Going outside your comfort zone can help connect with patients
By learning more about football, mental health nursing student Felicity Allman was able to build up a therapeutic relationship with a patient with paranoid schizophrenia.
By learning more about football, mental health nursing student Felicity Allman was able to build up a therapeutic relationship with a patient with paranoid schizophrenia
My first placement when I started training was with a community mental health service, where I helped care for a patient diagnosed with paranoid schizophrenia.
Gary (not his real name) was a large man in his forties. His difficult childhood, in which he suffered abuse from male relatives, led to a paranoid fear of men. He heard voices telling him men were a threat and would attack him.
My male mentor had worked with Gary for months, but the voices didn’t identify him as a threat. This was likely due to his slight build and gentle manner.
Slow and stilted
To continue the work my mentor had been doing with Gary, we met at a local café once a week. This was to help Gary get used to being out in public and help him understand his history and diagnosis.
Progress was slow and conversation stilted, with Gary monosyllabic for the most part. He was also withdrawn and had a habit of staring, especially at men.
In the vicious circle of Gary’s world, the voices told him men would attack him. But his staring could lead to confrontations, reinforcing his beliefs.
Although I struggled to get a response, my mentor was able to tease words out of Gary. Their longest conversations were always about football – Gary and my mentor supported opposing teams, which often led to humorous interactions.
To help me converse better with Gary I started watching Match of the Day, listening to BBC Radio 5 Live and reading the sports sections of newspapers.
The last time I saw Gary we were waiting outside the café while my mentor went to a cashpoint, so I took a chance.
‘Did you see the game yesterday?’
‘Everyone seems happy that Leicester are doing so well.’
‘Nobody seems very happy when my team wins. Nobody likes Millwall.’
‘Don’t worry, I support Chelsea. Nobody likes us either!’
Smiling at last
Goal! It was the longest sentence I’d heard him say. He was smiling the whole time, and maintained eye contact for about 20 seconds. After we took Gary home, my mentor told me I hadn’t noticed a large man walk past us, but more importantly neither had Gary. He had been too caught up in a joke about football to feel threatened.
Going outside your comfort zone can help bring new results. In this case, learning about a new subject really helped me build a rapport with Gary, which was its own reward.
Following this experience, I always try to find out what interests my patients so I can provide the best care and treatment they need, something we can all try to do.
Felicity Allman is a second-year mental health nursing student at Plymouth University