Training and career development 
Once you have qualified as a mental health nurse, there are a wide range of opportunities. You could specialise in working with children and adolescents, as a primary mental health worker; or women or in a field such as transcultural psychiatry, looking at how mental disorders and their treatment can be influenced by cultural and ethnic factors. You may want to work or move into management, teaching or clinical research. 

Tom King is a mental health student nurse in his third year of training. His university life, between the downtime of going out like every other student, consists of being on the ward actively working with mentally ill patients.

His last shift was on placement at an adolescent ward for children aged 13-17 with a wide variety of mental health issues, ranging from psychosis to depression to eating disorders

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6.00am - I woke up and got ready for the day ahead.

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7.00am - I caught up with the nurses in the office and talk for a while with a patient who was sitting in the communal area; he hadn't slept as the voices in his head were particularly bad that night. I asked him about them but he's too tired to talk, so I left him with a glass of water and make a mental note to play some football with him later to try and offer some distraction.

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7.10am - I met with the nurses who had just been on duty for a handover session. It's an important period, as urgent tasks are noted down and any observations or comments are shared. Once this was over, the shift began.

7.15-8.15am - For the first hour or so I made sure the ward is ready for the shift: that the communal areas are tidy, the food is laid out for breakfast and the medication trolley is ready to go. While this goes on, another person is walking around the ward to check everyone is okay in their rooms. At this time, most are usually still asleep but these checks really can't be too thorough: self-harm and suicidal thoughts (not the same thing) are an unfortunate but common reality when it comes to mental health, so we need to be aware of people acting on these thoughts and then work with them to find an alternative method of coping. On this particular check, a nurse found a young girl in her room with fresh cuts to her arms. She had used a piece of sharp plastic broken off from her window sill. She is taken to the clinical room and the cuts are cleaned and treated. This girl had been working especially hard recently to not use self-harm as a coping strategy, so she was upset and angry with herself for 'failing'. She was reassured that what she has done is not a 'failure', but a natural setback that comes with mental health recovery. Self-harm can become a habit of behaviour when emotions become too intense, and it can often take a long time to substitute this for another way of dealing with them.

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8.20-8.40am - Once all the kids were up and awake, they had their breakfast and go to school. Some were a bit reluctant, but that's the case with most teenagers. We need to be aware not to lump every behaviour a person exhibits as a mental health symptom; certain things need to be put into context.

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8.40am-2.50pm - While the kids are at school, the nurses caught up on some paperwork, which includes writing care plans, risk assessments and case notes. As a student, I use this time to look through my practice book and make a note of what I need to tick off by the end of the placement.

3.00pm - Once school is over, the kids came back onto the ward and we tried to engage them in activities. The most important thing here is not to be patronising. As a mental health nurse, you must remind yourself that you must earn the trust of the people you care for; your uniform does not give you an entitlement to intrude.

 

4.00pm - I found the time to play football with the lad who didn't sleep last night. He started to talking to me about his frustration and I reassured him.

5.00pm - I debriefed from my shift and handed over to the nurse about to start theirs.

 

6.00-6.10pm - I used the drive home to reflect on the day's events.

 

6.15pm-8.00pm - I got home and talk to my friends and family but was cautious not to breach any code of confidentialit