By Tessa Moriarty Credentialed Mental Health Nurse Consultant.

To read articles about nurses raw experiences during COVID19 go here

To write for The Nurse Break go here

Nursing In a Pandemic – A Mental Health Nurse Perspective

Where do I start. Here and now, at the place we never thought we’d still be. At home in a telephone supervision session, in lockdown, with a supervisee, when our conversation is interrupted by an earthquake. Or, back last year when the pandemic was still novel – for more reasons than a virus we knew little about. Some of us thought it was a bit of an adventure at first, navigating our first weeks through changes in homelife, workplace, and routine. Until people we knew, or knew of, or read about, started dying – as we saw it unfold before our eyes, in disbelief and horror at the images flashed through our televisions, from the other side of the world into our living rooms.

Cities emptied and barren. Images of people dead on the streets, or crammed head to toe on stretches in Emergency Departments. Makeshift hospitals in carparks and sports grounds. Buildings boarded up, so people couldn’t leave. Residents screaming from balconies for help with their sick and dying relatives. Every day, all day, and every night. We watched, held our breath, and prayed.

Yet with every development, every rise in the number of those with the virus, those requiring hospitalization, the international health workforce (the majority of which was made up of nurses and midwives) turned up to the call, rolled up sleeves and went to work. Twenty-four seven. Challenged, but undaunted by the tasks at hand.

My own job as a nurse had only just taken me out of the acute setting when the pandemic hit. I was coordinating a workforce project in a regional Victorian health service. In addition, I had a caseload of health professionals for whom I was providing regular clinical supervision and also working as an external Mental Health Nurse Consultant to several Primary Health Networks. Often on the road, at site, in a facility, working with providers providing direct care.

Now, no longer at the cold face, but in a second-line-of-defence role, I sat with (through zoom or mobile phone) and guided and supported many of those still on the shop-front floor. Or with others in management and educational roles, developing or teaching mental health programs as they (and the rest of the world) grappled to understand, and manage the disaster as it unravelled. All, irrespective of workplace or location, spoke of distress, heartache, and strain, as they navigated unfamiliar territory, working in a pandemic. As I tread further back along the corridors of the last 18 months, I see light and grey.

There are those who were willing to take on the challenge and build their own resilience, every day an opportunity to give, learn and grow. While others struggling and frustrated by constraint, balked at the lack of resources and the cost to self, amidst an ever-growing need. I feel still, the memory of my own fear, the twitch and disquiet beneath my skin.

The agitation building around me in a world with so much uncertainty. And I carried my tiredness from one week to the next, un-changed by rest, as the weight of nursing in a pandemic, slowly sapped my vitality. And I wrote. To make sense of what I was going through and to find meaning in the chaos. I used my own supervision to separate out what belonged to me and what I needed to let go. I sought out ways to unwind and restore. I rode my bike into the wind and walked the streets and the beach, asking the universe for answers.

I took to social media to connect and to know I was not alone. I shared what I was learning and used my experience alongside the stories of others to develop workplace strategies and new ways to cope. In my work at least, I found (and still do), a sense of purpose and belonging. I listened and facilitated understanding and knowing in others, while helping to untangle the angst of the unknown. I heard dismay and despair and held the anxiety this brings.

And the work kept coming. I rose to the Morning Wake Up on my headspace App, then a gratitude prayer. I took this into my workday. In my online groups I tried to focus on the positives. The silver linings. The small gains and teachings hard times bring. But people were (and still are) tired, weary. The mental health impacts of living in lockdown, missing out on connections with family and friends, and the support that social contact and physical touch brings, was taking its toll.On those I supported, on their organisations, on me. I presented at an online webinar panel on tips and strategies for using technology in mental health consultations. Over two thousand people attended. I focused on intentional self-care and clinical supervision.

How to work well from home. I facilitated professional development sessions for a nursing team and filled my blog and other pieces I wrote, on managing fatigue, preventing burnout and the mental health impacts of bullying. Then the year that was, ended. Alongside colleagues, those I supported and everyone else – we were able to share Christmas with others. Grateful to be reunited but stunned by what we had just been through. Barely a week later, I got the call-up. Willingly – because I’m proud to be a nurse – I joined the thousands working Covid-testing sites. Humbled, through the heat of summer, in my PPE kit, I gained new skills.

Back to the present. Very little has changed. Many tell me they feel worse. There is a deeper layer to their fatigue. But the human spirit keeps us going. Gets us out of bed and into the day. I am still supervising and supporting those who support others. I still ride my bike into the wind and writing gives me a tool to reflect. Every day despite my tiredness, I am grateful. Every day is also a new one and with it there is always something to learn, to know, to share.