Where client was when I met them: Client was admitted in hospital when I first met them as their nurse. Upon discharge from hospital, I followed up with home visits in the community to ensure client remained safe and compliant with their treatment plan. Client had been experiencing stress induced psychosis. Client had a busy life working in a family business and also experienced lots of psycho-social changes in their family life. This caused increasing stress until eventually client could not cope, became psychotic and was admitted to hospital.
Effect of their problem: Their stressful experience had a massive adverse impact on their: young family, other members of their wider family, their social life, professional life and finances.
Where they wanted to be: The client wanted to feel better, be their self again and be able to support family, especially the children. Client wanted to be in a career they enjoyed and feel able to connect with friends and family to expand their support network, and feel empowered to manage stressful situations.
How and why, they had an intervention with me: Client was allocated to me as their community nurse to encourage them to comply with their treatment plan. This included supporting them to adhere to prescribed medication, and engage them in psycho-education. This enabled them to be safe in the community and gradually built their confidence to be able to live their life well by improving their social, family and psychological wellbeing.
What I did as a professional: As their nurse, I actively listened to their needs by spending adequate time to build a rapport with them and getting to know them, which made it easy to pick up their body language and understand them better. I also encouraged the client to do some journalling to get to know themselves well. I then worked with the client closely to explore and identify healthy and evidence-based interventions that they could fully engage with to help their recovery journey. In this client’s case it was to build social networks to connect with others who were experiencing similar challenges and also working through tasks in bite size chunks so they don’t feel overwhelmed with their daily tasks. I encouraged the client to create a personalised activity plan as per their ability and interest to engage in the interventions of their choice. By so doing the client felt empowered and able to implement their chosen interventions. The client and I set a plan to evaluate some activities weekly and others monthly. It was vital that we worked well together as the success of the client’s recovery depended on it. We worked together for three years, which enabled me to see the progress of the client’s recovery, review interventions that were not working well and adopt and implement others that worked well.
Where is the client now? The client is currently doing well, they have added to their young family, they continue to maintain a healthy social and family connection and remember to ask for help when needed. They have learnt new skills to help them identify when they are experiencing life stressors that they are unable to manage and then start to implement their coping mechanisms to address the challenges in time.
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Burnout: A carer’s experience of balancing parenthood and professional life
Where client was when I met them: Client was struggling with being a parent to a child who was diagnosed with autism and emotionally unstable personality disorder. Client was in a high-end job which contributed to them experiencing a lot of pressure at work with the added pressure of caring for a child with mental illness.
Effect of their problem: Client openly informed they were stressed and burnt out due to their family and work pressures. This adversely impacted on their social, family and work life.
Where they wanted to be: The client wanted all the challenges to stop, child to have the right support and treatment to recover, and experience joy at home and at work.
How and why, they had an intervention with me: Client was referred to me by another healthcare professional, as I was the mental health practitioner with the skills to support the client. They felt they had had many consultations and interactions with professionals over the years but did not feel listened to. They were initially reluctant to engage as they thought I might judge them about not having time for their child and spending more time at work.
What I did as a professional: Client realised after 2 minutes of conversation with me that was not the case. We quickly established a rapport and I explored in depth their social, family and work life challenges. We agreed to go for walks during our sessions, talked about what makes them happy and what makes them sad. Conversations were structured in ways to help the client identify things about their life they miss that used to make them happy. Ample time and space were given to the client to vent their feelings, the client was emotionally expressive during some of the sessions and commended me for make her feel safe and valued when they were feeling vulnerable. We explored interventions such as mindfulness, coaching and physical activities which the client thought they might benefit from. Client was encouraged to actively engage in these interventions and keep a journal to help them offload their worries. They felt empowered to implement changes at work, which included delegating more to find time to spend with family. Client’s family did more activities together which also improved their child’s mental health.
Where is the client now? The client is in a good place now and feels bold to address challenges. The client’s family are happy, and they are able to manage the child’s mental health needs better. Their work life is good and they spend more quality time together as a family. Client did not have to use medication to feel better, having support to make simple changes to their life was what made a positive difference.
Burnout: manager at work dealing with work pressures and isolation
Where client was when I met them: Client was in a leadership position at work managing quite a few staff. Client was struggling with increasing pressures at work to ensure staff were performing well and achieving targets. Client lived alone, so work was their haven and they performed highly due to dedicating most of their time to work. However, at the time I met the client they were experiencing heart palpitations, felt physically sick and dreaded going to work.
Effect of their problem: It was evident that the client was experiencing extreme burnout and needed immediate support, they were experiencing sleep deprivation, overeating, anxiety, isolation and felt low in mood.
Where they wanted to be: Client expressed missing their old self, though lived alone, they previously had a balanced social and professional lifestyle. Client wanted to be sociable again, have a healthy lifestyle by eating well and becoming physically active. They also wanted their sleep to improve, worry less and find joy in working and their personal life again.
How and why, they had an intervention with me: Client was referred to me by their GP as they were on the verge of being diagnosed with clinical depression. Client’s GP believed I would be able to explore in detail the challenges that client was experiencing and suggest solution/interventions to enable recovery as I am a qualified mental health practitioner.
What I did as a professional: I invested time in building a rapport with the client, which encouraged them to open up to me. We spent ample time exploring their challenges in detail as well as reflecting on past positive experiences. The client was supported to draw up a change in lifestyle plan which included activities they were willing to undertake. Client then made a decision to take leave from work to attend a knitting retreat as they enjoyed knitting and wanted to go to a remote place where they could spend time with likeminded people. Client was encouraged to explore different meditation styles they find useful to practice daily. I taught the client some sleep hygiene techniques which improved their quality of sleep. We also worked on some techniques to alleviate anxiety such as looking at the worry tree which helps one to focus on addressing issues within their power.
Where is the client now? The client is in a much happier place, has found balance in their work and personal life. Client is socialising again, attends knitting retreats quarterly to ‘recharge their batteries’. They have also been going out for coffee with friends and have found ways to work smarter at work and only works within working hours with no overtime hours. Client has ample time to rest, sleeps well and appears more relaxed while enjoying the very simple things in life.
Burnout: relationship breakdown, grieving and working life
Where client was when I met them: Client was feeling extremely overwhelmed with their life challenges. They had experienced a relationship breakdown with their partner due to loss of their child. They were struggling with increasing work pressures and felt that their employer had no empathy for them.
Effect of their problem: Client felt detached and alone in the world, had a negative outlook on life, felt helpless, felt stressed and burnt out. Client felt undervalued by their employer and with their ongoing personal challenges, they at times felt that they could not go on.
Where they wanted to be: Client wanted to experience how life was prior to losing their child. They wanted to be with their ex-partner again, feel happy and enjoy going to work like they did before their workload increased. They wanted to experience the good relationship they had with their employer prior to the challenges in their personal life.
How and why, they had an intervention with me: Client was referred to me by their GP. They felt they had had many consultations and interactions with professionals over the years but did not feel listened to. They were initially reluctant to engage due to their negative experience with healthcare professionals in the past. They felt that I might judge them and suggest interventions they were not interested to engage with. During the first 10mins of meeting the client, I created a warm and welcome space which encouraged them to open up to me and we quickly established a rapport.
What I did as a professional: After establishing a good understanding and ensuring the client felt relaxed and able to open up. I actively listened to the information they were sharing, observing their body language when they shared sensitive information. The client was not interrupted with inappropriate questions for a duration of 30mins. I acknowledge all they were sharing and empathised with them, this encouraged them to vent their upset and frustration with what they were experiencing. In our follow-up sessions client was in a better frame of mind to discuss way forward so we worked on identifying activities that they might find helpful. We also explored what they like and don’t like about their job and ways they can improve the work situation. Client was encouraged to implement their identified solutions that could positively address the challenges they were experiencing. This included attending bereavement counselling sessions and relationship therapy sessions, after, they were able to resume communication with their ex-partner. Together with the client, we reviewed their progress and explored other social interventions they could adopt to enable their wellness. Client expressed profound gratitude that I listening to them without judgement as they had been struggling for months and felt unable to talk to professionals without feeling judged.
Where is the client now? The client has been able to grieve properly and they now have an amicable and supportive relationship with their ex-partner. They also feel supported by their employer after taking measures to have a candid discussion about their struggles. The employer supported with flexible ways of working which has really benefited the client. The client now engages in regular meditation/mindfulness which allows them to deal with life challenges better.
Burnout: losing parents or loved ones and struggling with work pressures (Revolving Door Syndrome)
Where client was when I met them: Client was on admission in Hospital when they were allocated to me. Client had been diagnosed with psychotic depression. They had lost both parents within a space of one month and had no other family relations they were close to. There were ongoing social issues as they were struggling with work and feared losing their job. They had recently been evicted from their home and they were sofa surfing in a friend’s house as most of their earning was being spent on recreational drugs used to self-medicate, so unable to afford the cost of living on their own. Client was being treated in hospital and was ready for discharge when I first met them.
Effect of their problem: Client had been experiencing extreme burnout in both their professional and personal life leading to their mental breakdown and being diagnosed with psychotic depression.
Where they wanted to be: Client wanted to get their life back on track, able to work effectively, socialise with confidence and find their purpose in life.
How and why, they had an intervention with me: Client was allocated to me as their community psychiatric nurse. I had to use my nursing skill to empower and encourage the client to be compliant with their treatment plan as agreed by the multidisciplinary team and the client themselves. I was able to quickly establish a rapport with the client when I first met them, which meant we could work together effectively on their recovery journey.
What I did as a professional: Because I had established a therapeutic relationship with the client, it was easy to learn a lot about them as an individual, their social environment, family background and professional life. We then agreed a working plan which identified the challenges they were experiencing and the interventions they felt able to engage with to enable their mental wellness. In additions to administering the client’s prescribed monthly injection which I educated them on its side effects and benefits, I also suggested and encouraged social activities such as joining a walking club and I met with them weekly at a coffee shop. This enabled the client to build confidence, improve their physical wellness, find a job which was less stressful and connect with family they hadn’t spoken to in years.
Where is the client now? Unfortunately, the client’s family history informed of parents struggles with their mental health and were diagnosed with depression. As a result, the client had a genetic predisposition to become mentally unwell. This is because Mental illness is a biopsychosocial disease with a strong genetic component. Although the client’s mental health improved during their recovery journey, they also experienced relapses which led to other hospital admissions. The client was supported again during these periods to recover but due to their genetic predisposition they experienced periods of wellness and periods on admission, which professionals sometimes refer to us revolving door syndrome.
Burnout: having a young family and experiencing burnout from work and family life stressors
Where client was when I met them: Client was admitted in hospital when I first met them as their nurse. Upon discharge from hospital, I followed up with home visits in the community to ensure client remained safe and compliant with their treatment plan. Client had been experiencing stress induced psychosis. Client had a busy life working in a family business and also experienced lots of psycho-social changes in their family life. This caused increasing stress until eventually client could not cope, became psychotic and was admitted to hospital.
Effect of their problem: Their stressful experience had a massive adverse impact on their: young family, other members of their wider family, their social life, professional life and finances.
Where they wanted to be: The client wanted to feel better, be their self again and be able to support family, especially the children. Client wanted to be in a career they enjoyed and feel able to connect with friends and family to expand their support network, and feel empowered to manage stressful situations.
How and why, they had an intervention with me: Client was allocated to me as their community nurse to encourage them to comply with their treatment plan. This included supporting them to adhere to prescribed medication, and engage them in psycho-education. This enabled them to be safe in the community and gradually built their confidence to be able to live their life well by improving their social, family and psychological wellbeing.
What I did as a professional: As their nurse, I actively listened to their needs by spending adequate time to build a rapport with them and getting to know them, which made it easy to pick up their body language and understand them better. I also encouraged the client to do some journalling to get to know themselves well. I then worked with the client closely to explore and identify healthy and evidence-based interventions that they could fully engage with to help their recovery journey. In this client’s case it was to build social networks to connect with others who were experiencing similar challenges and also working through tasks in bite size chunks so they don’t feel overwhelmed with their daily tasks. I encouraged the client to create a personalised activity plan as per their ability and interest to engage in the interventions of their choice. By so doing the client felt empowered and able to implement their chosen interventions. The client and I set a plan to evaluate some activities weekly and others monthly. It was vital that we worked well together as the success of the client’s recovery depended on it. We worked together for three years, which enabled me to see the progress of the client’s recovery, review interventions that were not working well and adopt and implement others that worked well.
Where is the client now? The client is currently doing well, they have added to their young family, they continue to maintain a healthy social and family connection and remember to ask for help when needed. They have learnt new skills to help them identify when they are experiencing life stressors that they are unable to manage and then start to implement their coping mechanisms to address the challenges in time.
