vehicle and another travelling behind the ambulance. This wasn’t so unusual as the police often accompanied a nurse when an assessment of this nature was to occur. At this stage I was still feeling pretty confident that I would carry out a fairly routine assessment and the patient would return with us to the hospital.

We travelled further down the road and as we approached South Armagh, I now observed that the convoy had grown and included a British Army armoured vehicle at the head and another at the rear. Now I began to get nervous. Where was I going?  Why all the protection? 

The route we were going to take in the ambulance was through the infamous Jonesborough Sunday Market and I soon learned why we had protection. The convoy slowed almost to a halt and suddenly the ambulance was being rocked from side to side. There was banging on the walls and windows and I was extremely thankful that the dark privacy glass meant that no one could see me inside. As I looked ahead through the front windscreen there appeared to be hundreds if not a thousand people outside surrounding us. We didn’t need to travel any more than 0.5klm through the market area however it took the longest 20 minutes of my life to complete that journey. My now high level of anxiety about what was going on, on the ground outside meant that initially I was unaware that overhead the army helicopters were providing another layer of protection. As we emerged from the roaring crowd, I could hear the blades of the helicopters getting louder and louder. We journeyed further along the road which became narrow and I knew that we were now deep in the countryside. There were a few farm houses which gave it a more peaceful appearance but the noise from above reminded me it was far from peaceful.

We eventually came to the end of our journey at a small farm house. There were about 10 men all standing around the gate talking. One of the ambulance officers turned and said “its over to you now”. The ambulance doors opened and as I went to jump out my attention was drawn to the many, (maybe 20/30) soldiers appearing out of the hedges around the farm, they were coming from 360 degrees towards me. All I could think of was who is going to be the most nervous, me or the patient? maybe he was used to this!  A man stepped forward and introduced himself as the GP. He discussed his thoughts on a provisional diagnosis and gave me some paperwork. I have no idea what he said and the truth is I don’t think I knew at that time either. I do remember saying “can you please tell me where the patient is”? He pointed to the back steps of the house where a man was sitting, I took the few steps up to meet him and without thinking I introduced myself and said “normally I would take some time to ask you a few questions and find out how things have been for you recently but would it be ok for you to come to hospital with me and we can do it all there without this audience?”. Never before have I had such a compliant patient during an admission under the Mental Health Act.

He got up, I asked if he would like to take anything with him and he replied “no, let’s just go”!

We walked to the ambulance and we were assisted to get in and the doors closed. As the ambulance turned around, I could see that the soldiers had disappeared as quickly as they had appeared. There was no one by the gate, the helicopters were still overhead and they remained with us until we left that area. As the sky became quiet and we reached Newry the Army vehicles also disappeared. It was then I felt that it was time to get back to being a Mental Health Nurse. We had a pleasant conversation which was a bit guarded from the patient due to paranoia but, as we reached the hospital and the police vehicles disappeared, I knew I was on home ground and once we were inside the Psychiatric Unit walls I could get down to the real job and complete the mental health assessment and make my patient comfortable.