In this series, ACMHN members talk about their passion for mental health nursing and how they have grown professionally. In this article, Tessa Moriarty shares her unique experience growing up in and around an asylum, the lessons she’s learnt over the years, and how being a mental health nurse is a core part of her identity.

If I could have my time over again, I wouldn’t change a thing about the profession I have chosen. In the twilight of my working years, as I reflect on my career as a mental health nurse, I know that I’ve loved what I’ve done and have always felt blessed and grateful to be in this versatile and rewarding speciality.

It’s been a privilege to walk alongside others and learn how to be helpful in their journey of recovery. As it has been to guide and support other mental health nurses through their own career paths and the undulations of their working lives.

But even though I’ve loved my career, it doesn’t mean the work has always been easy. Far from it. I’ve been stretched to the limit of my knowledge and skill, and my capacity to care. My compassion worn thin; the energy and joy for the work depleted, beyond exhaustion. But I have always come back. To the profession that gives me more than it takes from me, and a lifetime of satisfying work.

My background
I come from the land of the long white cloud, Aotearoa, and a long line of psychiatric nurses. Both parents and three siblings, setting the example I followed. Mum and dad worked in a huge asylum that was surrounded by pristine working grounds, with gardens in which patients were the gardeners, and in kitchens, laundries, engineering workshops, and storerooms where they were employed alongside staff. I used to joke that I grew up in this asylum. Not as a resident, but as the proud daughter of mental health nurses. And my experiences of witnessing how people were cared for (or not), left its mark on me, alongside the lived experience I’ve had of mental health struggles in my own family and the hand of care that Maori culture can teach.

Like my parents, I trained in an asylum – not in New Zealand, but here in Melbourne, where I learned the art of psychiatric nursing during some of the most significant advancements in treatments that occurred in the 70’s and early 80’s. These include improvements in the use of ECT, Lithium Carbonate, the psychotherapeutic milieu, the development of unconditional positive regard, and overdue changes to the use of restraint and seclusion, to name a few. I was also trained (alongside my allied health colleagues) in individual and group psychotherapy by a wonderful psychiatrist.

But there were also many dehumanising experiences for those in our care, that I felt perpetuated the illnesses we were actually trying to treat, by the life in an asylum. So, in 1984 I was glad to join the mass exodus of deinstitutionalisation into community mental health nursing. Since then, I’ve found my place across public, private, and primary mental health sectors services. In acute in-patient units, general hospitals, and community-based organisations in clinical, education, leadership, senior executive, and external consultant roles.

Lesson’s I’ve learned, those who have taught me
To say that I’ve learned from the best gives testimony to the hospital-based and university tutors who supported my education. Just as important are the lessons my wise and compassionate colleagues have taught me, primarily, “how to do what the text book doesn’t tell you”.

But I’ve learned the greatest lessons in my career from those with lived experience. From consumers who’ve taught me to regard them as people first, beyond their diagnosis, to speak respectfully about them in my communication, and never assume I know better than they do about what they need.

In the early 2000’s, I was speaking with a consumer consultant colleague who said, “the way you nurses speak about us in the handover-room shows through in the way you behave towards to us at the medication trolley”.

She was talking about the negative, pejorative, and hurtful language and behaviour nurses sometimes use – often to relieve their own anxiety – to speak about patients they found challenging to work with. My colleague’s words seeded the idea for a series of staff workshops we ran and then a conference presentation titled ‘Cruel Talk’. She has since passed away, but her lesson to me lives on. Uncomfortable but true - our unconscious bias, and the lack of understanding and empathy, we sometimes have for those in our care shows through, in what we say and what we do.

I’ve also learned, through the work itself and particularly in the toll of the pandemic, how important it is to look after myself and those that I now care for – nurses I provide clinical supervision to. The emphasis I now place on wellbeing is louder and more central to the supervision process and dialogue.

“How do you need to care for yourself?”, a question I no longer leave to the end of the conversation.

A core part of who I am
I love where I see mental health nursing has travelled. We now work side by side – as we should – with our lived experience colleagues. There are more choices in what we do and there is a place for us across so many different work settings.
In addition to our familiar places of work in public and private mental health settings, the prison system, and university and TAFE sectors, I meet so many mental health nurses in primary health care, Primary Health Networks, in general practice, community health services, primary and secondary schools, the department of defence, and our new Mental Health and Wellbeing Locals (a service offered in Victoria).

Recently, I’ve worked with First Nations services and many of my colleagues who also have their own private practice as counsellors, psychotherapists, and clinical supervisors also support those under the NDIS. Our skill base is broad and the range of roles we can undertake is phenomenal.

I may eventually stop working but I can’t imagine ever not being a mental health nurse, because it is a core part of who I am as a human being.