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John Palencia is a Registered Nurse who has written about his new grad perspective during his recent graduate year in Mental Health and why you should consider it!
A little about you?
Hello everyone, my name is John Palencia. I work as a registered nurse, and I have recently completed my new graduate program in mental health. Beyond my professional identity, I am currently twenty-three years of age; have a passion for personal development, and am the youngest child of Filipino migrants who taught me the value of diligence and education. I am also running my first full marathon in Sydney later this year and am a lover of herbal tea!
What inspired you to become a nurse, and what made you choose mental health nursing?
Like many young people approaching the end of their secondary studies, I struggled with choosing a career path. I knew I was passionate about health and wanted to work with people directly, so I was torn between ideas of working as a physiotherapist, dietitian, psychologist as well as a health education teacher.
Both my parents work as carers in aged care, and I also have two elder sisters who work as registered nurses. This initially pulled me away from the thought of pursuing nursing until I did my research on the profession and became attracted by the versatility of the role, the lifesaving skills that it could empower me with, and the opportunities, especially for travel, that it provided.
Fast forward to my enrolment at Southern Cross University, I learnt that working in a general hospital ward was not a position that I wanted to pursue long term and that I was more drawn towards less well-known nursing roles.
To answer the second part of the question, I chose mental health nursing specifically largely due to a recommendation by my General Practitioner, who made a profound impact on me and first taught me the value of healing through dialogue and therapeutic communication.
My previous employment as an assistant nurse (or equivalent) working with people with mental illnesses also grew my interest in working in mental health, but ultimately, it was my mental health placements at Recovery Camp and within various teams within the hospital during my final six-week placement which guided me to undertake a new graduate position in mental health.
What has your mental health graduate year consisted of?
During my mental health new graduate program within a regional hospital, I had rotations between the acute mental health unit and the community mental health team where I worked as a case manager. I also volunteered for multiple deployments in the mental health rehabilitation unit, crisis team and emergency department. As a new graduate nurse, I received over ten facilitated study days throughout the year to help with my transition from student to specialist practitioner. I was well supported by preceptors, educators, and the multidisciplinary team throughout this process.
Mental illness can befall anyone, and indeed, the patients I had the privilege of caring for patients whose ages ranged from adolescents to older persons. They were also from a variety of diverse backgrounds and socio-economic classes. Most of our patient presentations included psychosis with distressing beliefs of paranoid, grandiose or persecutory nature but we also cared for patients withdrawing from non-prescribed substances or excess alcohol use; people who attempted or currently had plans of dying by suicide; and those living with severe anxiety and depression.
What have been some of the most rewarding and challenging moments as a graduate nurse in mental health?
I find working in mental health incredibly rewarding and love being able to build relatively long-term relationships with individuals who I find to be incredibly resilient and are oftentimes some of the most creatively gifted people I have met.
Upon reflection, there have been many rewarding moments during my time as a graduate nurse. These include Sunday barbecues and laughter shared with patients, and quiet and special moments when they trusted me enough to disclose experiences that have changed the trajectory of their lives. The colleagues I got to work with were also some of the most supportive and hilarious people I have met. There is never a dull day working with mental health practitioners.
Conversely, there were also difficult moments that I experienced through the role which relate to cognitive dissonance and have deepened my appreciation for the scope of improvement within our mental health system. As I consider myself to have a largely positive outlook on the world, it has been challenging to hear about the worst aspects of humanity through the stories of those I work with and the systematic and sometimes, intergenerational challenges that many of our patients live with. Thankfully, I have the support of my colleagues and can use the knowledge that I have gained as a mental health clinician in my personal life to manage these challenges.
How do you build therapeutic relationships with patients in mental health settings?
Building therapeutic relationships with patients is a fundamental skill that I got to hone during my new graduate year. Essentially, building therapeutic relationships is akin to building uplifting relationships with others in our personal lives and is centred around respect, awareness of yourself, being genuinely interested in the person in front of you whom you get to share the present moment with and create space for connection.
Practically speaking, what has helped me build therapeutic relationships with patients is saying, ‘goodbye’ to them at the end of my shift, and doing what I can to help patients feel seen and heard regardless of whether they are allocated to me during the shift, even if it is just giving a smile and nod of acknowledgement. You may also be surprised by how powerful offering PRN (as needed) hot chocolate or tea can be in developing your therapeutic relationship with patients! When respect is given, people are usually inclined to reciprocate.
What did the university not prepare you for?
Although the following can be said about any area of health, for me, what truthfully surprised me most about working in mental health is the proportion of administrative tasks compared to clinical duties and the well-known and systemic limitations of working within a non-metropolitan based hospital, particularly regarding the recruitment and retention of permanent staff which can be heightened within a niche area such as mental health.
What advice would you give to other new grads or students considering mental health nursing?
To other new grads, congratulations on making it here and I hope you enjoy your first year of practice just as much, or even more than I did. The fundamental skills you can gain in mental health such as effective communication, attention to detail, de-escalation, time management and knowledge of self will bleed into your personal life and make you an asset in whichever organisation you work for. The advice I would give to you is to always ask for help when you are struggling, take care of your mental health and always escalate concerns whenever you are uncertain. All the best!
Meanwhile, to all students reading this I would advise you to be open-minded and to learn as much as you can during your mental health nursing placement, as although you may not have plans on working solely in mental health, you are likely to work with patients experiencing mental health concerns regardless of which setting you work in. It is well known that mental health nursing can look very different to, or challenge our perceptions of nursing, but you may find that this specialist area strongly aligns with your ideal approach to care and the way you want to make your difference in the world – if you are open to exploring it.
For students who already have an interest in mental health, I would highly recommend liaising with your university to attend an additional mental health nursing placement (if possible) as it is my view that a minimum of two weeks of mental health placement does not provide enough exposure for the breadth of work that can be undertaken in mental health. If undertaking an additional mental health placement is not possible, I would suggest that you speak with professionals in the field or seek paid or volunteer work within a mental health setting to help determine whether mental health nursing is suitable for you.
Top tips for applying for a mental health grad year?
When applying for a mental health graduate position, remember the reasons you chose mental health nursing. In preparation for our interview, take note of the organisation’s values and how they align with your own and be mindful of the Nursing and Midwifery Board of Australia’s code of conduct for Registered Nurses that underpins our practice. Your careers team and academic staff at your university who have occupied management positions can also be a great resource should you seek clarification on what employers are after during the recruitment process.
What are you looking forward to in the next 5 years?
In the next five years, I look forward to exploring more of what mental health nursing has to offer both in Australia and internationally and seeing how the mental health sector will evolve.
My long-term goals include working in research, academia and leadership to amplify my impact, but as I also have an appreciation for public health, I would like to contribute to systemic innovations that broadly and positively impact the mental health of populations by focusing on the prevention of the root causes of mental health issues.
For now, I am set to commence post-graduate study in mental health later this year, and I look forward to gaining more knowledge that I can use to better the lives of patients and practice at an advanced level.
