Tracey McMahon is a Delphi nurse who has developed her interest in mental health by working in a prison environment.
Read Tracey’s story in DDN Magazine
As a child travelling on the train with my mum, we would go past a large mental health hospital. In the ’80s this was referred to as an asylum and this intrigued me. I would ask questions and tell my mum I wanted to work there one day.
As I grew up I forgot about this and wanted to teach English in Africa, but at 18, returning from travelling and waiting to start university, I started working in an elderly care home with nurses. Inspired by their commitment, I decided I wanted to be a nurse.
I started my training at Salford University in 2005, qualifying in 2008. I then started working as a mental health nurse at a medium secure unit, where I worked for the next ten years with various client groups at various stages of their mental health recovery. It was during this time that I developed an interest in substance misuse. I started a new programme co-facilitating psycho-education groups.
With my ongoing interest in substance misuse, I applied for a job as an alcohol nurse in a prison, which became recovery nurse when the healthcare provider changed. I was helping patients within the prison who had varying substance misuse needs, mainly focusing on those who were new into prison and had self-identified as being dependant on alcohol or opiates.
I saw a job advert at the mental health hospital I’d been obsessed with as a child and applied. I was working with patients who had been detained for over 20 years, and they continued to struggle with their mental health. During my time there I saw many changes including the patient group changing dramatically – they became younger, substance misuse became more prevalent, and within the service it was identified that there was a lack of substance misuse knowledge and support. I, along with a few colleagues, became involved in offering interventions for those with substance misuse needs.
I attended various training courses and spent time with specialist substance misuse services. I also did a level 6/7 course in psychosocial interventions to complement the substance misuse knowledge I had gained.
Throughout my nurse training I had always felt better suited to secure settings and working with this client group, seeing their mental health improve, was rewarding. Many of them would spend time in the hospital setting, away from their families and community for many years, and being able to work with the same person for this long really does allow you to build up a rapport and help them holistically.
Seeing the dramatic change in a patient once they had stabilised on their opioid substitute treatment or completed their medically assisted alcohol detox was extremely rewarding. Not only was there a change to their physical appearance, but their whole outlook on life and positivity towards the future.
I completed the non-medical prescribers’ course in 2019 and started prescribing. I have enjoyed this new aspect to my role and the challenges it brings. I attend an inpatient detox twice a month to prescribe and gained a lot from working in a new environment with completely different challenges to secure environments, focusing on my clinical skills – an area of my nursing I hope to keep developing.
As team leader of the service, I find that each day – each hour! – is different. I can be prescribing one minute, offering clinical advice next, having a consultation with a patient or offering an intervention. I might then have a staffing or service issue that I need to look into, involving risk assessments, action plans and service improvements. Looking at the service and patient care and improving standards are a massive part of the role I play within the team.
The favourite parts of my job are my nursing/NMP role – spending time with clients, building a rapport, and getting to a place where you can have a laugh, be open and honest about their treatment, what they want and what is realistic. Talking is so important yet often underrated by services – I’m lucky enough to work for a company that realises how important the small things are and the huge impact they can have on a person’s recovery.
Working in the prison environment can be quite oppressive with its restrictions, but having a good team really makes your working day easier. Making a difference to patients is so rewarding, as are the challenges and problem-solving aspects of the job – from linking patients up with community support to transferring care from a secure setting to the community.
Nursing will throw many challenges at you and at times you will question if nursing is for you. But the positives outweigh any negatives and it’s such a rewarding job.