Medical News Today spoke to a registered nurse whose regular day job is looking after patients on psychiatric units. Now, he finds himself caring for people with COVID-19, as well as patients on other wards.

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Joe is a registered nurse in Chicago.
Image credit: Joe, 2020.

Joe, who asked us not to include his surname, is a registered nurse working in a hospital in the Chicago suburbs. He usually works on an inpatient psychiatric unit.

Because of the COVID-19 pandemic, Joe and his fellow nurses were asked to take on roles in other departments, including caring for patients with the disease.

In this interview, Joe tells us about his work, gives his view on how the pandemic is already taking a toll on mental health and how it will likely continue to do so, and describes how he tries to unwind after his shifts.

Joe also shares two things he wants everyone to know about COVID-19.

MNT: How has your job changed in the past few weeks?

Joe: The hospitals are trying to accommodate the COVID-19 cases by pulling nurses from a variety of departments and ensure they provide adequate training to care for people with COVID-19. We are planning for a surge and want to be ready.

I usually work in adult inpatient psychiatry, but due to the staffing demands caused by the increasing numbers of COVID-19 patients, the hospital asked me, and many others, to rotate and train in different departments.

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MNT: What was your last shift at work like?

Joe: It’s hard to describe and give an accurate description of what goes on in one shift. But I will try.

The last time I worked on a COVID-19 unit, it was a med-surgical floor, which is now dedicated to treating only COVID-19 patients. On that day, we discharged someone who was getting better to go home to self-quarantine. However, we also witnessed a patient’s family saying goodbye over a video conference because they couldn’t visit.

The person later passed away. So, it’s a really hard time right now. It’s hard to anticipate. What has been consistent, though, is that everyone is doing their best.

MNT: That sounds really hard and very different from your regular day job. Is your hospital doing anything to help prepare you for this very different way of working?

Joe: If you’re feeling unsafe or feeling like it’s too much, the hospital has been doing a good job of providing additional training and giving all the support needed. It’s not easy, but it’s what has to be right now.

MNT: Do you feel safe when you are at work?

Joe: Yes, I do.

MNT: How quickly has the situation changed in your hospital?

Joe: It was probably 3–4 weeks ago, right around when the stay-at-home orders came out. The number of COVID-19 patients has been continually increasing over the last 3 weeks.

MNT: Do you have enough capacity to take in increasing numbers of patients?

Joe: Thankfully, so far, we do. We can accommodate all these patients by expanding into different departments, but there is going to be a point when there is not enough room. We haven’t hit that point yet.

MNT: Because your job has changed so much, are you ever reluctant to go to work?

Joe: All of this has happened so fast. I am not reluctant to go to work; I want to do my part to help be part of the solution to this pandemic.

It is, however, stressful. I find myself out of my comfort zone, working on a different unit than I usually do. But I have been working with some amazing nurses. Everyone is doing their part to help.

MNT: What do you do when you get home? How do you switch off?

Joe: I like outdoor activities, just being able to be outside. I have been avoiding large groups and public places, but being alone outdoors helps me relax.

At the moment, we are still able to be outside where I live, as long as it’s not in large groups. But this could change at any time. Hopefully, it doesn’t get to that point.

MNT: As someone who usually works in psychiatric units, how do you see this pandemic affecting the mental health of your patients, your colleagues, and also the wider community?

Joe: Well, unfortunately, there’s a lot of anxiety. This is a traumatic experience for every person in the world, in a sense. So I foresee an increase in cases of psychiatric admissions following this.

We are already seeing people coming into the inpatient psychiatric units with paranoia, anxiety, and depression-related issues due to the pandemic and isolation at home. So it’s already starting.

I see it getting more progressive, and, unfortunately, there is already a shortage of mental health services. There’s always a demand for it, and I predict that following this pandemic, there is going to be even more demand.

MNT: Are there practical things that people can focus on to help them deal with their anxiety and worries around COVID-19?

Joe: If it’s fear of contracting COVID-19, follow the published recommendations. If someone needs to go out in public, wear a mask, wear gloves, learn about cross-contamination, wash the hands, stay away from other people.

Otherwise, STAY HOME. Stay up to date on the current recommendations.

At home, isolation can be hard for a lot of people. There are lots of resources online — lots of tools and techniques that people can look up and use to help them cope with anxiety during this time. For example, mindfulness techniques, and taking each day as it comes — one day at a time.

Unfortunately, right now, a lot of outpatient therapy and mental health services are closed down to minimize the transmission of the virus. So take advantage of the resources available online for now.

MNT: Everyone is relying on you and your colleagues to look after them, treat them, and in some cases, accompany them during their last moments. How do you think healthcare professionals might deal with these experiences in the long term?

Joe: I think everyone deals with anxiety and stressful situations in very different ways. It helps to know that the support is out there if we need it, knowing we are a team in this pandemic, and knowing that every fear someone holds is valid and that we need to take it seriously.

We are dealing with something very stressful, difficult, and with little room for repose. If things become too overwhelming, don’t hold it in. Talk to someone who can help.

MNT: Is there something that you wish people to know about the new coronavirus?

Joe: There are two things. Firstly, while there has been a lot of coverage of the COVID-19 pandemic, one thing I would say is to take it seriously. Take the recommendations seriously. If there are stay-at-home orders, follow them.

The people who work on the front lines and see these cases up close can vouch for how serious it is.

The second thing concerns the amount of publicity and focus on the nurses and doctors battling this on the front line. But there is a whole other group of people at the hospital who play vital roles.

Whether that is the housekeepers being exposed to infectious material, or the respiratory therapists, the techs, nurses’ aides, the unit secretaries, security services, transporters, the front line in the hospital goes beyond the nurses and doctors.

There are many more to add to that list as well, and I think that every healthcare worker should get the support and backing that nurses and doctors have. Without everyone working together, we would not be able to battle this pandemic.

MNT: When you think about the day that lies ahead of you, do you have any worries?

Joe: I try not to worry about it beforehand. I try to go into work as relaxed as possible and address things as the day unfolds. The way that I get through my shifts and the way that I do my best at work is to go in with an open mind.

MNT: Do you know which department you will be working in today?

Joe: Yes, it will be a COVID-19 unit.

Here is a list of resources that Joe put together following our conversation with him:

  • Telephone Support:
    • The National Suicide Lifeline: Call 800-273-8255 or chat online here.
    • The Trans LifeLine for peer support for trans people: 24-hour hotline 877-330-6366. This hotline is staffed exclusively by trans operators. It is the only crisis line with a policy against non-consensual active rescue.
    • The National Parent Helpline: Emotional support and advocacy for parents. Call 855-427-2736
    • The Disaster Distress Hotline: A free, national hotline providing 24/7, 365- day-a-year crisis counseling and support to people experiencing emotional distress related to disasters (including infectious disease outbreak). Trained counselors offer crisis counseling, information on recognizing distress, tips for healthy coping, and referrals for local care. For English speakers, call 1-800-985-5990 or text TalkWithUs to 66746. For Spanish speakers, call 1-800-985-5990 and press “2.”
  • Virtual Meetings:
    • Depression and Bipolar Support Alliance: Find online support groups here.
    • Refuge Recovery: Join online meetings here.
    • Alcoholics Anonymous (AA): Find online meetings here.
  • COVID-19 Information:
    • Medicare and Coronavirus: Find answers about COVID-19 and Medicare here.
    • CDC:Find out more about mental health & coping during COVID-19 here.
    • SAMHSA:Find out how to cope with stress during infectious disease outbreaks here.
    • Mental Health America: Find help here.
    • Mental Health First Aid: Courses in response to COVID-19 here.
  • Resources for families with children:
    • The National Child Traumatic Stress Network (NCTSN): Find a guide to help families navigate COVID-19 here.
    • Child Mind Institute: Supporting families during COVID-19. Phone consultations are available here.
    • The National Association of School Psychologists offer a guide on talking to children about COVID-19. More details here.

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