A day in the life of a ... mental health-credentialed primary health care nurse

1 May 2014

6.15am: I leap out of bed and go for a walk ... NOT!  Reality is that I snooze for another 15 minutes then drag myself from my happy place to make a cuppa...  Read on and find out how the rest of the day pans out for primary health care nurse Robynann Dyson.

NAME | Robynann Dyson JOB TITLE | Primary Health Care Nurse (MH credentialed*, PG Cert)  LOCATION | Bush Road Medical Centre, Whangarei

6:15AM THE ALARM SOUNDS.

I leap out of bed and go for a walk … NOT! Reality is that I snooze for another 15 minutes then drag myself from my happy place to make a cuppa. I knock on teenage daughter Bridget’s door to wake her and then life is all go …

8:00AM SCHOOL DROP OFF

I drop Bridget to school on the way to work, and try and engage in a positive conversation … but she is a teen and not a morning person. She says she loves me as I drop her off and I then start praying I’ll get to work on time – an annual goal of mine, but it’s actually working this year maybe due to the recent mental health training* which has helped me live more in the present.

8:27AM ARRIVE AT WORK

Arrive at work with three minutes to spare, a miracle. Oldest daughter Anna (a farmer) has texted to say have a nice day, and hubby Ted has rung to say he will make dinner tonight. On arrival, the clinical nurse manager asks me to have the 2nd year nursing student work with me. The student and I sit down to discuss and plan how to meet her goals for the week.

I am booked to see patients for 20-minute appointments throughout the day with a two-hour gap to cover lunch breaks. My first patient is a no-show, so tell the student my career started with enrolled nurse training at age 18 followed by my RN training three years later. I initially worked in hospital surgical and medical nursing, then eight years as a family planning nurse and for the last 10 years I’ve worked as a primary health nurse with my current general practice. I told her working as a practice nurse – with a special interest in women’s health and mental health – were the last areas I wanted to work in as a young nurse. Yet now I have an absolute passion for all these areas and firmly believe that this is where I am meant to be.

9:00AM FIRST PATIENT

I see my first patient for the day. It is a young girl referred by one of the GPs for support with her self-esteem issues. I introduce myself and ask permission for the student to be present. I use open questions to ascertain what is concerning her. I listen to her concerns and together we come up with a plan to help her cope with her feelings of insecurity with her peers over the next two weeks. When she leaves, she is smiling and says she feels stronger, which makes me again realise why I love this job. I then see a toddler for immunisations, followed by a man for a punch biopsy.

10:15AM QUICK COFFEE BREAK

10:30AM ANXIOUS PATIENT

I see another lady, referred to me three months ago because of her long history of anxiety and depression. Initially, her assessment results for anxiety and depression were high but, after walking alongside her in her journey and meeting regularly, her score today is within the low range. This lady is an inspiration to me as she was the first person I began seeing for mental health issues after I became MH credentialed. The MH training has meant I’ve been able to effectively assist her in her journey, which is great. Initially, we needed to meet weekly for 40 minutes and now it is 20 minutes every two-to-three weeks.

My next patient is a young man needing wound management, and during screening I find he’s a smoker who’d like help to stop. I give him some information and will talk again at his follow-up appointment. I see another man for his quarterly 40-minute Care Plus appointment to manage his chronic disease, which takes me to midday.

NOON PHONE CALL TIME

I am at last able to clear my messages and return the seven calls to people wanting test results and advice about a sick child. I also ring the lady who missed this morning’s appointment. She’s been having some family difficulties and is grateful I’ve rung. I support her over the phone and we arrange to meet on Friday.

1:30PM LUNCH

2:00PM BACK TO WORK

My last three patients of the day are a lady for an IV infusion, which takes 30 minutes, a little girl for immunisations and another man for his IV infusion. I check my taskmaster and inbox for things I need to follow up on, I manage to clear three tasks and check that there is nothing else urgent. The student and I go over the day and discuss tomorrow. She says that she’s enjoyed her day and feels she’s seen a different side to practice nursing that she likes. 

I clear my phone messages once again and return calls to patients. It sounds like the afternoon is not as busy … but time just goes and before I know it is 5:30 and time to leave.

6:15PM HOME – TEA WAITING

I get home and Ted has made yummy bolognaise for tea. Bridget is doing homework (Facebook) and Anna is home for tea. Ted and I go and feed the ducks and chickens and have a catch up on our day. I am thankful for my little piece of paradise that I live in and am grateful for the job I am able to do as a nurse. I play a couple of games on the computer and watch some mindless programme on TV. I find I need to do this to unwind, as I feel mentally drained when I get home; and it is nice not having to think for a little while. 

10:30PM BED

I read a bit then drift off …

*Robynann Dyson is one of eight nurses working in Manaia PHO general practices to recently complete a mental health credentialing programme run by the College of Mental Health Nurses.