Scaling down aggression during COVID-19
Clear communication with mental health consumers and reducing boredom is at the heart of an effective strategy.
The COVID-19 outbreak has forced mental health facilities to suspend patients’ outside leave and restrict visitors, leading to fears that patients might become more aggressive, but one facility has successfully managed the crisis.
Peta Kleinig, Nursing Unit Manager at The Chisholm Ross Centre in Goulburn, told The Lamp that keeping consumers informed about infection control measures and engaged in therapeutic activities has been a key part of their strategy to deal with the COVID-19 crisis.
“We hold meetings with consumers every morning to explain what we are doing, and they really appreciate what we are doing to keep them safe,” Peta says. “We’ve actually been surprised by what a positive response we’ve got from consumers.”
“We have over 100 nurse-led activities per month, and we’ve kept that up with along with activities run by allied health workers, including a peer support worker, social workers, a diversional therapist and a vocational officer.”
The 32-bed facility has an internal courtyard open all the time, but it has changed how the backyard, which was also open all the time before COVID-19, is used.
“We’ve broken up access to the backyard to blocks of two hours, three times a day, with nursing staff supervision to ensure that we are aware of any issues that may arise in regards to COVID-19 restrictions.
“We do remind consumers constantly about physical distancing. In our low dependency unit people remember to social distance, but in our high dependency area it has been a bit trickier.”
When the Chisholm Ross Centre had to close to visitors from mid-April, the access to open areas and the daily activities program “helped to take the boredom out of things”, said Peta.
An increase in nicotine replacement
The unit has always been a non-smoking unit, in accordance with NSW Health policy, but since Covid-19 staff have increased the use of nicotine replacement for consumers with nicotine habits.
“We have not seen an increase in aggression on the unit as the nursing staff have always been consistent in their approach to the non-smoking policy.”
From mid-May the centre has allowed visitors to return, with a policy of one visit per patient per day for 30 minutes. “We review that every Friday,” says Peta.
As an acute admissions unit, the facility takes admissions from EDs, police, ambulance, courts, and community teams. The centre confirms with the referrer that new arrivals have been screened for COVID-19, and the screening is repeated during the Chisholm Ross admission process.
“In the small number of cases where screening indicates the need for testing, consumers are isolated whilst we await the results. We have had four people isolated on the unit, all with negative results.”
Rosters have also been amended to accommodate staff with co-morbidities or who are older. “For example, we have one nurse who is doing night shifts until the COVID-19 crisis is over. This has minimised her contact with consumers and still allows her to continue working.”