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

Being a mental health nurse during the COVID-19 outbreak

Being a mental health nurse during the COVID-19 outbreak is an exceptional experience we were untrained for. No mental health text book, no university lectures, no seminars have prepared us to deal with this clinical reality, which was thrown upon us unexpectedly. 


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 nurses who work with people who are mentally unwell? 


Although as mental health nurses, we are not on the frontline in caring for patients who are COVID-19 positive in the same way as general nurses are, some are still designated to work with COVID positive patients, and the risk of COVID query patients is always looming around for everyone, including nurses working in mental health settings. Besides, we still have to look after patients who due to their mental health difficulties, they experience increased distress during these difficult times. If there are pre-existing mental health issues, these could become worse. Patients will not suddenly stop relapsing in their mental health and stop being admitted to Mount Carmel Hospital because of this outbreak. It is imperative that the mental health services continue to function, as a breakdown in these services can be detrimental to the national health of the country. 


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. Now we are relying on distancing while at the same time have to show the same attributes. 


Mental health nursing presents certain challenges which are unique to psychiatric practice. When a patient is not abiding by his or her careplan, 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 the nurse need to visit the patient at home, when a patient in hospital is so agitated that cannot be contained 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 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. Overcrowding of wards, which was always an issue, has become a significant health problem. 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 and we need to avoid becoming a source of infection. Anxiety is something even mental health nurses are experiencing and they need the necessary support and assistance to continue providing the care required to people with mental ill health. 


As mental health nurses, we might not be on the frontline, but our work remains imperative during this outbreak. We have a key role in helping patients coming to terms with what is happening, explaining the changes which are taking place rapidly and helping them make sense of this new reality. We need to follow the Health Department’s directives and maintain social distance, as this will help Malta in fighting the virus. At the same time, it’s important to
keep monitoring people with mental ill health, as these can be the most vulnerable during these times and hence, our role is more than ever necessary to the well-being of the country.


Pierre Galea

President - Maltese Association of Psychiatric 

 

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