Abstract
An undergraduate nursing student tells her professor and classmates that she is interested in going into psychiatric-mental health nursing. “That isn’t real nursing,” or “You have to be a little weird or crazy to want to do that,” many of her classmates say. “Are you sure?” asks her professor. “You’re so smart. Why not look at another area of nursing? You’ll at least want to get in a few years of med-surg before going into psych.” Our student nurse is deflated and begins to second guess herself. Maybe psychiatric-mental health nursing isn’t the rewarding and unique career that she originally believed.
How Many of You Have a Similar Story?
It is no secret that there is stigma against psychiatric-mental health nursing, even within the nursing profession itself (Natan, Drori, & Hochman, 2015). We have an image problem and it is time to change that. With my theme, Psychiatric-Mental Health Nurses: Proud Partners in the Journey to Whole Health, I am proposing a mission for the coming year: To share our pride in what we do and change the perception of our profession, person by person. With these columns, I plan to articulate what it is about psychiatric-mental health nurses that makes us unique, what draws us to this profession, and why we are proud of our role. I challenge each of us to use these columns as a guide to spread the word about how incredible and important the work is that we do.
Let us start at the beginning: students. Many nursing students view their psychiatric nursing clinical rotation with an intense fear and anxiety that negatively affects their perception of working with psychiatric-mental health patients and sets them up to view the profession as unworthy, dangerous, or somehow “not nursing” (Wedgeworth, Ford, & Tice, 2019). Students who are interested in psychiatric-mental health are often dissuaded from pursuing this type of nursing career. In interviews with a group of American Psychiatric Nurses Association (APNA) Board of Directors Student Scholars, almost every single one indicated that while in school, they were actively discouraged from pursuing psychiatric-mental health nursing by their peers and even by faculty.
Do You Remember When You First Voiced an Interest in Psychiatric-Mental Health Nursing? What Sort of Reaction Did You Get? Why Did You Persevere?
In addition to understanding why students do not choose psychiatric-mental health nursing as a career, we need to appreciate why those students who do choose this path make that determination. Research shows that factors such as an interest in psychiatric-mental health issues prior to school, personal experience, and external validation of their potential in the area influence a student’s choice to go into this field (Ong et al., 2017). Nursing-specific studies are a bit challenging to find; however, a study on how to encourage French medical students to choose a career in psychiatry discovered that “quantity and quality of the teaching in psychiatry” during school was associated with a student’s choice to pursue mental health as a career (Andlauer et al., 2013, p. 463). So, we are looking at a combination of interest, exposure through personal experience, quality education, and external validation.
We can use this information to help us change the narrative—to showcase psychiatric-mental health nursing to students as the rewarding and appealing career it is. While we cannot make someone have an interest in psychiatric nursing, what we can do is strive to provide students with positive exposure and validation.
What Moments Were Pivotal for You in Choosing Psychiatric-Mental Health Nursing as a Career? How Can You Create Moments Like Those for Others?
Mentorship is one important opportunity. Take time with the student nurses when they are on your unit and reach out to new nurses. According to Siu and Sivan (2011), the key phases of cultivating a successful mentorship for psychiatric-mental health nurses are first becoming acquaintances and developing a bond, then ensuring the mentee feels included and is given affirmation. Certainly, this progression is something that we can actively engage in easily, given our skill set. We simply must make it a priority to be accessible and reach out to these potential and fledgling psychiatric nurses to share our enthusiasm around what we do and validate their interest in it.
We can make use of existing networks to reach out to our communities, as well. According to Andlauer et al. (2013), local associations can be the crucial link that spreads information to students interested in the psychiatric-mental health field and organize direct access for students to local professionals and their experiences. There is no reason that we cannot use our local professional networks to do this. For example, many APNA Chapters are actively engaging in such outreach by offering scholarships to students to attend conferences and events, thereby giving the students the valuable opportunity to build connections with psychiatric-mental health nurses in the field.
Now that we are all committed to reaching out to students to spark an interest in our profession, let us examine how we can communicate just what it is that we do and why we love it. Psychiatric-mental health nursing can be notoriously hard to describe to someone who is not a psychiatric-mental health nurse. What we do is an “art and a science” (American Nurses Association, American Psychiatric Nurses Association, & International Society of Psychiatric-Mental Health Nurses, 2014) that often defies categorization. Our skill set is often less tangible than say, starting an IV. There are multiple ways to get to the same place in our profession and no single right or wrong approach.
Here is how I describe what psychiatric-mental health nurses do in a positive and understandable way to those unfamiliar with our profession: As psychiatric-mental health nurses, we are helping people work on their life puzzle. While other nurses have the edge pieces, which are straight and linear, we have the interesting interior puzzle pieces that complete the whole picture. It takes a different eye to put those pieces together. You need to be someone special who can observe and gather clues with an appreciation of how the entire picture will come together. It requires unique skill. Think of the satisfaction you feel when you fit an interior puzzle piece in and begin to see the full picture emerge. You’ll get that and more from psychiatric-mental health nursing.
What Images Come to Your Mind When You Think of What You Do? What Stories Illustrate Why You Are Proud to Be a Psychiatric-Mental Health Nurse?
I challenge you to put together your own pitch for psychiatric-mental health nursing and to share it at the next opportunity. We must create these opportunities. When we all use our voices with intentionality and purpose, we can make an incredible impact. By bringing more bright and passionate people into our profession, we will benefit the many people across our country in need of recovery-oriented mental health and substance use care.