The COVID-19 pandemic has not only illuminated the physical demands of caring for patients exposed to the virus, it has also brought attention to the damage the illness can wreak on patients' mental health and the role of nurses as a prominent source of support and encouragement. Here are some ways to ensure you address the needs of patients.
What Types of Support Do COVID-19 Patients Need?
According to an April 2020 Kaiser Family Foundation poll, 45% of participants indicated that the pandemic has affected their mental health, with nearly one in five reporting major impacts on their well-being. Patients who test positive for COVID-19, whether hospitalized or at home quarantining or isolating, require emotional care and support in addition to management of their physical signs and symptoms.
Mental health support. Patients' physical symptoms and the associated isolation requirements can lead to or exacerbate mental illness. Ongoing fatigue that lingers for weeks and months and prevents patients from resuming their normal routines may trigger depression. Shortness of breath can raise anxiety levels or increase the likelihood of panic attacks. Feelings of anger, frustration, fear and sadness are not uncommon, but each patient is likely to respond differently.
It is important for nurses to acknowledge these feelings as well the trauma generated from such experiences. For many patients, the visuals alone — of nurses wearing layers of personal protective equipment (PPE) and people of all ages struggling to breathe or being placed on ventilators — can cause distress and induce anxiety, especially in minors and those with pre-existing mental health issues.
Physical symptom management. The uncertainty surrounding the virus and its transmission, disease progression and reinfection potential calls upon nurses to disseminate accurate evidence-based recommendations. Although treatment protocols have evolved and become more effective, there remain limitations on the management of physical symptoms caused by the virus. Much of the inpatient treatment consists of allowing the virus to run its course while monitoring vitals and offering supplementary care, like oxygen support. For patients who are isolating at home, nurses can provide detailed guidance on self-care practices and clear advice on when to contact a physician or seek emergency treatment.
What Resources and Advice Can Nurses Share With Patients?
Nurses can help patients cope by providing compassionate care and sharing timely information and best practices for recovery. For example, establishing a self-care routine is an important part of healing, so nurses should encourage patients to:
- Maintain a regular sleep schedule, if possible
- Prioritize rest to conserve energy and allow the body to recover
- Exercise regularly, as able, to maintain or build stamina
- Perform deep breathing exercises to improve lung function and calm anxiety
- Avoid smoking, drinking alcohol or taking medications other than those prescribed
Patients in the hospital or in quarantine at home and distanced from other household members often struggle with the loss of their support systems. Nurses can recommend that patients use phone calls, texting or video chats to stay in touch and up to date. For severely ill inpatients, nurses should be prepared to facilitate communication on the patient's behalf.
The Centers for Disease Control and Prevention (CDC) created a comprehensive list of COVID-19 resources that nurses can share with patients. Several states offer hotlines and virtual support groups and services. A COVID-19 information guide and helpline is available from the National Alliance on Mental Illness (NAMI).
The isolation and quarantine strategies designed to mitigate the spread of COVID-19 frequently have a detrimental impact on patients' mental health. Nurses are not only critical in providing guidance in the handling of the disease's physical manifestations, they are increasingly a key source of support for patients attempting to cope with the pandemic.
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