Trudy George is a 51-year-old registered nurse at Odyssey’s residential co- existing disorders service in Counties Manukau. She came to nursing later in life after working in accounts and as a gym instructor – and after having raised five children.
Her work involves assessments, monitoring the physical and mental health of service users, administering medication, training staff and working with visiting psychiatrists and doctors.
She started at Odyssey in 2014. It’s a job she loves and in which she can use her past experience with physical health, nutrition and motivation. A “natural people person” she wanted a nursing job where she could deal with people and their health in a holistic way.
“I didn’t want to be in a public hospital where you’ve got two minutes with this person and then two minutes with that person. I wanted to use my skills in developing relationships with service users,” she says.
But Odyssey had never had a new graduate nurse before so Trudy completed the Postgraduate Certificate in Health Science (Mental Health Nursing) at the University of Auckland under the New Entry to Specialist Practice (NESP) programme and with the support of Odyssey management.
She says it was a pretty tough time.
“Luckily my children are older and I have a very supportive husband. It was my first year in the job. I was working dreadfully long hours, and my weekends were spent doing assignments. Maintaining a good work-life balance was virtually impossible. I got used to it, but I really had to work on my time management skills.
How Odyssey helped
Odyssey kept her on full salary while she did the training which meant things weren’t too difficult financially, and the fortnightly travel to attend the course was not a significant challenge because the University was nearby.
She also received a lot of support from Odyssey Quality Service Manager Sydney Cuthbertson who was her preceptor at the time. Sydney helped with some of the course work, gave plenty of advice and organised replacement staff on occasions so Trudy could get time off for a break.
“It was a bit of a whirlwind,” says Trudy, “but Sydney was great. I often felt quite alone because there were no other nurses, but Sydney was always there for me.”
What is different for the NGO setting?
Because Trudy was from an NGO, where resources can be limited, she faced a number of extra challenges not faced by nurses employed by district health boards (DHBs).
“The hospital nurses got extra days off for study on top of those needed for the course. My only study days were on the weekend. They also had a lot more access to resources and research libraries, whereas I had to get by with the University library and the internet.
“But the biggest thing was that I didn’t have the wide range of professional colleagues to call on for advice that they did.”
What about Odyssey's experience?
Of course putting a nurse through training poses a number challenges for NGO employers as well. Registered nurse Patrick Johnston is Trudy’s line manager and is in charge of Odyssey’s three co-existing disorders programmes. He says having nurses studying can place added pressure on managers’ time.
“Our challenges are mainly around having fewer nurses and staff than DHBs have. There are a lot of demands around supervision and mentoring for studying nurses, and having nurses take days off to attend lectures can be a real issue,” he says. “It takes commitment from everybody.”
Trudy says that despite the challenges, the training was extremely beneficial and that much of the course material related directly to her work.
“Probably the biggest things were the different types of nursing assessments and care plans. We also covered the different types of disorders according to the latest DSM (Diagnostic and Statistical Manual of Mental Disorders). We went over a lot of the material covered at Unitec but in much more depth and detail.
“I really enjoyed how we had to present case studies too. It was great to learn about the experiences of other nurses and to see how people work in other fields. I picked up a lot of knowledge from these.”
Patrick agrees that the course was beneficial.
“Nurses coming into a specialist service such as mental health encounter a different paradigm from what they learn in undergraduate programmes. For example, we use a therapeutic rather than a strictly nursing model. NGO nurses work quite independently, too, so I think they need a higher level of training.
“Also, I think the training gives people confidence in their skills and in their ability to advocate for service users and their families/whānau. I think it gives them a better way of doing assessments and formulating recovery plans. This is often a real challenge for new graduate nurses.”
Trudy does feel much better able to support service users now and to focus in with them on their recovery journey. She says an example is helping them understand their medication and its importance.
“A lot of service users start to become well and want to stop taking their medication, but my job is to help them realise they are well because of it and to stop would mean becoming unwell again. It’s not really any different to someone who has diabetes medication, so taking medication does not amount to failure.
“Learning new assessment skills has also benefitted service users and I picked up a lot from the study about how to develop good therapeutic relationships.”
Trudy found that applying her new learning in the workplace could also be a challenge.
“As long as I gave a good rationale, existing staff would usually be willing to try new approaches. Sometimes, however, there was some resistance and it could leave me feeling quite isolated as I had no fellow-nurses around to back me up,” she says.
“Resistance is something that happens when staff are trying to implement new learnings in the workplace,” says Patrick, “so it’s really important to be completely transparent and have these conversations openly and honestly on a professional level when there’s potential disagreement.
“For me it also means being there when Trudy needs to talk something through, supporting her when the change idea is good or helping her understand why we do things the way we do.
“I think NGO managers considering this sort of training for their nurses really need to be mindful of the time investment required to make it work, but they should also know it’s worth it. Trudy is absolutely putting what she’s learned into practice and she’s a real asset to the team and to our service users.
“So I would encourage other managers to be open when nurses come back with new ideas because we are all always learning.”
NESP as a stepping stone
Having done the NESP programme has made Trudy realise she could go on and do more study.
“I thought anything above a degree would be beyond me, but now I know it’s not. It’s given me that courage. I love learning and I think the more up-to-date your knowledge is, the more benefit you can be to others.”
She’s very happy in the work she currently does but thinks one day a Master’s degree could lead to possibilities such as becoming a nurse practitioner.
“NESP opened the door to mental health for me, but it’s also made me aware that there are a lot more opportunities and career pathways than just doing your basic nursing.”
Patrick Johnston and Trudy George, Odyssey