Clinical placements

Kindness is tangible in a mental health crisis

A nursing student reflects on the profound effect of taking time to share a meal with a patient with schizophrenia

A nursing student reflects on the profound effect of taking time to share a meal with a patient with schizophrenia

Picture: Alamy

My third placement in the second year of my mental health nursing degree was on an acute adult psychiatric ward. 

The patients had been diagnosed with a variety of mental health conditions, including major depressive disorder, bipolar affective disorder and schizophrenia, with many previously known to services.

Building a therapeutic relationship

One of the patients I worked with was a young man in his late teens who was struggling with a first presentation of psychosis and subsequent diagnosis of paranoid schizophrenia. A major bereavement about a year before had caused his mental health to deteriorate, and he presented with significant paranoid ideas. 

The patient believed he was being poisoned and refused to eat or engage with staff, fearing he would be harmed. He became isolated, refusing to leave his room, and his unwillingness to eat had caused him to lose a lot of weight. 

It was clear the patient was struggling, so I decided to try to build up a therapeutic relationship with him to get him to trust me, using interpersonal and communication skills.

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After gently encouraging him to leave his room and sit in the dining area, I eventually offered him something to eat, which he accepted. Bending the rules slightly, I sat with him to eat, using various techniques to normalise the process and motivate him to engage socially. 

Helping him to see that he could trust me, and by proxy the staff, had an ameliorating effect on his symptoms and his mental state improved significantly. He put on about 7kg in weight, and became brighter and more spontaneous in his speech. I hear he is now doing well. 

It was only a few days later when the charge nurse asked to speak to me that I realised the profound effect sharing a meal with this patient had on his progress

A nurse who had seen me share a meal with the patient asked whether I had been guided by my mentor or self-motivated in my approach, to which I replied the latter. 

It felt like the right thing to do at the time, and it was. It was only a few days later when the charge nurse asked to speak to me that I realised the profound effect sharing a meal with this patient had on his progress; he started eating and drinking, taking his medication as prescribed, and demonstrated improvements in his behaviour. 

See the individual

Reflecting on this experience, I realise that taking the time to build up a therapeutic relationship with this patient and showing compassion allowed trust to grow between us. 

Alongside knowledge and experience, effective communication and a caring attitude are the biggest assets mental health nursing students can have. I was surprised by how tangible kindness can be when someone is in crisis, and this experience has changed how I connect with service users, inspiring me to see the individual in each patient.

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I am reminded in particular of two of the 6Cs of nursing: compassion and commitment. In the ever-changing profession of nursing, it is important that we, as students, do not forget the basics of care and continue to be courageous and act with compassion. 

Caring about people is what we do and, if we are willing to show that we care, it can change people's lives. As I was once told by a service user, ‘the small things are the big things’. If we put this into practice, and continue to put patients at the heart of what we do, we can overcome any challenges in nursing's future.

William Hanna is a second-year mental health nursing student at Queen’s University, Belfast

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