The Maltese Association of Psychiatric Nurses (MAPN) is a non-profit, apolitical, voluntary organization that represents mental health nurses in Malta. The association is committed to advance the practice of psychiatric mental health nurses by promoting and empowering the nursing profession in mental health, with focus on awareness, education and recognition.
Message from the President
These are surreal times we are living. I’m sure none of us would have imagined living this reality, which resembles more the setting of an apocalyptic movie than our usual, perhaps ordinary living. Due to the highly infectious and mortality risks associated with it, the COVID-19 is putting a big strain on the health services, and all health departments are buzzing with activity in preparation for the worse. The nursing profession, has never been so significant, most probably since the times of world wars, and at times and regions where similar outbreaks have happened.
But what does this mean for the psychiatric mental health nursing profession? What impact this pandemic is going to have on us, as nurses who work with people who are mentally unwell?
One thing is certain. It will have an impact. If we look at the history of mental health nursing, any major world events had an influence in the restructuring and development of our role. World wars are the main events, which have contributed to the role of trauma in mental illness, which caused the psychiatric nursing profession to be at the forefront in treating soldiers, focusing on the therapeutic relationship, the development of community care and emphasizing trauma related practices in our role.
The COVID-19 outbreak has a number of themes which have the potential to affect mental health related issues. Frequent hand washing, until a few weeks ago was one of the main symptoms of OCD. Today it is an activity we are encouraged to do and its core is based on very rational fears. Health anxiety is something the whole population is experiencing to a certain degree, (and probably going to continue experiencing for some time) and not a hypochondriac symptom. The extreme measures like quarantine, social isolation, disruption of routine, loss of income, lack of meaningful activity…can all contribute to a decrease in moral and an increase of depressive illnesses. Therefore, I do believe that our profession will become more relevant due to this outbreak.
Moreover, as nurses who work with people who have mental health difficulties, our usual work have become all of a sudden more challenging. Our profession is based on the very activity we are being discouraged from performing…human contact. Our profession dictates that we sit down with the patient, show warmth and non-verbal communication which translates to empathy and compassion. Touching of hands and facing the patient is something we use to convey care and understanding. Now we are relying on distancing while at the same time have to show the same attributes.
However, I believe the real challenge comes when we have to deal with patients who due to the nature of their illness are uncooperative. When a patient is due for the depot medication and is refusing to attend, when the patient’s paranoia is meddling with the reality of what’s happening around us, when the patient’s personal hygiene is a constant issue and that imperative homevisit have become a major hazard, when a patient is so agitated that cannot be contained and requires physical restraint, while the nurses have to be vigilant about the mode of transmission. Containing the spread in a psychiatric setting is complex and tricky. Patients can be interactive, uncooperative and alarmingly chaotic. We always based the treatment of mental illness on engagement, therapeutic activities and close supervision, which with the current situation might not be possible, since the rest of the population is being asked to limit interaction. Overcrowding of wards, which was always an issue, has become a significant health risk. On the other hand, promotion of social distancing may lead to social isolation, which puts people with mental illness at greater risks of relapse, which might instigate further admissions. Hence the need for community support, dialogue between in-patient and community services and looking at innovative ways of working, is imperative.
We also need to safeguard ourselves and our mental health. We all have loved ones at home, and we need to avoid becoming a source of infection. It is vital we follow principles of infection control to the optimum, but also to maintain control over our thoughts. Anxiety is something we are all experiencing. We need to focus on what we can control, and trust we are doing the best we can.
There is no one easy solution. I feel that as to what is happening around us, in Malta and the rest of the world, it is important to support each other. We are all in this together, and simple acts of support and kindness towards each other can work wonders to lift our spirits and help us face these difficult times. We are all dealing with this surreal reality on a personal and a professional basis. We’re in it together. And we will come out of it together.
As MAPN, we would like to offer support to any nurse experiencing psychological distress. We do not have any momentous solutions to the challenges we are experiencing, but a word of encouragement and someone to talk to might be what you need to keep going.
If you or any of your colleagues would like to have a chat with any one of us, let us know by emailing us on email@example.com , and we will be in touch.
Meanwhile stay safe. And yes, keep washing your hands.