This Brilliant Career
By Tessa Moriarty
In "This Brilliant Career," Tessa Moriarty reflects on her 40-year journey as a mental health nurse, expressing gratitude for the lessons learned and the rewarding experiences she had while caring for patients, mentoring colleagues, and navigating the evolution of mental health services, as she approaches retirement.
I’m squatting close to the ground, next to Bert. We’re in the courtyard off the dayroom, and he is talking to an American Chinese dentist in the Vietnam War while nursing the butt of a cigarette he rescued from the bin. Now and then, he gives me a sideways glance as he talks. But it isn’t me he turns his head to. He’s looking at someone from his long-ago past, and he's in a place he once went but never really came back from.There are others outside here too. Several men pace the yard like soldiers marching in stilted unison, while a woman sings a rendition of songs from The Sound of Music. Her voice flows like pure crystal, from the mountain streams of Salzburg – where she sings. In song, she has control and mastery of herself. But away from the music of her past, she flounders in a world she cannot recognise.
Most people who come out to the courtyard stand or crouch in silence, alone. But some, like Bert (not his real name), are engrossed in thought or conversation with someone only they can see. Despite the sunny day and the outdoors—fenced off though we are—being outside is a welcome change from sitting in battered chairs against the perimeter of a smoky dayroom, waiting for something to happen.
Then Sergeant Boss Nurse, as Bert has fondly named the Shift Leader, walks out into the sunlight and calls for lunch. Suddenly, there’s a rush indoors, hoping for something novel and delicious on the plate, only to find the same meal that’s been served a million times before. I think to myself—at least it breaks the monotony of the late morning, and half my shift has gone. But for those who live here, it’s just another meal. Just another day. The same as yesterday and the day before. And the day before that.
As we get up to go inside, Bert winks at me—perhaps acknowledging the end of a conversation that I’m not sure we even had. But at least he seems happy, and with a wide grin on his face, he tucks the precious little cigarette butt behind his ear and ambles towards the lunch queue. Sergeant Boss Nurse hands me the clipboard. I look for a spot in the dining room out of the line of traffic between tables and the servery, trying to make the head count I’m doing appear less awkward than it makes me feel. But I needn’t worry too much about remembering people’s names because the population rarely changes in this ward. People seem to move in for the long term. They become familiar to me quickly because their faces are easy to remember. Their stories are hard to forget. I write the date, time, and my signature on the sheet and make neat, even ticks against thirty-six names.
It’s 1981, and I’m a post-basic student psychiatric nurse working in a locked ward of a Victorian mental asylum. Some days I wonder what the hell I’m doing here. Other days I feel like I’ve found my calling.
But thankfully, things have changed a lot since the 1980s. The ‘bins,’ as the asylums were called, have long since closed, though fragments of a few remain. In graffitied and petrified shadows of their former selves, they are crumbling reminders of what many would rather forget. And as I meander back through time, I find memories from those years that are worth retrieving. They’re images of being with patients who taught me what Sainsbury’s Key to Psychiatry (1974) couldn’t, how to actually care for them. How to stay close—at arm’s length—without intimidating. How to reassure without patronising. How to be honest and kind.
Then there were those who, through the turmoil of what they were going through, made me look beyond my fear of their psychosis to the people they were on the inside. To them, I will always be grateful.
Fast forward from my training in the institution, through community mental health, private practice, children and family life, postgraduate studies, clinical, education, and executive roles in public and private sector services, and supervising others and consulting in the primary health space, to the work I do now in 2024. And I can barely believe more than forty years as a mental health nurse have passed. These days, the work takes me mostly between caring for the carers—as a clinical supervisor or undertaking consultancy work in the governance space for primary mental health services.
On a wintry afternoon in a community-based facility, I’m sitting with a group of staff who work with people with lived experience of mental illness. Our discussion moves from the passion and commitment they have for their roles and their work with consumers to what they need to manage the workplace change they are navigating. They speak of the need for honesty with each other, transparency from their leaders about the change, and the importance of this time they have with me to reflect. They share their difficulties, they own their differences, and in doing so, gain a deeper understanding of each other. This process they share with me helps them connect differently to their work, their colleagues, and themselves.
The following morning, I’m in a video supervision session with a young man early in his career. The questions he asks in the session are for himself as much as they are for me. They’re about his developing sense of identity and where he finds his place in our profession. Our dialogue takes him into his own knowing about those for whom he cares, and who he is uniquely becoming—as a mental health nurse. His ability to reflect on his own journey and practice is refreshing. He has a level of insight and humility that took me many years of my own career to develop.
Later the same day, I am back at the computer screen with another supervisee. She lists the familiar demands her job places on her in the context of a public sector service struggling to fill vacancies. As she temporarily balances the work-tasks of several roles, she has had less time to take care of her own well-being as she normally would. So, our conversation focuses on small strategies from her own toolkit that she can reinstate into her routine. One day at a time. There is no need to offer her any suggestions from my bag of tricks. Her own tried and tested solutions suit her needs much better. She’s just forgotten to use them. So, then I ask her what keeps her in the job. She answers emphatically: ‘It’s because I want things to improve for our consumers.’
The mental health nurses, clinicians, and others I provide clinical supervision to love the work they do, and so do I. And now, as I look back on this brilliant career I’ve had, I feel nothing but gratitude. For the opportunities my career has given me to broaden my skill set in the jobs and roles I’ve had across the spectrum of healthcare services. I’m also grateful for the many lessons—some learned very hard—that I’ve had along the way.
I know I will miss not working. Not being connected to people and the profession that I was destined—from childhood—to be part of. My job has been integral to who I’ve been in the world, and now I am choosing to retire. The next phase of my life—though excited as I am about it—will take some getting used to.
So, to my profession and all those I have worked with, I leave and say: ‘thank you and goodbye.’
Tessa Moriarty
Credentialed Mental Health Nurse Consultant
TAGS Australian College of Mental Health Nurses membership, mental health career change, mental health nursing career, mental health policy Australia