Quick interview with Senior Lecturer and Associate Professor of Mental Health Nursing

Before we get into Louise’s journey about mental health nursing, if you’re a nursing student or nurse in Australia, you’re currently reading this on your very own free, nurse-only community that we built for you. It’s where you can join forums, connect, and share all things to do with nursing. Quickly join here in 30 seconds and then continue to read this article and all our other articles, webinars and resources.

Please tell us a little bit about yourself

My name is Louise Alexander and I’m a mental health nurse academic living in Melbourne. My clinical background is forensic mental health and my research area of interest is mental health nursing workforce sustainability. I’m married with two children, and I love travelling. I also like to go walking (very!) early in the morning…early like 4.30am with my dog Ivy, who is scared of the dark and on antidepressants for anxiety! 

What drew you to forensic mental health nursing?

I realised pretty quickly that there were elements of nursing that I just didn’t enjoy, but that I loved my mental health placement. General nursing felt far too task-oriented to me. At one point, I had thought about doing criminal justice, or criminology so forensic mental health allowed me to combine the two areas. 

What did a day in the life of a forensic mental health nurse in Victoria look like back when you were starting out?

We’d begin with handover in the nurses station, followed by staff allocation. They’d try to allocate patients who you were primary nurse or case coordinator for, so there was continuity of care. I’d usually have to do medication rounds, which could take quite a long time if patients weren’t wanting to take their medication. I’d spend time with my allocated patients, chatting, doing activities, and we’d also have to run groups.

There is lots of supervision in forensic mental health, so we’d also have to do routine room searches, supervise meals and outdoor times, and if anyone was in seclusion, we’d have to coordinate routine visual observations and 4hrly medical rounds. Sometimes we’d take patients out for appointments, or coordinate court appearances. Lots of note writing, especially risk assessment and mental state examinations, and then handover to the next shift. 

What’s one thing you wish more people knew about mental health nursing?

That mental illness isn’t just a mental health nurse role; all nurses need to be able to navigate supporting people experiencing mental health challenges. If you want to be a nurse, then you also need to be skilled in supporting people experiencing mental ill health. Mental illness affects far too many people for it to be the responsibility of one specialty.

What sacrifices have you made and what kept you going through the toughest moments?

Balancing a PhD, full-time work and young children is a massive challenge. What sacrifices have you made and what kept you going through the toughest moments?

I sometimes reflect back on this period of my life and think ‘what was I thinking’!? It was challenging but I was very strategic in how I managed my academic career. During my PhD, I never applied for additional roles in my job, I made sure my focus was finishing my PhD, then sought to expand my skills. I’m very organised and live by my calendar! Even now, I use my calendar to block out dedicated writing time. This ensures that I keep this time protected, and that I can meet deadlines. From the home perspective, I have a very supportive husband, and we share the load of raising a family. 

What are some tips for other nurses interested in becoming a lecturer or nurse educator? 

My number one tip is, if you’re thinking about working in education at the university level, then make sure you do a masters by thesis. I have many honours students who did a coursework masters because they didn’t think they’d enter education, and now have to return to study to be eligible to enrol in a PhD. 

What did you learn in the process of writing a textbook (while doing a PhD?

What did you learn in the process of writing a textbook (while doing a PhD? What happens behind the scenes that other nurses may not realise?

Mental Health Nursing 1st edition Hercelinskyj | Cengage Australia

Yes this was another one of those moments where perhaps my judgement wasn’t the best! It was very hard, but for the most part, the textbook was more enjoyable to write than the PhD because the concepts were very familiar to me, so it just was a matter of getting the words down on paper.

I learnt that coordinating a book with so many other authors is both wonderful, but also like herding cats! I guess you could say it was like organising the largest group assignment of my life! Behind the scenes while there is lots of support from the editors and publisher, you are largely responsible for essentially all of the content. 

Ensuring mental health nursing remains an undergraduate curriculum priority?

Yes this is something that I’m really invested in. Presently, there are no requirements for a discrete mental health unit in the undergraduate Bachelor of Nursing curriculum in Australia – it is up to the university to decide how they manage this. The lifetime prevalence of mental illness in Australia is around 45% and this means that almost half of the population will have a mental illness sometime during their life.

Nurses need to be able to safely and competently work with someone in mental health distress and to do so, these skills need to be grounded in theory and safe practice through dedicated mental health units, and quality mental health placement. Finding appropriate placements in mental health remains a challenge for many universities. Research tells us that students who have a quality placement are more likely to consider working in mental health. This is vital to sustain the mental health nursing workforce over the next few decades. 

What do you believe the next generation of mental health nurses needs most from their education?

A course that balances lived experience perspectives with foundational/core knowledge about mental illness and treatment. I think we also need to be more actively educating about iatrogenic conditions resulting from psychotropic medications. As nurses we can play a significant role in closing the premature mortality gap for people living with mental illness. Nurses are the largest workforce in healthcare and as such are perfectly positioned to have the greatest positive impact.   

If you could make one major change to how mental health is taught to medical and nursing students, what would it be and why?

Oh this is a good one!! I would advocate for greater lived experience perspectives and the consistent use of simulation in mental health nursing education. Lived experience perspectives are vital for mental health reform. Simulation is pivotal in allowing students to practice skills in a safe environment, where they can learn from their mistakes without harming consumers. 

Looking back, what has been your proudest moment in your career and what has been the hardest lesson?

Proudest moment would probably be finishing my PhD. Many people embark on a PhD, but few complete one. The hardest lesson is probably handling manuscript rejection… Writing manuscripts for publication is very rewarding but can also be very difficult. You put a lot of effort into a research publication and if it’s rejected, it can be hard to pick yourself up and try again. Being resilient is very important in this space. 

What’s next for you, and what kind of legacy do you hope to leave in the field of mental health nursing

I’m really looking forward to pivoting to research as my substantive role in a few months. I love working with nurses in the clinical space, especially in understanding how they believe mental health practice can be improved. They know better than most what parts of the system need improving and as a nurse researcher, I love helping them turn their ideas into outputs. 

I’ve been privileged to write two postgraduate degrees during my career. The most recent, a Master of Mental Health Nursing for Deakin University. I’m really proud of my contribution to postgraduate mental health nursing education, and excited that I’ve played a small part in educating the future mental health nurses of Australia. That’s a pretty cool legacy to leave!