The pandemic and its effects have caused stress and fear for all due to uncertainty and loss. Nurses are in a particularly difficult situation, caring for COVID-19 patients often in understaffed environments with limited resources. It is not surprising that many nurses are experiencing high rates of burnout and anxiety. The experience of a psychiatric nurse in the midst of a pandemic is an interesting one. They may not be treating the physical symptoms of the virus, but rather the complex mental health issues patients are facing. The additional stress of COVID-19 has expanded the number of patients requiring psychiatric treatment, which impacts the role of psychiatric nurses. How has their role changed, and what can be done to better support our mental health patients and professionals?
The Psychiatric Nurse Work Environment
Unfortunately, not much is known yet about the true effect of the pandemic on psychiatric nurses. Psychiatric nurses’ top concerns were explored in one recent study which assessed how COVID-19 has affected mental health nurses’ ability to deliver care. Adapting to an evolving work environment was the number one concern as many practices have moved to working remotely. This has some benefits, such as providing continuity of care and preventing the spread of the virus, but still has downfalls. Older adults may struggle with how to access digital technology such as patient portals while children with autism and special needs may experience paranoia and not understand the virtual experience.
The nurses expressed more exhaustion with remote work due to expectations of booking more appointments one after another. Additionally, nurses in a variety of mental health settings felt that they were working longer hours and experiencing an increased workload in relation to staffing shortages.
Empathetic nurses strive to provide excellent care for their patients, but many stated their patients were not receiving adequate care due to the reconfiguration of services. They also felt that the impact the pandemic was having on themselves personally was also affecting their ability to provide quality care. Community health psychiatric nurses also observed the lack of appropriate care they were able to provide to patients in their homes and the consequences of such situations.
Difficulty of Providing Inpatient Mental Health Care
Psychiatric nurses also identified the difficulty of attempting to socially distance between patients on the unit. Not surprisingly, the top concern among nurses working in inpatient mental health facilities is their risk of infection.
Mentally ill patients often do not comprehend or follow proper guidelines related to masking and social distancing. Nurses often have to de-escalate aggressive or combative patients without notice, which can result in no time to don proper personal protective equipment (PPE). Nurses in mental health facilities are also experiencing reduced levels of PPE, inadequate testing for COVID-19, and inconsistent or confusing infection control guidelines.
What Nurses Need to Provide Optimal Mental Health Care
70% of mental health nurses surveyed felt that support from their managers was key. This included guidance from local leaders in the mental health setting regarding clinical guidelines and how to navigate changes.
Unfortunately, they felt that general support resources were not as valuable. Additional staffing is necessary to prevent burnout from increased workloads. Telehealth policies from the American Psychiatric Nurses Association can be referenced for how to navigate working in a new digital environment.
It is critical for nurses to practice self-care, which they frequently recommend to their patients. Nurses must also practice self-compassion as they learn to cope and navigate caring for themselves and their patients during this historical time. It is not a sign of weakness to feel exhausted or overcome by stress and anxiety, and it’s imperative to ask for help.
Psychiatric and mental health nurses may not be the frontline workers we are used to hearing about, but they are vital to the holistic treatment of patients. The pandemic has highlighted the need for better mental health care for both patients and providers. More information is needed to understand the impact of COVID-19 on the role of psychiatric nurses and their patients. In the meantime, it is essential for all healthcare providers to take an active role in assessing mental health concerns in their patients, as well as amongst each other, and offering nonjudgmental support.
About the author: Maegan Wagner, RN BSN CCM has worked across many nursing specialties including hospice, acute care, travel nursing, and case management. Aside from helping others, she enjoys reading, CrossFit, and days at the beach.