View from the ground, by Tamsyn Crane
When I started training as a children’s nurse, I knew very little about mental illness. After 2 years of postgraduate level training, I didn’t know much more. If we did have any teaching on mental health, it was sparse and, clearly, ineffectual. And I have no recollection of any support for students being offered, although perhaps that was just because I hadn’t needed it. I was blissfully uninformed.
After I started working as a nurse in neonatal intensive care, I began to learn a bit about parental mental health and postnatal depression; and although I found it mildly interesting, it was only in my periphery.
After a few months, I went to my GP as I was experiencing episodes of chest pain and shortness of breath. I had the usual investigations and there was no obvious organic cause. It was put down to stress, which I honestly thought was a cop-out. I had no idea that psychosomatic symptoms not only existed, but could also be so painful, so acute.
I have now been working in neonates for nearly 10 years. During that time, I have had bouts of insomnia, irritable bowel syndrome (IBS), panic attacks, and have been on and off a low dose of selective serotonin reuptake inhibitors (SSRIs). But it’s only in the last year that I have truly understood that throughout all this time, I have been suffering from anxiety and depression. That most of my physical symptoms could be put down to a struggle to cope with the stress and emotional distress of my job.
Last Christmas Eve, my father died after a traumatic and debilitating battle with glioblastoma. My grief manifested itself in acute anxiety and depression, and I was signed off from work for nearly 6 months. It was during this time that I really began to comprehend mental illness; how it affects you and, in my own limited experience and understanding, how to make things a little better.
Getting back to health, to myself (or some semblance of) and getting back to work especially, was hard. In order to manage ‘normal’ life again, I put myself first for a bit. That was a massive change for me, and something I still can’t get right a lot of the time. Sometimes, as a healthcare professional, you get so wrapped up in what others need that you forget about yourself. And that’s before you give to all the others in your life: children, family, partners, friends. Self-care is vital, whether you are mentally fit and healthy or not. Find out what you love to do, what makes you happy, and make it a priority. Put your oxygen mask on first.
I am very lucky to work in a team where I feel comfortable enough to share my experience. And they have been more than supportive. I could never have got back to my job without asking for the help of my husband, my friends, my family, and my phenomenal colleagues. I know that if I have a bad day, if my anxiety is rising, if I’m feeling overwhelmed, I have people who will be there, who know my triggers and can help. Not only that, but my workplace has developed a fantastic ethos of promoting wellbeing and understanding the impact of burnout and compassion fatigue.
I don’t know if this is a direct result of my crisis, or if the healthcare profession is overall embracing a culture of promoting staff mental health and sending a message of ‘it’s OK to not be OK’, but I see traces of a change in philosophy in a multitude of places. Is the stigma of mental illness slowly dissipating? Perhaps. Or maybe I am just more susceptible to noticing these messages.
It has become a passion of mine to support others to cope with the impact of what we do for a living; to share my experience and the message that it is OK to be unwell, to take medication, to have therapy. Just because we are healthcare professionals does not mean that we cannot have mental health problems. In fact, it is more likely. It doesn’t change who you are as a person, and it doesn’t make you incapable of doing your job. It is not a weakness to have an illness. And just like having the flu, or a broken bone, it can be OK with time and with the right treatment.
Neonatal intensive care unit clinical education lead, University Hospitals Southampton