Journal December 2025 Release - Flipbook - Page 9
7
Michael White and David Epston, the originators of the narrative approach,
visited South Africa on several occasions between 1992 and 2004 and conducted
workshops in various centres in the country. I was very fortunate to learn from
both in person.
The problem story
Working night shift
I worked nights in psychiatric nursing to support my studies. One night, I reported
for the night shift at 18:45 for a “handover” from the day staff. The day nurse
looked exhausted and said they had had a trying day. They admitted a familiar
patient, Joanna, who had a reputation at this psychiatric service as a difficult
patient, often attempting suicide and self-harm. According to the day report,
Joanna turned the entire clinic on its head within minutes of her arrival. She
resisted her admission, in "crazy acting-out behaviour". They said the patient was
loud and refused a voluntary admission, tried to run away, and even climbed a
tree to hide from the admission nurses. Her resistance earned her admission to
the small isolation room adjacent to the duty room, where there was a one-way
mirror for observation. We were given strict instructions to keep her on suicide
watch as a serious suicide attempt preceded her admission. The chaos
necessitated isolation, observation, and chemical restraints.
Although experienced in the critical moments of clinical psychiatric nursing, I felt
concerned about what might await me that night. I timorously peeked through
the one-way mirror between the nurse’s station and her room, and espied a tall
woman, lying motionless on a mattress on the floor, both wrists heavily
bandaged. She was breathing easily. For her protection, the isolation room
contained no glass, sharp items, or extra furniture, merely a paper cup, a bedpan,
and her mattress. The day staff were visibly relieved to go home.
During my shift, I performed my regular tasks, which included counting
medications, reviewing prescriptions, distributing night medications, assisting
patients who had difficulty sleeping, and providing support to those requiring
additional attention. I remained concerned about Joanna, alone on her mattress,
but every time I checked on her, I found her sleeping soundly.
An Apprenticeship in Extremis
Journal of Contemporary Narrative Therapy, December 2025 Release, p. 5-44.
www.journalnft.com
