Story Series: Ian Ssenyonga, Mental health nurse - Eating Disorders
I’ve been at SLaM for three years as a nurse on the Eating Disorders Inpatient Unit at Bethlem Hospital. I work with patients who have eating disorders such as anorexia, bulimia and diabulimia (which is a combination of diabetes and bulimia). Many patients with eating disorders also have autistic traits, for example difficulties with social communication and emotions.
The patients are amazing people. It’s great to just talk to them and get to know them ‘apart from the illness or its presentation’. Every patient has a back story that is quite difficult for them – and having the opportunity to tell it may help them and those caring for them better understand how the illness got started and why it is having such a big impact on their lives.
Part of my role is about being able to empathise with the patients and trying to understand their situation. Sometimes just sitting down and engaging with them as individuals is really important and may be all that they need in that moment. At SLaM events former patients sometimes talk about their experiences and it’s so fulfilling when someone remembers that you or the team were there and helped them in their time of need.
My day starts with a handover from the staff on the night shift. This includes checking that the patients are awake and looking at their medication and physical observation charts and planning out the day with each patient's personal goals in mind.
The daily routine is generally built around meal management and support. We want to restore patients’ physical health by reintroducing meals into their daily activities while also caring for their mental health needs.
We try to support and encourage the patients by eating meals with them. We chat with them about anything from politics to the weather, what makes us laugh and smile, and plans we have for that day or weekend. Mealtimes can bring up strong and painful emotions. For example, some patients have talked about hearing voices strongly urging them not to eat and being extremely negative to them. Others talk about urges to purge or self-harm because of the emotions brought up around mealtimes.
We offer to talk with them about their feelings and give them the opportunity to vent their feelings and frustrations while offering a safe space to look at alternative options to manage these emotion without causing harm to themselves. We might also play a board game or watch TV with them as a distraction or reassurance that you are there for them if needed.
The patients are prescribed different medications including multivitamins. They attend sessions with a psychologist and occupational therapist. They are encouraged to engage in activities to help them rediscover what they used to love doing. Most, if not all, the patients I have had the opportunity of working with are extremely intelligent and talented.
Working as part of a multi-disciplinary team with other professionals and knowing what therapies and activities the patients are receiving and engaging in, I can be more confident about supporting the patient with their different needs. At SLaM there have been many training opportunities and the other professionals I work with share a wealth of knowledge and professional experience. We have the opportunity to view the illness through so many different perspectives - for example, the carers’ workshops are an amazing way to learn and share with family and friends involved in the patient’s care.
I love what I do and in future I’d like to work towards a management role, to be an advocate for my colleagues as well as the patients. What’s important to me is to be able to be available mentally, emotionally and financially for my family and work.
I would tell someone considering a nursing career that you cannot forget the basics - that you are there for the patient and they need to come first. Caring is key. If you have that drive then you are on the right track. You need that inner motivation and passion to keep you going as a nurse. There will be difficult times, for example if a patient is very upset, low in mood or aggressive. You can look around at the team and think “This is why I am here… the patient is probably as scared and freaked out as I am, if not even more. I’m not going through this on my own”.
