COVID-19 and Mental Health: Part 5 (Interview with LTC Nurse)

David is a licensed practical nurse with long term care, operating room, and medicine experience.  Normally David works at a retirement home supporting elderly patients but was recently redeployed to help with the care of confirmed COVID-19 patients in the medicine wards at his community hospital.

What impacts (positive or negative) do you experience as a direct result of the (no visitors) visitation regulations? How have these regulations changed the way you support families and residents in regards to social contact?

While it’s of course difficult for patients to not have their family because it is lonely.  Families also help with the continuity of care for patients.  Families can help answer questions about patients, provide a history of the patient’s care and situation and help nurses better understand the patient.  Without having visitors during this time a lot of that history and information sharing can be lost.

On the other hand, especially for nurses, we often don’t go into the patient’s room when families are there.  We want to give families and their loved ones space – [healthcare staff] take a back seat.  During a time like this we know we need to be there for our patients and be their support since they can’t see family.  We spend more time with them now because we can go in and do our clinical support and provide them a level of emotional support as well.

Routine can be very important, especially to elderly patients.  Where possible I would assume that most retirement homes are trying to find ways where residents can support each other and find activities within the sites to do.

On the medicine wards when I do need to wear PPE, I try to lump everything into one visit.  It takes a lot of time to properly put on PPE and you want to avoid exiting and entering a room several times.  So what would normally be two visits to a patient, I now do one visit.  Rather than seeing them once for their medication and then once for their food I may see the patient once and ask them if they need anything on top of giving them their medication and food.

What coping strategies do you implement for your own mental health during these times?

The most important coping method I use for my own mental health is reading my Bible and praying. Faith is a big part of my life and a big part of [my religion] is the opportunity to trust in God and give Him your worries.  This is a large part of how I can focus on my nursing and not be distracted by the other additional stresses that come with working during these unprecedented times.

I also rely on my loved ones – girlfriend, family, close friends.  Regular check ins are important.  Due to the risk of exposure I have, I’m not able to live with my family and so this can be quite isolating after a long day at work.  Technology has been helpful for staying in touch.

I also exercise regularly which I find is a good way to keep myself active and give myself some time to decompress after a long day at work.

Do you feel stress has impacted your ability to provide quality care?

Because of the coping mechanisms above, I find I am overall not very stressed during this time,  but I do acknowledge that these are stressful times.  The biggest thing for me has been my reliance on my faith.

I think I’m lucky that I have a lot of operating room experience, so I am used to putting on and removing PPE.  I’m used to the intensity and sterile procedures.  I know a lot of my peers who haven’t had the same experience have shared that they are struggling during this time.  It’s a lot to think about how to ensure you are protected and ensuring you’re protecting others with proper PPE removal.

How does your response to stressors directly impact the well-being of others around you? How does your facility’s response to COVID-19 influence your views on the benefits of visitation and mental well-being for residents?

I find and I hope that when I walk into work, I am able to have a calming effect on the patients and coworkers around me. I find that when you are stressed and others are stressed, all your stress amounts to even more stress. But if you are able to be calm and confident others will find that refreshing. Being able to talk to people about life, share in faith and pray for them has been good as well as I find it often allows them to destress.

I think it’s important to be aware of the virus and how contagious it is.  I think generally isolating populations and residents may seem extreme, but unfortunately people in the community who are sick, potentially even experiencing symptoms, continue to go out and risk exposing others.  Facilities and governments have had to take extreme approaches to address the risk of people exposing others and not self isolating.

Photo by engin akyurt on Unsplash

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