MEET STEPHEN CARROLL

Our 100th Credentialed Mental Health Nurse, and Member of the Australian College of Mental Health Nurses

MHN, RN, PGD Psychotherapy, PGD Counselling, MA (Psychoanalysis)

Being the 100th Credentialed Mental Health Nurse in Australia made me reflect upon my career as a professional nurse.

I began my General Nurse training in 1976 at The London Hospital in the UK. My three-month placement in psychiatry set the seal on my further training at Guy’s Hospital, London for the postgraduate qualification of Registered Mental Nurse. It was an experimental 13-month course that changed the focus of my professional working life. There was only one intake a year of eight students – and my intake had only six. The premise of the training was to demonstrate the potential of mental health nursing and encourage professional autonomy and independence. Guy’s Hospital was unique. All staff held joint responsibility for patient interventions and all the health professions held each other in equal regard. No one discipline held the key to knowledge. The training covered mental health nursing with a particular leaning towards therapeutic communities and the nurse as primary carer. I still call upon aspects of that training today.

I rather naively thought all health systems worked in this way. In 1982 I came to Australia and needed to adjust my nursing practice. Through The Prison Medical Service, The Cummins Unit, Rozelle Hospital and other psychiatric centres I saw a very different picture to what I had been trained in and come to believe in. I lived through the time of the Richmond Report implementation and after all these years am still saddened at the disasters that continue in its wake. I made the decision that I could no longer continue in a health system which at that time did not place its patients first.

I undertook postgraduate training in counselling and psychotherapy and for many years have worked as an independent private practitioner. I feel that I have a successful practice that is underpinned by my mental health nurse training. Once GP’s, psychiatrists and other mental health workers know you are a mental health nurse as well as a “therapist” in private practice they begin to value your opinion. As Registered Nurses with proven professional expertise in mental health we easily cross the divide between the physical and the mental. We can treat, for example, issues of loss or relationship problems and also assist with medication for the schizophrenic client. We can monitor antidepressant medication and implement psychotherapy at the same time as following the client’s new treatment for epilepsy or diabetes and be aware of the effects it will have upon the therapeutic outcomes. Demonstrations of severe mental illness do not disturb us as it may with other professions. My Mental Health Nursing skill and postgraduate training has taken me from private practice to Sex Therapist to “Problem Pages” in magazines and newspapers and the professional speakers circuit presenting on male sexual dysfunction, key-note speaking at conferences and radio shows and TV appearances – our professional practice is only constrained by our professional imaginations. The ability of Mental Health Nurses to “contain” and utilise these multi-therapeutic aspects is what makes us unique in our practice. No other health profession has the knowledge base to reconcile these aspects of client care.

The Credentialing system of the College allows us to work in aspects unthought of by previous generations of mental health nurses. By being Credentialed I am able to demonstrate the advanced and specialist nature of my work. The process of Credentialing and the awarding of the Credential show me the regard in which my peers hold me. My clients are able to gain access to Medicare benefits and private health insurance rebates and this assists them in meeting their health needs. The process also encourages me to further my skills and to maintain my Credential in years to come.

I appreciate that Credentialing is not for all Mental Health Nurses. It is process that demands a commitment to specialist education and work practices over and above general practice. Credentialing takes time and it takes effort. It does not rely only on the gaining of qualifications but also on how this translates into professional practice and professional involvement. Credentialing is based upon the praxis of Mental Health Nursing.

I needed to move out of nursing to work as an autonomous practitioner in a manner that allowed me to provide optimal patient/client care that was not available within the health system of the time. Now Credentialing allows nurses to remain in their chosen profession and work in such a way as they choose. Credentialing also allows us to move more easily into private practice, a move that I am sure will happen more and more and which I fully support. Credentialing is a process and opportunity to move Mental Health Nursing into the 21st Century. The Australian College of Mental Health Nurses has a key role for all of us in this profession and it behoves us to support its work in whatever manner we may.

I look forward to meeting the 500th Credentialed Mental Health nurse and also the 1000th and to reading their stories in the future.

All documents for the ACMHN Credential for Practice Program are copyrighted to the Australian College of Mental Health Nurses. All rights reserved. No part may be reproduced or copied in any form without permission except as provided under the Copyright Act, 1968 (Clth). or for credentialing applications only.