“Being a registered nurse in this area is not only unique, but empowering,” Sarah Andres says about working in community mental health with teens and young adults.
Though the idea of working in this field made Sarah nervous as a student, her professor encouraged her to accept a preceptorship in adolescent mental health.
“When I thought of working in mental health as a student nurse, I thought of One Flew Over the Cuckoo’s Nest,” says Sarah. “It wasn’t until I was working in that area and talking to people that I realized my initial perception was inaccurate,” she says.
Thirteen years later, Sarah has her master’s in counselling psychology and has continued practicing in community mental health clinics.
“I’m able to help clients in a different way than my social worker and psychologist colleagues,” says Sarah.
Her registered nurse education included pharmacology, so she has an in-depth knowledge that allows her to educate her clients about psychiatric medications and their administration, monitoring, evaluation, and the importance of following the prescribed regimen.
“Right from day one in nursing school, I was learning about medication care planning, administration, patient rights, and side effects,” says Sarah. “Mental health clients need to be assessed for physical health conditions arising from their psychiatric medications such as metabolic syndrome, extrapyramidal symptoms (muscle spasms, restlessness, rigidity and/or tremors), or serotonin syndrome.”
She says it’s her RN knowledge and skills that offer the unique capacity to conduct this holistic assessment for her clients and address complex medical issues.
When a client begins to experience some of the undesirable side effects of medication before the benefits kick in, Sarah works with them to determine what time to take medication, discuss whether or not to take it with food and evaluate the outcome of these changes.
As an example, Sarah described a situation where she worked in a clinic alongside a psychiatrist. He started a client with post-traumatic stress disorder on a new medication, but the client had had past sensitivities to other prescriptions including headaches and nausea, causing her to stop taking the medication before it could help.
Because of this history of medication complications and adherence, and knowing it would take a month or two for the psychiatrist to see the patient again, Sarah followed up in five days. When she did, she recognized the client was tolerating the medication and the psychiatrist approved an increase to the client’s dosage. Sarah was able to assess the client’s needs and support her by monitoring and following up in a timely manner. This was the first time this particular client gained traction with medication, which helped make therapy more successful.
Sarah’s medication knowledge, ability to address complex medical issues and her scope of practice to address them have been unique in her interprofessional teams.
“The combination of advising about medications and acting as a family counsellor adds an additional lens to my team. It adds a valuable, unique dimension that benefits my clients every day,” says Sarah.
Sarah Andres works as a family counsellor with the Child and Adolescent Addictions, Mental Health and Psychiatry Program in Calgary, Alberta.