ruggling for understanding
With little education in mental health or knowledge about
how recovery from anorexia takes place, participants
struggled to understand such a complex disorder. Many
participants believed that their patients had caused their
own harm and needed to ‘fix it themselves’, and they were
angered about this when there were ‘really unwell ‘‘kids’’
on the ward’ who (by implication) were more deserving of
care:
Frustrating
...
there’s nothing pinpointing why they’re that way. It’s
all in their heads. There’s no set guidelines as to ok this is what you’ve
got to do to fix it
...
they have to fix it themselves. Basically
...
when
there’s
...
really unwell kids on the ward
...
you think how can you be
doing this
...
(Skye)
Their frustration made them sceptical and pessimistic about
‘full’ recovery and therefore disillusioned with their patients
and this type of work, regarding it as ‘easy’ and ‘a waste of
time’ compared with other forms of nursing, which they saw
as having higher status in the hospital. Many participants
believed that they themselves were ‘failures’ because they did
not feel in control of the recovery process (Crowe 1997, King
& Turner 2000). Although they characterized work with
anorexic patients as ‘easy’, most found it stressful for long
stretches of time because of their frustrated attempts to
understand anorexia and recovery. Much of this stress also
came from the ongoing struggle for control about which they
were eloquent. Jodie explains: ‘
...
it’s all a question of
...
an
emotional and psychological battle with them and that
constant battle can be
...
quite
...
distressing for some staff’.
As a member of the group under study, the researcher was
aware of the lack of education and training in mental health
issues for nurses in this particular acute care setting.
Currently, this hospital provides no formal education focus-
ing on the care of adolescents with anorexia. A few
participants mentioned previously attending a course, which
dealt with understanding anorexia nervosa and other mental
health issues, but this course no longer exists. Nurses with
training in mental health are more likely to have acquired
knowledge and skills to assist them in caring for people with
this challenging condition. Education for these ‘specialist’
nurses needs to include an understanding of the elements,
stages and turning points in recovery from anorexia nervosa
and not only of its symptoms and aetiology. As a conse-
quence of this study, an education package has now been
compiled for nurses caring for adolescents with anorexia in
this hospital.
In Australia, there are specific training courses for nurses in
‘Child and Adolescent Mental Health’, run by organizations
such as the Royal College of Nursing and through universi-
ties. Generally these courses come at a cost to the consumer,
both personally and financially. However, it is vitally
important that nurses caring for adolescents with anorexia
receive this training in mental health issues, and the health
care system needs to take some responsibility in ensuring that
its nursing staff are appropriately