19 PANDEMIC

by Nurses and Midwives Leaders Think Tank Ug

CRITICAL ROLE OF NURSES AS PART OF THE CARE TEAM

5 MINUTES WITH A LEADER: PSYCHOSOCIAL CHALLENGES FACED BY NURSES AND MIDWIVES DURING COVID-19 PANDEMIC

Psychosocial challenges, refer to the negative impacts imposed on an individual when both psychological and social needs are not met or fulfilled as expected. The psychosocial effects are felt on both the mind and body. The reason is sophisticated and hypothetical, and its response depends on external environmental stimulus. For example, when information is pleasant to the individual, it responds positively, but when it’s unpleasant, it reacts negatively. Similarly, when needs are fulfilled, it responds positively; however, it responds negatively if demands are not satisfied. However, this also depends on the individual’s mechanisms of coping and resilience. People with solid strength quickly overcome challenges. Those with weak power find it hard to manage, experiencing mental health symptoms such as stress, depression, anxiety, phobias, panic, unresolved persistent physical symptoms, and other mental disorders. The Nurse or Midwife has a mental aspect of health that can be affected by her nature of work; if this is not resolved, it can affect his/her psychological and social functioning. Psychologically the Nurse/Midwife may develop disturbance in thinking, reasoning, decision making, perception, and behaviour. It can also lead to dysfunction in work, relationships with colleagues, friends, family members, and level of cooperation. If the Nurse/Midwife can adjust, she/he can deal away with the situation but, if not, may develop mental health problems that require intervention.

Psychosocial challenges faced by Midwives/Nurses during the covid-19 pandemic.

The pandemic has not spared health workers of the effects of Covid-19, especially the psychosocial challenges that have significantly impacted their lives. These include:-

• Persistent fear of contracting the disease. • Nightmares and terrors • Anxiety • Psychological nervous loss of appetite • Depression • Stigma • Discrimination • Mistrust by family members due to the nature of their work • Unstable family relationships including divorce due to the nature of her work. • Self-blame for the death of patients. • Failure to attend to their families socially. • Increased workload due to managing patients with multiple problems/conditions. • Failure to provide psychosocial support to others.

Danger mental-health signs to look out for in a Nurse or Midwife

• Unprovoked anger and irritation • Reduced productivity at work • Absenteeism • Isolation or reduced level of socialisation • Tearfulness or persistent sadness/depression • Unexplained fatigue, headaches, loss of appetite, loss of libido • Reduced sleep • Persistent nightmares and terrors • Swing of moods • Unusual or odd behaviours • High levels of stress

Available resources to support Nurses/Midwives.

i. Peers ii. Fellow workmates iii. Counsellor iv. Supervisors v. Psychiatric Clinical Officers vi. Psychiatrists vii. Psychologists

How can managers support Nurses/Midwives better to avoid breakdown?

• Managers should learn to be supportive to the upcoming nurses/midwives. • Conduct individual/group meeting to discuss issues related to work, especially during the pandemic. • Managers need to have a listening ear and be effective communicators. • Acknowledge and appreciate the work of midwives/nurses by motivating them, giving social praises, study leaves, duty offs, lobbying for more staff, risk allowance, and salary, flexibility on shifts of work. • Inculcate in nurses/midwives the culture of sharing in times of happiness and sadness. • We are learning each nurse/midwife’s character and attitude to work. • Provide talking messages on covid-19 of hope and encouragement in the ward. • Ensuring free screening tests for covid-19 for Nurses/Midwives • Provide time for relaxation on the ward • Reduce workload by planning and advocating for more workforce • Encouraging further post-basic training • Continuous provision of guidance and support on the use of SOPs • Console, comfort, and counsel those in need • Motivate staff recognition of her exemplary services • Understand each staff as a person

• Early identification and referral of nurses/midwives with mental health problems to specialists • Engage staff in planning for activities of the ward and avoid dictating unless were necessary. • Be close and accessible to the midwives/nurses to build a good working relationship. • Managers should be fair and exercise justice to all staff.

By Harriet Kwagala, Mental Health Nurse