Psychiatric Nurse- COVID-19 Unit Volunteer

[jeastridge, BSN, RN]

Interview With a Psychiatric Nurse

This interview with Morgan L., an inpatient psychiatric unit nurse, started before the onset of the novel coronavirus. During the time of the interviews for this article, she volunteered to work with any patients infected with the virus. At this writing, the patients suspected of having COVID-19 are being sent to a nearby hospital for observation. She remains on standby to work in that capacity if needed.

1. I understand that you volunteered to work with COVID psych patients. Why?

I volunteered to work with COVID psych patients because our administration said that if they didn’t have any volunteers, they would pick staff members from each unit, but certain staff members would be excluded if they had young children or were caring for someone elderly/immunocompromised. I knew I would be picked if I didn’t volunteer, and I didn’t want my administration to essentially say that my life is less valuable because I’m not actively caring for a child or elderly family member. Right now we don’t have a COVID unit, we are screening patients and watching for symptoms. If they have symptoms, we isolate them, send them for testing, and they usually get admitted to the hospital if they’re positive to be monitored for decompensation. We will only open a COVID unit if we see a significant surge in psychiatric patients with the diagnosis.

2. How has it been so far?

COVID has been stressful on our unit - we’ve seen a lot more admissions for suicide attempts, anxiety, and drug relapses because patients can’t handle the stress of being out in the world right now. We’ve restricted a lot of our previous activities to limit patients’ exposure, so we no longer go to the cafeteria, have visitation, or go to activities groups. This causes the patients to be on the unit a lot more, cooped up with one another, and we’ve had a lot more disagreements and codes because of it. Needless to say, we’re all ready for this to be over.

3. Where are you from? What interested you in nursing?

I was born and raised in Maryville, Tennessee. I initially became interested in healthcare when I was diagnosed with aortic valve regurgitation at the age of 12 after frequently experiencing shortness of breath and fainting spells. The nurses who cared for me throughout the numerous tests did everything they could to make me feel comfortable, even when they were going out of their way. I realized then that I wanted to do something with my life in which I could help people feel safe and loved when they’re scared.

4. Where did you go to school?

I went to the University of Tennessee, Knoxville, for undergrad. I was delayed in school for a year and took three years to finish nursing school due to an arm injury that left me unable to move my arm. My current credentials are BSN, RN.

5. Where have you worked in the past?

Throughout my undergrad I worked as a pharmacy technician at a chain pharmacy. The job was very stressful but I learned a lot, especially with medications. I also was a healthcare coordinator at a Summer camp in Occidental, California, for two summers, where I ran the first aid center and managed nurses and camp staff. I did my practicum during my senior year at Peninsula Behavioral Health and continued to work there as a behavioral health technician until I graduated and until I started work as an RN.

6. What interested you about psych nursing?

Originally, I was interested in pediatric nursing due to my previous positive experiences. In a leadership program in college, I was paired with a child psychiatrist and spent many hours shadowing her as she worked in both inpatient and outpatient settings. I came to realize that while I love kids, I do not love the nursing aspect of caring for kids (LOL). I was very interested in the psychiatric side of things, and loved my clinicals in psyche nursing that followed.

7. What do you like about psych nursing?

I love being a psychiatric nurse because I feel as if I can care for people who are not only suffering mentally, but are also fighting against the stigma of mental illness that exists in the world. I feel like patients who have mental illness are not only fighting their depression/bipolar/schizophrenia, etc, but are also fighting to inform others that their illness is real. A lot of patients have never had anyone listen to them before, so it is good to be this person for them.

8. What do you dislike about psych nursing?

The hardest part about psychiatric nursing is balancing both mental illness and behavioral problems. A lot of patients have never had anyone listen to them before, so they have learned to make their presence known by acting inappropriately. Behavioral modification is necessary for these patients, and it can be exhausting.

9. Can you think of a particular case that stayed with you? That impacted your practice in a positive way?

The case that comes to my mind is a patient from about four months ago who tried to commit suicide by driving her car off a cliff. She was severely injured and came to us after spending 2 weeks in the ICU She had a broken leg, a broken wrist, and over 50 stitches in her face. She was in a wheelchair because of a femoral cast, leaving her unable to walk. When I came on as her nurse the first day, I noted that her hair was matted. She told me she hadn’t had a shower since before her suicide attempt - 2 weeks in the ICU and no one had bathed her! (Except for a sponge bath in bed). Later that day, a tech and I took her to the walk-in shower and helped her shower, and I spent over an hour combing the glass, dirt, sticks, and blood out of her matted hair. She told me all about her family and how she had three children at home. She was a single mom, and two of her kids had disabilities, and her husband died unexpectedly the month before. She had become overwhelmed. It became very apparent to me how quickly certain life circumstances can change someone who previously had never been depressed and how mental illness truly does affect all of us. She became a new person after that shower, and had a more positive outlook solely because someone took the time to listen to her. This is why I love psych!

10. What advice would you give other nurses that might want to pursue psych nursing?

I think if a nurse wants to pursue psych nursing, they need to make sure that they can aim to be non-judgmental with patients. A lot of our patients are judged in every other area of life, and they need a place to be where they won’t be looked down upon because of their choices. Also, have boundaries! Patients (especially those with addiction disorders) can be manipulative and will try to push you. It’s important to have boundaries with patients and stick to them.

[A Hit With The Ladies, BSN, RN]

Very informative, thanks for that. I also work in inpatient psych, and I actually posted a thread earlier about how COVID has caused my unit's acuity level to skyrocket. The aggravation among my patient population is through the roof!

I volunteered for my hospital's Coronavirus unit, but it only opens periodically so I never actually got to go take care of a patient there. To be frank, I'd much rather be floated there and take care of one single Coronavirus-positive patient than deal with a dozen-plus patients on my unit (most of whom are combative/destructive, and will mean special team and/or code one after another).

I actually called off the last of my three-in-a-row weekend nights the other night because the mental stress of having people constantly yell at me or punch the medication room door while I was in the med room was driving me crabby. You end up hating some of these patients!

I went into psych nursing to get some psych experience (I'm in a psych NP program). I used to work medical ICU and then acute hemodialysis. This is a very different kind of stress for sure!

[jeastridge, BSN, RN]

10 minutes ago, A Hit With The Ladies said:

Very informative, thanks for that. I also work in inpatient psych, and I actually posted a thread earlier about how COVID has caused my unit's acuity level to skyrocket. The aggravation among my patient population is through the roof!

I volunteered for my hospital's Coronavirus unit, but it only opens periodically so I never actually got to go take care of a patient there. To be frank, I'd much rather be floated there and take care of one single Coronavirus-positive patient than deal with a dozen-plus patients on my unit (most of whom are combative/destructive, and will mean special team and/or code one after another).

I actually called off the last of my three-in-a-row weekend nights the other night because the mental stress of having people constantly yell at me or punch the medication room door while I was in the med room was driving me crabby. You end up hating some of these patients!

I went into psych nursing to get some psych experience (I'm in a psych NP program). I used to work medical ICU and then acute hemodialysis. This is a very different kind of stress for sure!

Thank you for sharing your comments and insights. You are so right. These are hard and stressful times for us as caregivers and for our patients. Joy