My job

Advanced nurse practitioner in personality disorder

Jodie Alder explains why she chose to work in secure services for men

Advanced nurse practitioner Jodie Alder explains why she works in secure services for men

Jodie Alder

What is your job?

I am a band 7 advanced nurse practitioner in personality disorder in an all-male, medium-secure unit in Birmingham.

What are your main responsibilities?

I work with 12 men diagnosed with personality disorders. As senior nurse in the clinical team, I undertake assessments and deliver group and individual therapies. I train the staff team in, for example, the Institute of Mental Health’s Knowledge Understanding Framework, and supervise the nursing staff. I also work on quality-improvement projects and just try to be around as much as I can for the patients and the staff.

Why did you become a nurse?

My aunt was diagnosed with bipolar disorder, and I grew up with an awareness of how this affected her and the rest of the family. Her son was later diagnosed with an antisocial personality disorder, and I have always been drawn to helping men who express pain through violence and offending. I knew that I wanted to work in forensic mental health services before I began my training. I couldn’t imagine a career outside of it.

What do you enjoy most about your job?

The people I work with. I have fantastic support from my line manager, the unit matron and the ward manager; I couldn’t do the job without them, as they seem to understand what I am trying to do while challenging me and pushing me to learn more.

What has been your greatest challenge and did you overcome it?

The stigma of personality disorder. There are many difficulties: recruiting staff to work in the service, supporting them to stay, and reassuring people who don’t work with us that we are a worthwhile and essential service.

Ours is a high-cost and high-risk service, but we are starting to offer the best possible care in the best possible environment. Recognising that there are no quick results, and that we may have more bad days than good ones at first, may be the only way we can overcome this stigma.

We are working towards the enabling environment award from the Royal College of Psychiatrists. This represents a huge culture shift. As a quality-improvement project, it is perfect for our men and for the staff, who want to help but often feel ill-prepared after nurse education to work with this group of people. It is worth the challenge though.

What inspires you?

The men I work with. To survive secure services with humour and resilience is incredibly inspiring.

What do you do in your free time?


What achievement makes you most proud?

My qualifications leaving school wouldn’t make me eligible even to apply for nurse training now, and my brothers and I are the first in our family to go to university. If I make my mum and dad proud, that makes me happy.

What makes a good mental health nurse?

Heart and humanity. I can work with someone who lacks academic ability but, if a student doesn’t have heart and the ability to sit and talk, they will struggle. Our men are the most fantastic judges of character; they can spot disingenuousness a mile away.

What is likely to affect nurses working with people with mental health needs over the next 12 months?

The move towards co-production and co-facilitation in mental health services is about to take off. I recently attended the annual conference of the British and Irish Group for the Study of ‘Personality Disorder’, where one quarter of those who attended disclosed a lived experience of personality disorder. It had such a different feel to it from any other conference; I came away thinking of all the ways I want to involve our men more.

What advice would you like to pass on to students and junior staff?

Use social media to your advantage. I have learnt so much from Twitter and had some great opportunities. One of the jobs I do each year is act as a judge for the Positive Practice in Mental Health awards, and it has been amazing to see such great practice, when we often hear about when things go wrong. I see some amazing student accounts and think they should start practising as soon as they can safely do so.

Follow Jodie Alder on Twitter @jodieannalder

Find out more

British and Irish Group for the Study of ‘Personality Disorder’

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