mhw interview: Mandy Rayani, Divisional Nurse, Swansea NHS Trust

Why did you choose a career in mental health?

I had always had an interest in caring for people and whilst growing up had come into regular contact with older people living in the residential home where my grandmother and mother worked. This, I think, sparked my more formal interest in care. It was only when I came to apply for a career in nursing that I realised I could train specifically in the field of mental health. After finding out more about the care and treatment of people with mental health problems, I decided this was a field in which I could make a contribution and hopefully make a difference.

Who has had the biggest influence on you?

There have been a number of people who have influenced my life apart from immediate family members. I recall (during my teenage years and a catholic education) being greatly impressed by Martin Luther King. I was struck by his vision, his beliefs and his passion. I was also greatly impressed by Mother Theresa of Calcutta, by her strength, stamina and love of mankind.

From a work perspective I have been influenced by many but in particular a former manager who instilled in me the need for standards. Not just basic standards but to have a goal of achieving the highest standard possible. This has led me to always look at how we can improve upon what we are doing.

What changes have you noticed during your career in mental health nursing?

There have been many changes during my 21 year career in nursing. Apart from the almost constant reorganisation of the NHS and more local reorganisation of services, I have seen a positive shift in care for people with mental health problems. Services today are quite rightly community focused with emphasis on the recovery model. The huge shift in the development of user involvement and the true value placed upon user feedback is another positive step forward. The increased emphasis in recent times on carer support through the carer assessment process is also to be welcomed. I would say, however, that there have also been some changes which have resulted in the baby being thrown out with the bath water so to speak. I am pleased to say that I now feel that a higher profile is being given to the issues affecting mental health services within the overall healthcare agenda.

What is your greatest achievement?

I am proud to be in the position I am today as a Divisional Nurse – professional head and clinical governance lead, but I am particularly proud of the MSc in Healthcare Management I acquired a few years ago. In terms of achievement from a service perspective, I am pleased that as a service we have responded positively to change and new ideas and new ways of working. I am particularly pleased that I have been able to promote a more supportive culture of openness and empowerment. There is, however, still a lot of work to be done.

What are the main challenges of your job?

Life is full of challenges and work life brings with it constant challenges. Trying to keep up with the e-mails and paperwork whilst absorbing the sheer volume of information circulating around the system is perhaps one of the greater challenges on a day to day basis. Trying to be visible and be out and about to meet staff and service users, which is something I really enjoy, is also somewhat challenging given the diary commitments.

What are the issues facing mental health nurses in Wales?

There are significant workforce issues to be tackled by NHS Wales. To meet the needs of service users today and address the requirement associated with the new Mental Health Act, the make up of the workforce needs to change. Mental Health nurses need to refocus their energies into developing the skills and knowledge which will enable them to deliver the most effective therapies. This refocusing can only occur if we hand over some of the more administrative tasks to others as well as delegating certain activities to other appropriately trained staff. We need to value the very unique contribution that qualified mental health nurses have to make to the whole patient experience.

What are your views on patient and carer involvement?

Meaningful user and carer involvement is key to moving services forward and ensuring that the service received is appropriate to individual need. Users and carers need to be supported to be able to make a contribution at all levels with the real costs associated with user involvement needing to be recognised and addressed.

What are the three key things that can improve life for people with mental illnesses?

(i) Reduction in stigma – enhanced social inclusion.
(ii) Meaningful engagement and involvement.
(iii) Being treated with dignity and respect

What makes you happy?

Being able to feel that my contribution has made a positive difference as well as being able to achieve a good work life balance.