Which part(s) of the NMC register are you on? (Please check all that apply) - Other (please specify): - Text
Specialist Community Mental Health Nurse
Mental health nurse and Children's nurse
Dual trained, working in mental health services.
Specialist practitioner in mental health

Please indicate the SPQ you hold: - Other (Please specify): - Text
Post Grad Diploma in Cognitive Behavioural Therapy
PGCE MRES Educational Technology, Lancaster Univ. PG(Dip.) COPE Univ. Manchester
Non medical prescriber in community psychiatric/ addictions
Specialist Community Public Health Nurse
SCPHN. Specialist Community Public Health (School Health)

In what country did you first register as a qualified nurse? - Other country (please specify): - Text
first qualified and registered as mental health nurse in 1996 in Trinidad. Then I was recruitment by UK NHS Trust in 2000 and worked as a nurse on the inpatient wards, then community.

Who is your current employer? (Please select one) - Other (please specify): - Text
NHS - North West Ambulance Service (Emergency operations Centre)
I am an ARRS mental health nurse, so although I am employed by an NHS mental health trust I work for a group of GP practices within a PCN.
NHS and University (Dual contract) - should transition to a joint contract soon.
50/50 funded NHS mental health trust and ARRS funding - GP surgery.
INDEPENDENT PRIVATE NHS LOCAL AUTHORITY UNIVERSITY

What is your contract type? - Other (please specify): - Text
6 months secondment as a B8a from a permanent B7 role
Seconded to current role from permanent position

Would you describe your job role as primarily: - Other (please specify): - Text
As a nurse consultant it is a mixture of clinical, leadership, education and research
i am a clinical lead with responsibility to supervise staff
I work part time, providing clinical supervision nor sure if you consider that leadership or clinical and some clinical work
mix of clinical/management/leadership and education
3 days as operational lead - operational management duties 2 days as team leader so some occasional clinical work
clinical lead, non medical prescriber and trainee advanced professional practitioner
Based on the 4 pillars so incorporates clinical, leadership, research, education
I am employed as a nurse researcher in an NHS R&D department - so slightly between the tick boxes for 'researcher/tutor' 'education/research' roles.
Health Promotion, safeguarding, line manager
Clinical and Leadership in equal measures
Combination of roles: Operations & executive roles (including leadership & financial record keeping) Clinical management Education/Research
and management, new role as Band 7, previously 7 years as Band 6
practice development - clinical, mgmt and strategy
Trainee Psychological Therapist in CBT (clinical and in education)
clinical and management can vary month to month

Where are you primarily based? - Other Specialist services (e.g., substance misuse, eating disorder) (please describe): - Text
Outpatient eating disorder / inpatient eating disorder
CAMHS, mainly neurodevelopmental assessments but do some generic mental health initial assessments and CBT-informed anxiety / low mood work. Across multiple locations
Manage in patient and community mental health and physical health for a large geographical area
Bank Community Mental Health and bank hospital
I have a role that covers urgent & in-patient /community and social care for mental health
Memory Clinic - routine, diagnostic but sits in secondary care.
resilience hub covering the whole of greater Manchester
Criminal Justice Assertive outreach Team
LSU, Inpatient and Community Rehab, PICU, Services for Military Veterans, Resilience Hub
Covering inpatient and outpatient mental health services for CAMHS
A clinic type community service where patients attend daily from 9.30-3.30
Personality Disorder Service - group psychotherapy
High Intensity User Lead based in Urgent Care Services
Liaison mental health based within general hospital
Based with emergency services to attend 999 calls for MH concerns
Manage inpatient, respite and a community team
Service for younger people with dementia
Director range of services - talking therapies, court liaison and diversion, EUPD, OAPs, gateway into services
Community, urgent care, living well, older adults and community. My post covers all areas of my division.
i oversee the care and treatment for clients placed out of area
Perinatal services, mum baby unit and perinatal community teams

How many beds does your ward / unit currently have (excluding beds closed / not available for use)? - Number of beds: - Text
Mental health liaison covers a hospital sight
Covering a number of wards - around 40 beds
20, not all in use currently 11 patients on the ward
I work in a liaison team so beds is however many the paediatric ward have
I support clinical teams with regards to reducing restrictive practices by adopting Quality Improvement methods such as PDSA cycle.
Not applicable I work for Psychiatric liaison team at RCHT covering the whole of the hospital.
Manage 8 bed female picu And 25 mixed bed acute
We cover x2 general hospitals and x1 A&E department
2 wards currently both on reduced beds due to staffing/care safety issues so one is 15 and one is 14

What was your last shift? - Other (Please specify): - Text
my working hours are 4 long days 8 am to 6 ;30 however i work 07:30 till 6;30
9am to 5pm officially although I start work at 8
I am meant to work 8am till 4pm. But, I then tend to work extra hours to keep up with the demand and these are not logged
Normal day but 7 till 7 is usual. Guess should be 9 to 5..
08.00 - 18.00 (officially although is often longer)

If no, please describe:
Under staffed hence using the leadership team to step fully in to clinical numbers
3 support staff short 1 staff nurse short
numbes run on 6 but often run on 5 budget for 1x band 6 1x band 5 and a mix of band 2 and 3 but often have 1 staff nurse or charge and a mixture of 4 staff between band 2 and 3
Budgeted for 2x registered nurses. Only me, therefore had an extra nursing assistant to fill the vacancy
Sickness and late bank cancellations/no shows impacted upon expected roster mix.
Male to female ratio on other wards meant staff had to move
international RGN nurse, other RMN was sick
Redeployed, sickness reduced numbers of staffing
2 x staff cancelled shift due to sickness
planned staffing level of 7; 2 registered and 5 healthcare assistants
meant to have 8 staff including 2trained and 6 HCA s due to enhanced observation level but had only 2 trained and 3 HCA in the morning and 2 trained and 2 hca in the afternoon
one off ill, a couple short due to not being able to recruit
Increased staff - above basic template based upon complex need of patient
Short staffed, so staff had to be contacted via bank to cover shift and staff had to come from other wards to cover the deficit.
sickness and maternity leave affecting the rota
Sickness, annual leave and unfilled vacancies.
Almost always below the staff numbers identified as minimum
last minute sickness and off framework agency
Agreed number is 3 as had a large number of patient on increased observation
There were approximately 5 clinicians covering the northwest England Myself and 4 paramedics
We usually have 1 nurse and 2 NAs. Due to ward acuity we had to have an extra nurse and an extra agency NA.
1 band 5 nurse (community psychiatric nurse) CPN 1 band 5 CPN post out to advert (no applicants) 1 band 6 CPN post out to advert, the only applicant for interview next week pulled out
Sickness - I’m deputy manger and mostly work clinical, was working in the numbers this shift due to staff sickness but should of been on a management day
There should be 2 trained and 2 or 3 hcsw
Staff sickness resulted in agency being booked
Patient off site being supported 4:1 4 close observations on the ward insufficient staffing numbers and rota system down
2 people on sick leave, 1 person on placement elsewhere and 1 vacant post
A member of staff did not arrive on shift as planned
agency nurse did not turn up for shift i was on call manager for site but had to support agency nurse as one nurse down
Nurse on day shift had to swap to cover night shift
Rostered less, staff redeployed from other wards
I was working a twilight as part cover for a night shift
We should have had an extra HCA due to a 1:1, however staff member cancelled 2 hours prior to the shift and it was unable to be covered
As a community team we are 6 or so understaffed in both teams I work with.
Sickness Increase in observations Lack of regular staff- high numbers of agency staff
Lack of additional nurse (Number of staff are supposed to be 2 Nurses and 4 clinical support workers)
Should be two RMN's on nights given I work on bank
Unavailability not covered, resulting in a lack of RMN numbers on shift.
1 support worker/trainee nursing associate off sick with covid.
We are community . Outpt. Camhs. 4 on long-term sick. 2 on sick for over a week
We work in a small team supporting families living with dementia, we are 2 band 6 nurses and a clinical lead. Only the 2 band 6's worked the last shift I did.
Only 1 qualified Not enough PMA (restraint ) trained staff
Baseline numbers are 8,8,7 (early, late, night shift). We had 7,7,7 with 3 service users on 1:1 observations, 1 escort requiring staff.
x2 staff sickness Numbers should have been 4 with me covering it made it 3
one staff down fro staffing matrix as planned
Agency covering sickness, Bank staff covering missing shifts due to lack of permanent staff
One staff member did not attend as planned
required more staff so had to use bank/agency who were not familiar with the ward.
We were working at about 50% staffing capacity due to vacancy, leave and sickness.
Should be 2 staff on each shift, I worked alone from 6pm
High volume of long term sickness plus 3 patients on one to one nursing due to challenging behaviour, sexual disinhibition and high risk falls
1 nurse off sick, one had to swap days off
Sickness Assaults leading to I jury and high obsrvation levels and care needs
increased obs, short staffing due to out sick, lots of agency/bank and some borrowed from wards
Regular staff replaced with agency due to sickness
Sickness meant one nurse did not work, shift not covered

Who was the person in charge on your last shift? - Other profession / staff group (please specify): - Text
Newly qualified nurse (just qualified last month)

If yes, please briefly describe...
Mental health rights. Potting up supplement drinks for people with eating disorders
Contracts and finances can be done by others.
answering the phone, going to the door, admin, 1 to 1 time
admin duties such as logging appointments and updating diary which could be completed by an administrator
booking in appointments, letter writing, audits/data pulls,
supporting the ward and filling in the gaps created by short staffing issues.
Some administrative jobs- such as baseline spreadsheets
Administration - arranging MDTs, appointment letters, sending post,
Admin work like uploading, rota management. planning patient reviews.
Clinic room audits, observation audits, security (searches), supervising use of a computer for patients.
Patient Review Meeting Notes Booking Review Meetings
Ringing patients / families to rebook appointments. If no clinical matters need to be discussed, I feel this could a more effective use of admin staff time, as they often ask us to ring to rebook appointments
Admin work, data analysis, offduty, hr stuff, investigations,
Admin Sorting out broken equipment Coordination of placement
Producing prescriptions from the electronic system, delivering prescriptions, sending letters
blood taking telephoning patients helping nurses to do their job supporting with duty rota
There are many jobs within nursing that are now related to admin work that are now completed by band 6 and band 7 staff. In the trust that I work in office managers have now been removed from the site of community mental health teams with the work they did falling on band 6 and band 7 staff. Often nurses are completing forms for consultants and Drs To sign which seems not cost effective use of nursing skills and time.
administration, chasing results for doctors
Lots of data entry more appropriate for admin staff
Admin tasks, Review of caseload, telephone calls, clinical letter typing
ADMIN management admin should be done by recruitment and HR now all passed to nursing manger to complete
Taking notes during MDT and adding them to the patient records. Opening referrals. Answering support calls Booking next appointments. Driving to appointments
More admin support for emails, organising teaching sessions etc
Admin including sending opt in letters etc
Trained nurses cleaning and replenishing stores etc when there are untrained free. Would allow trained staff time to interact and support more in keeping.
Some of the more basic paperwork such as referrals to other teams
administration tasks in relation to system data
When the ward is busy, tasks such as bed making, laundry and continuous interventions for more than 1 hour would be better suited to healthcare support workers as there are tasks I do that they are unable to complete (MDT meetings, administering medication, updating risk assessments and care plans).
Collating patient information for reviews.
many of the admin and duty task could be completed by HCSW Some of the physical obs of patients could be completed by HCSW
ECG VENEPUNCTURE STOCK ORDERING STOCK REPLENISHMENT CLEANING ADMINISTRATION
Administrative tasks that remain with clinical teams due to constraints in the systems we use (carenotes)
Arranging of meetings & pulling together of info to support meetings
Much of my current role (Service Manager0 would be better done by an Administrator; but we have not been successful in recruitment to this post.
For example, admin not caseload admin but inputting my own assessments, rota ect
- Making phone calls/referrals for dentist appointments. - Making referrals for citizens advice appointments. - Other tasks that are outstanding for patients that are within the capabilities of the health care support workers.
signing off rosters, trying to get relevant data, trying to get building work or repairs done, trying to organise venues, trying to start HR processes etc
Security related work specific to forensic inpatient mental health.
Admin support, opening appointments and helping staff manage admin tasks as well as clinical work
Section 147 enquires from children services I think could be an administrative task.
Lots of tick box tasks, checklists, data collection, admission process.
connected lives assessment, they take far too long to complete and we are expected to offer every SU one which is unachievable
admin, particularly keeping my diary and typing up notes
Support work: assisting clients to attend appointments etc.
Basic tasks are often missed by some HCA's
Lots of admin bits... Phoning families to book/cancel appts Booking those appointments onto systems Minuting and uploading clinical discussions
MDT notes are written by clinical staff they used to be done by medical secretary
Admin type tasks Lack of medical staff leadership meant have to take on some of those tasks
Lot of admin stuff that I think could be done by admin as opposed to me i.e. sending letters/emails/referrals that I have already written but getting them to the correct person
administrative tasks such as managing and developing forms spread sheets etc..
Taking patients out on leave, 1-1 time with patients, taking physical observations (if trained), writing incident reports, taking phone calls
A great deal of time is spent doing security checks and routine patient checks which do not require to be carried out by a qualified staff. On day duties theses are regularly completed by nursing assistants.
Admin, reviewing data would be more appropriate for a data analyst
routine administration- not clinical notes
psychosocial interventions - Support staff carer support - Carer Support Workers
Sorting out depot cards and getting them rewritten
some home visit can be completed by CSW.
uploading documents to EPR Locating appropriate data.
Physical health screening Bloods and ECGs Inpatient assessments Weekly 1-1 time with patients
when support worker on shift should be able to locate patient information, but they have no means or training to do so. There is no roles for B2 support workers only B3, we are the only service that has B2 support workers, not B3.
We currently do not have a housekeeper and are having to complete all housekeeping tasks on top of nursing tasks.
taking out prescriptions, visiting patients ready for discharge, telephone calls, general support to patients
Admin, onward referrals, booking diaries, operational activities above paygrade (service management)
Administration duties and booking appointments
Care Act assessments for care packages , are expected for those on caseload, along with those seen on initial assessment , which all care coordinators have each week - in addition to duty work. Social workers and CPNs have the same number of caseload; nurses are more likely to have those on depot or clozapine medications, which are those usually on the care programme approach and who have severe and enduring mental illness who have complex health and social care needs. CPNs are expected, unlike social workers, to attend and manage physical health , side effects , in addition to all of the social work responsibilities.
Referrals to other support like wellbeing housing social prescribing
Admin, managing appointments, updating spreadsheets
Spreadsheet/performance could be completed by admin
administration that could be supported by a lower band
Copying and pasting excel reports sent from the Business intelligence to send to SLT and commissioners could be done by the Business intelligence team before they send to me to check the reports.
High number of admin and data collation tasks
collecting prescriptions, money advice, housing advice, signposting
Letters requesting routine GP information required at point of referral.
Administrative minute keeping Data collection and reporting
Some tasks could be carried out by secretarial staff.
all administration and especially letter writing, lots of admin used to be done by secretarial staff and these staff have been cut over recent years, so nurses do all their own admin.
Some basis rostering and finding cover for absences
Collecting information about a patient via GP/Police/other agencies.
Duty rota - management should do given capacity, medication/prescription chasing
Answering phones and doors. Meditation ordering. Stock ordering. Cleaning bodily fluids
Arranging emergency accommodation for a patient who was going CTMA but homeless, ringing in maintenance requests, cleaning rooms, preparing supper
Compiling Social Circumstances Reports can be done by Social Workers.
None clinical risk assessments Sourcing clinical rooms
Admin roles such as creating Agenda’s sending out agendas papers/ diary management
Recruitment admin, creating team brochure, writing up minutes from team meeting
Food preparation and cleaning the kitchen (do less now than used to).
Formulating GP letters. non-clinical phone calls eg regarding logistics or reiterating a plan already formalised and documented,
Writing notes could be done by admin Writing complaint letters could be done by administrators Recruitment organisation Data collection
information / support for social matters- eg benefits, finances, etc.
Physical observations, calling people for medications, ensuring patients are up at certain times for planned activities
Admin work such as scanning documents, making packs of info for patients up, making clinic appointments
Quality work does not necessarily need to be completed by a qualified Nurse although extensive personal experience aids my work, in fact other experience/profession can enhance it.
Administration. Currently 1 admin person covering 3 teams
Get asked to do admin based jobs such as meeting arrangements/documentation
Cleaning, food prep, laundry, filing, printing and refilling files, organising new work space
Filing and organisation of documents Rostering/timesheets/agency shift booking
Updating caseload spreadsheet Updating assessment waiting list Telling admin when to book appointments for myself and the consultant/medics (despite having set slots each week they could follow) Chasing admin to ensure appointments have been booked Chasing admin to ensure letters have been sent Creating an MDT form each week Completing the MDT minutes each week Updating CT/MRI scan waiting list Checking for CT/MRI scan results Copying information from clinical assessment letter into RiO core assessment forms and visa versa Updating diagnostic waiting list Ensuring admin are sending out correct information/additional forms with appointment letters When patients telephone - always sending call on to me even if it is something admin could answer (eg, yes we have your scan result, we will discuss it and then offer you a further appointment. or yes, you are on the waiting list, I will look for the next available appointment for you.)
administration of recruitment and HR processes
typing clinic letters, scanning assessment tools etc
Large amounts of administration around rotas which have found their way into the community manager role. Supervision of clinical staff (5's, 4's and 3's) due to majority of AMHT band 6 roles being held by locum CPNs who are reluctant / unskilled in supervision. Supervision of all admin staff (non clinical) as the trust do not have appropriate numbers of band 6 or above admin staff.
We would benefit from in house OT and SW support
Administration jobs, communication aka passing on messages to other professionals, supervising searches, supporting incidents when another nurse is already present
Security audits (and other audits) that could be done by non-clinical staff e.g. counting number of staff that come through the building
Access to record requests, rota management,
Admin tasks Serving of meals Cleaning up of any bodily fluids as domestic staff are not allowed to do this Changing of laundry/ washing
personal care and direct care tasks. Having a role as part of a patients staff team.
many hours are being spent covering shifts on the roster due to the system being very complicated and an over reliance on agency staffing. A lot of time is also spent completing reports to provide assurance for senior management and above. Also on recruitment work, the majority of which is computer admin work progressing things on our online system.
I work in a psychotherapy service that employs a cross section of staff from many disciplines
We do own admin and arranging of our appointments but can't be done any other way as working in schools !
I worked on the Duty Desk at the CMHT and many of the tasks I undertook were administrative but there was no one else to do them.
admin work such as writing letters, adjusting rotas, arranging professional visits.
Contacting parents/YP to arrange appointments, main point of contact to reschedule if necessary Basic letters
Personal care, physical observations, cleaning, documentations, laundry, security checks,
Cleaning the ward in depth Administration
Support worker role with patients on my caseload; due to lack of staff in the team practitioners (ie nurses and social workers) are having to act as support workers on top of their practitioner role.
Tasks that could be carried out by administrators but due to not having enough admin, all staff need to do a lot of admin to support
LOTS of admin tasks. Diary invites, organising training etc
Taking minutes for all professionals meetings- completing daily documentation audits, writing up SEC 17 leave for RC to check and sign
filling in information in the handover book filling in the names of staff on shift allocating observations
I do all my own appointments in the programme used by the receptionists. This is not a nursing task
Answering telephone calls for triaging before being passed to clinicians. Completion of forms.
we are team-based, personal care, room cleans and NEWS etc are routinely done by nursing staff
writing and uploading notes, liaising with clients
A lot of administration tasks. Phone calls to parents that didn't need a clinical member of staff
Following contact with each PT we have a 6 page assessment to complete, 2x diary entries, first contact entry, risk assessment and core assessment to populate. Some of the population and diary entries could be completed by non clinical staff. Non clinical staff could also triage and stream phone calls. However, there is only non-clinical covwr between 8-5 week days.
food shopping for patients, sorting bills for patients, making apts for GP, defrosting fridge, clearing out date food fridge, having animals re located
Care Act Assessments, applying for adult social care funding, applying for supported accommodation/other housing needs for patients, benefits advice and advocacy, other social work-related duties, administrative duties, huge amounts of paperwork which all has to happen manually
Patient Safety Team - many parts of the role could be carried out by administrative staff
Unlocking unit, emptying bins, cleaning clinical spaces, filing, typing letters
Rota managed by admin staff would free clinical staff to be patient facing
Photocopying, printing, topping up cupboards and drawers with non-clinical items, ordering stock
Admin tasks - due to lack of funding i am covering three roles as well as B7 management roles
Administrative tasks Research Project work
Crib sheet template copy and paste on Rio Progress notes Restock and print temples of obs sheets etc for the next shift Phys obs and record Food and fluid charts Clean ward
Admin tasks which we cover during the weekend as we have no admin available (scanning and uploading documents, for example)
Administrative tasks, writing meeting minutes
Admin tasks - we don't have admin on the weekend and theses tasks are left to nurses.
Admin work such as chasing referrals and submitting GP requests Ordering medication for the ward
Creating resource packs for group sessions Booking rooms and desks
supportive work practical and could be completed by a support worker
Fluid diet charts, observations, physical observations, security checks,
Physical obs, meal support etc Some CSW’s do this but some play the clueless game and its safer to do myself to make sure its done right
admin tasks e.g. taking referrals, transferring information between systems.
Chasing doctors- doctors should be on the ward however medical team is understaffed therefore a lot of responsibilities get brought to the nurses.
some admin, working with uploads and spreadsheets
admin tasks frequently. especially compared to doctors
Opening up referrals on carenotes Completing referral paperwork
Taking referrals for assessments - we cannot decline a referral therefore there is no need for a clinically trained professional to take the referral.
Nurses often have to help with NA roles, like leave, patient observations 1 to 4 and cover these more so NAs have breaks
We have recently begun using care notes as well as GP systems so admin time has increased and could be completed by admin staff
We are required to see patients awaiting a bed every day to review as there are no beds. This can be undertaken by our very experienced support workers who work under the supervision of our qualified staff
We have to cover for admin when she is off eg monitoring the phone, processing referrals etc which would be better done by a bank admin
Roster management, auditing, estates chasing maintenance
Shift allocation, appropriate sections of admission checklists,
I do all my own paperwork, minutes etc arranging meeting
Significant amounts of administration work.
Many admin responsibilities which don't require qualified nurse. Uploading notes, documents to EMIS records.
I triage patients, and have admin support, which is not always available
roster management, emails, site management, networking events.
Organising CPAs, Chasing updates from professionals like social workers. Spend a lot of time doing paperwork rather than spending time with the patients.
Populating assessments to different parts of RIO ie: core. MTE, risk
There is a lot of paperwork and admin work that I do.
Completing some of required paperwork with patients, documentation daily of patients allocated to them for support. Day to day cleaning and tidying of Ward environment and weekend tasks.
preparation of paperwork for day shift cleaning
referrals, telephone calls, info sharing
taking to arrange benefits and housing appointment
search patients and their rooms search the perimeter of the ward conduct urine drug screening
Computer typing, writing emails Shift verification
Administration, updated clinical software is the majority of the work remit.
Minutes Chairing meetings Liaising with social care
Physical observations (not interpretation but taking them), attending Care Plan approach meetings
letting service user in and out for several times, walking too much to access clinic room as it is far away from the ward
reviewing care plans and risk assessments
Nurses doing too much administrative tasks which could be undertaken by admin
Administration, coordination and diary planning
admin work mainly and physical obs (height / weight / BP)
Choosing an appropriate dishwasher to replace broken one. Organising fire evacuation training with fire evac manufacturer and LnD team
Admin . Efficiency cuts to admin team take me away from leadership role fir routine admin
Administration, resolving infrastructure issues e.g telephony, printer access etc Unblocking toilets Investigating housing options
Administration tasks. It would be more appropriate for some of our patients in the community to be seen and complete a piece of work with support workers rather than nurses however we do not have enough in the team so this is not an option
follow- up visits to check welfare, offer support,
Attending discharge CPA meetings/Ward rounds. Delivering medication.
Reviewing badly written reports, arranging appts, admin
Admin tasks such as booking in supervisions,
rostering, parts of the recruitment process, data, business plans
Booking follow up appointments, telephone calls, uploading documents, liaison with schools or other services and more
finding/applying for accommodation on my clients return to county
Admin and letter writing. Appointment booking and outcoming
Social support, accessing hospital appointments, attending meetings, completing mounds of unneccessary paperwork not relevant to my practice but insisted on by CQC/Trust
admin tasks- online rostering, Timesheet sign off,
taking the patients out to the garden and cleaning up the garden with the patients, the activity worker was not on duty.
Some other HCPs can also do discharge paperwork, or KPIs if they have worked with the client.
Letters Answering Phone calls Finding 136 suites
Practical interventions with service users, anxiety management and coping skills
Lots of admin tasks that could be delegated, but because it would take time to explain how this all works, I often don't have the time to do this, so I end up doing it myself.
Admin - Following up patients to make next appointment/follow-up DNAs, etc.
arranging appointments- typing letters, chasing other teams for responses, organising MDTs. Primarily admin work.
the admin work, chasing referrals, support with social issues, benefit issues, filling out forms etc
Checking first kits, removing out of date stock and re-stocking. Checking AED. Refilling condom stocks.
Many admin tasks (such as outcome measures and monitoring data for NCAP) could be done by admin or support staff or adequate technology (eg patient could complete on an ipad which could load directly onto their records, which would save unnecessary additional data input). Routine physical health checks could also be done by an adequately trained HCA/RNA, as per in GP practices. A lot of clinical time is also spent trying to arrange medical/psychiatry input, when needed in a crisis, by an allocated psychiatrist who knows them well, rather than signposting to A&E. Increased face:face psychiatry time would mean a patient could be seen, assessed and a prescription provided within a short space of time. However, we are frequently in a position of being asked to go and re-assess based on additional questions by a psychiatrist (choosing to work remotely), then further liaise by phone, receive a prescription by email, arrange it’s provision to a pharmacy and then to the person, before then completing large volumes of paperwork to document all of the above steps. Housing, benefits and food provision also form part of the role which are incredibly important to a persons psychological wellbeing, but do not primarily require specific mental health nursing skills.
As band 6 expected to take on the role of duty worker,answering calls,gatekeeping beds for admissions for 12 hours ,this could be better placed.
admin SSTS letter wirting HR staff management
Mainly thinking management wise collecting data
Lots of admin as no ward administrator staff
We are required to duplicate appointment information into a research related spreadsheet.
Staffing day to day Certain documentation Certain interventions clinical in nature
Admin - booking appointments, completing diaries.
Discharge paperwork Chasing social services
room checks, serving food, doing menus. could be done by our house keeper

If yes, please briefly describe...
some of the tasks we have delegated to HCAs I think would be better undertaken by nurses but it is a matter of capacity
I work in a crisis team and we have support workers doing visits to risky people. Whilst this appears to hold people i do worry that critical risks and changes in core clinical symptoms get missed. Historically crisis teams were only qualified staff
Witness to medication as many of the HCA’s don’t practice this often so knowledge is affected. Incident reports/clinical notes are often written by HCA’s. Whilst their narrative is imperative, I believe this should be interpreted and written by a qualified staff member with further training in this area.
deciding and setting up S117 meetings without telling the primary nurse
Contacts with clients is often delegated to support workers etc due to lack of capacity nurses have to do face to face interventions
Reviewing care plans Preparing for ward rounds - we should have time to speak to relatives asking them to come In to share care plan and treatment ideas
Support workers are often conducting one to one's with patients when I would prefer to be able to but am unable to do all that I want to do
Triage calls telephone review medication discussions
contact with clients regarding appointment changes
Monitoring dynamic risks including risk to self or others.
1:1s with clients, increased observations
Enhanced care observations, talking therapies, group work, family interventions
We have support workers in the team, and I think that the risks that we hold in our service - a crisis home treatment team - indicates that we should be a registered professionals only team.
Handling of medicines (frequent mistakes made by band 4 HCAs)
Assessments, called "Initial Conversations" in my service, are being poorly undertaken by unqualified staff
non mental health trained QNA dealing with distressed patients and answering questions inappropriately due to lack of training
Increased involvement in personal care would be good
Blood pressures and clinical jobs as we don't tend to have to do these very often, there is to much paperwork
Leave and 1:1 time with nurses, family contact
Obs - done but not understood and action not always appropriate
Not always having a nurse available in the office. More complex cases being booked into slots with nursing associates or support workers
Assessment and care planning, reviewing of patients
Nursing staff to assess patients off the ward more
Phlebotomy is better done by someone who knows the patient well and has time. Trips in the community done by others. But would allow staff to assess pts. Group work done by others. But would allow staff to build therapeutic relationships
1:1’s spending time with patients - what we trained to do
Tasks have been shifted to non nursing staff such as clinical interventions /NG feeding / Meal Support - whilst this on one level can been deemed as useful on another level the inexperience of nurses doing these jobs can create more work for nurses - trauma to young people of delayed discharge through inexperience meal support
Some Brief interventions and some group work carried out by support workers and assistant psychologists.
some instances of observation and engagement when the person is very distressed/disturbed and a more continuously thorough assessment is required.
Assessment at admission, is often undertaken by non nursing staff, who do not understand the full implications of a head to toe assessment, so patients are getting their physical health missed most often
we aim to run on 50% nurses and 50% support workers. We often run on a higher proportion of support workers though due to recruitment difficulties which means support workers are providing more of the care. there is an increasing emphasis on support workers doing key working.
Supporting calls into the service. Sometimes admin try and manage more than they need to in order to help clinicians who are also busy with appointments
Some unqualified staff do assessments and run groups without enough support or supervision
Typing own letters, putting own appointments on admin programme
TAKING RESPONSIBILITY FOR PEOPLE IN CRISIS. Responsibility for recording SBARD.
1:1 Patient conversations, Medication rounds
Monitoring meds side-effects, giving GP signposting advice, assessments for patients with physical health needs
Apprentice staff carrying out interventions which are not necessarily direct learning
Some administration requires clinical experience/expertise
Telephone assessments, risk management, crisis calls
There is a theme of registered nurses overseeing junior staff (selected- this is important as their competence is carefully scrutanised and their role carefully crafted in order to make it work for unqualified staff) to undertake roles that would normally be undertaken by now non existent qualified staff.
Non qualified staff contact with people referred to establish suitability for services.
Junior staff doing duty. Taking crisis work on
Within service we struggle to recruit nurses, and therefore have social workers and therapists within "mental health practitioner" roles. But at times i feel nursing is needed, as the skill set for mental health support, assessment and treatment is different.
Assessment of people coming into physical health clinics.
Clinically supervise 2 mental health coaches who is employed by MIND charity. They have no clinical risk management training, and no in debts training regarding mental health needs.
Our ward, regularly NAs help with daily progress notes for patients due to nursing staff not being able to be visible on the ward to observe patients ADLs etc. Nurses should be able to confidently see and adhere to patients progress with some input from floor staff but not all. Sometimes, we rely on NAs opinions to adhere to the notes applied to records
clinical minutes from referral meetings/discussions
Some patient care Taking on lead role when nursing staff are short
Call handlers on crisis line should be registered clinicians as Trust is expecting non clinical practitioners to provide the same level of support as a registered clinician.
Choosing the appropriate furniture for our Huntington disease patients due to their involuntary movements. Devising a hospital wide rota in my hospital Inclusion, diversity and equality programme or engagement
Physical health interventions Psychosocial interventions
Due to pressures of other tasks, some aspects of key relational/therapeutic are overly delegated to non-registered staff
They are being asked to do risk assessments and provide care coordination for some patients- beyond their remit and not safe.
This does not relate to me personally, but from professional observation, very often mental health nurses are excluded from therapeutic activities such as psychosocial/psychological interventions or even group interventions.
Duty calls and lone working dueto delay in patients initial assessments again due to shortage of staff.
support staff regular do support work beyond there experience and pay grade with high risk patients
Assessing patient that should be seen by a senior member of staff
Not my role specifically, but I understand that a Peer Support Worker is in charge of our AMHT Resus checks.
Facilitate staff training on Mental Health Awareness to teaching and non-teaching staff.
Our support staff are expected to issue equipment and take over care after 1 assessment by a clinician. These include unsafe discharges from hospital. We are very lucky to have experienced staff working above their banding.
Social worker doing post ect obs Support workers managing complex visits
Observations and engagements (obs 1:1s) for those at risk to self or others, tend the be covered by the least qualified staff, when nurses should be engaging to enable therapeutic engagement, assessment and review of care
Direct clinical work with patients - RNs describe feeling more like resource managers than nurses.
Seeing people at risk of hospital admissions

The last shift you took sick leave, what was the MAIN reason for this? - Other (please specify): - Text
Dental pain... lack of NHS dentists and dental support in the area. Had to use private dentist which cost over 1000 pounds for dental work. Dental care should be something provided for as an NHS worker. I feel very strongly about this and it will impact on other staff
Feeling overwhelmed trying to manage admin tasks whilst balancing patient needs.
Covid, with a mandatory 7 days off work.
I had 2 periods of respiratory illness which lasted for long periods - which is very unusual.
Minor car accident on way to work, very shaken up
Family crisis affecting my mental health
I had cold symptoms, but underlying this was mental fatigue and general feeling of exhaustion.
Career burnout and physical health concerns
Advised by the doctor to take time off due to stopping meds and becoming vulnerable.
I have a back issue and was off for 24days with this.
Planned hysterectomy them planned kidney stone removal. Not had sick day in 35 years before this
Grief Gastro oesophageal reflux No sleep
My parents died within ten months of each other, which has resulted in me taking time off work.

What support was offered? (Please select all that apply) - Other (please describe): - Text
my line manager visited me, took me for coffee and called me every day
Return to work interview, although it's basically pointless
I took a day's A/L for the first two weeks- still having physiotherapy
Supportive conversation with line manager
offer of support from my manager with occi health which I did not feel was necessary
Supportive phone calls from my line manager :)
As an independent nurse, I had an open conversation with a manager. I explored best ways of working including flexibility in my days running my clinic. Preempt consideration, as I value those taking the time to attend my clinic.

Which of the following (if any) are reason(s) you might / did work when unwell? (Please select all that apply) - Other (please specify): - Text
I have a chronic long term illness so at some point, this may hospitalise me so I don't want to use my sickness for minor ailments should I need a longer term of sickness off
Very rarely do I feel this but was teaching (do this 2 days a week) and had lectures felt I had to go in as cancelling would mean number of students be let down.
I haven’t taken any sick leave but have noted reasons why I would take sick leave
I am disabled on a number of levels and since changing trusts I have been fighting with the trust HR department on behalf of staff with diverse disability needs for them to be treated with equity and respect and above all humanity. The equality act 2010 seems to have passed the NHS by. It almost feels that some NHS policy is designed for virtue signalling rather than actual shop floor treatment of staff. Almost like a badge of honour "disability confident employer" while breaching or not meeting the needs of its disabled staff.
I thought COVID-19 was just a cold but tested during the shift and was sent home.
Sick policy meaning that you feel like you can't take days off when you're sick or you get staged for it, I have worked when feeling way too unwell to work so I don't get put up a stage
Pressured during covid to return to work , when very unwell. Returned to work when very unwell.
only when feeling slightly unwell would i attend work feeling unwell, i would respect those I see and work with to not spread anything
I’m a bank nurse & don’t get paid when I’m off sck
A very restrictive sickness policy, some senior managers have been unsupportive and even obstructive in the past.
My own guilt complex and role as a people pleaser.
didn't feel that unwell, knew i would be better off in work and could isolate myself away in an office to avoid patient contact that time
Became unwell on shift and didn’t want to leave the ward understaffed
On return in supervision, I was told I should not be off sick and for others to pick up my work.
First impact on therapeutic relationships with patients
I am morally inclined to attend my work & feel I am able to assess if I was too unwell that it would impact on safety.
Previous LM called me to do work when I was off sick with Covid in 2022
Feel a little unwell but still able to work
I worry that if I take sick leave due to my anxiety, it will not help. The work-related causes of my anxiety will not change if I take sick leave. Therefore, will it make it harder to return to work after a period of absence? Will I return at all?
No pay for the first 3 days of sickness. Unable to afford any time off sick even when very unwell.
fear of being on a sickness stage which leads to more stress and sickness
With remote working and virtual clinic, it helps me tremendously as I have long-term chronic physical health condition. Being in constant pain can sometimes be awkward/embarrassing and being around others.
Am bank nurse - don't get paid if I don't work
It is difficult to know the right thing to do sometimes when the reason is mental health. I have ongoing difficulties with mental health due to complex trauma. Some days I do not really feel up to going to work but I know I have to push myself or it is a slippery slope from there. It definitely isn't a binary "sick=be off, not sick=go to work" type situation.
If I worked directly with other colleagues (as I have done previously) this would be/has been another reason to. Also, there is a 100% attendance expectation for my training which is once every week.
Judgement for not being as strong as others who have been in the job for longer.
Already been threatened with sickness monitoring

What do you plan to do next? - Other (Please specify): - Text
partial retirement but staying in same job
Currently Seconded as Service Manager; returning to substantive role as a CPN.
Retire and rehire. 3 months off return to work 2 days a week
Seeking alternative options such as charity or third sector organisations
I am applying for roles within my current organisation and also outside of my current organisation
Another role using my experience and qualifications
I don’t know. I am good at my job and have very good clinical results, but I’m burned out. I don’t feel able to do my job as well as I could due to stress and pressures at work. However, I feel trapped by my salary and the likelihood I would need to take a pay cut to change jobs.

If yes, please briefly describe:
Organisation not valuing the role of senior nurses and ensuring that a nurse sits at Board level.
the attitude of the workplace unsafe staffing not enough nurses too much responsibility
Workload unprofessional behaviour from colleagues constant moanjng
- The hospital I work at is new and therefore experiences challenges other hospitals do not. - Morale is low. - Staffing levels are dangerously low. - There is an expectation on myself and other managers to cover staffing shortfalls often (working almost 24hrs shifts) to the point it made me and peers mentally and physically unwell. - Work/life balance is impacted because of staffing shortfalls and the guilt put on me to cover the shortfalls. - Incident levels are high and the experience of overall staffing team is poor meaning the hospital feels unfairly unsafe when other parts of the trust could support. - Senior management are too snowed under with the amount of major incidents that need investigating that the welfare of staff is their last concern (as they are more than likely stressed themselves). - Unrealistic expectations from departments external to ward based areas for us to perform at a certain level and have targets met in a timely manner whilst I am expected to work as a ward based nurse and not the manager I am employed as. - QRV and CQC inspections are not a true reflection of the daily stress the staffing team experience. - I often feel I am the last to know about major changes to the way in which the hospital/ward is run which makes me look incompetent.
Lack of value by some managers in the consultant nurse role. Lack of seeing patient face to face. Not fully utilising the consultant nurse role. Feeling deskilled and devalued. I have secured another job.
The workload is high and the student experience is low.
Pay is the biggest one. As 9-5 worker I miss out on enhancements and regularly work into the evenings to catch up which is unpaid. Have applied for shift based work over 3 days to gain additional pay
Unsafe staffing levels, unsafe number of nurses requiring support on preceptorship programme, heavy workload with limited time to meet expectations, unsafe patient mix, staff sickness levels & lots of bank and agency staff.
Job not being as described. It seems I spend more time doing assessments like a conveyer belt rather that providing or contributing to therapeutic interventions. Seen as a number, not being asked what our preferences are
lack of measures to ensure psychological safety within the senior leadership team.
Relentless pressure Lack of staff Focus on performance as opposed to quality Lack of understanding from senior managers/ directors Constant change Well-being not being taken seriously but often spoken about Staff promoted but not always appropriately
The pressures of the job, lack of supervision, lack of development, lack of services to refer people onto, the level of acuity and overall long hours, the abuse, feeling like you are no longer making a difference
Pressure and low staffing always leaving late
Short staffing, little respect for nursing role. Long standing culture resistant to change. Decisions taken to discharge not in best interest of patient care.
Money being wasted on services that look good on paper but do not impact the patient in a beneficial way. Terrible management decisions that seems to be the perception is more important than the reality.
Short staffed Unsupportive managers Poor leadership Lack of autonomy Bullying
The overwhelming belief that they system is set up to fail those most in need. Every patient I come into with care has not received the right support at the right time and the system has caused them more trauma through a lack of understanding amongst professionals.
The attitude of the organisation. Targets being prioritised over patient care and the pressures around this. High caseload. Unrealistic expectations from management with no support structures in place.
My caseload as a community mental health nurse is 45 patients - it is completely relentless
Short staffed Lack of training Poor communication Poor management/leadership Lack of team work Blame culture Restraints Treatment towards Eating Disorder (ED) Patients The Consultant Psychiatrists approach to ED The Dietician's restrictions and recommendations Lack of progress with patients Patients being readmitted Relationship with Community Teams. Personality Disorder patients having long admission
Lack of resource lack of upper management understanding work on the ground volume of emotive work volume of complexity of work lack of good outcomes wait times
Increased "Managerialism", which has taken Nursing away from the Caring role and patient contact. Complex processes and contradictory "paperwork", which is unhelpful and boring. Increasing Aged Population which, despite being expected, does not appear to have been planned for; particularly in Social Care. Not enough Care Home and Care at Home places, so these people get into (Mental Health) distress unecessarily.
been doing it so long - want to live more freely
Workload Endless admin toxic work culture social care input- feel like a social worker 90% of the time.
- low levels of staffing, which impacts on patient care. It’s also impacts the nursing staff’s workload and many feel that due to staffing shortages they are unable to spend adequate time with their patients and ensure their patient’s safety. There is not enough time to provided therapeutic activities at times and the main goal is to ensure all patients are having their basic needs met and nothing more can be given due to staffing constraints and challenging patients being on the ward who need to be on 1:1 or 2:1 observations to ensure their safety or dignity. Which staff feel guilty about but are unable to do anything about as no one wants to pick up bank shifts or come in for any over time which is fair enough.
Working full time has been intense pressure / tiring
NHS as a whole, poor communications and systems
Pressure to meet un-realistic targets. Managers lose sight of clinical work and the importance of it if it doesn't meet targets. High access rates to meet commissioner's needs for funding. Often concerned about medicalizing very normal feelings in people's lives and actually creating problems rather than normalizing them.
Unstructured care Lack of clarity about role Tired of working in crisis only service Not wanting to work lates/weekends anymore
Workload Lack of training opportunities and promotion
Not able to see people due to being on duty constantly. Work in a n intensive service hence smaller caseload, but unable to do what signed up to do
too few regular registered nurses to safely work on the wards Poor pay - pay is higher in costa
Processed silo working without an overall vision for the health system. External pressures from organisations impact severely on all local ICS developments.
we are losing experienced nurses due to traumatic incidents (assaulted by patients) there have been times where I have almost wanted to be assaulted by patients to have an excuse for time off. There is a lot of reliance on agency and bank staff who don't know their way around the ward or have access to online systems (meaning that end of day notes have to be done by nurses, which has a big impact on completing tasks by the end of the shift. Or that they don't know procedures - i.e. how to manage if the fire alarm goes off, not knowing where items like pads and toiletries are kept) I have spoken up to the freedom to speak up person at my trust but there is a feeling with myself and other nurses that no matter what we report nothing gets done.
the change to patients being able to access mental health beds when necessary, making community mental health nursing unsafe for patients and staff at times
There is no clinical senior support for mental health nurses No offer of CPD or relevant training for mh nurses Working long shifts and having to work 60 hour week with days and nights in same week
Too much workload Not enough support from senior management
I have worked for the NHS on and off for nearly 40 years. I think things have changed and I am looking at retiring and working for a MH voluntary organization which is the future of MH services
Other staff members getting pay rises or new bandings. As a nurse i feel that our role is being diminished we are not valued as a profession. I cannot afford to eat on the wages i am paid
Too much pressure and lack of support Frustrating to not provide full holistic care
Management attitude Fast turnover of staff Risk adverse trust Constant changes of procedure - as an example 1 on the 1st of September and now all change again on the 1st December - Being employed as a GP liaison nurse now told I have to work in CMHT with secondary care clients - take on Duty plus lots of other constant changes over the last 2.5 years- It wears you down both physically and mentally trying to keep up with it all. Trust employing agency nurses who work remote from the other end of the country doesn’t help. Shut down when you try to raise issues. Keep being told we are a trail-blazing service but in fact it is a shambles with no experienced managers heading it.
the number of patients you are expected to care coordinate on top of duty, and also backfilling the vacant nursing posts - because I am the only nurse care coordinator, it comes to me to do, When I have a full caseload, I am having to backfill for nurse colleague who is regularly off sick , and when I ask for support with social work by social workers who are 4:1 in ratio, they say no and management say - we need to look at why you can't cope ... even when I have been the only care coordinator with a full caseload - (30). Most of which are on CPA, whereas most social workers patients are not on CPA. Carer support worker who do carer assessments, only do it for those only open to outpatient . I have said those under outpatients only are the most stable and therefore have the least need and risks and thus impact on carers; i have regularly asked for carer support worker to help those open to care coordinator , but am told this is expected from the care coordinator -- this could mean if a carer has 2 carers who are entitled to an assessment, an additional 60 assessments along with care coordinating and managing (mental state monitoring and risk) ... it becomes absolutely overwhelming and unrealistic which management just refuse to acknowledge!
Being micro managed with time and not able to offer adequate time to patients. PCN cares more about quantity than quality of assessment and therapy
Repeatedly assaulted (verbally and physically) by patients and visitors with no support or debrief. Individuals are blamed for system failures. Management not supportive of wanting to progress career.
I feel that I cannot go on in nursing in the current structure of MH services in Northern Ireland. Our senior manager is very unsupportive and I am terrified of losing my registration due to systematic reasons that have led to me unable to complete my job effectively
Lack of support, lack of training. Staffing pressures in other areas which impact on my work. Management attitudes.
The workload in primary care feels unrelenting. It is also frustrating to be employed as an ARRS nurse as you end up in a situation where you are answerable to both your w playing organisation and your Primary Care Network manager, I have found this leads to additional barriers when exploring development opportunities. Also, there is a real clash in culture and expectations between primary care and secondary care, and it’s difficult to straddle both worlds.
The culture and politics within the organisation
Management ineffective in providing resources and support to colleagues. Some poor standards of care.
Lack of support. Bullying. Lack of understanding empathy.
Lack of staff to offer high quality care 'Firefighting' due to service gaps impacts on my stress levels
Unfairness in roles, poor management of people with conduct issues.
Inconsistencies with unsafe discharges and problems with risk management as l hold a complex case load.
Unrealistic work load - Quantity over quality is valued - KPI driven. Lack of feedback and support No outcome to concerns raised No response to others poor work conduct Lack of training.
Lack of suitably qualified staff. Management Staff morale Qualified staff leaving. Use of international staff with variable skills for area.
Work pressure and never ending new guidelines suicide prevention, soical problems, drug and alcohol etc. Revalidation, focus on people from other parts of the world, which leads to communication problems. Lack of suitable work stations, lack of leadership, mainly female colleagues who are complete bitches.
No time to doing any meaningful work with patients, providing them with skills/coping strategies to manage their mental health problem just seem to be fire fighting. All time is spent on medication rounds and dealing with patients that are not suitable for the ward e.g. very mentally unwell and need a bed on a medium secure ward - no beds available so stay with us longer term and impact negatively on other patients. Have a lot of 'revolving door' patients as poor community mental health services and social service input.
Bullying Unfair culture towards BAME especially black people
Exponentially increasing workload and reduced influence to achieve meaningful results.
- work load too much sometimes - lack of management support - poor staffing numbers, often feel unsupported and unsafe on shift - reluctant to support with flexible working - no opportunities for career development
Have raised concerns about non-nursing colleagues over the past year and no lasting changes have been made or are planned to happen. The expectations of my work are not what the job was described as. Although it is still in line with the job role, I have been covering the same vacant job post for over a year and there is no plans for me to be able to change areas to support other staff in the next 3-6 months. The workload continues to increase with no additional support in place, a year and a half ago my caseload was around 60 patients, it now sits at 170.
The risk associated Pressures to get things achieved Management focusing on things that I don’t believe are as important or necessary, e.g. it sometimes feels like cleaning the ward should be prioritised over patient care
Bullying Uncaring Unsupportive Culture Institutionalised care
To much time filling in paper work, reading sops that change .
After over 31/2 years in the same role feel that it is now time to move on due to risk of stagnation.
Frustrations with MDT decisions e.g. patient admissions, transfers, discharges, treatment plans; effects of severe levels of patient distress and feelings of powerlessness on my own mental health, empathy burnout with certain groups of patients, lack of professional development and time to work on clinical learning, lack of psychology input on ward fir patients
Relentless demands, changing the goal posts, lack of support and encouragement, recognition or reward. However, I have a small circle of people who do support me, and champion the work we are trying to achieve across a complex system that speaks of integration, but actually is bullying and a blame culture.
The current staff that i work with. Their lack of caring and poor standard of care.
Extreme pressures and expectations Feel the service I work for lets people down and unable to meet service users mental health needs
Very sadly, I'm about to leave a job I've loved for the last 11 years, because the work pressure from the wider organisation has become too much for me to handle - particularly in terms of additional travel and time away from family.
Poor management, lack of team moral and support, working hours not allowing me to have good work/life balance.
Current caseload 9100, inability to manage number of young people with the current resource. Have also proposed staff cuts due to financial recovery and additional staff teams joining the service.
the decreasing influence of practitioners experience and knowledge. It can not seem to be conveyed how under pressure some of our front line services are. If we have nurses that do not take a proper break because of their commitment to the important aspects of patient care, why do organisations think they might have the time to put aside some protected time to full in the staff survey . too many people looking at charts and not enough people looking into the eyes of patients
Workload is significant and constantly getting new responsibilities. Despite flagging there is no action. Job is virtually impossible for 1 person
Relentless pressure and lack of appreciation.
It's mostly not using my MH nursing skills, I'm rarely able to help people, it's unsustainable levels of pressure, my physical health is not good enough to sustain it, it's traumatising and triggers my C-PTSD, I don't have the right reasonable adjustments in place, my employer is not accessible for neurodivergent employees like myself, my employer actively harms neurodivergent patients, my employer has taken the parts of my role I enjoy away from me so it's effectively no longer the job I applied for.
No line manager support, supervision or service direction Lack of staff mean i am covering clinical work a lot Tension with other B7 lead colleagues poor working relationships Impact on health-burnt out earlier in the year, no support on return and has got worse Cannot offer clinical work to my own standard of care Irritable with colleagues Impact on own self esteem and MH
Bullying/poor leadership, and lack of support
Too many referrals and volume of work to cope with in a service that is broken and lacks resources to offer patients. We routinely have to work extra hours to manage. Often we work with patients with complex and acute presentations who have lots of needs/risk, but there is not the resource in our Trust to help them recover. We work in a culture where an assessment or a GP letter are called interventions. Increasingly, we signpost on to the third-sector, which becomes the go-to care plan, but resources in the third-sector are also becoming overwhelmed, with services closing or waiting lists getting longer. I also believe there are often gaps in service remits so patients are bounced between services because they don't quite meet thresholds. This is bad for patient care and frustrating and unsatisfying for professionals. We end up working defensively, and are essentially risk screening rather than care planning - and interventions can end up being crisis intervention. I think despite best intentions by practitioners, there is a general sense of unsafety and anxiety that something will be missed. The great fear is of a serious incident and ending up in coroner's court. I think the danger of working in this way, because we can't recruit or there are not the resources, means that staff morale and well-being is affected, practitioners want to move jobs or leave the profession, or are absent due to sickness, and there isn't the breathing space to reflect on practice or think about professional development.
Like many of my colleagues the work load has become insurmountable, I am unsure if the senior managers really understand (having been a manager and been asked to add more tasks to staff workloads) what it is really like for many of my colleagues.
Greater demand than capacity resulting in extremely long waiting lists, years for routine. Too many duty calls that it takes several months to respond to some of them. Constant pressure knowing there are so many waiting. When completing initial assessments it is hard hearing their story when you know they will be waiting for years
lone working as too much working from home now
low staffing, poor morale, pressures from the general hospital.
Unrealistic work load Care that we provide to patients with EUPD is inappropriate and puts patients safety at risk
I have just left my role in my previous area following burnout and lack of support of the ward nursing team. Expectations and normalisation of this.
Working in a toxic organisation that does not know how to manage or lead in mental health services. They use the blame culture and directions from Board do not allow the mental health services to do what is needed, but remove autonomy and empowerment. The Organisation has become too task focused in MH services removing to quality aspect of the relationship and art of MH nursing
a culture of perfectionism. Too much work load, impossible case loads. In ability of team to support nursing staff. Lack of conjoined services
Workload is rising and I feel that I'm underpaid
Lack of development, endless workload, not feeling valued for role, no involvement in decision making or processes, management dictate our tasks - no room for initiative. Frustration with knowing the waitlists are so long for those I want to help. I feel like a robot, no flexibility or creativity, just do what needs to be done and do it quickly, move on to the next. New processes are just told to us, no room to be involved. Lack of respect/value for role I am in (Band 7).
I find working leading new research is harder than clinical work, and because of the length of time it takes to get research grant applications developed and funded, for me there had to be a cut-off time where I stop submitting as a co-applicant, which is difficult when I am currently co-leading a three year NIHR grant-funded study. I am struggling with menopause symptoms both mental and physical, and so have decided to take the Mental Health Officer status option to retire at 55 rather than plough on after 36 years.
I'm finding that I am constantly in pain and I want to be able to focus on improving my physical health. My line manager and OH are trying arrange equipment but visiting patients with chairs with no backs etc causes me agony. However, I don't want to be stuck in an office!
High demands on shift combined with mentoring and management responsibilities
I part time due to trust the service requires a full timer, I'm currently completing the work of a full time member of staff on 3 7.5 days its not sustainable.
clinical opinion is not valued in the slightest
Lack of support from managers. Favouritism. Managers discussing personal issues with colleagues
Treatment by line manager and some of management above. Don’t appreciate or value for hard working staff, harassment and not listened to. Not enough time to complete training. New things constantly introduced but not none takeaway in its place hence repeating jobs/tasks. Causing overload of work. Rigidity in some of rules - flexibility in shift patterns. Workload too much or short staffed at times that staff not able provide support to patients or other demands required. No therapeutic spaces for staff .
poor management unsupportive team niche skill set
Lack of senior executive leadership and service direction. I dont know what the plan is . It seems very disorganised. Scattergun approach to working with people Lack of joined up services
the managers are horrible, they don't care, they protect each other and come down hard on the staff who step out of line, ward staff won't approach managers for fear of retribution and bullying. staff are very scared of being labelled a trouble maker
Focus on targets at the expense of everything else. Job doesnt feel safe anymore, getting harder to work with outside agencies in particular housing and social care
Monetary restriction's impacting on service provision
No support from management. Line manager has her favourites and doesn't treat all team members equally.
lack of service provision for patient's falling through the gap that this role is intended to fill. not set up properly lack of professional trust too many expectations from numerous managers and GP's an expectation to work outside of competence, delivering psychological interventions when we are not psychology staff. An expectation to hold risk alone as I do not work as part of an MDT. then not enough time to deliver interventions or prepare for patients paranoia about not doing enough- expectations very high paranoia about job security, such as the ending of contracts the belief that MHP's are counsellors and when counselling patient's is declined due to being out of scope, surgeries taking issue to this with the MHP personally.
The internal & external systems and out dated policies and procedures. So many barriers that prevent & reflect modern society & culture. We are working in outdated structure, systems and with professionals unequipped or skilled to support the demands for both mild to moderate mental health conditions.
My manager is almost useless The expectation on me is that of at least 2 or 3 senior members of staff Managing people and care when there is little of either to offer is too hard emotionally
Workload is too high, pressure and increase stress is now impacting my health.
Changes to the Trust, understaffing, inconsistent management, burn out, hearing difficult human stories every day and the expectation I will make it better. Admin/office/management staff are valued more than clinical staff. my long service has never been recognised despite there being a policy that I have chased up for 2 years now
The NHS is broken both in terms of patient care and how it looks after its staff.
Senior managers making decisions about staffing levels and work force planning without understanding the needs of the frontline staff
Unhelpful culture amongst leadership team Surface acknowledgement of need for consideration of wellbeing but often feels patronising/invalidating Acute patient care and organisational pressures that mean real reflection on work based challenges is not possible Shortage of key personnel in clinical leadership positions across the wider unit Lack of efectice support following serious incidents High degree of moral distress Lack of recognition and autonomy Service structure and resource levels that feel inevitably unsafe Lack of hope that real change or improvement is planned Lack of belief that real challenges of front line clinical work are understood by senior national NHS leadership or government/civil service Perceived increase in unfair criticism of nursing professionals by the public, press, regulators and leadership teams Increase in cultures of reactive blame for clinical failings
unsupportive manager pressures from senior management constantly asked to complete duties outside my job description/capabilities lack of career progression lack of development opportunities
Toxic management structure and people, unrealistic expectations when caseloads are double the level that is safe yet we are blamed if there is an incident or an unexpected death and investigated No one listens to us .
I can forsee that- things will become increasingly difficult. Currently my team is well resourced as it is a new service but over some years I have seen that the climate of the NHS is changing and doing a good job becomes evermore difficult. I think this is sad - I have had a wonderful career and am proud to be a mental health nurse but I am tired, it's time to go before things get more difficult.
9 patients a day, half hour appointments, ten minutes admin time between them. Impossible pressure that leaves patients feeling rushed and myself feeling overwhelmed. Highly isolating job.
Lack of support, caseloads too high, no changes despite staff feedback, can't do the role properly because of time constraints.
Toxic atmosphere.Managers bullying and lack of basic human support.Team was in special measures. Lack of interest in my welfare and that of colleagues
Stress, burnout, continual negative impact on my own mental health due to overload, unachievable targets and expectations
Recently applied to do a training course. A junior member staff got onto the training over me.
Lack of personal development and opportunities for progression
frustration at waiting lists lack of clinical capacity and increase in patient demand overwhelming workload
Caseload of 55 patients unsustainable, working 12 hour days for 7.5 hours pay
Stress of working with hard-to-engage clients; feeling responsible for managing high levels of risk; lack of support from management
The level of pay compared to my level of training/qualifications. I am largely moving to psychotherapy work because the work conditions/expectations are much more realistic, actively recognise importance of own wellbeing more when assigning workload, and the pay potential is significantly better. I am currently undertaking my fourth university qualification (PGDip in CBT following a BA, MA, MSc) but don't get paid anywhere near as much as I might in other countries or a different field. My sister-in-law (in another field) gets paid significantly more than me with 3 degrees. It also seems extremely likely that in nursing I would need to get a minimum of one (Doctorate in Nursing, PGDip/Cert in Leadership, and/or Prescribing Qualification) in order to progress in comparison to other fields. Also, if I had a child it seems it would be much easier to work flexibly if I ran my own business or worked for a different employer/field. I also find hierarchies within nursing to be entrenched, often with a strong sense of 'it's not what you know, it's who you know'. My commitment to patients and the work is the reason I stay - but it is not a job I would recommend for its benefits/culture/stress levels/pay.
Management support and high volume of management work I am expected to undertake. Toxic team environment.
-Patient Group. -Higher management making unfair decisions. -Increased workload -Staffing issues; recruitment and retention. -Lack of time for development or lack of further training available.
Following a prolonged period of my own mental ill health, I cannot see myself working within the NHS beyond the next 6 months. The chronic chipping away of resources, lack of care about staff wellbeing and low morale feel too toxic for my own wellbeing and sadly I have felt the full force of this recently. I must (for once) put my needs before the needs of my employer and the people we serve.
Primarily, the impact on my mental health. I have just moved roles and had to leave my supportive team to now work as a physical health nurse as an RGN in new community mental health teams. However, the toll of this environment is difficult to withstand. I am due to take maternity leave for approximately 1 year and I am unsure if I will return to the mental health sector or nursing in general. I may go back to education.
The service is changing, more workload with less staff, unable to provide a good service anymore, if I keep going the way i am, i will end up getting burnt out
My particular department has been in a state of flux since 2018. Mental health has never figured highly within this, a predominantly physical health setting. I and my colleagues who do the same job as me are constantly expected to pick up the slack because recruitment is so difficult, especially in the South-east. We have reduced from 12 MH Clinicians to 5. When I leave in April 2024, there will be 4 people.
Spending more time doing administrate role,than I spend with patients face to face in community.lack of appropriate training ,elearning now predominant method . Not having time to do positive interventions.
extreme stress caused by sheer volume of work and the relentless nature of it. Plus understaffing/carrying vacancies. Society expecting the NHS to them with no personal responsibility taken
Lack of support from senior management and not enough nurses. Pressure on staff and pushing bed numbers which is unsafe when no staff nurses or the staff nurses are temporally and don't know ward or patients
Stress , compromised values and unmanageable workload
Staff shortages Staff burnt out Higher focus on ops instead of quality
Lack of support from seniors, unfair workloads, inability to meet patients basic needs at times due to staffing numbers and legal obligations to stay with patients on enhanced observations.
Uncapped caseloads, pressure to increase productivity which means that time previously spent doing admin, CPD or preparation for treatment sessions are used to do face to face appointments.
Poor management, inexperienced, lack of clinical knowledge when making decisions. Continuous pressure to do more, lack of support for staff well being
living in the culture is very different to what we say

What is the main thing your employer could do to improve your working life?
Think about actual people having to work the shifts when they are doing rostering e.g. having more than one day off when finishing night shifts, not too many shifts in a week
professional nurse development with education and new roles.
Options to purchase additional annual leave
I am lucky I am currently in a strategic role working across the system my pressure come from outside my organisations around demand and capacity in the system
Deal with the nursing workforce issues, I know this is a challenge as it is a national issue. Looking after the nurses we have and treating them well Being realistic about what can be achieved when we have the staffing issues we have. Of course quality reviews will find issues when there are 30% vacancies in some teams The exec team and senior mgt being more in touch with what is going on in teams
Better welfare provisions in the place of work - staff rest room, canteen provision 24hrs a day instead of vending machines.
not hold nursing posts, employ more staff, different roles, have more beds, stop cutting beds that cause bed pressures daily which pushes discharges.
Better provision of dedicated staff spaces at inpatient settings.
more overtly valuing individuals input, talents and strengths
As a whole would be the NHS pay bandings. More incentives at work, more car schemes that are affordable. Discounted rail (I know this is out of an employer control). Hampers or tea/coffee/biscuits as a 'well done'.
Better staffing resources. If we have enough nurses we can all do our jobs properly, feel that we have done a good job and have time and space to reflect, think, manage risk decisions and have peer supervision/training - cup of tea!
provide staff with a good skill mix and improve nursing roles.
Flexible working policy and fully staffed rotas
Communicate decisions on the future of the Trust
looking at introducing twilight shifts of 4-12 increasing staffing levels
More visible leadership to share the load of managing sevices
Increased recruitment and retention of registered staff. Stop opening new hospitals they can’t staff, which then depletes our workforce
Offer more local incentives to support staff to staff in trust . Pay is set nationally but trusts could offer well being incentives , bonus , rewards , improve loyalty to long serving staff not just recruitment incentive drives
- Respect people’s work/life balance. - Not put pressure on or mither me to cover staffing g shortfalls. - Prioritise supervision (which I’ve never had) and encourage open conversations about work experiences.
A safe staffing assessment should not just be about the bare minimum to run a ward. It needs to include staff that provide extra opportunities for therapeutic engagement for the patients. This applies to both physical and mental health nursing. To provide staff with free personal training throughout the trusts catchment area so that staff maintain a good standard of fitness if needed to respond to an incident.
Value my skills and experiences to support the service. To be more connected to the clinical workforce Very top down approach Poor understanding of clinical roles and expertise No future planning for services
I feel lucky in where I work as I feel the area I work is flexible and caters for everyone’s needs. I do feel more supervision could be required
Flexible working and trust that can do the job
My employer is doing well with the resources they have.
Senior managers being seen more, coming on to the wards to see how their colleagues are doing and the daily struggles they have. Rather than away days which involves being spoken to for hours at a time about work related things, to book an activity for staff to actually have fun together and to grow as a team. More incentives such as nurse of the month, HCA of the month, OT of the month- to have these per setting. To have a christmas meal paid for by the trust.
Improve staffing levels and provide more training for staff in my organisation to be able to understand various systems and processes, how they fit into them, and the impact of their role within those systems and processes.
Better rates of pay, better staffing levels. Offering career opportunities and external training to develop my career.
Flexible working for childcare problems and health appointments and mentorship when in training and on preceptorship
Increased clarity of goals when allocating cases.
do not feel this is appropriate for me to answer as I am working on bank in a place I am happy to do so and could walk away at any point..as I am retired.
Increase staffing establishment, reduce workload or increase protected time to be able to meet expectations.
Acknowledge in person that we are struggling with difficult situations
Looking more further into the wellbeing and welfare of their staffs.
Nothing so far, only been working there a month so I haven’t noticed anything yet
Having more mental health nurses so the message of support patients and colleagues can be wider spread (physical acute trust)
Stability in being given a substantive post as have been in a 3 month secondment for the last 21 months. HR have not matched the JD until last week.
Involve me in informatiom dissemination, invitations to apppropriate meetings and recognise my contribution
Train to develop better people's skills and management skills
Give us options of types of work, play to peoples strengths
I always prioritise patient care and spend extra time out of work completing management/admin work. More staff would help to ensure high standards of care and free up time for me to do the rest in my work hours.
Invest in a mental health workforce which reflects the volume and complexity of mental health need of patients.
Empower me by removing the red tape which is a barrier to timely and effective decision making. Trust me to do my job without pulling me away to provide endless assurance
Increase capacity to undertake the improvement and development work Genuine Acknowledgement that this cannot be done alongside the "day job" A proportionate response to the inevitable critical incidents that are sadly routine within modern MH care Less tweeting of inanities and celebration of the mundane as a smokescreen to the challenges to delivering a meaningful service.
Listen more Review systems and processes that are not working Push back to senior managers on what isn’t achievable
Reduce the amount of admin/paperwork Allow staff to create forms/ paperwork which are more efficient and capture the best information to make clinical choices Give us more working space/rooms to have clinical discussions in
Give feedback on concerns raised with other staff members.
Acknowledge it is not possible to do two full time jobs at once for a sustained period of time without help
Clearer defined roles, increased staffing levels, better wellbeing for staff
Get an understanding of what life is like working in the wards
Provide rest rooms & stop taking about women’s health it’s time to act Greater understanding
Provide better, supportive leadership with clear guidance on what my role is with systems in place to enable me to do my job.
Look after us, speak with us and show that they have listened, provide adequate rest area and mainly our manager should know their staff and listen to an overall feedback rather than just respond to the loudest voice all the time making others adapt to suit one persons will or voice
Have NHS-P pay top increment for Band x p/t staff avoid NHS retired NHS CMHNs (and others) having to work for 'agencies'.
my staffing numbers are down ie staff recruited in to new posts so i have vacancies but i have been told we cant recruit Band 6 nurses currently THis impacts on my small team as colleagues are under work pressure
Flexible working is the main thing for me
Job security - in a secondment which is unsettling, especially when considering planning a family I need the security but don't feel this is something I could talk openly about for fear of being disadvantaged.
Be more transparent and listen to innovative ideas or team solutions when made. do not micro manage senior staff who have the clinical expertise to manage their own work load. Be more inclusive with training and supportive of an individuals IPDR nit dismissive of it.
Protected time away from the ward to complete audits without interruption
not penalise me for having sickness which I have no control over
I feel in a good position as a person who has been able o retire and return in the same post....albeit with a different emphasis part time.
There appears to be a disjointed approach throughout the NHS which is related to lack of adequate management training starting at band 7 and working up the ladder. At most managers are given little to no training in managing staff and know very little about employment law and issues such as the equality act. Having to teach managers and HR about equality diversity and inclusion should not be the job of the nurse with the disability. This seems to be exacerbated by the wish to employ within the organisation such roles as freedom to speak up. Employed within the organisation managed within the organisation and yet independent! The same applies with equality and diversity leads some who are in Roles because of their willingness to help the trust to collect badges of honour rather than deliver the changes needed to ensure the service delivers the requirements of the equality act 2010.
If the service manager was more supportive of training opportunities
Treat each nurse as an individual with unique skill sets and strengths. Build teams around these skills rather than just base numbers. Recognise that we are not robots and are doing a very difficult, at times life saving, job.
continue to promote staff wellbeing sessions within the team. praise for the good work staff do has a positive effect on staff morale and working. more staff recognition would be nice, however i do feel that my managers do show great support to the team.
give trust to staff to work autonomously with evidence based practices rather than tickbox care for patients
More staff Pathways that complement one another rather than work in conflict
LESS RED TAPE! Less paperwork. Reduce Caseload numbers for community staff. Acknowledge burnout and their part in contributing to it. Less micromanagement and move to better leadership! Honesty
Main issue is the stress related to the role of clinical leader/manager for services under constant extreme pressure with lack of resources including adequate staffing.
Ensure adequate staffing levels review community workload to reflect reduction of inpatient beds provide consistent medical cover for service areas.
Make better decisions. We have been let down by poor management. Too much nepotism with appointments to these posts. The wrong people in the wrong jobs.
Appreciate my value, give me developmental opportunities, have enough staff to meet minimum requirements.
better support/flexibility for parents/carers and more staff
shift patterns awareness, in need of one than 1 day off at a time.
reduce / streamline patient administrative /EPS systems /tasks
Better support systems within the Trust as a whole- very poor support for staff suffering with work-related stress
Let us care for our patients according to the NMC code of conduct.
Recognise the role and value that I add.
Limit caseloads to 30 for fulltime staff, administration roles and more support workers to help with paperwork and care plans
increase staffing to allow us to spend the required amount of time with patients yet still have enough time to complete the mountains of unnecessary paperwork that is mandatory. reduce the amount of paperwork
be clear with the public what a secondary care MH service will offer and support lowering public expectations. Manage poor performance better
free up time by allocating adequate admin time and funding
sort out our long waiting times and lack of staff
An understanding of how it feels to be on the shop floor and face the individuals and their families with such limited resources
Flexible work Support staff with home purchases
Recognise my value occasionally. The longer you stay in post the less you are valued. Fresh blood os not always best blood.
To recruit staff who are suitable for nursing both qualified and HCAs and not just recruit them to fill the numbers. Also to recruit people from a wide age, not just young people.
remote working has really changed my working life for the better except on teh days I go in as parking is so stressful especially when moving around the locality. reduce back to back meetings .. breathing space in between and no meetings snuck in at lunch time.
Stop expecting me to do extra shifts all of the time to make up for staffing issues.
Appreciate the staff that are still working for the Trust rather than take them for granted. That way not so many would leave and make life difficult for the remaining staff who stay. Provide a better career development opportunity that does not entail going into management and away from clinical practice.
Be mindful of workloads and time pressures, be flexible in working hours i.e. If i need to leave early for a doctors appointment not being penalised as I work over and above my hours regularly
Greater parity in pay scales between the advanced nurse and medical workforce as the jobs are becoming identical.
Increase staffing levels Close waiting lists
Manage my workload better and that of other peoples. Those who work hard get more and those who don’t get less
Communication needs to be improved from up on high
mental health orientated CPD - funded opportunities to grow as a practitioner and learn new skills - opportunities to do adv prac, convert to psychology, step up to medical?
More admin, maximum caseload, clearer role definition,
I've been lucky to have a very supportive work environment, I would prefer to have more flexibility around working from home as needed. I would also like stricter guidance around people working in the office when ill, they could often work from home (or take sick leave) rather than potentially making others ill.
Provide a working drinking dispenser/water machine
Banding revision Support from management Transparency Role specification
Address recruitment of MDT (inc nurses) so that resource is equitable
Have my salary reflect the specialist work and training I am doing. I am currently in a specialist role earning less than I did on a ward and in the retail sector
Less demands - so many aspects to manage & deliver on
Opportunity for home work for administration purposes.
Many attempts to make work/ life better (Health Walks, staff wellbeing surveys etc) are a sticking plaster over the actual problem. Which is poor management leading to resources being directed away from where they would be clinically helpful (I am a manager) and chronic lack of investment. Visibility of Senior Managers is often raised and is a easy complaint. In fact Senior Managers are just as stressed and confused about direction. People just want to know what is expected of them and clear leadership to deliver this. If that happened they wouldn't care about Senior Managers.
Very little, better facilities, but it is not really possible
Full staffing of area management not agreeing to cover other team roles ie when their team is we are already overwhelmed. and short staffed.causing burn out in team Recognising staff overloaded.
Better facilities and buildings and enough staff.
invest in staff numbers, wellbeing, morale,
The main thing my employer could do is challenge the system where agency staff, who are increasingly utilised across the board, are being paid up to three times as much to do the same job, often at a lesser expected standard. If the wages across disciplines and bands were fair, for example, if a newly qualified nurse was paid a competitive band 5 wage from the beginning, with extra financial incentives for staying over the years and so on, then I believe staffing issues would be much less. The idea that nurses are drawn to the career as a calling above all other things, and especially money, is just outdated and ludicrous.
Flexible working Introduce Toil so that I am not working for free over and above my hours to safely practise Less toxic work culture
- recruit more staff. - have regular meetings to discuss problems. - manage the work environment appears to be a “blame” game in my ward. Where people always want to blame people for things instead of just understanding things happen sometimes and it’s no one’s fault.
Involve me, as a senior manager, in decisions to change structures etc and not just send out a consultation paper The overall employer, the government, could start valuing the NHS, stop trying to make money out of people's ill-health, and start paying us what we are worth.
Improve staffing ratio's. Currently work in an enhanced community mental health team therefore we cover a crisis service. Rostered on for crisis shifts as well as trying to manage own caseload is virtually impossible. Also crisis service staffing ratio has been decreased to only one trained nurse and one health care support worker to cover crisis service for the whole locality. Often have multiple crisis assessments waiting and a lot of responsibility lies with the only trained nurse on shift. High pressure high risk assessments with very little support and time between assessments. Staff often don't get breaks and have to stay hours beyond finishing time to complete important paperwork in timely manner.
Reduce the demands to allow for sufficient time to be spent on each project and its implementation.
Admin days from home Mental health days Protected breaks Better processes More inpatient beds
More mental health nurses inteam to reduce stress and caseload pressures on the remaining mental health nurses .
Improve the staffing level. I also feel that managers/ Chief Execs should consider incentivising staff working in more stressful areas so as to encourage recruitment into those areas. Apologies if I have not made myself clear.
Look at how our Division and/or my job role can be split up to make it more manageable and equitable to peers in the other Divisions.
Flexible working Access to physical health care
I work in an acute medical unit. We need mental health nurses on shift to support our mental health patients
reduce caseloads as too high and unsafe and unrealistic expectations of paperwork
Rate of pay to retain staff who love their jobs but have poor pay when other employers can offer more. Update resident facilities. Easy access to purchase/replace clinical equipment.
More nursing staff to cut down large caseloads
more opportunity for flexible working, condensed hours
Listen to staff about changes to service
take on more staff/reduce the workload/change the amount of admin we have to do
wages increasing to make life easier and feeling the more valued
More staff to support role More resources and training around role
More CPNs to manage high and complex caseload numbers More training to develop therapy based skills to support patients
Add another member of staff to help with the role
Understand and act on the concerns and needs raised.
flexible approach to working hours in regards to collation as at time will work outside hours but unable to claim time back due to banding
For Team Leaders to be present in the office more.
Have some confidence in the ability to manage without the need for micromanagement
Listen to views/concerns regarding work load, training opportunities .
Electronic systems, which speak to each other.
Reduce admin related tasks to enhance more time with patients to provide high standard of care. Reduce bullying in the workplace and listen to staff when this is raised. Not ignore it. MDT working to support family members that can be challenging. Feel supported, work within the sphere of my role not outside it. Reduce locum doctors as increase permanent doctors to provide greater support to the team and patients.
flexible working, senior managment not changing everything, lessadmin
It's not really within thier control, but more staff. Posts are all out but we can't get enough staff
Caseload Training and development plan with a view to promotion
allow for staff wellbeing time during working days to prevent compassion fatigue
improve retention of skilled HCAs / RMNs / RCs
Help me to convert from RN(A) to RMN. They’d rather recruit general nurses from overseas on a special scheme lasting 12 months but I’m not eligible. Stop HCAs handling medicines and doing physical health observations. Too many mistakes made
offer more support, feel listened to, regular supervisions
Improve staffing levels and re-jig management structures/look at who they are employing in management roles
Better office space. As a team of nurse specialists we have to constantly fight for basic resources like computers and desks etc. Really frustrating and communicates we are not valued
Resources Time Staffing Administration support A visible presence
Pay Employment of more staff - particularly staff who can carry out the administrative tasks that take up much of my clinical time
retain more substantive nurses, social workers and psychologists pay better millage (doesn't cover petrol costs!!!) senior managers being more present
4 day (30 hour) working week at same pay.
Increase staffing levels/ have a max number for case loads Flexible working
Improve systems for recording as can be time consuming and repetitive Utilise the skills I have Give me recognition for the lengthy experience I have Let me be involved in mentoring students as I have a lot to offer Challenge ageist culture - challenge comments about being older, being in services for long period not always valued
Recognise workload and adequately staff it
Connect up all parts of the organisation so that the vision and approach is clear and unified.
reduction in patient's being admitted into overflow beds (turning the ward from a 19 bed to a 21 bed ward) More experienced RMN being employed who can actually do the job (rather than agency staff who can't get into systems or don't know the patients)
decrease workload and demand, reduce paperwork and repetition with writing up assessment notes, more staff to reduce the workload. more and easier access to enable my patients to get treatment /therapy quickly. Stop pushing the latest left leaning woke ideas/ideology.
actually recognise the strain staff are under due to staffing/workload pressures- not just pay lip service to it. eg advising staff support then issuing tasks that have to be done, despite lack of staff
Be open and honest about plans for changing ways of working instead of pretending to consult.
Flexible working i.e. start at 8 till 4 instead of 9 to 5 .in clinics
Recruit sufficient staff, provide better in service training, relating to the specific clientele and environment. Foster better relationships between managers and ward based staff. These are rarely seen unless there is a problem. More openness and improved flow of information. Managers often appear ignorant and or dismissive of the policies pertaining to HR.
work load management, stop last minute asks at the end of the day with next day expectations
Look at the shifts and not make staff work early long days in same week as 12 hour nights Understand the role of mental health nurse Offer relevant training and cpd Access to clinical supervision
regular supervision - feedback whether positive or negative. being more visible. offering development opportunities.
Take genuine interest in health and well-being. It is a male dominated team and women are treated less favourably
Safe staffing levels with appropriatly trained and competent staff
Reduce my caseload and work responsibilities
Allow staff time to access restorative clinical supervision
make expectations clearer respect the fact you have too many people on your caseload support more relevant CPD
wok on reducing patient assaults on staff
make nursing more appealing so more people train and the workload is shared out evenly. Also pay me more
case load, unreal expectation of what you can mange safely
Bring back secondments for nurse training. Stop designing specialist teams that are not fit for purpose and take away experienced staff from other areas.
more staff but not had the applicants to roles advertised that were suitable for the job.
Different shifts, working 4 days a week is too much. Meetings with senior management Designated room for breaks Staff days out
End the working from home culture that some staff still adopt since COVID simply because it is easy for them
Help with paperwork, had no induction when started and only 7 months on doing training
My colleagues and I cannot not take beaks, we are not allowed to take first or last break which is trust policy. I have to cover other gate keeping services within our trust due to lack of staff. We have now been informed that we have sole responsibility to make a descion to admit patients when this role was a consultant psychiatrist role, I am a B6 being coerced into making these decisions. My colleagues and I work in a toxic environment, institutionalized bullying and nepotism is very much on the agenda here. Management staff regularly promote each other not always because they have the skills for the role. Fraud and deception also takes place daily, senior managers are fully aware but will not take action because they choose not too, also do not have the skills or competence to address these issues. These issues have been raised but fall on deaf ears. 1 example a senior manager was filmed and included in C4 news report, however was identified as a security guard, this was not correct he was the service manager. How is this possible that managers are not held accountable for any of there actions which constantly impacts staff on the front line, patient safety is compromised, cannot see any improvement in the future.
Allow for good shift patterns ensuring time off gives more than 1 day and nightshifts are no longer than 3 in a row.
My employer should ask front line nurses for their ideas on how to improve the service. Our staffing level NEEDS to increase. Nurses are taking home laptops and working hours of extra unpaid work just so that they can get the bare minimum done. Previously, we would increase our staffing levels to allow for nurses to complete their workloads. Now if we up our staffing, they take our staff and put them on understaffed wards which hinders our service. The employer company have no regard for staff well-being which is essential for patient safety. We have 3 nurses off sick with mental health related sickness at present. The employer does not care.
ALLOW LEAVE WHEN REQUESTED. RECOGNITION OF THE NEEDS OF MH NURSES IN THE WORKFORCE. EDUCATION SPECIFIC FOR MH NURSE.
More flexible thinking (regarding hybrid working for example) and less judgement/more compassion from managers
Ask those of us doing the job our thoughts before implementing another thing for us to do that usually will not work. To actually check in with staff, not just a tick box "how are you feeling?" in line management supervision. To provide a decent staff area and encourage breaks. To enable staff to attend courses To show staff they are valuable and heard
More awareness of difficulties faced by nurses Clearer direction
Culture within the executive leadership level
Staffing levels are adequate and good skill mix on shifts
Have realistic expectations of all staff
Give staff the opportunity to work longer days in order to have more days off
Provide effective staffing levels - numbers and quality
Listen, open honest communication, agree and maintain flexible working. Not be punitive if concerns are raised.
Due to working between PCN and trust, the trust needs to support access for my role to have direct contact /support to the secondary care teams for MDT / support/ advice/ direction as a intrinsic part of the agreement. This could be 1 set day per time frame for discussion.
A be kind culture- sadly mental health trusts do not consider the stressors mental health nurses have. Listening to trauma of clients has an adverse effect on your own mental health, this isn’t considered - supervision is a farce and not up to standard and I consider it a tick box task as far as management is concerned- I haven’t had or been offered an appraisal in the last 2.5 years.
More autonomy in role, particularly if you have a proven record of being able to do this well. Better delegation between the team.
Stop gaslighting -open door policy- not offer help Stop offering training and not realising them I'm a B6 and a prescriber, read ecg, diagnosed etc yet won't offer a pay bang
Ensure that patients booked with me are appropriate.
Pay more money and allow people to buy and sell annual leave
Employ more permanent staff to reduce use of agency. Change systems (particularly online ones) to enable agency staff to be useful and able to contribute when they are on shift e.g. no online medication administration system. No online observation system.
improve staff use the whole MDT to support; often , because nurses do physical and medical, and are also expected to do social component too - there is nothing nurses can say out of my competence. whereas social workers cannot do healthcare side, so have a very specific role - which is extremely important , but nurses are expected to 'know it all' . in my team when I have asked for support , it doesn't come
Allow more time with patients and not cut appointments down
Reduce caseloads and make them more manageable so not under stress/pressure and this impacts on mental health
Have a good manager who actually manages
Employer making appropriate accommodations. Unable to identify anything else at the moment.
Care about staff wellbeing, protect staff from assault/abuse
Flexible working- nonexistent in band 7 roles (I have a 2 and 5 year old) and cannot be present for them and work.
Provide management who are knowledgeable and supportive. Understand our role, improve staffing numbers and patient experience.
Understanding unique difficulties for single parents who have no input at all from children’s other parent
Less pressure to perform and more focus on safe staffing
I am in a very privileged position in my role currently and my team but I know other teams I link with are stretched due to non filled vacancies and very long waiting lists and some areas have more complexity and acuity to deal with now with little experienced staff to manage this i.e. the inpatient units .
Stop making changes to teams, moving people around without agreement, 'consultation' is not agreement and should be 2-way and provide adequate office space to feel respected and welcomed in work. There are many poor and bullying managers in the NHS, I am lucky to have a brilliant manager who encourages the best in me, I would not risk working with a different manager again.
Address the staff shortages and IT infrastructure
Reduce micro management Enable positive working practices Recognise personal commitments and encourage flexible working practices
Support to explore flexible working options and career development. My biggest source of stress at the minute is my work life balance and feeling trapped in an unsustainable pattern of working.
To ensure that expectations and objections are clear: ensuring the mental health voice is strong within the organisation and there is parity for us in mental health- same access to opportunities & funding
Change the leadership before every manager leaves
Ensure there are sufficient staff on duty
Listen to staff needs and values about what is needed to provide a good level of service. Support from line managers rather than them just giving orders about non clinical things, such as data collection that makes them look good but is a cause of stress to Nurses trying to provide clinical services.
Make decisions based more on clinical information rather than bed management
Better access to mental health support for those working as nurses. Better awareness of risk of mental illness/suicide for NHS staff - opportunities for open discussions around this. Choice over where to receieve care.
There is currently only 1 complex case practitioner in my area which is a large area to cover. We need at least 1 more, but have been told there is no money to recruit.
Many decisions get made at a senior level without consultation of those it will impact or have working knowledge. Often decisions seem to get made as a knee jerk response without fully weighing up the pros and cons. My manager can try and protect me but at times this is too much and transforms into micromanagement or me not being involved in meetings/conversations.
Find out why people are leaving the service
Better understanding of the specialist area we work in, caseloads are not just numbers they are people, improved supervision, management team that understand the complexities of risk and mental health
Support staff towards retaining them in senior roles.
More staff. Better skill mix. Stop moving staff around. Support staff after incidents. Communicate about plans. Stop employing wellbeing officers because their stuff can’t be accessed by nurses. So it is a benefit for non clinical staff, but used as examples of how we are supported.
Continue to progress the reduction of Agency staff. Review of framework for contracted agency staff who still get paid a significant amount more than substantive staff without the responsibility.
Management to be visible and approachable. To offer more support in terms of emotional support services for staff
My role is very niche (court liaison). There’s not many people doing it. I bet the upper management of the trust don’t even know they provide a service to the court. It’s a clinical specialty which I believe should be seen as such.
Managing sickness to fit individual cases.
Not freezing clinical posts Not keep adding more to the to do list thinking we are machines. Stop perpetuating the idea nothing is ever good enough regardless of how good it is. Recognise when something really is great Allow more time for teams Have more senior leadership on wards out of hours to save having managers on call who don’t know the units. Presence of the right people out of hours as managers would ni prove care, safety and support staff.
I think more credit and recognition to those who work hard and show up to work. I disagree that people who are off on sick for long periods of time then get annual leave as well. Those who show up day in and day out are exhausted and get no extra rest time.
Provide permanent base to complete paperwork
To enable me to work part time- when I asked I was told that was not an option as a working mum that is EXTREMELY disappointing..in that it’s ok for me to provide care and treatment to young people and their familes, support NQNs on the start of their nursing journey but not able look after my own family in a manner that I would like. On a basic level it’s “archaic” that NHS Employers still think a working week is 37.5 there should be a move to a 4 day week or better options for working mums (& dads) as sometimes the flexibile working policies only work if it “suits” the organisation rather than the person, which I can understand but I don’t think they transparently state this. HR in the NHS is shambolic and creates a lot of unnecessary barriers
Reduce beurocracy and duplication. Reduce number of meetings expected to attend that don't relate to my area of work and take me away from the work I should be doing.
Management showing more empathy and compassion for the nursing team. More thoughtful recruitment of staff, taking into consideration communication skills especially.
Hear me say I can’t manage a case load of 40 and complete a useful preceptorship at the same time
stop trying to save money by taking staff away or stop telling us to do more work with less staff.
Realistic workload expectations. Often work late, gaining TOIL which i then cannot use due to low staffing levels. I have TOIL from April 2023 to use, according to my trust policy this has now expired. It is very hurtful that I am put in a position whereby I have to stay due to safety/risk and expected documentation, and cannot choose when i recover that time. This greatly affects my work life balance, recently having to withdraw from a social club as i can not guarantee i will finish work on time.
Acknowledge the challenges and attempts made to overcome them in a validating manner.
Offer more flexibility in terms of doing night shifts.
Employ suitably qualified staff, not just a nurse with a 'pin'. Look at longer term solutions not constantly short term 'fixes'. Transparency. Being honest
Better office space with natural lighting and car parking facilities.
Recognise my strengths and abilities and use them to benefit patients
Better leadership, no nepotism! A team leader who is capable of addressing the mainly female problems in the team. I've worked with some vile female colleagues. Instead of increasing the pressure on mental health services and expecting us to deal with the worlds problems, try listening to the staff who are patient facing
have more staff included MDT and lower workload
safe staffing levels - correct skill mix. Pay better wage. Have more power to move patients to more appropriate wards.
Open, transparent fair ad just culture fairness in distribution of tasks Listening to concerns Unfair blame culture
allow flexibility to work around my family.
There needs to be investment/consideration of retention of staff, no trust I've worked in has a commitment or policy around this - there is a lot of focus on recruitment (especially international) but this has actually caused further challenges for us trying to mentor and support new nurses, it's added hugely to the workload. Nurses are leaving services regularly for varying different reasons, retention is difficult and multi-faceted and it feels like nobody is even trying to address it, just plugging the gap with new nurses who eventually leave. Nobody is asking why, and if they do ask why then nobody seems to want or know how to address the issues
Better pay for band 5 preceptorship nurses who are left running the ward as nurse in charge. No late shifts (1-9) if working a long day after as there is not enough time in between finishing at 9pm and getting into work for 7 am the next day. My manager is flexible with my shift allocations and annual leave.
For me personally agreeing to partial retirement this will ensure that i can continue to work for the NHS for a few more years without getting burnt out
Recognise clinical experience and training and place all employees on the appropriate pay band
Create an open culture whereby senior leaders are supported to speak out just as much as clinicians are
Allow clinicians with the expertise to make the necessary decisions about discharge without the outrageous pressure implemented by a 'bed management' system/colleagues, who are not clinically qualified challenge Consultants clinical rationale. Not being coerced into making potentially unsafe discharges to improve 'flow'. Flagrant lack of respect for the clinicians (who sit with all the responsibility and accountability) in the course of enforcing discharges, putting people out on leave/using leave beds without supporting the team to then resolve the issue when people return to no bed. Reduce the amount of time and effort spent by non clinicians trying to enforce/introduce impotent , meaningless and time consuming ways of reviewing 'progress' towards discharge that make no difference to patient outcomes. Improve relations with key partner agencies such as housing and social care to get more explicit collaborative working relationships. Focus on cutting back corporate services that do not add value to patient care. Tighten up internal governance of executive and senior level leadership to eliminate bullying and improve integrity.
stop / reduce implementation of systems or processes constantly that create more work for staff on the ward - e.g. moving from bank to NHSP has caused endless issues, lost staff and taken up hours of clinical time sorting which could and should be spent on patient care
All the 'wellbeing' things in my trust are just tick box exercises, you're thrown back to the wolves straight away, we need enough staff, we need to be paid for the level of skill we have and the risks we manage. We need proper training to manage the influx of autism diagnoses we see, we need wards that are suitable for managing these patients, we need enough beds, we need an end to diagnostic overshadowing in acute trusts. It all just needs to be better.
I think when you have worked in the NHS for a longtime you learn that change is an unrealistic goal
Flexibility of working hours rather than rigid shift patterns.
Reduce unnecessary administrative burden, better communication and better team working to avoid repetition/duplication of effort.
- more flexible with flexible working requests, appreciate that people have a lot going on outside of work and to work more with staff than against them
Improved staffing levels through retention and recruitment of staff, with retention also focussing on access to support for staff mental well being at work.
At present, working life is good. My biggest concern is the commute and the traffic around Oxford making community nursing almost unbearable. This is not something that my employer has much control over. Generally, I work in a fantastic team who are flexible, supportive and helpful.
Create warm and inviting places to eat and have food away from work areas.
Hold other colleagues accountable for their work Consider increasing staff levels for the increased caseload Placing a hold on new referrals until we have caught up with current waiting list Flexible hours Regular check-ins
Stronger and more responsive HR processes to manage staff with wrong work ethics, bad culture and attitude.
Provide suitable resources Improve staffing levels
Behave in such a way that is fair to all staff
To fill vacant team lead role as I am currently covering this since the role became vacant for most of this year
Increase the level of staffing in the community roles to take the pressure of with caseloads. Have more admin staff to assist with non clinical / administration work.
Fewer changes and pre-digested e-mail information (to avoid information overload.
I would prefer not to be protocolled to other wards / units
The big people at the top need to consult us 'little people' at the bottom before making any decisions. They have very little experience on the shop floor - and if they do, its not recent experience - and they don't understand the impact of these decisions and how much chaos and disruption it causes when they make uniformed changes. Some respect for their team, show that they care instead of menial token gestures that we can all see through and know that its just part of a tick box. Value the people and pay them what they are worth.
Recognise value of older nurse’s experience Recognise and act upon junior/ inexperienced nursing staffs limitations eg manage them effectively rather than allow their limitations to continue Support whistleblowers
To many managers who make decisions without consulting workforce. They do no appreciate the impact of the decisions made .
Campaigning for parity with London regarding high cost of living supplement to enable us to compete in recruitment and thus have fewer vacancies / or opt out of AFC entirely and set local salaries for roles. Work with all bands in developing job plans to enable realistic time management and expectations. Remove duplicate systems for booking staff into bank or locum shifts - going from spending 10 minutes a month to generate the monthly rota to spending upwards of 4 hours a week on the same task is demoralising.
Reduce workload/caseload to a more manageable size. Return retirement age to 60yrs.
Increase safe staff levels on all days ensuring skill mix is considered.
Recognition for all that we do especially skilled and experienced nurses that are substantive. We are often seen as replaceable, just a PIN number and often given work on top of our own workload that agency or bank cannot do. Provide the more opportunities for career progression, lots of blocking in NHS.
Listen more to ward staffs frustrations and more positive risk taking to enable patients recovery
Increase our staffing levels so that people feel safe, not ignore the frontline staffs' requests and to LISTEN to us. Not wait for an incident to happen, which could have been prevented, all to STILL not review the staffing levels. Stop making us work to facts, figures and text box exercises. Provide more competent nurses with a better student nurse programme, rather than a shift full of inexperienced nurses (because we cant seem to retain experienced nurses) which puts extra stress on all other nurses on shift.
Be more accommodating to flexible working, condensed hours
make pathway for career progression make realistic promises make staff wellbeing a concern provide a comfortable and accommodating staff room for breaks have a retaining strategies to keep staff because staff that are actually good at their job are leaving because of basic things the trust can provide
Pay London weighting in other areas paying comparable housing prices. Having lost over 20% of the value of my wage in the last 15 years, compounded by living in one of the most expensive cities the ongoing lack of material reqard to allow an improvement in home life is crushing. What it says is that this job is of little value, and anyone who talks it up as such without addressing the actual material reqard is a joke. It gets tedious in the extreme to have patronising well paid managers come round with "non-pay benefits" and schemes as a solution- such as 2 mindful minutes when I can barely pay the gas bill without having to work precious recuperative time off with my family.
Ensure that freedom to speak up programmes etc work. Ensure safety of raising issues about senior leaders and acting appropriately when this happens.
Streamline the internal sources of my workload - too many cooks!
Workload management, help guide transition from clinical practice to education.
flexible retirement more staff recognising that I work above and beyond my band 6 pay
Better pay and sick pay. Less administration tasks. Employ other staff to carry out investigations/complaints tasks. Reduce the workload for my role
Somewhere to eat lunch, (instead of sitting in the car park), have regular access to the MDT, and get supportive let alone restorative supervision regularly, (which gets dropped first). Emphasis is on tasks, regulatory and mandatory activity, not working from a person centred approach, despite people trying their hardest to achieve that on a daily basis.
Work harder to try and retain staff which would improve staffing numbers. Stop giving inexperienced staff senior leadership positions just to retain staff as it causes significant issues and also depletes the junior positions which are hard to retain.
clear communication with clinical staff. improved management style, less passive aggressive approaches. less admin work. opportunities for training.
Nothing, the main concern is due to lack of funding from the government
work less hours consider different roles and the
Understand my workload and accommodate requests for time off ward to manage this
more hospital beds reduced waiting lists improved staffing levels
Would change a lot of the staff that i work with. It is not a lack of training but more lack of care.
More visible leadership from Senior/Board Level
Ensure that the executive team demonstrate the values and behaviours of the trust.
reduce paperwork/admin processes / work in line with current demands such as time restraints due to staff shortages
More flexible working hours, opportunity to work from home to write patient records/documentation. Implementation of routine restorative supervision for all staff by professionals outside of organisation.
clear structure and purpose of our service
Better quality staff to work with Improve communication with night staff Explain expectations/roles better
reduce aditional requests which are not job specific and take up time eg, being asked to complete questionaires (I only work 6 hours per day and every minute is precious)
offering progression prospective into band 6 roles
invest more into the service to increase staffing levels
. Staffing levels, Paid sick leave even for first 3 days
reduce paperwork Make systems slicker Better use of technology More incentives
increase staffing levels, pay on call supplement
I already feel well supported and like my job
To be able to push back against government targets and stop spreading our work so thinly that it's barely recognisable as appropriate clinical care.
Challenge the relentless nature of the KIPs we are expected to hit. I was working as a CPN during COVID and our team manager only cared about us hitting our care planning target. I know this is because it was a CQUIN target but even in the face of a global pandemic she either did not feel able to say to her managers that this was unrealistic or she didn't care. Making sure all the care plans being up to date when managing someone who was actively suicidal whilst having restrictions on how I could see them was so intense. After COVID abated feedback events I went to did nothing to contextualise this fact. If someone had sadly died all that we were told as a learning point was that the documentation needed to be updated but there was no mention of the unprecedented pressures and unknown working conditions at the time. It seems ridiculous to me that the managers in our health service are completely unable to think in compassionate terms about the staff that they manage and only want to hit the targets. If you don't look after your staff how do you expect them to look after mentally unwell people themselves.
If we can have less responsibilities as nurses. currently nurses are covering social aspects relating to clients.
Improved staffing (nursing and medical) and resources
Take future aspirations seriously and allow training for progression towards this
let me work from home 1 to 2 days per week
Staffing levels are safe, ensuring that 2 qualified RN are on each ward daily, all staff have a break, staff are not moved to unfamiliar wards, management are present on the ward, staff are given management days to complete mandatory training e-learning and not pressured to do it on shift or days off. When a staff nurse reports an issue of poor performance from hca's, they are taken seriously. Nurses have allocated time to complete CPA reports and don't have to hope they get a quite night shift.
Better flexibility of shifts Refer for mental health support
Allow protected time to complete on line mandatory training.
Review safe staffing levels in line with engagement and observation policy. Review current preceptorship programme which is having a significant impact on the amount of take charge nurses per ward.
Listen to staff concerns more and raise them higher, rather than using the system as an 'excuse'
I don't now. I think lots of student nurses do not learn resilience which is an important skill in mental health.
Better management from the top down. More health support in the workplace, both mental and physical health.
To advocate more about what we can and cannot do in the NHS. NHS states that it provides a service for all but in doing that quality of care is compromised when the resource cannot manage the numbers. Also more attention on the impact on staff retention and wellbeing when asked to to continually do more
Feedback - am I doing the right things? Stop giving me the impression that I am not giving enough (encouragement to work more, join things out of working hours etc) Be more vocal in support of staff when the trust gets bad press, stop the naming of staff in the local paper following coroners inquests - bad for psychological safety Not respond to complains by going against clinical decisions/backing us into a corner to deliver support that is inapporapriate
care about their staff. listen to what they have to say. communicate better
pay me for the additional hours i regularly work
to maintain my working conditions, ensure adequate staffing and provide support
Look at my workload and take into consideration cognitive decline ( post menopausal) this really affects my ability to multi task/ function effectively/ full potential at times
When looking to make changes, ie moving the team base, to actually use the consultation periods as a time to genuinely consult and listen
Give us a very good staff room for breaks because we don't have any on our ward
Stop changing the job responsibilities and adding new
Change to a 4 day working week Offer more flexible options of career progression
have a consistent approach to staff workload and recovery plan for the unit, currently there is an inconsistently divided workload impacting some staff wellbeing
Agree and provide a safe working ratio of nurse: community mental health patients.
More support and acknowledgement of the work I do. An understanding of the work load and how difficult it is to work with unwell patients who we cannot offer what would help due to the state of CAMHS and NHS services.
allow flexibility so have a work life balance that suits
Increased staffing levels- we are currently running at 50% reduced capacity due to struggles recruiting
Closer connection between the board and the operational
Re-open up the mental health ward that was closed down some years ago.
A proactive attuited towards staff wellbeing, not just lip service. i.e directing to a wellbeing website but not allowing time for restorative supervision, debrief ect. Empower staff to feel their wellbeing is important and not burden upon clinical outcomes. Listen when se say, it's unsafe.
i am fortunate that i work in a very good team with supportive management, in past though it has been different, managers not around, unable to approach, no knowledge or skills base but appointed in post , some forceful and trying to dominate and not listen to concerns and just keep pilling on the work making it feel unsafe for staff and patients
Senior managerial support for reality of frontline working.
We need more staff to manage the case load in the community - you did not ask how many hours do you work extra and unpaid for me it is roughly a minimum of 8 hours a week Also for senior nurses with advanced roles the pressures are very different to new nurses
Implement mandatory neuro-affirmative management training to all team leads and managers.
I am about to retire/return - have taken a corporate role in preparation - only thing for improvement s improving systems around patient safety reporting/investigation - introduction of PSIRF should help with this.
Ensure line management and support is a priority
We need to be able to introduce and retain staff nurses
To carry out only one role as an 8a. In relation to Agenda for Change, having worked clinically all the time, I have lost wages by taking this post and it will not change for 5 years. I think about returning to full-time clinical due to financial pressures.
Solve recruitment and retention problems in order to remediate the moral injury of being unable to offer a timely service to young people
we need a salary raise and also being involved in decisions about the ward/hospital. Improve staffing levels to prevent overworking.
Listen more and take note of effective and efficient ideas. Have the structure to actually implement these Have coherent and workable policies and procedures that prioritise patient care Remember the NHS is about patients, not high management Be flexible with work hours Support newer employers
Nothing at present I feel satisfied in my work
Recognise that "safer staffing numbers" are not safe. We have a new tablet to input data regarding level of observations and incidents etc on a shift-by-shift basis and this shows us to be short on the ward by at least 2 staff every shift, however, we continue to be questioned if we book one extra member of staff or request for additional support as all that is mentioned is trust finance.
Listen when staff speak up - a number of freedom to speak up cases where raised - however the trust only took action on the same concerns when CQC visited- this has left staff angry
Bring back staff health and wellbeing hubs, or think about the current offer because the workforce deserves to be better cared for.
Employ managers that understand both the clinical area they work in and how to manage staff to get the best for them and the patient group. Understand that supporting staff means better patient care, less movement of staff between teams and out of the NHS and therefore a better NHS. The NHS relies 100% on its staff to get the job done well, so look after them.
Find the means to recruit into community mental health - particularly working age services, and specialist services such as neurodevelopmental - the waiting lists for assessment in the latter is shamefully long, and this is fast becoming a huge area of assessment and planning that we need. Always pay is key - I think to recruit into community there must be a conversation about basic pay offer with enhancements as in order to recruit from acute settings where unsocial hours boost income, nurses won't leave if it means a drop in salary. I don't think there are any other enticements that are going to do the job. I think if caseloads or shifts were better staffed it would make all the difference to well-being, patient safety and culture within teams.
Currently my organisation is very much aware of employee welfare and is doing all it can to ensure staff are looked after and wellbeing is maintained. Personally I do not feel anything needs to change but am aware that I work in one of the least stressful areas and others may have very different opinions.
Would be great to have better carparking facilities/cover on street parking charges as this seems to be causing me the most stress/having to get in super early to ensure I can park
Travel is expensive these days A safe place to use a campervan and stay over would help
More staff in core teams and less talk of patient flow which will only flow if there is staff. Ideas to create patient flow teams just sucks the life and staff from the core teams that actually do the work. It is so simple.
Environmental changes - ensuring that there is a staff break room
Reduce interference with rotas from non-clinical management
I don't think its employers that need to improve things, I think the government needs to make it less hard to become a qualified nurse so more can join to take pressure of existing staff and reduce agency staff. You don't need degrees to be a good nurse.
Give enough support after being off sick following ward related incidents
Promote a Just culture Provide more leadership courses
Recognise the actual length of time it takes to complete tasks so that a job plan is accurate
Listen to staff and employ more Nurses (Band 6)
I am a NQN ivevaaked for support but it feels like it's gone on deaf ears. I work with eupd patients and they are team splitting and it makes it very difficult to have a united standing front
Communicate clearer, there is currently a real disconnect between decisions at the top and those on the ground,
Hire more nurses that have already done their preceptorship. Almost every shift I am the only nurse or with a preceptor (i know we all started there) but to expect me to run a ward as the only nurse, do my band 6 audits, do my uni work (a uni course my trust pressured me to do then gave me no study leave for) AND do preceptorship competencies with them when theyre on shift, is totally unrealistic and unfair.
clear objectives and having a team/shared office space
Improved supervision and debriefing opportunities Improved staffing levels Increased flexibility in working hours
senior leaders to be available. when you ask for help for them to respond and not fob you off saying "leave it with me" then never getting back to you better support from senior leaders (above line manager) when there has been a grievance made against you instead of being made to feel ostracised .
listen and support and redeploy solve concerns rapidly
staffing levels understanding pressure of workload praising excellent care - genuinely
respond and acknowledge good practice, and pay me more!
Fully staff the service - to match the wait times better. I.e. the current proposed staffing levels for the team are not enough to ever come close to reducing wait times at all!!
I'm not sure, there is a whole system failure however my managers acknowledge this, there's just not much they can do either.
Physical working conditions; fresh air, natural lighting, comfortable chairs, good working computers and tech
Support the nursing clinical team in acknowledging that the current state of mental health wards across the country is not appropriate and being physically present on the ward (removing the blame culture).
It would be good to have wellbeing activities/talks I can access locally to me. In the community teams we often see great opportunities for activities and talks after work but they are all centralised and involve at least an hours travel just one way. You kind of feel a little forgotten out on the community.
more funding, less pressure to meet targets when over stretched, capped caseloads. More cpd and flexible roles
Have a higher patient to staff ratio. Resources to increase staffing ratio at times of high demand.
Provide good physical working environment. Was over hot in summer not enough space. Very cold in winter.
improve the building for the benefit of its staff. not make changes which worsen working conditions for its staff so that more patients can be seen there by other teams
Share responsibility, encourage passions and interests and allow for development/ leadership. Encourage specialising and doing things outside of the workplace to develop.
Take more leadership in embedding clinical research consistently, so our work is not seen as an 'add-on' to clinical care delivery.
Pay rise - current pay is not enough to live a basic life with the cost living rises
better staffing levels / funding / incentives Appropriate staff for the role
Acknowledge a job well done occasionally.
Continue to support our workforce to have the resources to be able to provide excellent standards of care for our patients
Flexible working. Better office space provision
Improve the poor lack of funding to mental health resources for patients. Employers being more open to change and working in a smarter way. Employers to supportive of condensing staff paperwork in a smarter way. Or provided protected to time to realistically complete paper work. Finally provide adequate staffing and clinically training colleagues
Im incredibly proud of the team i work with, they are actually one of the best ive encountered in all my previous bank work experience, hence why I took the role when offered, however, before changing over to joint trust with our current employer, staffing levels were always so adequate to give full therapeutic care to our patients. We could fullfill the huge turn around of inpatients without jeoparising the levels of staff. Now, we are redeployed if we have a full staffing team Teams should utilise our team to show how good, structured teams work, instead of breaking us up and failing our patients
Challange the toxic blame culture at a senior level Treat staff on the wards with respect and not to be just seen as a number
its difficult because it may not be something that can be done, its pressures across services with all the cuts to social care and housing, patients entering mental health services tend to be more complex with multiple issues including housing, debt, etc- and even though its not in our job remit to help with these things it does impact the persons mental health so they do need additional support. extra staff would always be welcome, and the work support staff do is invaluable. im not sure how things can change in this climate.
recognise and take action when community staff are overworked - currently the organisation puts all the emphasis onto supporting inpatient units
Proper staffing levels, more mental health beds, better resources
Provide more training. I worked 15 years private before the NHS and I got more training there in one year than 8 years I have worked in the NHS. We are seen like cannon fodder despite the promise of investment and 5 year strategies to promote staff with the trust and train staff up.
The main issue with work is currently our premesis and hardware. Everyone's always looking around for wires, and if unable to find, they're unable to work. We only have a small number of PC desks, which makes life quite hard when you don't have a laptop, or the leads are missing! It's not practical
listen to the people doing the day to day jobs more
Improve the IT system to avoid repetition on patient records.
Offer incentives for bank shifts/additional hours
Focus on ways to retain staff. Offer more substantive roles rather than fixed term or secondments. Employ more nurses by offering more interesting jobs rather than ones that involve only crisis management. Offer more promotions and access to professional development. Look after staff better by monitoring reasons for sick leave. Offer more incentives and better working conditions - some working environments are terrible and depressing to be in. Have more respect for the nursing profession
Agree to increase budget to improve safer staffing numbers. Agree that current working current conditions reduces retention of new staff.
Stop putting pressure on staff by thinking everything is okay, when it is very clearly not. I do not feel that despite having an opportunity speak out that anything in reality happens as a result. I have not used this service, but I have yet to see anything of value when others have done so.
have increased admin roles on wards to support the workload -
Ensure there are adequate staff, in my current post we have had vacancies for some time which management haven't tried to fill which has increased our caseload and made us feel v unappreciated. Leading to increased staff sickness and more pressure on the team.
Reducing tasks that could be completed by non clinical roles improving senior management understanding of our tasks & roles Improving staff retention and recruitment and not making this the job of ward managers
My induction was interrupted due to having to take prolonged sick leave. Now, I feel a bit of a newbie and out of touch with I.T/ admin things so I have lost my confidence. I feel good about my clinical skills but struggling a bit otherwise.
Improve staffing levels with suitably qualified staff
Team building activities More liaison with management
An increase in the staff ratio and having positive feedback as regards to work.
Actually come speak to us about what we do in our roles and how hard we work.
provide learning opportunites that suit my needs, not me having to attend training to suit there's
Increase staff in team and teams we work closely with to enable us to better support patients who are acutely unwell and awaiting admission whilst they are still in the community to enable us adequate time to support our other patients on our caseload.
Reduce the amount of duplication in work, such as having something on paper in a folder and having to upload it on rio and in a care plan and on a risk assessment, as this is time consuming and things wind up being missed.
employ me full time and employ others to fulfil the demand on the service. Sometimes there are too many managers and not enough workers.
more robust admin time and/or protected time
Ensure adequate staffing levels at all times, covering sickness and absence leave as a routine , all through my working life in what ever area, there is always times when staffing levels are not covered for large periods of time, which has knock on effect on all staff working over that period. Staff immediately feel undervalued as you suddenly have to just 'get on with it', all the so called caring for staff disappears. Why if someone is on maternity leave for a year, do other staff have to 'cover' that, most noticeable in inpatient units , where the workload is not flexible. Also some professionals are able to create waiting lists, so control their workloads, where as others are not able to.
Provide staff, provide appropriate tools to do job
I feel my employer has been nothing but supportive. I am very lucky to work within a dedicated team.
Listen to staff when they say they are exhausted and can't do anymore and not add additional pressures and say it is what it is and its got to be done. Removed the ridiculous layers of senior leadership that do not improve service provision.
I am very new, but I think in a bid to not overwhelm me, I am often left to my own devices with nothing to do. My current transition from student to registered nurse has had many good days but also many slow ones. Due to staffing issues and many people still opting to work from home, there aren't many opportunities to shadow and learn from colleagues.
Ensure escalations regarding managers are taken seriously
Provide therapeutic spaces for staff for breaks or time out. Flexibility in shift patterns. Protected time to complete training/CPD Allow staff to show their skills and leadership with out harassment. Respect and listened to Safe staffing levels and skill mix Removing things/tasks that no longer work in the processes to avoid repeating of jobs
More staff but more mh nursing staff. Mdt team. But many non nurses. Sw. Therapists etc Less process to report. 50 clicks to get to one note. Or record a contact. Too much. I'm in a senior role . But some folk feel wfh or very flexible working is only to suit them. Not always considering work force.
More visibility of leadership team in my area.
provide basics not ask too much understand pressures
Acknowledge and appreciate the clinical work and not just get caught up in the management of a service
The NHS as a whole could financially reward staff for their loyalty and experience
I am in quite a lucky position. I work in a small, well established and close knit team. I have a good team manager. We are all aware of our roles and duties. I qualified in 1996 and have worked in HMP since 2002. The trust hold strong with Mindfulness and compassion focused care.
be better at your jobs, stop lying in audits that everything is o.k at the time of audits, stop putting inexperienced people in senior roles, they don't know what they are doing. I know you will ignore these comments, so I don't expect things to change, NHS staff are treated very badly and are bullied and ignored. you produce pieces of work like this to show that you know what the problems are, but you do nothing about them.
acknowledge the circumstances in which we are trying to provide care being dire as opposed to saying we are striving for perfect levels of care. No beds for days on ends for acutely unwell patients.
Recognise that the level of competence where I work is not where it should be for true care & treatment of patients. There should be a greater emphasis on accountability on all, including managers for actions, or lack there of in roles that impact on Care & Treatment and governance around this. If people are held to account, standards rise and you see better outcomes. Morale also improves as everyone is held to the same standard regardless of position or relationships within teams.
Offer our team our own space where we can meet regularly and work as a more cohesive team rather than hybrid as the majority
Recruit more staff to ensure case loads are manageable.
Happy with current set up but overall am wishing to partially retire
Have realistic job plans/descriptions for appropriate WTE duties in current climate of capacity/demands.
trust better work life balance make it safe to speak out
To be around to talk when required. Feel supported by my immediate manager
Improve staffing levels that are being classed as 'safe working numbers'.
Secure my position as permanent and reduce the portfolio of teams that I cover
Be more open to new ways of working, looking at staffing in different ways, be less draconian in thinking and decision making
Increase staffing so that I can get off on time- often have to stay on for a late shift after an early if not enough staff - this is part of the role of my band 7 but I have worked an extra 30 hours this week alone and am shattered . It’s just relentless .
Better staffing, more appreciation from above, less administration, listening to ideas
Improve staffing levels, more incentives for retention. More management support from senior managers who are often invisible
Having time to hear out decision making rather than jumping to it being a mistake or a wrong. Concerns that my business - personal or professional - may be discussed with others of the same paygrade which I have not consented to. Being able to complete more clinical duties - I miss being a nurse! Operational needs to be able to lean on our background skills or these need to be recognised more in order to make informed decisions. Concerns that are escalated from team members - such as the increase in pressure - need to be recognised as this is significantly impacting on the retention of staff. Listening and taking action rather than listening and ignoring in the hope that the issue will go away. I have come up with the solution - please allow my the autonomy (and funds) to do this!
Treat us like adults and value our contributions, e.g allow us to have a set of drawers or personal space at work to keep belongings rather than expect us to take everything home every day
full staff quota so waiting lists can be tackled (but they can't magic people!) so unrealistic expectation
Ensure regular clinical supervision that is fit for purpose.
Accept what we can’t do and don’t offer to provide assurances to political masters that are unachievable
Agree the priorities for the organisation, not try and do everything at once, invest in education, make workloads manageable, reduce admin, allow people to have accountability
Allow band 5s to progress to band 6s within the area for retention
Recognise continued learning - I have a masters degree but because it was one specialising in dementia rather than ANP course I am still a band 6. My level of expertise is not rewarded financially
Better staff wellbeing. Staff retention and recruitment improvement. Better CPD availability in CAMHS. Better CPD for Paediatric nurses working within CAMHS.
Hold open conversations with staff, listen and name issues without being defensive
Condensed hours Flexible working Mentoring and coaching programs 360
Restorative clinical supervision being embedded into the organisation
Work load and expectations with limited resource
Protected reflective sessions, induction programmes, and mentoring.
Hire more staff, or give more incentives so more staff want to join, make sure reasonable adjustments are implement, I struggle with dyslexia and more concrete support would be helpful, or even purchasing programmes like Grammarly which I had as a student would support me. Proper support for my mental health.
Employ more staff to reduce caseload burden and to provide adequate services for patients.
I am one of the lucky ones I have good managers and line managers. I wouldn't have an issue reporting any concerns to any of them.
-increase our wages. improve working conditions.
Equally split the workload between nursing staff.
I believe my immediate manager and trust do all they can to look after staff but there are competing demands and what would improve working life is probably out of scope of my employer. It requires political will, funding and a change of priorities
Generalising (I am self-employed): If I work for any employers (past or future), I would like them to consider the following: I would be grateful for any positive support they provide during any hectic and stressful times. There were times when I questioned my behaviors and what I did wrong due to negative challenges from employers. I am frank, open, and honest. I believe in good clinical practices, transparency, and a fair culture. I shouldn't be punished for this. In previous role(s), I became increasingly confused about the attitudes and behaviors of my colleagues. When I asked for advice and politely questioned their motives, I was undermined. I realized that my experience, my skills, my knowledge, my years of service and my courtesy had no place among the majority. For the first time, I felt like a minority. It tormented me and the feeling of emptiness didn't help. “When life is hard, life is hard and hard things happen,” but too much to overcome. I was so grateful to my family, friends and BAME staff network for their support and strength. I was also introduced to the Guardian Service, who saved my life. During that time, I lost many family members and friends. These sudden losses were the most overwhelming grief I had ever experienced. At the same time, grieving the loss of my job/role, none of my fault, but my coworker gave me a virtual shoulder to cry on. Our first meeting was very moving and during my incessant crying, a colleague understood my pain and had the right words to console me. It was indeed the lowest point of my life, but I never gave up. Instead, it made me more resilient. In the meantime, I had several meetings with different staff members of the organization. Once again, life seemed much brighter. Even though some problems persisted, I continued to follow my career path that matched my skills and specialisms. I worked closely with the Trust. I thrived in that environment – stimulating and engaging. I explored tasks outside of my comf
Extend patient appointments and the time between them.
More support, show some care for staff, better staffing levels.
promote equal opportunity open and transparent when introducing change to work practice- transformational change
Reduce the workload whilst i settled into new role so I can learn the role first
I personally feel a Team Manager Band should be an 8a not a 7.
I think they've been fair, allowing flexible working, giving me autonomy.
not micromanage. Trust nursing staff to do their job and support them with difficult decisions taken as they made the best choice they could at that time.
To give the correct amount of duties per week.
This is hard to answer as I feel my organisation is supportive but the demands on services is extreme, unachievable. If service demand reduced/employer had greater and more resources to support children in our care my role would be more manageable.
Not sure- after a 28 month sickness absence I was able to return to work in a role specifically tailored to my physical health needs. My employer has made a number of "reasonable adjustments" enabling me to work remotely which has avoided me having to retire on medical grounds.
Continue to offer part time hours that fit around childcare
promote flexible working reduce case loads and improve staffing levles
provide access to dental care (im unable to get an NHS dentist and had 6 months of being in fluctuating pain - bloody awful at times - until tooth was removed at hospital) Encourage socialisation of staff (this year management have been saying no to xmas parties whilst on shift, saying we are defrauding the NHS if we have a party - staff are majorly pissed off) - evening doos are difficult to arrange these days as staff live so far away from each other
Deal with people who can't/won't do their job
Continuing with hybrid working (working from home and office)
Flexible working life. Trust their staff more
Campaign for regulation of senior NHS managers (Board Directors) to give them more power to NHS managers, to oppose government cuts or efficiency savings (see NHS Kark Review). Managerial regulation was agreed 21 years ago during the NHS Bristol inquiry - (response from the government in 2002 point 70). Managerial regulation was not recommended by Tom Kark KC, but was an option when other mechanisms for management accountability issues failed, which they have. Also the Mid Staffordshire Public Inquiry 2013. - Recommendation 23 was about NICE carrying out Independent Safe Staffing Research. This recommendation was closed in 2015 by NHS England, therefore the safe staffing guidance that NHS England have produced is not independent.
Flexibility around hours/ choice of location to work.
Stop the micro managing and unreasonable requests
Employ more staff and reduce the bloody admin - when I started nursing in the 90s, around 80-90% of my time was clinical; I would suggest that my clinical time is approximately 30% due to the endless, increasing demands of box-ticking exercises that are demanded by people who don't or have never done the job.
My employer recently made the decision to downgrade my bank nursing practice from a B6 to a B5 citing that I do not bring relevant skills to the nursing role to justify my level of pay, they did this for all bank workers on their rota despite the nature of our day to day work. Having previously worked as a B6 in primary care mental health nursing and currently as a B7 psychological practitioner I would think I bring a great variety of skill above and beyond a B5 to my role. I often find it difficult to adjust my practice down to practice in line with my pay and feel that I am frequently offering an input of skills and experience in my nursing role that far exceeds my levels of pay. This impacts my job satisfaction. A better recognition of highly skilled and experienced professionals would be a significant improvement. As well as placing patient safety above cost saving measures.
Focus upon recruitment and retention of staff and their well being.
My employer could ensure that all staff has access to staff room where they can eat in their breaks and not at their desks or in their cars.. My employer could ensure that parking is free and accessible for all staff who need to use their cars for work. My employer could listen a bit more before carrying out decisions.
Reduce the amount of paperwork, much of it meaningless, that takes us away from just being with patients. Registered nurses are busy in the office and the least qualified staff are on the floor.
Increased creativity around flexible working options - thinking outside the box
reduce my clinical caseload- employ more RMHN's
Get more staff and be more considerate when giving an overload of caseload which was not agreed.
Continue being open and supportive, ask about caseload and wellbeing
Funding and staffing levels across all services.
Continue promoting a supportive work environment.
Not really anything to be honest. Mental health nursing is a hard field, and sometimes, you just have to get on with it. I can only reduce my caseload so much because of the demand for care coordinators in our team.
That's difficult, because ultimately if we were better paid more people would stay in nursing, but our CEOs etc cannot control that. If it were purely what people within my organisation could do it would be to promote the skills and experience of nurses - so we are not seen as 'lesser' than or subservient to psychiatric doctors, psychologists, etc.
Be more organised and communicate better. Nurses aren't taught how to be managers they're just expected to do it and not all do it well.
I don't think it's my employer that needs to improve it. The government need to step it up!
More encouragement to complete training.
Offer regular and appropriate clinical supervision with a suitably experienced supervisor. This is not management supervision, I mean clinical supervision with an emphasis on wellbeing an the impact of the work.
more staff, more support, to be listened to by managers
Reduced case loads- more staff with smaller caseloads. Admin days and set days for personal development or wellbeing. Debrief sessions every day in the last hour of the day for a space to vent, or cry. A clear plan of a role- Care coordinator DOES NOT HAVE THIS- there is so much talk of change, but nothing improves quick enough so staff leave.
Listen to staff concerns and act in a timely manner to address them. Reduce the number of middle managers as they confuse things and are generally ineffective
reduce the amount of work we have to do in the same amount of hours
Increased access to clinical supervision.
Reorganise the service so that the ward focuses solely on the rehabilitation of patients
Team meetings could be a fluid information exchange rather than a 'top down' information cascade. Wellbeing funding available to promote team cohesiveness. Pilots to see if admin could be streamlined and to be able to use mobile technology. (We used to have iPads. We could write patient notes, order equipment, and fill out BRADEN/MUST forms among other relevant paperwork, including NEWS2.) These were taken away due to cost of updating security certificates through 'Apple'. With older work force, we need technology that is easy and relevant to our work.
Make changes with more consideration of time, impact on staff and patients, communication with staff.
Improve staffing, ensure cover at both ends of the shifts
Cut out time consuming tasks which do not provide direct benefit to patients (these are mostly paperwork related). Ensure acceptable behavioural standards are applied to medical doctors, in the same way they would be to the rest of the healthcare workforce. Take significant steps to address the blame culture that exists following any incident in Mental Health which is different to, for example, the approach to incidents occurring in physical health.
Listen and feel acknowledged. Stop focusing on the things that aren't done due to immense pressures ,lack of staff.show more support to staff that are working hard. There is too much expectation despite constraints. Far to few supportive managers,feel they need more training in supporting staff .
Find more staff (which could be/is impossible) or somehow decrease the referral rate into a SPOA service. The word used is relentless. People now have a societal expectation that the NHS and especially the mental health services can sort out ALL problems ie housing, benefits, anger, loneliness, addiction, unemployment, PIP/DLA, safe guarding, grief/loss. GP's as the majority referrer are so stretched they will refer any/everyone towards SPOA/ICMHT. Once the referral has been made the "problem" not the client or patient becomes the issue for the SPOA team to resolve
Acknowledge chronic excessive workload and work to identify solutions, instead of attributing stress to own time management and 'resilience'
Listen to the workforce and nurses when we say the wards are unsafe
Follow reasonable adjustments instead of pushing staff to breaking point to meet needs of service over welfare of staff
Supportive admin to avoid unnecessary tasks Increased staffing
Adequate staffing levels so I'm not working 13 hour shifts with no break due to being the only quallified. More staff would mean meeting patients needs also
Support managers to be able to implement effective HR policies so that people who do not meet these values are not kept in post. Instead we cycle through performance, sickness management and they eventually move to another post
Hire more staff. Change how some.of the services work.
Improved access to inpatient beds. I have worked in a crisis team for over 10 years and the access to inpatient beds has deteriorated dramatically. When I stared there was always a bed avail if needed, no such thing as he’d managers (not needed) then after a while there was always a bed for detained patients and could be at times a short wait for informal admission. Now despite the threshold for admission being much higher there are no longer enough meds even for patients needing detention under the mha and informal admissions are practically becoming a thing of the past. This is a major issue for patient safety and is having a knock on impact on all community teams. We have multiple patients in general hospitals awaiting transfer, and patients in the community with medical recommendations for detention but no bed to detain to. I find this issue disgusting and bed capacity seems to be cut as the population grows.
Trusts need to be shouting about how bad things are in reality, own it, ot trying to make do with less, it impacts staff and patients. Stop jumping through hoops to please CqC and minimise action plans, shout how bad it is, its only by doing this together, showing the reality that's things will change We should be transparent
Better support with my own health difficulties - not made to feel guilty for sickness absence, being able to attend health appointments
Strengthen the voice of nursing in the organisation and more broadly in society - senior nurses need to speak out about the impact the shortages of RMNs has on the quality and safety of patient care. The only voice currently is coming from Unions.
Tell me when they're giving me another patient.
Flexible work Safe staffing Sharing of admin
Listen and respond appropriately when I ask for help and support to maintain my health and well-being
Adequate breaks, better staffing and resources
To discuss changes to the unit with the staff that work on the unit prior to implementation
Looking at skill mix. Many areas are staffed pretty much exclusively with new qualified nurses who are offered minimal supervision, support and development.
In brief, most of the time currently we have enough staff to cover the shifts, unfortunately, since Covid, we have staff on duty that are not able to undertake certain duties expected of us when in A&E department for example. This will be due to staff member having other health problems which make them susceptible and therefore they decline to undertake assessments/work required in these departments. This placed added stress onto staff that are able to complete the work.
See the staff members as people, not numbers and invest in the PNA role
Have compassion and belief a d trust in staff members

Please add any other comments you would like to make about being a nurse working in mental health.
I am really leading on a very interesting project around support mental health within a acute hospital system, i have a good relationship and support from my line manager and have extremely good engagement from my colleague in acute hospital around supporting mental health within their trusts
I am so glad I am near to the end of my career. I hope to retire and return early next year. I feel so sorry for the nurses just starting out, there isn't the support for them that there should be due to lack of nurses. Many of them don't stay in nursing for very long due to the issues I worry about having to go into hospital or any of my family going into hospital due to the workforce issues. I see the impact of not enough nurses daily
Being a nurse working in mental health services has changed since I first qualified and the nature and degree of need has changed. I think we should place more emphasis in nurse training on trauma, acquired childhood experiences and increase provision into school aged children.
I have worked as a MH nurse for nearly 30 years and have never experienced the pressures like we have had in the past 12 months. The expectations of the Nation currently are different - they would like immediate response and resolution. The expectations on health services are unrealistic. The newer generation of junior nurses are also not always equiped with the skills, yet think differently and are sometimes being put into senior roles with less experience (to retain?) and the situation perpetuates itself.
I enjoy my job and think i make a difference with the patients i do therapy with. I am already thinking about reducing hours or taking extra (self paid) annual leave in the future to have more time away from work.
it is currently the worst its ever been; staffing levels are at an all time low
Important to be hardy and non emotional at times
I feel genuinely sad that I have come to dislike my current job so much. When working as a band 6 in a different hospital within the trust I absolutely loved my job, felt valued, listened to and promoted my profession to anyone who would listen. My recent experience of mental health nursing over the past couple of years has changed drastically and I believe it is down to the trust biting off more than it can chew in relation to expansion. I have decided to move to another role within the trust when I return from maternity leave and hope this will reinstate my love for the job.
It would be nice to have a team of nursing assistants that you could call and ask to assist a patient with a meaningful or therapeutic activity. Some of these teams do exist but it is all focused around physical health and they follow a timetable. To provide patients with positive distractions that encourage socialisation at all dependancy levels would be so beneficial to patient recovery and boredom.
In this particular trust it has been extremely difficult as they do not understand my role. Sadly this has come to the point where I have found other employment Managers that are not clinicians do not understand the clinical workforce and especially MH nursing
The resources are poor. For CAMHS the need does not much the staffing level. Nurses are also poorly graded/paid compared to the rest of the MDT dispute holding higher risks and qualifications
It is a stressful job with little reward, you feel under appreciated by the trust as a whole.
Lack of funding, lack of staffing and over criticism of failures in services which are hugely understaffed by the CQC and other bodies is not helpful. Senior managers are aware of issues on the wards but feel unable or do not want to address them and just bury their heads in the sand or behind the HR wall of red tape.
I have felt proud to work in Mental Health with older people and have many happy memories and some very sad ones. I feel fortunate that I have been able to retire but return to work, on bank, on reduced hours with flexibility I am grateful for as this suits me at the moment. I work with the same team and I am not the only retired bank nurse within this team.
Something needs to change to retain staff who are burning out & to enable us to provide the level and quality of care that we want to & the patients deserve.
Working in the mental health has left me with great opportunities to be able to care for the mentally ill challenged.
working day shift is a very different story. I have only moved to working nights after I requested this 18 months ago. Night shifts are more manageble
I think there needs to need to be more emphasis on mental health nursing as a career choice, so many people do psychology degrees hoping to become a clinical psychologist and aren’t successful…. we have so many vacancies in mental health nursing
There is conflict between managing MH resource efficiently and time that is required to invest in meaningful therapeutic intervention. Ultimately the focus for patient wellbeing is very short term and segregated according to service provision as opposed to what may support longer term recovery. We apply a sticking plaster and have to contend ourselves with that being good enough at that point.
I feel privileged to have worked alongside people at their most vulnerable and believe that MH nursing can be a profession of great value. I am concerned that nurse education at present is eroding the uniqueness of being a mh nurse.
Just over a year ago I was much happier in my job. Changes in senior leadership have brought huge problems. The culture has changed and work and expectations are relentless now. I remain 100% committed to patient care and quality in mental health and I know I do a good job, but processes are making staff highly stressed
It's hard work and the systems and processes designed to support people with mental health issues often feel like barriers which need to be overcome. It makes the job frustrating and more exhausting. The amount of admin/paperwork is also quite exhausting and feels repetitive at times
There is a distinct lack of understanding by general health colleagues as to the role of a MH practitioner, with the old thinking that we drink tea adn chat all day, there seems to be little respect and acknowledgement for the risks we take on a regualr basis and teh amount of work that a 'quick chat' entails' find the attitude of other professionals difficult to manage adn frustrating when our role is belittled.
I am concerned the role of the mental health nurse is at risk as other professions seem to have more influence eg psychology
I used to love my job, now I can't wait to retire.
There are so many wonderful people out there trying to do the best they can, but the system is letting us all down.
It has evolved into a beast that is far greater than is manageable, when I first started your manager knew you and your unit and the whole team as individuals. We were able to create our own list of bank workers that knew the unit and could step in and know what they were doing. Now we seem to struggle with IT issues on a daily basis and get nowhere very fast with hours spent on seemingly useless tasks to tick boxes.
Mental health services have not continued to evolve - they have been static for decades. CMHTs the new institutions? I see evidence of old service characteristics / attitudes - the OPC, reliance on psychotropics frequent (re-)admission, lack of modality in treatment options, poor psycho-social interventions available. Once students are qualified they struggle in a custodial - risk reduction - risk averse environment / culture.
I have worked for may years in this field and still enjoy my job i am however doing more and more admin
It is a difficult role, especially through covid. There is a lack of mental health nurses leaving wards short at times. I really enjoy being a nurse and proud to be a mental health nurse
It is so very, very difficult and the job can lead staff to feel burnt out
As a nurse working with in mental health I feel that we often jump through hoops to provide excellent care for our service users. It is a shame that the NHS as the care provider for the majority of people in this country do not recognise as an employer that there staff are service users as well and sometimes require support from their employer
the workload is to big to ever feel that you can get a head of what is constantly being asked.
A very demanding and yet extremely undervalued role. Our patients are not well looked after, due to a lack of staff and lack of knowledge in the wider community about what our role is. Professional identity is incoherent, management decisions are never focused on patient wellbeing or god forbid staff satisfaction. Schizophrenic patients are routinely let down ,will never ask for help and will therefore never receive it. I feel the role is poorly defined and nurses are expected to be a catch all service for anyone experiencing emotional distress. This is distinct from mental illness and the expectation that professional help is needed for normal, if distressing, life events should not be encouraged. I also have unresolved anger about how nurses were expected to continue through pandemic working with very vulnerable patients. Patients very much needed nursing care however other health professionals and social work professionals disappeared and were allowed to absent themselves as non essential. This had a knock effect on the health and well-being of patients and the goodwill within mdt/multi agency working. Nurses particularly are expected to mop up the trickier parts of other professions jobs due to perceptions of nurses role being less important/professional. At the same time nurses sometimes are the only people prepared to make decisions about risk and care that other professionals shy away from.
It’s so hard and getting worse. I am not sure how we manage to come in day after day
I feel undervalued in comparison to other professionals, AHPs and Psychologists. They all have clearly defined parameters to work within while the expectation is that nurses will do everything else. I often feel sad about this. How can it be right that a community nurse can have a caseload of 70 but an occupational therapist is limited to 16? Unjust! It feels like no one is fighting our corner. If nurses complain that they are unable to complete work within their hours they are often told that it is their fault for not working efficiently. I am glad my children have chosen other professions! Roll on retirement!
There has been a steady increase of expectation on mental health services and then workload nurses are expected to carry with little time for career development and reflection I would not advocate to my own children to work in nursing. Something really needs to change to address the burnout or there will be no nurses left.
Nursing is my passion and I believe that a nurse can difference to someone's life
It is vital that we work not just with individuals but families/ other professionals to help people recover from mental illness, however this very rarely happens. Most mental health is related to attachment but this is not recognised.
My main reason for distractibility is my ADHD. I would like to see more pertinent conversations about staff mental health and wellbeing being led by senior management and embedded within the trust.
It's a stressful time to be a nurse working in mental health as it is a consistently understaffed and over pressurised area, leading to many good, competent nurses questioning whether they want to remain in the profession.
I love the principles of mental health nursing and the values in the Code but I do not feel that I am able to work in according to these principles and values.
I am being bullied by my line manager. The NHS does not tackle bullying and has a culture of mediation which is impossible if there is a power imbalance. Bullies are not dealt with. Up until 3 years ago, I loved my job, it was always difficult and stressful but I have worked well with every line manager I have had and felt we were a team who pulled together in hard times. My current line manager is a bully who has bullied people for many years but the NHS allows this. I do not know how much longer I can carry on. I have been to mediation twice and I have learned that nothing will be done about this. In 33 years this has never happened to me before so I don't believe I am the problem. This particular manager has had multiple complaints against them but the NHS preferred way of managing this is to sweep it all under the carpet. A community mental health nurse has an impossible job. One hour face to face assessment generates 2 hours of paperwork. It is impossible to keep on top of it. Our manager names and shames those who are behind on their reports. We are all seeing 5 or 6 patients a day. We work alone, most of us have been assaulted and feel fearful. Our manager constantly berates us and we operate in a culture of blame and shame.
Have nursed for 41 years and before I retired in March 2022 was absolutely exhausted and burnt out. A colleague suggested I carry on the next 5 months so I would be able to say I had nursed for 40 years! I had to explain that if I remained the last 5 months in that CMHT post I would kill someone... either a colleague, manager or a client. It would have helped if management had addressed our voiced concerns about service provision, supported us with adequate protocols and pathways instead we were left as one of the few services actually dealing with the public through COVID. This meant increased referrals for all sorts of weird and wonderful issues non mental illness related and overwhelmed our entire service and Team.
There's a disconnect between Senior Trust Management and 'shop floor', no matter what they say to the contrary.
I feel that at the present time that my employer is just recruiting anybody just to fill the staffing numbers. This sometimes results in people who are unsuitable for mental health nursing and at times this is reflected in some poor care being delivered to the patient group. The current rush at the present time appears to be training as many band 4s as possible to fill the nursing crisis. This appears to be a step back to the days of the State enrolled nursing which I feel will result in more pressure being passed on to the staff nurse as Band 4s are limited in what they can legally do.
It's a privilege that people work with you to help resolve their needs to lead a more fulfilled life from their perspective. Being part of a persons life even how ever small and making a contribution to their day is so rewarding..
It is impossible to do everything that is expected of you/your team but if something goes wrong you get the blame.
I wish I had not chosen mental health as a career. I would not recommend it as I feel it is too narrow a field in which to progress and specialise.
It's really hard work, there are very little resources available and no staff. There is a constant pressure to perform and hit target rates from commissioners and little understanding or acknowledgment that you need staff in post to do that. Today is my 19 years anniversary of being a qualified nurse and I probably have another 20 ahead of me and I can't imagine how I will do that in the current working climate.
The staffing levels are dire and there has been a decline in experience.
i would not recommend it as a career and I would not make the same choice to become a nurse f I had my time again. This is predominantly due to the poor state of Mental Health Services, lack of staff and work load
I have lost count of how many patients have told me they are going to kill themselves - after only just a few years I am tired and burnt out. My colleagues practice is stuck in the dark ages and no one wants to do things that could benefit practice. My organisations spends years doing things in upper management with very little to show for it - we are still on paper notes! I can do a job for about 2 years but need to rapidly move on cos of burnout and dis interest. moving on is easy as there are so many vacancies. I see agency nurses doing my job and earning three times what I am, this is very disheartening.
It's a fantastic job and I think clinical supervision is really important, it wasn't offered when working in physical health and having it now has made a huge improvement on both my work and mental well being, I hope that this is something which continues to be supported and job planned for.
You can often feel disillusioned and despondent when you are unable to provide positive changes or meaningful support to patients. Sometimes it can get you down, when you are unable to achieve the outcomes you dreamt of whilst training
I love mental health nursing and am proud to call myself one. * I do feel MH Nursing is in crisis. I was in Australia for 15 years and have come back to Scotland and it feels MH Nursing is devalued, while Medicine remains dominant and Allied Health (particularly Psychology) have gained prestige and power at Nursings expense. * In addition the NHS and Social Care service is in crisis due to chronic under investment and funding. Very depressing to try and do a good job in a service where things are like that.
I feel very lucky working within a CAMHs liaison team, as although it can be stressful in the moment, it is not an overly stressful job, the trust i currently work for are forward thinking and managers from the Modern matron and above are supportive and approachable. I have worked in other jobs where this is not the case and it has impacted upon my confidence, my mental health and my work/life balance
Staff's emotional health after incidents or emotional situations is overlooked. Supervision is focused on caseload management. i love working with patients and their family however due to low staffing i can't always visit as frequently as required. workload is relentlessand there isnt enough time in a day to complete tasks which leaves you worried on a daily basis. Colleagues are friendly and we help each other but everyone is stressed. Senior management are aware of issues however still put more workload on the team nothing is addressed.
I am saddened by the poor practice of others. Its the thing that upsets me most about my field of work
I feel privileged to work in mental health and hope that my contribution will improve the experience of people using our services.
- the environment can be very “bitchy” (couldn’t think of another word) - Again people always want to blame each other. - Appears to be a visible divide in the team. - some nurses are very rude and disrespectful to other staff, especially bank staff and patients. - Some staff also don’t like to listen to other people’s opinions on things and assume they’re always right. - there’s a a huge turnover of staff in my current position, nobody seems to stick around.
It's the most privileged experience and the information we receive and what people tell us is often something that they have never told anyone else. We have a responsibility to ensure that we support people to live the best life they can have. I do not believe it is our job to stop people ending their lives - but it is our responsibility to show compassion and care and show people that life could be better and that we will stand beside them while they try to do all the work that needs doing.
Over the last few years I have become so exhausted by the system as well as compassion fatigue that I often wish I could leave the profession if I had the opportunity.
I am extremely proud of my team. They are wonderful. However the system is completely broken, therefore it feels hopeless because despite our best effort my wider colleagues and teams are at an all time low in staffing and moral. I hate offering a sub par service to families because we haven't got the wider resources.
I think it remains a challenging job and I concern myself there will be enough NHS mental health nurses going forward as many seem to chose agency work . However this seems to have a detrimental effect on NHS financial budgets and patients may not have continuity of care / treatment .
I have worked in mental health all my working life. I am retired from my full time post but work part time as a Bank Nurse in an Older Adult Home Treatment Team. As such, I do feel to be under or experience the same level of stress factors that the permanent staff are under. We deal with a lot of clients who are at (high) risk in the Community including clients with both functional and organic illnesses. It creates a lot of stress to staff if there are no beds to admit them either in Hospital or for respite care in homes.
Mixing social work issues and mental nursing has made the job very complex. It should be one or the other.
It helps that other team members have insight in to mental health conditions. Staff must have patience and understanding of the people they are caring for.
Your main core skills, if not a registered mental health nurse, get forgotten and training in these areas does not happen.
I don't think managers appreciate or care about the effect their decisions have on our daily physical and mental health. I was suicidal a few months ago and no-one has asked me how I am since I returned to work - I think they are afraid of the answer (because then they would have to do something), or else they just don't care. I hate the way our senior managers don't speak to us at all ever, only to our line manager. I am also aware that most of us feel we can't take time out to attend appointments etc., The organisations talks a good talk but when the rubber hits the road they are just not there for us. I am not sure what I would do if I didn't work in such a good team. I wonder if anyone will actually read this, and whether this research will make any real difference?
It is more common now 'fire fighting' rather than nursing More emphasis should be with primary care Seems to be a lack of personal responsibility to manage own health (service users) Staff leaving to join the bank, earning more money, draining the NHS financially to do the same job
challenging, rewarding but often unvalued by other professionals
it feels as if working as a mental health nurse you are expected to save everybody with limited time, resourcing or staff and it's about 'protecting yourself' as opposed to good patient care. There is a growing need for mental health care - one in line with modern day mental health problems, such as social issues and psychological support - the system feels outdated and as such it's exhausting trying to consistently battle pathways and the system to provide support for individuals.
I’m an adult nurse and can never get a substantive post with this Trust. Short conversion courses available to overseas general nurses and nurse apprentices don’t apply to me they want me to do 3 yr full time undergrad course. Utterly frustrating. And I’d have to fund myself because I’m not substantive. HCAs are recruited to band 4 positions with no training or experience and often make mistakes, are in the majority in this team because they are cheap. The MDT daily planning is run by consensus so the wrong decision re patients is sometimes made
On a grand scale of things...its a new discipline and I love learning from peers and patients
not enough staff too many agency staff not enough resources awful buildings / environments
I am so tired as I have a disabled child and I have no carer support. I am exhausted as my role is so vigorous.
I've answered as someone who works in substance misuse services. I think I'd have a lot more negative view of things if I worked in a more specifically mental health service.
The team I work in are amazing and work very hard and do their best for our clients, however we all work within the constraints of the organisation/NHS and that can be hard. We are expected to help clients without the resources. There are also fewer places to signpost for support when they don't meet the threshold for our service. We work closely with social care and this is also a service that is lacking in funding. We feel like we are always fighting for the bare minimum for our clients. We are then blamed. We feel bad when we cant help.
It's very difficult to explain what I do to patients and patients families. If they have complaints then i am the face of everything that is wrong with the organisation and I have to face their frustration and annoyance. Some staff are not suited to working in the environment (acute) and I feel that I am unable to delegate jobs as on multiple occasions when I have they haven't been done, leading me to pick up the slack anyway. I have never taken a sick day for the sake of my metal health before this month but this month I have taken three as it has been relentless and I am mentally and physically exhausted. I used to love my job but now I'm just exhausted.
its a great job that can have positive outcomes esp for my client group (Veterans) who may have been dealing with their MH problems for many many, many years and being able to offer them a solution in a short time frame is great, and conversely trying to engage with someone who is not able or willing to engage or follow our suggestions/recommendations for treatment is particularly frustrating and may take up time I don't have chasing after them.
just feel like the care of patients in the community setting where I work is tending to be crisis management rather then a recovery model.
I continue to consider working in mental health is a privilege. Despite many changes over the years i remain positive and am committed to providing service users with the opportunity to reach their own potential .
I enjoy my role as a mental health nurse in memory I've worked for the same employer for 47 years in many different roles ,and found that they strive to continually improve the service and support their staff Education is always ongoing and stimulating Fellow colleagues are supportive to each other .and we all feel that the patients receive a good service from this trust and I would recommend my family and friends to attend it
For many of my earlier years as a nurse I was, proud of my role and felt motivated and keen to explore, innovate and do provide the best care for my patient. I felt part of a team and valued by my peers and managers, receiving positive feedback and encouragement frequently. I felt valued and listened to. This is no longer the case, there is no team work, bullying and back stabbing is rife and management appear to encourage a fragmented workforce as it is weaker and less threatening to them.
It’s hard , traumatic , dangerous, unsupported
I am in a niche situation where my role is quite nice. While doing bank in other teams it is clear that the culture is really awful and I have had staff report suicidal thoughts as a result of their job and poor higher management.
It sometimes feels that our role is endless, mental health, social work, housing, funding. Trying to help people but not having resources to do so. It can be quite frustrating. Media negativity towards mental health nurses not doing enough to 'save' people when we try our hardest. Being made to feel so guilty and poor at our jobs in a coroners court in front of families when we did nothing but try our best.
Having worked on inpatient wards and in the community it is not easy and always feels like there are never enough staff or resources. The public expectations of MH services is not always realistic and expectations are far too high. Now coming towards the end of my career, working in research is great as I don't have to deal with the stressors of frontline MH.
patient aggression towards staff is considered acceptable by the police - this is demoralising - police often refuse to attend MH wards
It is so much harder than when I started over 40 years ago. There was a reason we retired at 56 in the "old days". So many staff burnt out and emotionally unable to provide compassionate care. It's a struggle but when you get a grateful patient, it can make such a difference to your day
Working in inpatient mental health can be very stressfull - need adequate staffing, clear roles, increased admin staff, good supervision
Over worked Under paid Under appreciated Remains misconceptions and prejudice No support from senior management
Best job in the world but let down in terms of reaching potential by the funding and policy of successive uk governments
I used to be extremally proud to work for the NHS, I loved my job, it can be very challenging but also rewarding. I am a positive person, but when the pandemic happened our managers was very slow to react. PPE equipment was in stock but senior managers took the decision to change all the locks on the store due to pilfering, which was a huge problem at that time, however my question was how is it possible to PPE going missing when nurses on the front line did not have access to them. Senior managers held the key so out of hours services did not have access to. This issue was raised by myself, I was removed from my post for 18months for supervision, I was underpaid for 12 months and I received a letter from my bank to inform me that my accounts would be closed due to always going overdrawn. I was placed in an office where I sat at a desk with no phone, no access to pc, my colleagues was informed by senior management that I was not to answer the telephones or deal with patient queries. I was constantly undermined, my self confidence was really low, I was told I had to rewrite 2 assessments 10 mins before my shift ended, I was going on annual leave so stayed behind until 22.00 Then because I raised this issues I was removed from the office and placed in isolation alone in a small office through 2 air locks out of sight out mind!!! A very senior manager then notified junior managers NOT to sign my revalidation for NMC, one fantastic manager did sign my revalidation, but then unfortunately also became a victim to the same bullies. It is appalling really when you know that Lucy Letby had her revalidation documents signed. I can categorically state I have never harmed anyone my crime seems to be concerns that patient safety being compromised, and the gross mistreatment of staff.
Having sufficient staffing on all shifts. Time that nurses have to spend looking for other staff to cover shifts should be done by other teams and not by ward staff - this takes away from patient time/care. Patients are stuck in hospital as community services/alternatives are no longer available due to financial cutbacks and closure of specialist homes. Patients with learning disabilities should not be kept long term in MH wards - social services should be taking care of these patients needs if they are fit to be discharged.
Nursing in the mental health field is extremely draining. We care so deeply for our patients and we don’t have the facilities to give them the care they deserve. Even if our service succeeds in rehabilitating the patient, there is no support for them after us. I hope that one day the field gets the funding that it so desperately needs in order to save lives.
UNDER APPRECIATED, UNDER INVESTMENT IN MH NURSING, ALWAYS THE POOR SISTER TO GENERAL HEALTH. LACK OF RESOURCES AFFECTING HOW HELP CAN BE DELIVERED. ALWAYS FOCUSED ON THROUGH PUT INSTEAD OF ACTUALL HELPING PEOPLE TO ACHIVE POTENTIAL, TO RECOVER, REMAIN WELL AND FLOURISH.
As before really nurses but especially mental health nurses are not valued
We do not have the resources we need to provide the care and support our patients need. There are no beds available on wards when we need to admit someone. We dod not have access to the services needed to keep someone safe at home and avoid admission. We do not have enough doctors or nurses, or allied health professionals.
When I trained as an RMN the focus of our time was primarily supporting people to manage SMI. This has changed over time with much more focus around healthy minds and much lower level mental health issues as a result of increased social media outlets, 'me too' culture and a society that struggles to manage a growing level mental health awareness. Secondary care resources are being used to plug the gaps and services are having to soak up a huge raft of mental health issues across society.
Much more support is needed - inc psychotherapy
It's become increasingly difficult, less staff, less resources, being made to work harder for little reward or acknowledgement. Upper management and leadership is weak and safety in work over the past 10 years have declined. Hard to do a job when so much is also driven by socio-economic factors which are also broken in this country.
Due to current role being in GP practices I feel that GP don’t understand impact of mental health and how helping people impacts staff. Ensuring time to review patients fully and how to impact revolving door patients. They see revolving door patients as a service provision issue and don’t see they keep coming back because we are not getting time to get it right at the beginning . I work tirelessly to inform general staff to understand
Sadly the MH services are understaffed with nurses being stretched on the wards and in the community - Management turn a blind eye instead of addressing and supporting the staff they have. I see lots of nurses changing direction and finding a different career or joining agencies where they don’t have the constant worry of a permanent position in the NHS. Much better pay too
I have worked in many settings. I love my job I feel modern nurses often lack personal resiltlence and focus too much on their well being and not the patients
I am fortunate to now be working in perinatal services, where my experiences of working as a RMN strongly contrast to my past experiences working in other areas of mental health. If I had completed this questionnaire when I was working in other areas of MH my answers would be very different and much more negative. Past roles I have felt vulnerable, unsafe, without the resources to give the care I strive to and stressed to the point of long term sickness and having to start antidepressants.
it is completely demoralised profession. I think MH nurses should be trained in adult nursing , so nurses can change between psychiatry and medical to help avoid burn-out amongst other benefits. Nurses should have protected CPD , and also have safe staffing levels.
I enjoy the job, the team I work in. I work in perinatal mental health team and the team is being expanded and invested in but there is massive demand and other mental health services in the trust and NHS generally are being cut back so this impacts on the team and the care we can provide
It is hard to give our patients the support they need due to barriers. Gaps in service, declined referrals, waiting lists, time constraints. The numbers of staff need to provide true meaningful crisis support, to foster recovery and treat patients is not enough. We also need more community support, organisations.
Very hard job emotionally lots of support is needed
As a new graduate, I didn’t feel prepared at all by uni!
The role is something to be proud of and has more potential for development than is sometimes given the credit for in particularly its a good CORE profession to have to go into other roles like Psychological therapies but this sometimes gets dismissed by some of the developers of training for IAPT roles in particular ,I personally welcome RMNs to apply for therapy roles/training in my team.
Over time it is psychologically and emotionally difficult to cope with the hopelessness of some patients lives particularly towards end of life. I have previously worked as a ward manager on a very challenging inner city acute ward with a very bullying manager and left burnout and with no confidence. I have experienced first hand what happens when you try to get help from senior management and it was traumatic, I wouldn't do this again. I dropped down a band to my current post with a brilliant team and manager but this has made me very anxious about any prospect of changing from my current line manager which is a possibility due to proposed government led changes. I do not believe anyone above my line manager has any interest in my or anyone else's wellbeing in this respect and strongly believe anyone working in the NHS is considered expendable by their employers.
Making a difference to people’s lives is a powerful, yet rare, boost and keeps me in the job.
Working in this field is a privilege and I feel we should all work together nationally to shape the future of mental health nursing - breaking down stigma by association and celebrating this wonderful profession. To care and support and individuals recovery means the world. I wish to advocate for the future of mental health nursing!
I have seen the affect that compassion fatigue has had on a large number of MH nurses in the health board I recently worked for. This has lead to poor motivation and a minimalistic approach to care. It worries me that there doesn’t seem to be a solution to positively changing this approach to care.
I appreciate this is a stressful job. Personality is more important than training for longevity in this field, though training allows you to manage any stress you may be subjected to.
I love my work with patients, that's the only thing that keeps me in my current role. I do not feel supported or able to gain satisfactory outcomes to anything I raise as a concern, things are swept under the carpet to make things look fine, when they are not.
Lots of pressure, management of risk is difficult with high caseloads and lack of support from senior leadership members
The rise of anti psychiatry models is having a negative impact. Psychology pushing the trauma agenda with what seems like limited exposure to acutely mentally unwell people is divisive and demeaning to others working in mh. Some of the models of care are restricting positive psychosocial interactions as nurses are afraid of what psychology will say as it doesn’t fit into their model. The criticisms of mh nurses including on live streams on tick tok, X, fb etc is damaging. It limits the therapeutic relationship due to fear. Then medics on X constantly demeaning nursing at the moment doesn’t help. It is possibly the most stigmatised profession. This doesn’t happen to the same extent in LD, child, adult etc.
Wards are short staffed, agency staff create additional risk I am very lucky to work in the organisation I am in as the role of the MH nurse is protected and our recruitment ads are for MH Nurses only. We have amazing support but the job is becoming more challenging every day. Some of our substantive staff have left their post to join agencies. It feels like we are in a vicious circle of agency reliance.
Not sure if members of the public understand the role or value it
I see specialist mental health services, both inpatient and community, as a walled fortress, with concentric moats, the draw bridges pulled up, and archers on the ramparts aiming to keep people away. They have such a narrow focus on what a mental health issues are. So much work is put into excluding people. If you have certain diagnoses, such as EUPD, ASPD, or involved with the guys I work with in criminal justice, good luck, but you’re not getting in. Mental health nurses are complicit in this. Some of the disparaging attitudes to some of my clients has been shocking to me.
I am proud of the work that l do and strive to ensure service users have good experiences and achieve positive outcomes.
Nurse training needs to cover working with complex trauma More nurses trained Better cpd and supervision for nurses Better assessment of nurses own mental health to ensure fitness to practice and they get the right care and support Better speedy access for nurses to their own care to help keep them in work and well current nhs waits staff have as patients increases sickness levels and their struggle at work
During the pandemic we never got credit, we never received donations and gifts from local businesses like general medical areas did. We are often misrepresented and not considered real nurses
The systems and processes can be restrictive & clunky There is an overload of information distributed/disseminated The university’s are paying more emphasis on training new nurses in generic “physical” health than mental health - this lack of training results in clinical areas having to provide on the job training in the clinical area and realistically mean that NQN’s are taking 2 years post graduating to be skilled and competent, impacts on patient care. It is good there has been a directive to stop using agency staff, most of the unqualified agency staff in my opinion are lazy and added nothing to the care and treatment of patients yet got paid more than the registered nurses Limited HR support for nurse who LM - if you are managing a complex member of staff HR advise “you need to find the time to do this” no extra time is given to nurses who LM - this is “hidden” and to be honest is not fair
It is the hardest, yet most rewarding job working with children and their families. I feel privileged to be working for the NHS. I fear for our future though.
The skills needed as a mental health nurse are intensively people-focused. People skills with additional knowledge of symptoms, signs, reactions, risk, clinical judgement and decision making is what I view mental health nursing as.
A nurse in mental health increasingly becomes about risk management and multi agency care co ordination. Making referrals. Holding while waiting for a specialist intervention. The demands are huge and relentless due to gaps in other services. Caseload sizes are too high. Due to poor recruitment inexperienced staff now fill the posts of experienced staff. Nurses in mental health teams now do social work tasks with families due to lack of recruitment in social care. There are no nationally recognised safe staff:patient ratios in community teams.
It can be detrimental to my own mental health due to the pressures of workload and expectation of patients, families and other professionals that we can resolve every possible situation. It can also be draining in taking on so many problems of other people.
If a colleague is off with mental health concerns it feels as if they are forgotten, not mentioned, this very much depends on the person & the level of support they receive.
It's a terrible, thankless job, where the focus is on the patients and clinical staff are Expected to do everything.
I think its become more challenging due to the acuity of illness and reduced services. I suspect this is going to worsen. Despite enjoying and being proud of my on own career I would not encourage my children to go into nursing
There is often a disparity between the culture/support and sense of satisfaction felt within individual teams and that felt about the wider organisation. For example, the team i work in is consistently supportive, open, compassionate and person centred. I do not see those values being demonstrated at executive/senior level. What they 'say' is not what is 'done'. I appreciate we are in an extremely difficult financial situation but the cuts to service provision that inevitably contributes to SUI's sadly have the greatest impact on the clinicians with the least amount of influence, trying to do their best. This is what exhausts and burns people out.
I work in an adult eating disorders inpatient unit and I feel very lucky to do so - I love the job, patients, team here. I do not feel that my positive views represent in any way other inpatient units generally speaking and my understanding from colleagues and patients is that general mental health units are in a much worse way than us with poor retention and poor patient care.
Its possibly the worst mistake I have ever made. Had I got a private sector job that requires the same level of skill and dynamic risk management I would be being paid twice as much. This country treats nurses so badly its a total joke
Trust advertises flexible working but does not practise it. You are a cog in the wheel, too dangerous to speak out and exhausting
Skills mix and level of competence by colleagues is a concern
Not enough resources or staffing making wards feel unsafe
- a lot of pressure, not enough support, expected to be like a robot with no emotions and work in often unsafe environments, this is like the new norm, where unsafe numbers are tolerated. Not enough training for physical health issues, should be more training rather than fundamental training done electronically each year
Its a difficult job that often feels thankless- however, on the whole, it is rewarding despite all the challenges that we face. Being a nurse working in mental health can be difficult because we often feel that we must be physically and mentally strong, especially as mental health is our speciality. However, supporting other people with acute mental health problems can cause significant strain on our own well-being. The situations we see and deal with can lead to burn out and depression, which is not uncommon amongst our staff group.
Best job in the world when resources and people allow
I am proud to be a nurse and I know the work I do makes a difference. But this is not a role where you can give 70% and save energy for life outside of work, it takes 110% effort every day. There are no 'easy' days and the workload is relentless. If I have a day where I don't feel so well, or even just having time off for annual leave - there is no-one who covers my workload. I have 170 patients that I am responsible for in the community and even superwoman could not provide excellent care for that many people on her own. The expectations and referrals continue to increase, and the funding continues to decrease. I am doing the work of more than 2 people, and expected to do this within 37.5 hours a week. I do not know any community nurses who do not work overtime, whether they admit this to their managers or not is a different thing. I am exhausted and burnt out, but I continue to keep going for the sake of my patients. That should not be what nursing is, yet it is what we've grown to be expected to do.
More regular debriefs (throughout the day) would be useful especially after challenging patient interactions. 30 minute breaks are far from sufficient for the nature of our work.
Satisfying Making a contribution to society Worthwhile job.
the bursery needs to be reinstated to allow for the workforce we need
I believe we provide a good service to people but that we are not always recognised for it by those outside of mental health. There continues to be a lack of understanding about what we do and we often find ourselves receiving referrals that feel like we are the last resort. From my experience most mental health services are understaffed and this has the biggest impact on mental health nurses wellbeing.
Its exhausting. But I love working with young people and building that alliance. I love walking into their darkness with them and trying to help them walk into the light. I love the patients and my collegues. I have a strained relationship with management. I hate the government and the way they have made us the heroes in the pandemic and then public enemy number 1 now a days. There is no respect or appreciation or understanding of what nurses do. We just wipe bums for a living.
A rewarding and worthwhile career, which currently is undervalued and underfunded. The expectations of the patient cohort and that of our primary care is not compatible with the resources available to us.
I`m sad that it has become such a challenge to deliver care/treatment that is much needed. I am sad that I simply want to leave and retire because it is just too much some days. I don`t think it needs to be quite as challenging but recruitment appears to be very difficult and we are always running with vacancies in the team.
It is a very hit and miss experience. At times there are enough staff and other times not. It depends who your manager is and who there is in your team as to how your experience will be. Bullies are allowed to reign supreme in my organisation and are not dealt with. Conversely, they are often promoted into more senior positions where they hold people back. Services are so stretched it is often hard to ensure patients get the right care, from the right person, in the right place. Our local wards are not fit for purpose and are more akin to holding bays than therapeutic environments; it is hard to get a medic or AMHP if you need an MHAA on certain days, or times, as there are protected times and staff groups who don't have to respond, if they don't want to.
It's not worth it for the pathetic pay, I'm heartbroken that I'm having to consider leaving the career, not only to protect my mental health and get a better work/life balance, but because I don't think I can start a family on this level of pay and with so little opportunity for progression
The NHS is in crisis and frontline workers need to be listened to - and their points to ACTUALLY be actioned!
This is an extremely demanding line of work with a constant throughput of fresh distress and no actual vision of how we might address the issue as a society other than to coral people into under-resourced facilities with others in a similar unwell state. This is too often normalised where staff are trained to adapt to an unhealthy environment with lots of positive attitude and plans to help. I do believe we help in adverse conditions and take pride in the efforts I and others make, but rage at the fact that we are all , in reality, denied the kind of resources that would allow real choice about how we can live bountiful and meaningful lives.
I have worked in mental health for many years and the job has become increasingly more difficult, bureaucratic and administrative.
Important to look after own mental health before looking after others; e.g.) walking, connecting with nature.
there is still a stigma to say that you are struggling with your own mental health. ironic isn't it
I rang our employee relations service in tears once, due to work stress, and then had to wait all day for someone to call back, who asked, [ will you get over it?] to which I said, probably - then that was it !!
I feel that i have a privileged role supporting people at some of their most difficult times in their lives and i do find that this can be emotionally draining at times. What energises me is working with people and developing my skills. Training is minimal, well just mandatory training really. I do mental health voluntary work which energises me more as its time with people rather than my main role which is dominated by administration.
most challenging but rewarding job to be in
it is mentally draining at times, the need for breaks is very important
Working in GP practice is very different to any other role. It is isolative with accountability to the trust and the practice No man's land
I am exhausted but keep going because what we do is important to those we care for.
I completed my training in the School of Nursing attached to one of the old Psychiatric hospitals. There was no Supervision, Mentoring or Preceptorship in 1985 when i Qualified. The day after i Qualified i was handed the keys to a 34 bedded Acute Unit with 2 Mum and Baby beds and informed that i was in charge. Our training toughened us up. It was harsh but a thorough training. It was very much sink or swim and only the toughest survive. This training gave me the skills to survive and actually thrive. I am about to retire after spending 44yrs on the wards.
job is challenging and a positive team work ethos is essential to enable high standards of performance for best patient outcomes
Difficult to work with so much red tape, very frustrating, feels like no actions are ever taken about concerns raised, management are not always easily accessible or visible, not always the right care/resources/professionals available to provide care which meets service user needs, other services having strict referral criteria leaving gaps in system
Would not recommend it at all to anyone. Too dangerous and unsafe
I valued my job and proud myself helping with patients for their mental health recovery.
long hours , poor work life balance , newly qualified nurses do not appear to have appropriate skills leading to poor retention of staff
Perhaps less commonly so, due to the nature of my work (specialist personality disorder service), my answers are all a reflection of being a 'clinician' rather than specifically a nurse. I have colleagues from other professional backgrounds (OT, SW, etc.) in the same position as myself, and I would guess they would have very similar responses.
I love being a mental health nurse. I love working with people. I felt totally unprepared for this role by my training and I did not know how I would have to do things that I fundamentally/morally disagree with - no one should be restrained and injected in the name of health care. Recovery takes, time and resource and people who care. I care but this job has persistently taken more from me than it has given back all in the name of providing (to my mind) substandard care. People with mental illness deserve better than this.
Patients and their carers and other outside agencies can be very critical and ungrateful of our free and lifesaving treatment.
Each day I'm apprehensive that I maybe moved to another ward, not knowing the risks or having realistic time to read all their risks. Everyday you never know what threat you will be confronted by and deal with,and hope you make the correct and safest decision. Feeling helpless when people are at their lowest and needing support, and staffing levels and ward demands don't give you time to spend with the patient. Outside agencies and other trust services expect the ward nurse to be able to meet all their demands without acknowledging the ward duties and patient daily needs and staffing levels making requests delayed or unattainable on the day adding further guilt and feelings of letting the patient and the service down.
When working long hours (13) it can be hard to manage your emotions which can affect your home life.
I'm proud of the job I do because patients feel better after having a 1:1 session and seeing them go back into the community to live a normal life.
It can be challenging but also at times rewarding especially when a patient is discharged into the community.
Understanding your own mental health and ability to ask for help and be able to say to myself I can be weak at times.
I feel proud to be a mental health nurse. We just need more of us to get the quality of patient care we all strive to provide!
Not paid highly enough to maintain experienced staff therefore most of the team are often junior to the role. This puts additional pressure on those of us who are experienced. It’s draining! Clinical roles should be paid as well as management roles where there is experience.
the police need to take assaults in mental health settings seriously
I work in CAMHS which in my area is looked on as ‘well resourced’ but we could still do with another 1/3 of staff on top of what we have. I am a team of one working across my area and it is brutal.
it is a fulfilling job when you see the patient being discharge after recovery.
Proud to be working as a mental health nurse
Working as a nurse within Mental Health is tough. I don't feel there is enough recognition and support for nurses Health.
This is the hardest it has been and it is only getting tougher.
It is exhausting but I am aware of my limitation
Lack of respect for this particular field where everyone seems to be the 'expert', rather then those who have trained and worked in this area for many years.
It's exhausting. In my role, i spend 12 hours a day or night talking to people about suicide. There is no debrief, there's no where to expellee that relational trauma. Go from one patient to another and then required to relive that trauma by producing 6 page assessment documents that are required to be such high standard for coroners court and then if someone dose willingly end their life ... it's my fault and I'm expected to defend my practise, defend why waiting lists are so long, or why there are no beds. We are treated like outsider in the acute health hospital I work in. Like our patients are destroying the health services. MH services are not fit for purpose. We are routinely abused verbally and psychically by patients and family. so much is expected of us. My job impacts on my health and wellbeing.
This survey seems very biased to inpatient staff and is quite difficult to answer in terms of working in a community team which has different stresses and expectations.
There is no respect or support for nurses with lived experience of mental health. I feel that the medical model of mental health doesn't fit with lived experience, or with a MH nursing identity. The MH nurse identity is becoming quite devalued also, with community MH nursing roles mostly being generic MH practitioner roles open to nursing, social work or OTs interchangeably. I also feel that the MH medical models' view of MH is very outdated, especially when it comes to the correlation and interactions with neurodivergence.
It is not the job I started , way too many managers and not enough clinical staff
I have recently gone into a corporate role (until recently clinical/managerial) - however in MH - issues staff numbers, skills, attitude, premature promotion, lack of systems to manage conduct/capability issues, over use of bank nurses, focus on demand and capacity as opposed to patient safety/quality of care, financially challenged - underfunded, too many meetings, too much bureaucracy
The prevalence of suicide and suicidal behaviour has taken a significant toll on many MH staff. Lack of staffing and the huge demand placed on services has led so many great nurses to leave. As a result there has been a considerable shift in less experienced staff feeling overwhelmed and indirectly increasing demands in respect of further MH resources.
Media coverage, social media discussions and complaints are mostly negative due to how difficult it is to access CAMHS. Taking calls from concerned parents/professionals and having to say there is no intervention available is significantly impacting on the morale of the workforce. Assessing people who are in need and knowing there is a 2 years wait is significantly impacting the morale of the workforce. There are not enough adequately trained mental health nurses available to fil the gap and many well trained/experienced nurses are leaving the profession due to capacity/demand pressure. We would all do a better job if we weren't fielding so many complaints about waiting times.
It is a wonderful job, hugely rewarding when you accomplish helping a patient to get their life the way they want it and become fulfilled and proud of themselves. Nursing staff should be enabled to do a good job.
Undervalued. The public are less aware of our role and the emotional toll, knowing that staff resources are extremely limited and often poorly matched to people's needs.
Unfortunately, staff safety comes secondary to financial issues within the trust and the organisation. Senior management are also detached from the clinical areas, however, are the ones who have the decision-making ability about staffing and support required on the wards, without listening to those who are working clinically.
I feel front line teams are amazing but wider trust support is significantly lacking (unless CQC arrived)
It is a difficult job and if your home life is difficult also, it makes it a hard role to manage.
It can be emotionally demanding to be a mental health nurse, but I am very happy with my current work and have no intention of changing it at the current time.
Under-valued compared to other areas of nursing.
The situation with low staffing levels is dangerous. I hope that it is the government that is held to account rather than the hard-working staff and managers trying daily to manage risk with inadequate resources. We must return to a system where we pay people to train and give them a decent wage and satisfying career. I was lucky to train and work in a well staffed system prior to the system being dismantled. Staff joining recently have been leaving for better options in non-NHS services so that they can afford a home and a good quality of life.
We are under a great deal of pressure with the delay for mental health beds, it can be difficult when explaining this to general nurse colleagues. We cannot 'magic' beds, this has a direct impact on the general hospital
The job can be very stressful but also very rewarding
It is by far the most taxing role to undertake.
Ironically I don't think mental health nurses get enough support for their mental health. Sometimes the job is overwhelming and think we should get mental health days off as sometimes I really cannot do my job as I'm mentally exhausted but can't feel I can say that so will use a physical reason Why I'm off such as a UTI
Not only is it physical it's mentally draining and it takes awhile to recover from one shift especially if it's been full of incidents
Its not worth it. Not enough people want to work in mental health which makes the ones that do miserable because of short staffing
i have adhd and in the menopause and neither condition is understood . lip service is paid to the symptoms but no mention of adjustments
Most nurses in mental health want to make a difference and work very hard. This is made difficult by understaffing/underfunding and limited resources.
lack of community services placing incredible pressure on the work we do
Unrealistic work load Still a blame culture in the partnership, when something does go wrong it is not seen as a systematic failure but the blame is put on the nurse who was on that shift
I previously developed PTSD due to work-related incidents whilst working on a mental health ward and underwent EMDR therapy to manage this.
You have to have personal resilience. You need fabulous colleagues to make the day better. Without my colleagues I probably would have left many years ago. I have good friends outside work but I cannot talk to them about my work due to confidentiality.
It's a tough job that feels like it has gotten harder in the last two or three years. After qualifying in Australia I see how much responsibility we give young nurses and it feels sensible for some to leave the profession. I think overall, a major change to pay and conditions is needed to keep the people coming into the profession. Also pathways for senior nurses to pursue that are still patient facing. For example nurse consultant roles that are on the ward.
This has been an amazing profession in which to build a 36-year career, and which has given me great opportunities to develop personally and professionally. I have wholehearted respect for my younger mental health nurse colleagues, but I am aware that I have benefited from a different mode of nurse training (pre-project 2000) where not being supernumerary gave many more experiential opportunities to learn on the job than I believe there is now, and why can this not be changed back to what I believe worked well, especially with such chronic nursing shortages? I have also been lucky to access training and education in the years in the NHS when services were less stretched and under less financial pressure, which has led to a career specialism through clinical care and into research. I have learned an enormous amount from taking active steps to learn directly from people with lived experience of mental health difficulties which has been the most enjoyable and inspiring space to be in. So more opportunities to embrace this is of great value in keeping going in tough times, and I wish I had learned more about this earlier in my career.
They does not reflect the work and risk mental health nurses does and carry. There is not enough understanding of our role from general nursing staff. There is not enough readily available mental health support that is known about and easy to access without searching for it.
Due to the state of the NHS at present in the UK I find working as a nurse in mental health very disparaging at times due to the issues with the current psychiatric bed crisis, the cuts in funding for services, the constant increase in pressure on services and practitioners, the lack of awareness of the intricacies of mental health and illness from the general public and those in political power, among a myriad of other things. I believe those of us who choose to go into this job do so as we wish to help people, but it seems the odds are against us with the reasons listed above.
I feel that our team (peers) is currently struggling due to vague management and talked about changes that are not obvious to us on the front line.
I have a sense of resilience due to the aspects of work and hardship my work exposes me to, which can make me feel senseless when im quite an empathic person
Its exhausting, there is little reward, there are no fairy tale endings, you constantly feel like you are failing the people you are trying to help
As a return to practice nurse I made a conscious choice to regain my registration and I am proud to have done so
I am peri menopausal and Have ADHD so some of my answers are in the context of those diagnosis and not a reflection of the work place. I do work in a highly pressurised environment with high expressed emotions from the professionals that we interact with
I still feel very proud to be a mental health nurse after more than 20 years. However, I don't like the work any more. There is too much of a focus on crisis management, risk assessments (all important) but with the lack of preventative services, this is the work we now do every day which is emotionally exhausting and leads to burn out and sickness. The waiting lists for services are embarrassing and cause feelings of hopelessness and frustration within staff teams. Looking at services at ground level, I feel that people are exhausted and have lost enthusiasm for the job. I often feel that I am unable to provide a good enough service and often feel I am letting patients down. Sometimes I feel that the role of the MH nurse is not well defined which leads to a lack of respect for the role. The work we do is not rewarded with enough pay. Reflecting on what I have written, I hate hearing myself talk like this. I still feel that MH nursing is a really important role and I still feel passionate about it but I feel stuck in this role as to re-train would be financially not possible for me.
The job obviously takes its toll emotionally. However, if you work to create support networks to keep yourself and others safe/protect and nurture these systems - it is possible to hold hope, stay safe and keep a positive vision. My absolute standard advice to those I manage (including new learners and students) is to treat others as you want to be treated. Its a very meaningful message.
It is exhausting, poorly paid and we are increasingly asked to do more with fewer resources.
the job has changed vastly in the 40 years- not always for the better - safer staffing doesn't reflect the needs of a ward- need more registered colleagues. on a positive note- TNA and top ups great opportunities and nurses can develop exponentially to prescribers /ACP etc important to value the colleagues who are competent and happy to remain as staff nurses ** reflect their commitment in a way?? maybe more AL ?
I feel supported by my current line manager but sadly she's leaving soon. I'm anxious that new staff might not have the same philosophy and empathy as her.
Very draining working with agency staff. Extra pressures added to substantive staff including mentoring students and international students
I put alot of pressure on myself, because I want to do things a certain way. I will stay behind and spend time doing work tasks so that my mind is more settled when i leave, even when I've been advised against it.
Pressures are across all teams causing a wedge between services at times, when cmht and crisis should work well together, sometimes short staffing in both teams impacts the delivery of care to acutely unwell patients. This along with a lack of beds creates long waiting lists of people in the community who require hospital admission then increasing the pressure from community teams trying there best to support patients. This then has a knock on effect where you are constantly prioritising appointments and rescheduling appointments to allow for the care of more acutely unwell people. Then you find your lower priority patients become more unwell due to not being able to support them as you would like to be able to. This effects your own mental health at times as you feel like you are not able to do the best for your patients. Due to short staffing there is now longer waiting lists before patients are able to be allocated to a caseload and those patients who have been identified as needing support can become more unwell whilst waiting for support to start.
It's very challenging and rarely what you expect when you are training. Occasionally when the ward is well staffed we can have really positive engagement and this is a rush and makes us feel better about what we do but that can be challenging when staffing is poor with lots of agency staff working.
It exhausting, there is no real support. but it looks good on paper.
Nurses tend to be the ones who have to cope with workloads what ever circumstances, where as others can b more controlling and 'boundaried'
my role is unique. I do not have the struggles that my RMN friends and colleagues have, nor would I want them. the option to retire at 55 feels like an acknowledgement of the difficult emotionally challenging work being an RMN is. so many of my friends and colleagues are burning out, have had strokes, cancer and I don't think it is unrelated to the relentless nature of nursing.
Nurses have too much work to do with minimal resources.
It is a very difficult job, I do not feel we as mental health nurses are valued within the general hospital setting or by the government. The lines are becoming blurred in what people think is a severe enduring mental illness. When assessing in ED we are now assessing more people with drug and alcohol issues and social situations which are the main cause of being referred to us as a service and having pressure to safely discharge these from ED can be challenging. There is also an increase in frequent attenders which again we find are open to a community mental health team, however due to staffing issues are not able to be seen or speak to anyone from their service. Therefore they are brought or attend themselves to ED. Psychiatric liaison is difficult we can see over 200 patients in a month having to find a safe discharge plan for them. There is usually no further services to refer them to, or if there is we know services are broken due to staffing. The knock on effect is growing and we are starting to see the repercussions of this in the patients we see, due to further admissions, and there attempts at SH/suicidal ideation is increasing. Until the government makes changes to pay, to entice more people into the profession and be able to retain them then MH nursing is going to find bigger challenges that unfortunately we are not going to be able to meet.
It is a worsening role with less services and help for service users to facilitate
I am newly qualified, and I feel very supported as a result. People in my team are well-supported, meaning that everyone is able to manage and despite having some very unwell young people under our caseload, we work together and it makes it easier.
if i knew what i know now i wouldn't have done it
Camhs is a traumatic pace to work due to being under resourced
Theres a lot of pressure about not doing things wrong and ending up in coroners court- it makes it difficult to want to take on learning opportunities due to fear of failing and the consequences that can bring. I think rather than consistently reinstating the consequences, put things in place to avoid that being a potential outcome and offer training/support/guidance.
It’s mentally exhausting , self care is important. Might not see immediate rewards of patients recovering but does rewarding for making a difference in their lives.
These questions done seem to understand how many different areas mh nurses also work in. That comunity camhs is in the community ir hubs, family homes etc. Where is ndd ld thinking. Accessibility questions. We need more staff 19 vacancies, but not all nursing roles.but mh nurses roles vary so much. And I don't think people in work or other nurses understand the different roles. Physical health has its speciality, same as mh or ld. I don't think roles and teajnjbg capture that. Mh nurses are getting on with it too.. and not always talking about it. But newer training will not prepare for the current needs.. and I love ndd camhs. 36 years. But it's difficult work, great can be so rewarding. But few staffcand few applying. The role is amazing. Can be so different each day. Therapies, physical and mh assessment and diagnosis. Support. Networking. Helping families find their way back
I love being a mental health nurse. I feel that mental health nursing needs a national identity and we need to have the respect that other therapists have. We need to encourage a clinical leadership career structure that is paid commensurately. A career structure where mental health nurses can earn good wages for the clinical work that they do. Not be side-tracked into management or academia.
There are not enough skilled mental health workers, not enough student mental health nurses. too many "practitioners" that have no mental health training but can work in mental health services
The fire in my belly for mental health nursing went out many years ago. I'm still here, breathing life into my enthusiasm. I must like it otherwise I wouldn't have stuck with it for so long! But given the chance to earn equal or more money, outside of nursing and I would likely be gone like a shot.
bring back 35 year maximum service, then retire as staff are burnt out.
I am committed to my job and the work I do but if I knew when I qualified what I do now I would never have entered the profession. I do not feel I could recommend nursing to others which makes me sad.
The job is tough, but one I have done for a very long time. You need passion for standards and quality to ensure care & treatment is delivered in a way in which you can be proud. You definitely need tough skin to do mental health nursing, and it helps to be able to detach yourself emotionally at times in order to protect your own mental health. Its a thankless job too at times, and Mental Health nursing is the poor relation in comparison to other areas - we are not protected by the police and the "Zero Tolerance" campaign and that can be hard to accept especially when on the receiving end of violence, aggression or hate crime. There needs to be more investment in Mental health nursing from government and the training also needs overhauling as it is lacking in all areas. Mental Health Nursing, and organisations need to be under much more scrutiny to hold individuals, services and larger NHS trusts to account, this would make them safer places to work, and the outcomes for patients much more favourable.
Its a great vocation , a rewarding career in many ways however it appears to be overmanaged with non clinical staff making decisions regarding healthcare that do not consider the impact these have on direct care
It is not a profession that you can work in until 67 particularly on the inpatient/forensic wards. Burnout is high
After 24 years as a registered MH nurse my role has changed so much it's almost unrecognisable. There are upsides and downsides but the capacity to work well has diminished so much it remains difficult to keep up resilience. I have worked overseas as a registered nurse during this time and therefore can see it is UK culture based. Sadly politics has played too much a role in the provision of safe and appropriate healthcare. It is no surprise we are struggling to recruit, despite the many rewards possible in promoting recovery and positive mental health.
Safer staffing at work is very important
Really difficult at times. Moving back to general nursing where there is more support.
I think there should be an incentive like there was years ago with the mental health officer status so that you could retire early or have a higher rate of pay.
We are underfunded by the government as mental health not seen as important as physical health Underpaid and unappreciated for the role we do in mental health
It's tough on me as a family person and we don't get enough opportunities to protect our own mental health at work, we see some very difficult people at the worst point in their life (by definition of MH work) and it takes it toll if we're not valued
Too many staff with lived experience joining whose professional lens is prejudiced and counter productive
Mental health trusts do not support workers mental health well being. They feel offering yoga will support nurses but really more competent staff is all we want
I don t feel valued by my employer, my good record as a nurse, manager and clinician is given no regard.
I feel privileged working with PLWD and their families and have a great team around me although it can be frustrating when services are lacking
Extremely passionate and committed people are either broken on a personal level, or lost professionally to other careers because they are not supported, or are forced to work in inappropriate environments and cultures. The infividual syrengths that bring people to nursing are not recignised, rewarded or fostered.
Preceptorship / newly qualified programs being unable to be followed due to lack of staffing Being left to manage a ward on your own as a preceptor / newly qualified nurse Unsafe staffing levels / skill mix Severe pressure from high management Non-stop work load
It is a privilege and I have worked with some wonderful colleagues. But we are now suffering chronic underfunding, scarcity of good nurses, increasing marginalization of our vulnerable patients
Great resignation could become a great retention, as in the case of employee retention. This will prevent high performers from quitting unexpectedly. Value staff and invest in those who are passionate, committed and share a common philosophy in maintaining and improving practice. Relying on remaining resources and members to take on a specialist role while searching for a colleague's replacement or re-structuring the Mental Health Nurse's roles, can be difficult. This affects morale and could harm job performance and engagement. It is essential to explore employee retention strategies – e.g., work-life balance, effective change management, feeling supported, excellent & honest communication, building trust and respect to reduce friction/conflict. Last but not least, Mental Health nurse engagement is a representation of their investment, commitment, and enthusiasm. Organizations who do not have experience working with mental health nurses need strong, robust support to understand their role(s). And should establish: 1) a good connection, 2) improve employee engagement, 3) career goals and aspirations, 4) encourage/embrace & new ideas, and 5) productivity and priorities employees. The organization must have a genuine interest in the work that Mental Health Nurse actively contribute to. Just like caregiver burnout, a Mental Health Nurse experiences physical, emotional, and mental exhaustion. We need to be mindful of the word "Resilient" which can be used inappropriately. The importance of a staunch and dedicated support system facilitates the career journey with goals of hope, empowerment, and self-reliance of any Mental Health Nurses. As we all know with new services, in addition to attracting new Mental Health Nurses, I always encourage a safe environment for patients, their families and colleagues to express agreement and disagreement. Transparency is a necessary condition for finding a way forward. Services/organizations improve thanks to feedback. As sca
over the years mental health has changed but not always for the best. Nurses don't appear to as much hands on care as we did many years ago. Too much paper work.
Toxic positivity is toxic. Nurses who have mental health problems are sometimes allowed to misbehave and 'given a pass'.
I love my job but often it feels impossible, overwhelming and unachievable. I don't always feel like I can make a difference or can provide the service people deserve.
we used to have a sense of community. Since the large institutions have gone, the sense of family, looking after each other have reduced significantly. Despite services trying to change, the blame culture persists. Its the little touches that make a difference, such as i remember years ago that the chairman went around the services at Xmas and talked to staff, and gave out boxes of chocolate, these things dont happen any more
Its varied, lots of opportunities in a variety of different specilaisisms
Being a woman in a genderised profession, which is not recognised or respected by government is difficult.
As has always been, physical health services take priority and the money, leaving MH services poorly resourced and patients poorly served (well cared for under the circumstances)
Being a mental health nurse is very challenging where I practice at the current time. Pay and rewards are very low in comparison to the skills that staff bring to their settings as well as the acuity and demands of the environments. Many nurses are feeling over burdened and unsupported working in unsafe workplaces and this is unfortunately becoming wearily accepted and normalised. I feel there is a strong theme of hopelessness within the staff group that I work with.
In the current climate it is one of the hardest jobs available. The lack of respect that the nursing career has is appalling, it is under funded and under resourced, and needs a complete rehaul in how it runs. Mental health services are often left to deal with the gaps in community and social services. It leaves mental health nurses struggling with their own mental health and well being, and services do not focus on or prioritise staff well being and retention, leading to burn out and nurses leaving the profession. Ultimately, it is a rewarding and extremely interesting job, which involves meeting lots of wonderful people and helping them in their recovery. If it was resourced and respected as it should be, it would be a much better place to be.
All these questions imply that feeling affected even distressed by patients is a negative thing. If you don't time to give it up. COMPASSION - means to suffer with!!!!!
I am working in a primary care service which delivers psychoeducation courses to people using our services. I feel I am fortunate because our service has a relative amount of autonomy in how we plan our workload - we schedule our courses quarterly, so unplanned absence cannot be accounted for, but to an extent the workload can be flexed and adapted to our staffing levels. Our courses also do not require a nurse to be present so if I am absent, it is not difficult for a different team member to pick up that work. However, this is very different to how I remember things being when I worked on an acute ward, where the staffing/resourcing pressures felt very intense, often overwhelmingly/insurmountably so, and I remember feeling the weight of that very often when I did not feel like I had the resource to provide a high standard of care and that was very disheartening, and at times scary, because a poor standard of care could ultimately mean someone using our service comes to serious harm, and as the nurse in charge you are responsible for that.
I enjoy working in mental health and specifically my job. Unfortunately staffing levels are low. I feel well supported although overworked
I love the job I get behind with paperwork I like my colleagues I’m less certain about my manager’s ethics
I work for a very good team, which makes a huge difference to my work
Its the most rewarding job in the world, but cannot stress enough how important it is that we have more staff, more funding, not just the NHS as a whole but specifically in mental health care.
We're invisible. It can be lonely. I used to hear good things from the public about nurses, but now the government makes us convenient scapegoats or needs-less angels at every political shift in the wind. I find myself looking at how the NHS used to be - seeing old NHS cutlery, seeing articles about former staff clubs, staff accommodation, 'Mental Health Officer status' and flexible/good retirement options, etc and can't help but feel that we do not hold the same place in the public's heart. We can seem expected to continually give and stretch ourselves to grow and be more and more with less and less until we burn ourselves out. I adore my colleagues and I feel so humbled and grateful for the role I play in my patients' lives. I can't imagine a more rewarding job if there were better conditions. However, I qualified into a global pandemic and I'm exhausted.
The stigma and understanding of what CAMHS do and don't do is the main contributor to how I feel about my role and my job.
Underappreciated by others; -Media -Other nursing professions -Families/carers of patients
I have dyspraxia. I was assessed in 2018. I work part- time due to family caring commitments.
There is insufficient recognition of vicarious trauma in my workplace. The emphasis for staff wellbeing is to engage in self care etc. No amount of yoga or kale could have prevented me from suffering the way that I did in 2023 in direct response to the nature of my work. I had supervision 5 times in the 18 months before I went off sick and when i did have supervision it was not fit for purpose.
i hate i, i feel ashamed of the service that we offer
The expectation is to save lives of those who don't want to live or do not want help from the services or refuse to work with us but complain when we don't. Media state that we fail people all the time- it is a hated service who no one feels it benefits anyone. I personally feel it could be an incredible service but engagement is a huge issues as is patients. This impacts my mental health hugely. It is incredibly stressful and there is no recognition of trying.
There are high risk areas where I would not wish to work due to the lack of staff and inexperienced staff, with limited skill mix. Middle management remain ineffective and mostly toxic in my organisation following years of no action by the board and upper management.
you would think working in mental health your boss/manager would be more compassionate towards you than they actually are
I feel a sense of shame leaving the NHS. However, I left for self-preservation. Caseloads were too high, and risk poorly managed. Poor remuneration plus long hours made me leave, when I knew there were agency clinicians being paid ridiculously high hourly rates. It was demoralising and left me feeling like the NHS was an abusive “partner”.
My role is a senior nurse clinical lead for physical health and as such I am able to positively improve the parity of care between mental and physical health.
Have had my confidence knocked do to serious incidents in past few years
Many mental health roles are being opened to any nursing qualification (eg adult, child or mental health). While I really value these colleagues, it feels as though this is a risk to quality of care and significantly devaluing of the specialism of a mental health nurse; who would not be accepted to work on a paediatric ward or adult medical ward (in a non-mental health specific role), as they’d be deemed not to have the relevant expertise and experience. Mental health nursing is no different. A physical health nurse doesn’t automatically have the skill and expertise to undertake an expert mental health nursing role - but they are being accepted into roles (including senior/specialist ones) frequently, with no prior experience as would be expected of a mental health nurse to eg reach band 7 level of practice.
I have worked in the NHS for 37+ years. I was once proud to say it. Now it feels like the NHS is there to say no to clients, GP's, families and to other services. To direct people to 3rd sector often poorly funded voluntary sector services is totally wrong. The NHS is stretched too thin. Repeat referrals to SPOA are are happening over and over. It feels like a production line that has no resolution for the individual. Peoples expectations of what the NHS can offer need to be reduced hugely. Politicians need to stop talking up the NHS and encouraging people to seek help when the help is absent. Sadly i found this survey in itself quite depressing. I hope by staff completing it honestly real world change can occur. Thank you.
The job is rewarding when you can provide the care and patient care is the most important thing. However, pressures from above are not realistic, NHS has become a business not a caring environment. To many chiefs not enough Indians as the saying goes. Senior dont care if staffing levels are not well balanced. they dont care if agency nurses are all the staff you have and they dont know the wards or patients. They dont consider the impact it has on patient care. they just want their books balanced and wont take responsibility.
Everyday is different which can’t necessarily can’t be predicted and I don’t feel this is realistic reflecting in staffing and within the organisation
On many levels I love what I do. But the demands of the job as they currently are have left me feeling hopeless and jaded.
As previously mentioned the bed issue is my main concern makes the job impossible.
Constant moral injury due to lack of resources, working with more patients, more complexity, no additional resources to match this
Being a mental health nurse now is very different from when I qualified in 1998. experienced nurses no longer make up the bulk of the team, the nursing workforce is more transient, RMNs spend significantly less time with patients and the work therefore is less satisfying, less rewarding and feels less safe.
The organisation does not have patients at the heart of what we do. The focus is operational rather than clinical, focusing on audits rather than good clinical care and patient safety
Senior management should consult staff working on the floor before making changes to understand how these changes will work in real time
Mental health nursing has the capacity to be a fantastic job. Unfortunately ongoing staffing problems difficulty recruiting and retaining staff means that those of us who are left are struggling to manage the basics.
I feel my answers are slightly incongruent at times, I believe this could be because I have always had a bit of 'love/hate' relationship with the role as mental health. I believe that if we had more available resources working outside of the medical model then I would have a much better relationship with nursing itself.

What gender do you identify as? - Prefer to self-describe: - Text
i do not identify as anything. my biological sex is female.
i am non-binary, but do not feel comfortable with being out at work due to comments that have been made by some staff and the reactions from some patients.

Which nursing qualifications do you hold? (Please select all that apply) - Other(s) (Please specify): - Text
ENB 998 Teaching and assessing ENB806 Specialist Pactitioner ENB N45 Care of individuals with epilepsy
CPN(Cert) MRES PGCE BA(Hons) Philosophy / Computing
PgDip and PgCert in addition to nursing degree
PG Cert and PG Dip, currently completing a Masters
Completed 1st year of a masters in advanced clinical practice. Currently progressing through 2nd year.
I also completed the Registered Nursing Associate qualification
PGdip in Recovery in Mental Health Advanced Diploma in Nursing studies RMN
Post grad diplomas and certificates up to Level 7.
Midwifery degree SCPHN qualification V100
Non Medical Prescribing Currently studying masters
Degree in Cognitive Behaviour Psychotherapy BSc
Advanced Diploma in Mental Health Nursing
Have a BSC Hons in business information technology but retrained as a nurse.
post grad teaching qual. registered nurse tutor
I have a BSc (hons) but not a nursing degree.
Post Graduate Certificate in dementia studies
Currently on year 1 of my Masters degree
My pre-registration nursing degree was an MSc. I am currently undertaking a CBT PGDip course (related to mental health nursing).