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Though China's Mental Health Law, which went into effect in May 2013, raised the profile of patients with mental illness, few in the country are as familiar with their daily struggles as the nurses who care for them.
On Monday, nurses at Beijing Anding Hospital will observe International Nurses Day along with their peers worldwide. Nurses at Anding Hospital treat the mentally ill, a high-pressure career that requires specialized skills. Though mental health nursing has not always offered the recognition or career development of other health fields, the nurses say the job gives them access to life stories that often go unheard.
A slap in face
Liu Yulian has worked at Beijing Anding Hospital for 29 years and is head nurse of the third inpatient area, where about 60 patients with schizophrenia are being treated.
Liu starts her work routine at 7:30 in the morning, making the rounds of the wards, handling shift handover with the night staff and instructing on the day's priorities. Speaking with young nurses about their thoughts is also part of her job.
In personnel training, she believes that teaching by personal example is much more important than verbal instruction.
At the end of last year, Liu was slapped in the face by a newly hospitalized patient who insisted on being accompanied by family in violation of hospital rules. The head nurse said nothing.
Liu said that later in the day, one of the young nurses came over to her and said, "How can you make it seem as if nothing happened this morning?"
Liu responded that the patient would not have behaved that way if she had not been suffering from mental illness.
For Liu, showing the young nurses to have sympathy for their patients is as important as teaching them about safety procedures.
"I have never changed jobs, although I got the position by chance and didn't have much fun at the very beginning," Liu said. "After years of work, I began to love what I do very much because this experience has inspired and influenced my outlook on life and the world."
"There's a story behind every single patient medical record," she said.
Messages from a former patient
An Fengrong, director of the nursing department, began working at the hospital after graduation in 1985 along with Liu Yulian, her classmate in nursing school.
An worked as a nurse in the wards until 2011, and she still keeps in touch with some of her former patients or their relatives.
She once treated a college student suffering from anorexia nervosa whose weight was less than 40 kilograms at the time of hospitalization. To ensure the woman's normal food intake, An had to "fight a battle of wits and courage" with the patient to prevent her from hiding meals.
The patient was discharged from the hospital after a period of careful treatment.
"I feel warm each time I receive greetings from her, she's so grateful," An said.
As an administrative staff member, An is now more concerned with the big picture of the hospital. An said Anding Hospital faces a challenge in increasing the number of nurses as demand for psychiatric treatment rises.
This year's situation was particularly worrisome, as new staff recruitment was difficult and many employees had quit. An said the plan was to recruit 25 nurses this year, but only eight people signed contracts. About 10 workers left the hospital between January and April.
"Unlike comprehensive hospitals, psychiatric nurses face greater pressure and risks, but their career development looks less promising," An said.
Nursing psychiatric patients is a demanding job. Acute observation, good communication skills and psychological strength are all needed for a qualified nurse, she said, adding that a loving heart for patients is equally important.
"Psychiatric nurses should pass on love and warmth to their patients and help them get rid of depression," An said.
A young male nurse's ambition
Unlike in comprehensive hospitals, male nurses account for a much higher proportion in psychiatric hospitals. Of the 365 nurses at Anding Hospital, nearly 100 are men.
After graduating in 2010, Houzhi Jiaolong came to Anding Hospital to work as a nurse. He hoped that he could meet somebody like the protagonist of the film "A Beautiful Mind," who suffered from mental illness but was greatly talented in math.
But the real world is not so romantic.
"I have come to see that the patients are ordinary but kind. They are weak and get bullied a lot outside of the hospital," he said.
"I enjoy chatting with them. They have interesting ideas to offer and want to make friends with you," the 26-year-old said, adding he never regrets his choice and has a clear idea of his future career path.
With clinical experience, he plans to conduct research on traditional Chinese medicine psychological nursing, a field which intrigues him. He is preparing for further studies at Capital Medical University to broaden his knowledge on the latest developments in psychiatric treatment and rehabilitation.
Building self-esteem
With growing psychiatric disease awareness and the passing of the Mental Health Law in 2012, China's first law on the rights of psychiatric patients, medical practitioners in the field have earned more social recognition and respect.
No one understands the change better than Yin Li, who started working at the hospital in 1993 and now works at the outpatient department as a head nurse.
"I used to be afraid of telling people what I do. Now it is much better. There are more male nurses in the hospital than before," Yin said.
More than 20 years of experience with psychiatric patients have taught Yin that it's most important to let them regain their dignity and confidence.
With Yin's help, a former patient with alcohol addiction managed to return to society and is making a living in sales.
"Why did he become addicted to alcohol? It's because he wasn't treated with respect," Yin said. "What he badly needs is acceptance and recognition by society."
