Today is International Nurses Day – a day to recognise the efforts of nurses around the globe. Two nurses at the forefront of mental health and alcohol and other drug care in Queensland talk about their work during the COVID-19 pandemic.
Joanne Wild sometimes feels like she is living in someone else’s job, like she has walked into someone else’s office.
It is two months now since the mental health nurse took a phone call that she is sure will mark a turning point in her life and career. Will you lead the COVID-19 response for addiction and mental health?
Within days she had handed over her old job, relocated to a new office and was the deputy incident commander for the Metro South Addiction and Mental Health Service COVID-19 response.
And while the past two months have been, in Joanne’s words, like being on a rollercoaster, she and others in the mental health and addiction field know things will get worse before they get better.
Experts warn that mental health will be the next challenge facing our communities as people cope with the fallout from the coronavirus pandemic and the economic and social impacts. Suicide rates are predicted to rise and agencies such as Lifeline and Beyond Blue have recorded a surge in calls.
Joanne likens the current situation to putting out spot fires before the real work starts.
And, unlike other natural disasters such as floods and bushfires, where there is a plan and blueprint for recovery, the unprecedented nature of the pandemic and uncertainty of how long it will last mean mental health is now more important than ever.
“Previously all our experience has been around bushfires and floods, we know that game because we have played it before. This is so different and it doesn’t have an end date.”
Joanne says that while worse-case scenarios in terms of positive COVID-19 infections haven’t eventuated, the workload hasn’t waned.
“We have had to co-ordinate the biggest PPE (personal protection equipment) distribution we have ever seen. In mental health we don’t use a huge amount of PPE in our daily business,” she says of the change to working conditions.
And there has been the challenge of transferring to tele-health while ensuring that mental health nurses continue to deliver services. Joanne says many vulnerable people don’t have access to technology and many acute and complex cases would not engage on a phone even if they had access to it.
“The biggest phase for mental health is going to be the recovery. It is almost like our work hasn’t begun yet,” she says.
Joanne’s best friend is a nurse working in ICU in the UK, where now more than 30,000 people have died as a result of the virus, and the pair chat frequently. Joanne says it has helped keep her grounded.
Nurses are encouraged to take time out, to go to the “wellbeing trolley” for nice teas and hanged the way treats, and to take part in silly photo competitions – such as posting old photos of themselves and running a competition for the best caption for what they were thinking at the time.
Joanne says mental health nurses are a resilient bunch, accustomed to dealing with left-of-field situations regularly. And, like so many nurses the world over, each day when she gets home from work she showers and changes her clothes before greeting her son and husband.
Originally from the UK herself, Joanne qualified there in 2008 before moving to Australia. She has a Masters in health care leadership and will soon finish a second masters in mental health nursing.
Joanne is also an ambassador for the Pathways to Excellence accreditation scheme, which recognises a health care organisation's commitment to creating a positive practice environment which empowers and engages staff.
“As part of my role I am an ambassador and have observed so much excellence in nursing from the service over this time to support our application – the wellbeing trolleys was one of those initiatives,” she says.
Joanne says the catch-phrase “nursing is more than you think” has never been more relevant as the profession navigates the COVID-19 pandemic and its fallout.
ALEX YUM - Clinical Nurse Consultant, Alcohol and Drug Homeless Outreach Team Addiction and Mental Health Services, Metro South Health Princess Alexandra Hospital.
Nurse Alex Yum thinks his job is “pretty cool”.
As a clinical nurse consultant with the Alcohol and Drug Homeless Health Outreach Team at the Metro South Hospital and Health Service, he spends most of his working hours out on the road.
One of the most rewarding aspects is meeting someone in need, having a chat and, in his words, “planting a seed” about the help he can provide and leaving his contact details.
Often, within a few months that person is looking for him.
“That’s pretty cool when they do that,” he says of the satisfaction gleaned when someone comes to him for help with an addiction or seeking guidance.
“They trust you enough to open their lives to me. They tell me all the dramas and everything they have gone through, life at home, life in jail, what worries them. They open themselves up and it is a pretty amazing opportunity. I really like that about our work, that people are willing to trust me.”
Alex often meets people at the lowest point in their lives. Helping them to a better place is, he says, one of the rewards of the job.
“In terms of guiding someone, I kind of explain to people I meet, “I’m not here to tell you how to live your life, we can just have a chat and I pass you some options”.
Alex started his career in 2000 as a nurse, working in emergency and general nursing, inpatient mental health units and the community alcohol and drug area, along with a stint in the detox unit at Royal Brisbane and Women’s Hospital. After nine years in a clinical advisory role he is relishing being on the road. Since 2003 he has worked in alcohol and drug dependency, and is now in the fourth year of his current job.
“We become nurses because we want to work with people. We want to work with and support people.”
Alex spends a lot of time working with colleagues at agencies such as the Salvation Army and St Vincent’ de Paul, seeing clients collaboratively and devising plans for them.
“It is one of those roles where it is not just patching people up and sending them out.”
In his job, Alex gets to meet people all along the spectrum of addiction – from pre-contemplative, to contemplative, treatment through to the ideal, which is recovery.
“In my role I get to see and meet people right through that spectrum.”
While the face-to-face work has been complicated by the COVID-19 pandemic, one of the things that has happened is that homeless people are being housed now in hotels and hostels.
Recently, in a storeroom, Alex and his team unearthed an old bag from a homeless conference in 2010. The motto on the bag was “eliminating homelessness by 2020”. They had to laugh, given that in 2020 the homeless have been given temporary accommodation as the world fights an unprecedented pandemic.
And there have been challenges helping people adjust to a different style of life in hostels, and to feelings of isolation and fear of the virus itself.
As Alex points out, while this is a temporary measure, the issues that caused them to be homeless in the first place haven’t gone away.
Given that he is seeing some of the most vulnerable in society, there are highs and lows for people working in Alex’s field. The highs tend to be higher and the lows lower. Self-care is important, as is de-briefing with colleagues.
“We get our low days but our high days are really cool and it makes it all worthwhile,” Alex says.