B.C. psychiatric nurses reap rewards

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Nepal isn’t a good place to be born if you happen to have a disability. Vancouver’s Kelly Christie learned that when she travelled to the South Asian country to volunteer at an orphanage for kids with physical challenges. There, she discovered that her background in psychiatric nursing is something she can apply wherever she goes.

“Those orphans are pariahs of society,” Christie says in a phone interview. “They’re shunned, abandoned because they have a disability. Even if they’re missing half a finger, they’re spit on when they go out in public.”

The Douglas College graduate spent a lot of time helping the kids build self-esteem. The experience made her realize just how versatile her training proved to be.

Home to half of the country’s psychiatric-nursing programs, B.C. is a leader when it comes to preparing health professionals to step into the dynamic field. Douglas started its programs more than 30 years ago. Kwantlen Polytechnic University and Surrey’s Stenberg College also offer education in psychiatric nursing. (The other colleges are in Alberta, Saskatchewan, and Manitoba.)

Christie, who works at St. Paul’s Hospital, spoke at a recent registered psychiatric nurses’ world congress on the importance of taking psychiatry with you when you travel.

She’s worked with Burmese refugees in Thailand, for instance—kids who were victims of land mines. Besides enduring physical trauma, they had been raised under a regime that demanded they keep their opinions and feelings to themselves.

“If you ask them what their favourite colour is, they can’t even say; they’ll find out yours first then agree with you,” Christie explains. “They couldn’t express themselves in any way, shape, or form. They were super-traumatized and there was a lot of PTSD [posttraumatic stress disorder], but they couldn’t even cry in front of anyone.”

Christie got the kids writing in journals as a means of self-expression. They wrote voraciously. By the end of her time with them, they were comfortable saying what their favourite colours were.

At St. Paul’s, Christie works in the eating disorders inpatient unit and the acute psychiatric assessment and treatment unit, among other areas. Whether the patients she’s caring for have schizophrenia, bipolar disorder, depression, or anorexia nervosa, she says she tries to help them identify what’s going on on the inside so they can better navigate the outside world.

“The draw for me is helping people express themselves,” says Christie, 27. “It doesn’t really matter what problem people are faced with; my job is to help them be able to achieve congruency in their lives, between the inside and the outside. There’s a lot of self-expression; mindful meditation; enjoying the moment; and letting go of past baggage, trauma, and the negatives in your life—which is one of the best things you can ever do for yourself.

“I wanted to have a career that was totally unique,” she adds. “It’s fun, it’s exciting, and it’s never the same. It never gets old.”

Douglas College offers a four-year Bachelor of Science in psychiatric nursing as well as a three-year diploma program. Dean of health sciences Pamela Cawley says that besides learning basic bedside care, students study anatomy, physiology, neurology, and sociology. They also delve deeply into communication techniques.

“We work from disease to mental wellness, and psychiatric nurses’ communication skills have to be very advanced in terms of observation and assessment,” Cawley says in a phone interview. “They work with individuals and groups in a therapeutic way, within institutional settings and in the community.

“It helps if they have the ability to develop self-reflection skills,” she adds. “It’s not about being perfect but about how you fit in with your strengths and areas of growth. The more they’re interested in learning about themselves, the better they’re going to be at it. Oftentimes people who’ve had difficulties in their own lives are the best at this, at dealing with individuals with significant problems.” One of the most effective ways students hone their communication skills is through time spent in the school’s simulation lab, where they can be videotaped and their interactions with others analyzed.

Job prospects for graduates are excellent, particularly as services for people with mental illness are increasingly moving from institutions and hospitals to community settings.

“There’s a burgeoning interest in the field, especially the community aspect,” Cawley says. “Graduates get jobs quite quickly in a variety of fascinating areas. If they’re willing to leave the Lower Mainland, they have even more opportunities.”

Christie likes the fact that there are so many different routes psychiatric nurses can go, whether it’s working with teens or seniors, in mood- or sleep-disorder clinics, or with people who have concurrent disorders: mental illness and substance use.

And her shifts are nothing like the stuff depicted in movies.

“We don’t use fire hoses on patients,” Christie says. “I have never been injured on the job; I’ve never been punched out. Whenever there’s an issue, it can usually be solved by verbal de-escalation. Lots of times when people are upset, it’s because they feel like they’re not being heard. A lot of outbursts come from feeling frustrated, and most of the time you can sit down with somebody and have a conversation. When you say ‘I’m listening; I want to help you,’ it settles people down. Being listened to and validated means a lot to people.”

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