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Meet Professor John Hurley
John Hurley is a Professor of Mental Health at Southern Cross University and works clinically at headspace Coffs Harbour as a Credentialed Mental Health Nurse. He has accumulated over 40 years of experience as a mental health practitioner through developing and leading psychiatric crisis and home treatment services in both Australia and the United Kingdom. He is also the current Interim President of the Australian College of Mental Health Nurses.
Introduction
What inspired you to become a mental health nurse?
I had absolutely no idea of wanting to be a nurse until I met a male nurse when in hospital having a sports injury repaired. It struck me as a profession that had some meaning and purpose behind it. I started my general training and found it rather repetitive but had a rotation onto the psychiatric ward at the end of my first year and felt immediately I had found ‘home’. I could use my interpersonal skills to help others and the trained mental health nurses were…… ‘ my tribe’.
Can you describe your role on the board of the Australian College of Mental Health Nursing?
I am the Interim President and I am focusing on two main tasks: One is to advocate for all MHNs and the other is to make the College more appealing for people to join, especially younger MHNs.
What is your role in working with Headspace?
Headspace is my clinic day. I am a full-time academic Professor at Southern Cross University and my clinic day is where I have the privilege of getting to know and hopefully be directly helpful to young people with mental health challenges. University work is important but there is not that direct therapeutic engagement that makes mental health nursing so enjoyable.
How has Covid-19 impacted your work within the mental health field?
The clinical work has been challenging but telehealth has come into its own. Also, the headspace youth and I go for a walk and talk outside, rather than being in a therapy room, I prefer it to be honest. At the university, as with all work settings, Covid-19 has created a tsunami of mental health need that will need supporting for years to come.
Discussion and Advice
What qualities do you think makes a great mental health nurse and why?
What separates a comprehensive nurse from an MHN are two main factors. The first is the ability, if not the natural inclination, to work with the abstract. We don’t have scans, machines or blood tests for most mental health disorders we seek to treat so we work with narratives, unseen emotions and the highly individualised realities of others to seek to understand their experiences.
The second is a high tolerance of unpredictability. Throw in the emotional intelligence, empathy, and the grounded practicalities that most nurses have and you are in a good place to then add technical skills (such as psychotherapies).
Do you have any tips and tricks for performing a mental state examination?
Make it a narrative, a tale to be told and not a checklist. Maintain the utter interest that underpins all enquiry – why do people do the things they do, how did they get here now, what is the essence of this human in front of me?
The 5P formulation is much more helpful, so is worth learning. When you are done, minimise the number of times the consumer then has to repeat telling that same tale.
What are some key de-escalation strategies you have learned over the years?
Regulate your emotion first, then those of your partners, and then you both create and communicate a clear picture of what the desired outcome is you want. Then enter the situation. Ideally, and I know that is not always the case, you regulate the emotion of the consumer. Keep your words simple, keep your message simple.
How does a nurse’s emotional intelligence influence the delivery of care to patients?
I could talk all day on this topic. EI in short is enacting self-awareness, emotional empathy toward others, fusing technical knowledge with emotional knowledge to reach shared decisions with others, proactively building your own emotional wellbeing and being a positive influence and solver of problems for others. Now apply those to your nursing and tell me how it can’t improve consumer care!
Reflection
What are some of your most memorable moments?
Most of my career has been in psychiatric crisis teams, so I feel I have tested my skill set in the most challenging of circumstances, often to those with the highest need. That is a great feeling to have. Most memorable are those I have worked with. Anyone working in mental health has chosen to work in a field that most would not. They are by definition an oddity!
I have met the most intelligent, humorous, rebellious, courageous, philosophical and downright outrageous people in the shape of MHNs, regardless of their nationality….we are indeed a tribe.
Are there any mental health conditions/areas of research you have a particular interest in?
Youth, as there is a genuine opportunity to prevent, minimise and otherwise ameliorate mental distress. Better the fence at the top of the cliff than an ambulance at the bottom.
What advances in care within the field of mental health nursing have you witnessed over the years?
Whilst in its infancy the two biggest shifts are those around recovery and trauma-informed care. While mental health services sought to over corporatise these initiatives they are both in essence grounded in empathy and compassion toward others and are built on radical hope.
What is your vision for the field of mental health nursing in the future?
I know MHNs are capable of making an incredible contribution to all parts of Australian society. MHNs in primary schools working with at-risk families, working in high schools, workplaces as psychotherapists, counsellors, natural therapists, in hospitals, in the NDIS, and with aged care.
Other
What do you think is key to a successful career in nursing?
Mix clinical, academic and leadership/education knowledge rather than just focusing on one particular field of nursing. In the end you will see they are actually the one fused body of knowledge that supports really good nursing.
What is one thing you wish you would have known before you started your career in this field?
I wish I had known myself better. In my late 20s I eventually trained as a gestalt psychotherapist that is based around enhancing self-awareness. After four years’ training, hundreds of hours of therapy and spending thousands of dollars I had a much deeper understanding of my flaws. My friends later said they could have told me that for no cost whatsoever!