Clinical placements

Listening to my intuition helped prevent a patient's suicide

I learned having the courage to act on your instincts is an important part of being a nurse

I learned having the courage to act on your instincts is an important part of being a nurse

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In my first year of training, I had a clinical placement on an acute mental health ward.

One of the patients I was helping to support was a woman in her early twenties with a diagnosis of borderline personality disorder with bipolar traits.

The patient, I will call her Sarah, had been accessing mental health services since she was a teenager. When I asked her what it was like living with a diagnosis of borderline personality disorder, she said: ‘When you burn yourself, the skin is very sensitive, even to the slightest touch. That’s what it’s like for me on the inside, every single day.’

I was really moved by this – both beautiful and sad, this description has stayed with me ever since.

We had established a rapport

Sarah was roughly the same age as me and I built up a great rapport with her during my placement. She would often come and talk to me about how she was feeling, and I would do my best to make her feel supported.

Then one day, something changed.

When I approached Sarah and asked if she was okay, she said she was fine, but it didn’t quite sit right with me. Other staff members told me she was presenting as ‘stable’ at that point, but I knew something was wrong. 

Sarah was on hourly observations – she had not displayed any behaviours to indicate this needed increasing, but my gut feeling was she was going to do something to harm herself.

My concern was not based on evidence

Although I had no evidence to back up my fears, I was becoming increasingly uneasy, so while carrying out observations with another member of staff, I asked if we could check on Sarah again.

We knocked on her door but there was no response. When we entered the room, we found that Sarah had attempted to take her own life.

I immediately pulled the alarm and the emergency response team arrived soon after. A ligature was cut away and Sarah regained consciousness. The duty doctor examined her and carried out physical observations to make sure she was okay, with a nurse continuing the observations regularly afterwards to make sure there were no signs of delayed damage. 

‘The experience helped me to believe in myself more, and not be scared to speak up if something doesn’t feel right’

I was amazed at how quickly the team worked, pulling together to save Sarah’s life. Effective communication was key – everyone knew what they needed to do, which was vital to a successful outcome.

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As a first-year student, my role was limited, but I helped as much as I could by directing staff where to go, making sure other patients were moved away from the area and checking they were okay.

Later in the day, Sarah came to find me and thank me for getting the staff member to check on her. I was so glad she was okay, and that I had followed my intuition.

This experience taught me how important it is to trust your instincts. If I hadn’t acted on my concerns for Sarah that day, we may not have reached her in time to save her life. It also helped me to believe in myself more, and not be scared to speak up if something doesn’t feel right.

Having confidence, as a student

It’s always better to be safe than sorry if something just seems off, but it can be hard for nursing students to have the confidence to stand up and say, ‘something isn’t right’.

Although being in this situation can be scary, having the courage to listen to and act on your instincts is an important part of being a nurse. I have become more confident on placement since this experience, and feel that when I join a team, I am actually a part of that team.

Improving your confidence can also help accelerate your learning; if your mentor can see you have confidence in your own abilities and you can show you are capable, they may start to release the reins a bit and give you more opportunities to do things.

Your mentor and the nurses supporting you in your training are putting their PINs on the line for you, so as much as you need to be confident in yourself, they need to be confident in you.

Molly Kiltie is a second-year mental health nursing student at De Montfort University in Leicester


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