The following is a transcript from an interview conducted with a nursing student based in Montreal, Canada. The transcript sheds light on aspects of the work environment in a mental health care setting amid the COVID-19 pandemic, as well as the roots of passion that make nurses such determined members of society. The name of the interviewee and work location has been omitted for confidentiality.
Tell me a bit about your background, what you study and what made you go into the nursing field.
I’m currently a senior nursing student working as a health and social services assistant in a COVID-19 unit.
I’ve always known that I wanted to work in healthcare. Many members of my family work in this field because caring for the elderly and the vulnerable is deeply ingrained in our culture. Choosing this profession also means being able to support our family back home in the Philippines. I didn’t go straight into nursing after I graduated high school, as was expected of me. I didn’t want to be another cliche — I didn’t want to become a part of the ubiquitous Filipino nurse stereotype. It’s only after I witnessed first-hand the leadership and courage of nurse activists during my first trip back in my country of birth that I decided to pursue this profession. I saw nursing in a new light. I saw the role of nurses beyond the bedside. I saw their essential role as agents of change in the community. Despite working under inhumane conditions and receiving unjust compensation, the nurse leaders I’ve met relentlessly fulfill their duties within and outside of the clinical setting. I saw them fearlessly organize themselves to demand better treatment and care for their patients from a government that remains blind to their plight. Instead of going abroad for greener pastures, they chose to stay and serve the people in their country even under such dismal conditions. They remain unfazed by the numerous threats they face every day. Speaking out and disrupting the status quo was often met by violence and repression from the government, which is why most workers prefer to stay quiet than risk losing their livelihood or their lives. Witnessing such selflessness and fierce bravery ignited my desire to pursue nursing, but it also showed me the importance of organizing and cultivating empowerment among the community to create change.
What’s your workplace like and how did you get this position? Was it voluntary? Is there something unique about your situation?
I’m a nursing student, so I was asked to help out in hospitals. I didn’t want to stay home and just watch the number of COVID-19 cases increase every day, so I didn’t hesitate a second. I accepted a position at the hospital closest to our place, so I didn’t have to commute. Since April, I’ve been working fulltime in a COVID-19 ward that caters specifically to patients with special needs, intellectual disabilities and who have autism spectrum disorder (ASD). I never had experience with these types of patients, so I was very nervous at the beginning.
When you first became aware of the COVID-19 pandemic, how did you feel, or what did you anticipate?
I initially felt powerless because I thought I couldn’t go to the frontlines and help out since I was still training. Plus, my clinical rotations in the hospital were canceled. It was painful to watch the news while I was sitting all day at home. I was always checking on all my social media accounts to see how my family and friends were doing. Many of them work in healthcare, so I was anxious.
How has your work schedule changed since the start of COVID-19? What’s the atmosphere like in your workplace among staff and patients?
I used to work some double shifts (evening and night shifts consecutively) when we were short-staffed. Eventually, they hired more people, so I just worked my regular shifts (5 x 8-hour shifts of mixed night and evenings every week, including weekends). But some of the new hires weren’t even trained to properly don PPEs so it was very stressful. Their lack of training put the staff and the patients at risk. There were some thefts committed as well. Narcotics and boxes of PPEs started disappearing. Some employees eventually quit because they were so worried about their safety.
What’s a day-in-the-life for you from when you enter the hospital to when you depart?
In the beginning, I used to arrive an hour early before my shift started to change into my uniform and don my PPE correctly. It took a while before I got familiar with all the steps. Despite having learned them at school, it was still challenging to apply all the protocols they wanted us to follow. It was very confusing since they were always changing based on the availability of PPEs. For example, in our training, we were taught not to reuse a surgical mask. But now, in order to save PPEs, we were told to put them in a Ziploc bag if we only used them for less than 4 hours. There were many times when my visor or safety glasses were accidentally knocked off by a patient, especially when they displayed disorganized or distress symptoms. It’s impossible to maintain physical distancing when caring for our patients. Physical contact is necessary to care for them properly. Whether bathing them or helping them calm down when they get anxious, the physical touch was often the only way to reassure them. As soon as I arrive home after my shift, I always head straight to the shower and throw my clothes in the laundry to avoid contaminating my partner whom I live with.
At work, was there anything you had to figure out on your own or were you sufficiently trained? Was it a dynamic environment?
It was like stepping into a whole other universe each time I entered through the doors of our ward. It wasn’t the most cheerful place to be. To be honest, it felt more like a prison. It was located in a hospital wing that was already closed down for many years. It used to be the palliative care unit. The beds were ancient; they weren’t the ones you could easily adjust by the touch of a button. The windows were all sealed shut to keep the pressure negative. Each room was like a cell. The rules were very strict. Patients were not allowed to get out of their room except to go to the shower room once in a while. I saw a young patient get tackled by a security agent when he tried to escape his room. That was so heartbreaking to watch. There was a camera in each room to keep an eye on each of the patients 24 hours a day. They couldn’t even go out for a walk in the hallways to prevent contamination between patients and staff. Visitors were not allowed. Throughout my training as a nurse, we were always taught the importance of mobilizing patients to speed up their recovery and to prevent many complications such as bed sores. Many of our patients’ health deteriorated due to the lack of physical exercise. They would always be given sedatives when they were very agitated or left seated or bedridden for long periods. We had a young patient with severe autism who loved running around when she was admitted but couldn’t even stand up or walk by herself anymore when she was discharged. Witnessing their functional decline during their stay was gut-wrenching. I often questioned “what did I sign up for?”. This is not caring. This is not nursing. I wouldn’t want my loved ones to be cared for in this environment. This was so different from what I learned in school.
How are your colleagues doing? Have there been any fatalities?
Many of my colleagues eventually tested positive for COVID-19. Fortunately, none of them were hospitalized and they all recovered after their quarantine. This challenging environment certainly took a toll on everyone’s mental health, including the employees. There were no deaths, but the atmosphere was often gloomy.
Has anything been working out well now or in the past?
After a few weeks, we had enough PPE and staff for all the shifts so we weren’t asked to work overtime anymore.
How has COVID-19 impacted your life outside of work?
On top of working, I continued my courses online, so it’s been difficult to practice self-care and reconnecting with friends and family. When I’m not at work or studying, I also volunteer with grassroots organizations focused on helping out the most vulnerable in my community, like migrant workers and domestic workers and their families. We have this initiative where we connect individuals and families in need of resources and where we offer much-needed services like help with navigating the government financial aid programs and a tutoring and mentorship program for kids who are stuck at home during the pandemic. All this community care that I’m immersed in, that I’m witnessing every day in our community, has been what’s keeping me going, staying motivated, keeping me optimistic through this crisis that we’ve been experiencing.
What do you wish could be changed?
I wish we could provide a more healthy and caring environment for this vulnerable group of our population, especially within the pandemic context. In my opinion, the rules were too strict and caused more harm to their health and wellbeing. Putting them through 24-hour confinement, prolonged social isolation and the lack of physical activity throughout their hospitalization was inhumane. I wish there was more awareness about them in our society. If it weren’t for this experience, I wouldn’t have learned about their particularities and needs. Learning about ASD and how to care for this subset of individuals as patients should be a part of nursing curricula. It would better equip us in providing more personalized care and support for people with ASD and their families.
