I took my first introduction to psychology course in 9th grade; it was there that I first determined I would eventually seek out a career in this field. I come from generations of healthcare workers— doctors, nurses, pharmacists, psychologists. Helping those with compromised well-being was all I ever knew and all I ever wanted to do. Once I graduated from high school, I began my college career as a psychology major, before eventually realizing I wanted to be able to look at an individual’s complete health and therefore provide more holistic care. The switch to nursing has afforded me the opportunity to observe the effects of deteriorating mental health status on one’s physical health and vice versa.
I would now like to take my current scope of practice as a registered nurse a step further to become an advanced practice nurse, specifically a psychiatric mental health nurse practitioner. I place great personal value in the concept of lifelong learning; after all, a commitment to lifelong learning is vital in such a constantly evolving field. I want the ability to reach as many people as possible through education and treatment, ultimately helping to end the stigma against something that affects one out of every five people in this country. I have served as a passionate advocate for those suffering from mental illness in my community. My first real exposure to emotional and behavioral disorders came in the form of youth in the foster care system.
This vulnerable population has an incredibly unique set of needs that are often left unmet, or worse, completely unacknowledged. After completing a project in one of my nursing classes about the nurse’s role and ethical issues surrounding children placed in foster care, I volunteered to serve a two-year term as a member of one of Davidson County’s foster care review boards.
These boards are composed primarily of community volunteers that review about a dozen cases each month of children that are in state custody. Medical, dental, and academic records and assessments are examined before the board makes recommendations to the court to ensure each child’s emotional, physical, mental health and social needs are not being neglected. There was one day in particular that will forever stand out in my mind.
A teenage girl was discussing with the board the progress she had made in the months prior to this meeting. She would be turning eighteen soon, and this was the first meeting to ensure her a smooth transition into the real world. Her truancy and acts of self-mutilation had been replaced by positive coping skills, a part time job at a fast food restaurant, and passing grades in school.
This confident young lady was in stark contrast to the former juvenile delinquent with an extensive history of physical and mental abuse that her paperwork described. She temporarily walked out of the room with her caseworker to allow the board to privately discuss any questions or concerns. A retired teacher sitting to my left expressed concern and dismay that a 17-year-old had been prescribed Prozac, noting she was awfully young to have already been started on an antidepressant medication. She collectively asked the group if that should not be re-evaluated. Being the only one on this particular board with any sort of medical training, I felt compelled to speak up.
Usually more of a quiet, reserved introvert, my inner self was initially taken aback when I immediately and almost defensively responded with, “it’s a SSRI, selective serotonin reuptake inhibitor—it’s one of the safest and most widely approved antidepressants on the market.” I continued to explain myself, pointing out that none of us knew the full extent of this girl’s past trauma, that while it may be alarming to some, children and adolescents can suffer from depression just like adults. I explained that this class of antidepressants is considered the first-line treatment option and least likely to cause bothersome side effects.
I voiced my opinion that if Prozac had in any way contributed to this young lady’s higher quality of life, she should continue taking it as prescribed. A genuine interest in the mental health field has been my prime motivator for the past decade. It took me a little while to gain access to the incredibly private world of behavioral health, but there is no doubt in my mind that it is exactly where I want to be. I want to help children, adolescents, and young adults learn to deal and cope with their illnesses early on in the disease process. Treating patients at a younger age enables them to live more stable and fulfilling lives sooner without mental illness wreaking havoc on their relationships, academic opportunities, and physical well-being.
As a whole, our society needs to move in a direction where mental illnesses are treated early and often rather than keeping it locked away, stigmatized and ignored. Where primary prevention, early treatment and education go, less severe symptomology and better outcomes are more likely to follow. Additionally, when society brings mental illness out of the shadows and into the light, a sense of normalcy and acceptance can replace the feelings of shame and hopelessness that currently hang overhead like a dark cloud. Access to mental health care, or lack thereof, has been making headlines recently, as America faces a critical shortage of mental healthcare providers.
Psychiatric mental health nurse practitioners will prove to be invaluable members of the healthcare team, as recent policy changes and legislation attempt to make mental health treatment more readily available to consumers. By furthering my education, I will be able to fulfill my desire to counsel young people with psychiatric disorders to help enable them to pursue their dreams, while simultaneously allowing me to pursue my dream job.
I am excited to delve deeply into the academics of mental health. I want to continue pursuing further degrees, as the knowledge base of behavioral health grows by leaps and bounds continuously in this day in age. A Master’s degree serves as the first stepping-stone to the lifelong path of continuing my education. I have a desire to know the latest and greatest evidence based interventions, treatments, and theories currently available. Psychiatric nursing has proved to be a specialty with a unique set of challenges, challenges that require a unique set of skills. Not just anyone is cut out for a job in behavioral health.
Compassion, empathy, patience, good listening and keen observational skills, and the ability to maintain a calm, confident, and professional exterior in potentially hazardous situations are just a few qualities found in the best psychiatric nurses. We must have the ability to gain trust with patients that have every reason in the world not to trust a soul; we must develop a rapport with those during some of the lowest, most vulnerable times in their lives.
Most importantly, one’s heart must truly be in it if he or she expects to make a career out of psychiatric nursing. Although I’ve only been working with this population for two and a half years, it is what I’ve known I wanted to do for over ten years. I am passionate about helping, serving, treating, advocating, and caring for the mentally ill population. One of the best ways I know to do this is by obtaining my Master’s of Science in Nursing with a concentration in mental health nursing.
