I remember the first week, my charge nurse said,
"Can you go up to the toilets there
and just check on that patient?"
And I went up and the next minute he had me by the neck,
and he was trying to strangle me,
and it was fight or flight.
[MARYANA] How and why did you decide to start a career in mental health?
I'd left school with no qualifications,
and I just took a part-time job at a cash and carry store.
I remember a chap coming up with his family
to look at a radio,
and I went up onto the ladder to get this radio down.
And just as I came down, the chap collapsed
and banged his head on the glass cabinet,
and unknown to me, he'd had a heart attack
and he had died right out.
And I thought throughout that
for quite a few months after,
I felt that I could have done something.
And it was my manager, who was an ex-retired
mental health nurse, who said to me,
"Paul, it's really playing you up, you know.
Why don't you go down the route of nursing?"
And it was a hospital called St Lawrence's
in Bodmin, Cornwall.
And I applied for this job.
I didn't tell my family because they probably thought,
"Oh my gosh," 'cause I was a bit of a rebel in the family.
And I went for the interview,
and a couple of days later, I received this letter
to say that I'd been accepted as a nursing assistant.
As I went in on my first day, I really grew up.
It really made me think, "Oh my gosh,
this is a different world altogether."
And they put me on a ward that was extremely busy.
It was an admission ward, where patients came in
and they were assessed.
But eventually, I worked on most wards in St Lawrence's.
[MARYANA] What kind of illnesses were you dealing with at St, Lawrences?
The kind of illnesses patients had
were schizophrenia, manic depressive,
depression, OCD, anxiety.
And of course, not forgetting, back then,
you know, some 40 years ago,
you would have what they called back then
by the layperson as a village idiot
who maybe has gone out and smashed up a telephone kiosk
and has become a bit of a problem in the community.
They were actually sent to St Lawrence's,
and they'd been there for a long time.
[MARYANA] You were very young when you started.
How did it feel to be there surrounded by people with these quite severe mental health issues?
It was quite harrowing, to be honest with you.
I remember the first week, my charge nurse said,
"Can you go up to the toilets there
and just check on that patient?"
And I went up and the next minute he had me by the neck,
and we had white coats on,
and he was trying to strangle me,
and it was fight or flight, you know.
It really shook me up, and I came out and I thought,
"Well, one thing here, don't leave yourself..."
you know, "don't become complacent".
There was a lot of violence.
I mean, it didn't happen every day,
but you got to realise that on each ward,
with that volume of patients living under one roof,
there would be tension, and of course, the illnesses.
If somebody's paranoid or delusional,
there are cases where they think that you're after them,
you're gonna attack them, so they would attack you first.
And I remember talking to a patient
who I had a good therapeutic relationship with.
He just stared at me and I thought,
"Something's going on here."
And I said to him, "Are you okay?"
"No," he said, "The voices are telling me to kill you."
And it was so real to him, you know.
You have to be a certain person to go into nursing.
And those that aren't the certain people,
they stand out.
I often had that as a ward manager recruiting staff.
You could just tell if somebody's empathetic
and they're a caring person.
There's a line, you know. You've got to be strong.
There's boundaries with patients etc.
But it's all a skill.
All these are skills you learn over time, you know.
When you leave your shift,
it's about leaving it all behind and not taking it home.
[MARYANA] When did you make a decision to move to Broadmoor Hospital, and why did you do that?
On my last ward at St Lawrence's Hospital,
we had a lot of patients who had been
at Broadmoor Hospital for some...
I mean, back then, people were there for 30, 40 years.
Some were there for life.
I thought, "Well, you can't go any higher than this."
I've worked in a few hospitals,
but this is the hospital where patients
can't be managed anywhere else.
That's why they go to high-secure hospitals.
[MARYANA] So basically, Broadmoor is the place where a lot of criminals are held just because they otherwise present a threat to society
and they need constant psychiatric support, is that right?
Well, that is correct, but not all of them.
I mean, what you get is you get,
say somebody was sentenced to prison for 10, 15 years.
If they had a relapse, if they had any mental health issues
and they were category A etc,
they would come to a high-secure hospital,
whether that's Broadmoor, Rampton, Ashworth etc.
And there, they would be treated
under that security with medication.
Once they became well, they would transfer back to prison,
so it's hopping from one to the other.
And some people just continue to do that, you know.
People who have been sentenced to life.
[MARYANA] What kind of criminals did you meet at Broadmoor?
Well, I mean, everybody knows who's been at Broadmoor
and who was there.
It's the usual, Ronnie Kray and Peter Sutcliffe.
There's quite a few of them what you would call
the infamous patients of Broadmoor.
But I have to say, if I'll give you an example,
you know, we had one patient who was filming.
He was in a lot of soaps etc, with no names given.
And he went off set, he became quite psychotic,
and he went off and he killed somebody on the street,
and he was sentenced to Broadmoor.
And I remember all the work we did with that chap,
and then there's some coverage that came up
about five years later in one of the tabloids.
You could just see how he deteriorated
through that coverage.
It was just like, "Oh my gosh,
this is having a real effect on him," you know.
[MARYANA] There are quite a lot of examples of different criminals that were in psychiatric hospitals who created a lot of art, like Charlie Bronson or Ronnie Kray.
I think that's the only means at that time
that they can get through to people, especially the staff.
I know a lot of psychologists have said
art is a huge theme when it comes to breaking down
those barriers with a patient and building that trust.
That's why an art therapist is so paramount on a unit.
And it's about somebody who, if I give you an example,
is quite depressed and they won't speak.
There's no communication going on.
They'll do it in their picture.
They draw something and you can ask,
you can go in depth with it.
You know, "What does this mean?
You put this here. What does that mean?"
[MARYANA] What was the security like, and what was the training like?
You're trained to use what was called
control and restraint back then.
And that I believe came from British Airways
at the very beginning, because of passengers on flights
who were becoming problematic.
That carried over, and the high-secure hospitals
did that first.
So you are trained in that.
And so if somebody attacked you,
you have those different holds that you put on etc.
It's all because it's safe, you know, as nobody gets hurt.
And then I went on to do the shield training.
So that's like what the prisons do.
So if somebody did have a weapon,
you would bring the shields out
and restrain somebody with a shield.
That was very interesting,
because nobody likes violence.
Nobody wants violence.
And somebody who's unwell who doesn't realise
that they're doing these things,
it's about making it safe,
because people many, many years ago
have actually died through restraints.
You've always gotta think a couple of steps ahead.
You would never go in a room first, a patient's room.
You would always have somebody with you.
You would never leave yourself in a corner.
There's been times, and I know there were two patients
one morning fighting in the day room,
and the alarm bells went and everybody came in.
And I actually ended up on the patient's...
holding the patient's head.
This is all through your techniques that you were taught.
And we went into the seclusion room,
and the seclusion room's used at the last resort.
It's about bringing somebody down
who's maybe gone from 0 to 10
in an arousal state with aggression.
And I remember holding the head,
and you always numbered everybody.
You wouldn't call them, the staff, their names,
because you might have somebody with the same names.
And I said, "Number one, leave the room."
And they went out the room,
and I had the head and we turned them around,
so I had the legs then.
"Number two, leave the room."
And just as I was about to spring backwards
to be caught by the staff, the door closed.
And for whatever reason,
nobody really forgot this there,
they thought I'd actually got out,
I was out of the room, and they shut the door.
And of course, there's the patient,
who jumped up off the bed.
And to me, all I could think of is like, "Hostage.
You are now a hostage."
Now, it seemed like forever, but it wasn't.
It was maybe 10, 15 seconds.
But that was enough to make me think,
"Oh my gosh," you know.
[MARYANA] How did you manage to get out of that one?
That one there, I actually... they pulled me out,
and they went back in and restrained the patient again
and all came out.
I think the staff just couldn't believe it,
but it's still talked about today.
It's one of those incidents,
which I've seen a few and been involved in,
that always stayed with me,
because we had hostage training as well.
When you go deep into that, it can be quite scary.
[MARYANA] What would be the most disturbing things you witnessed at Broadmoor Hospital do you think?
Cutting, when somebody's cut their throat.
It doesn't have to be at Broadmoor.
It can be at any other hospital.
But that's quite something.
You deal with it, but it's something.
And obviously, when somebody's hung themselves.
That's quite...
Especially when you've got somebody so young.
I've come across a few that have been very young,
and you just think, it makes you feel how lucky you are
when you leave a shift.
When you've got somebody talking to you and smiling
and having a good joke, there's no indication
that they're gonna go and do something.
Usually you can see triggers with somebody.
You see triggers, like their hands
or the way they're looking.
You know that patient inside out, really.
But when somebody doesn't do that
and they're happy-go-lucky,
and then five minutes later,
they've got a sheet around their neck,
you think, "Well, there's no indication there."
You wouldn't have put that person on observations
'cause they didn't need them, you know.
And what I learned through my career
with hangings etc is that
if they're gonna do it, they'll do it.
They really will.
Whether it's in the hospital or the grounds, they'll do it.
But there's been lots of things
throughout the career where you thought,
"Oh my gosh," you know,
you just wouldn't see that anywhere else, you know.
And then you'd finish your shift after a horrific shift.
I mean, not every day's like that.
And you'd go into the supermarket
and you'd have a young lady going,
"Afternoon. How was your day?"
You think, "Oh, if only you knew."
And you do have a bit of guilt.
You think all the time,
all the input we've given that person
and you feel like you've let them down.
[MARYANA] Has it ever happened to anyone who you were kind of connected to?
Yeah. Oh yeah, yeah.
Especially at Broadmoor, when you're nursing there,
you are given so many patients to look after.
So that would be care plans, reviews.
You're their named nurse,
so you do build up that rapport.
They call it unconditional positive regard,
where you've gotta put everything to one side,
and I'll give you an example of that.
If you know a patient's being transferred up to you
and you have read the notes, that can have an effect
before the person's walked on the unit.
If you haven't read the notes and you build a rapport
and read them later,
you seem to have more of a connection.
It's all those different things,
like silence is the most powerful thing.
Whereas some people would be so uncomfortable with it,
that's a time for reflection for the person
to think about what you've said or for me as well.
It's about all the different things you would ask
and what you wouldn't ask.
You have to challenge some patients,
but you wouldn't just go in on your own
and challenge them whatever it may be.
You'd make sure that you had support with you.
[MARYANA] What would you say you liked most about your job?
There's lots of funny things over time.
You've got to have that sense of humour.
And I have to say, the patients
would have a real laugh with you as well, you know.
And that's what it was all about.
But the chap who went running to the toilet,
and I said, "Are you alright?"
"Oh," he said, "I've got the runs."
And he went off to the toilet
and I thought, "You've been gone a while."
So I went up to the toilet and I shouted the chap's name.
We'll just call him Joe.
I said, "Joe, are you alright?"
He said, "Well, no."
He said, "The doctors have given me some salts,
and that's not working out very well."
And I said, "Salts, what do you mean salts?"
"Well," he said, "I went to the ward round
and instead of prescribing me medication, he said,
'Just take some salts.'"
I said, "Open the door a minute."
So he opened the door.
Of course, there's faeces all over the walls and that.
And I said, "What kind of salts did you take?"
He said, "Somersaults."
And I thought that was really, you know...
from somebody who's... yeah, yeah.
[MARYANA] Why did you make the decision to leave your career as a psychiatric nurse?
Through 35 years I could retire,
and I had a good pension and a lump sum,
and I thought it was time to go,
but I didn't leave mental health.
I left as a ward manager.
I retired, got my 35 years
and continued to work voluntary
in lots of organisations.
I've always been linked to mental health, always.
And by going around doing surveys
around the United Kingdom,
meeting so many different people.
It's fantastic, yeah.
[MARYANA] Do you miss being at the hospital?
Sometimes I do.
When I go and visit units and support staff,
it takes you all back, being on the units.
And patients will always come up to you
not even knowing you.
They'll say, "Oh, hello, Paul. Pleased to meet you,"
and all that.
"You can tell you're a nurse.
You know, it's quite amazing, really.
But you never lose those skills.
You can have that rapport right away.
You can converse, and that's the biggest thing in nursing
is getting through to somebody.
But I always see it as a privilege
to work somewhere like that, absolute privilege.
If you can just change somebody
a little bit like that each day,
that's good enough for me,
because you can't expect everything.
People don't get well over overnight.
But if you can make that little bit of happiness
and make their day worthwhile, that's good for me,
and that's why I was in the job.