Who will protect the mental health of the angel in white?

Angels in white are the guardians of people’s lives and health. After the outbreak of the new coronavirus pneumonia, the majority of medical workers rushed to the front line of epidemic prevention and control without hesitation, making significant contributions to building a healthy China. At the same time, people are paying more and more attention to the mental health status of this professional group. According to the recently released "Survey Report on the Mental Health Status of Medical Workers in 2020", 27.7% of medical workers may be prone to depression and 19.8% may be prone to anxiety. Among them, nurses are second only to doctors in the proportion of mental health problems. Why do nurses become a group with high risk of psychological problems? How to relieve their "worries"? On the eve of May 12th Nurses' Day, our reporter interviewed some medical staff in our province and asked us to pay attention to the mental health of the angels in white.

Guangdong Provincial Workers’ Hospital carries out knowledge education lectures Ouyang Yuting/photo

Current situation

The physical and mental pressure brought by the nurse-patient relationship is the most obvious

Fatigue, tension, anxiety, depression... In March 2021, the "2020 Mental Health Status Survey Report of Medical Workers" (hereinafter referred to as the "Report") released by the Institute of Psychology, Chinese Academy of Sciences showed that my country's medical workers Mental health problems represented by depression and anxiety cannot be ignored. 27.7% of medical workers may be prone to depression and 19.8% may be prone to anxiety. Among them, the proportion of mental health problems among nurses is second only to doctors.

Why do nurses become a group with a high risk of psychological distress? During the interview, the reporter learned that high-intensity work, long-term night shifts, nurse-patient relationships, work-family conflicts, etc. are all important factors affecting the mental health of nurses. Among them, the physical and mental pressure caused by the nurse-patient relationship is the most obvious.

“Third points of treatment, seven points of nursing.” As the people’s demand for health services continues to grow, society’s expectations for nursing work will also be higher. But on the other hand, the shortage of nurse manpower has greatly affected the nursing needs of patients. It is understood that according to the requirements of the Ministry of Health, the ratio of ward beds to ward nurses must not be less than 10.4. However, many hospitals currently do not meet this standard, which invisibly increases the work intensity of nurses.

"Work is like a 'war'. It's almost impossible to get off work on time. Sometimes it does break down." A nurse interviewed said this. In their daily work, nurses in intensive care units, psychology departments, geriatrics departments, oncology departments, chemotherapy departments, pediatrics and hematology departments may face greater psychological pressure.

“They deal with psychological patients with symptoms such as anxiety, depression, mania, etc., cancer patients with low mood, and elderly and weak patients. Nursing care is more difficult and the requirements for nurses will be higher. High. In addition, during the special period of epidemic prevention and control, nurses in the infectious disease department and fever clinic also face greater psychological challenges," Li Li, head nurse of Huiqiao Medical Center of Nanfang Hospital, told reporters.

Chen Xiaofang, director of the Nursing Department of the Third Affiliated Hospital of Southern Medical University, said that the work pressure of nurses is mainly related to the complexity of the condition of the care recipient. The more complex the patient's condition, the heavier the workload that nurses bear, and the greater the physical and psychological challenges they bear. She gave an example. Nurses in the emergency department and intensive care department are faced with much greater unpredictability and complexity of patients' conditions than in other departments, and are more likely to suffer from psychological conditions such as anxiety and depression. Over time, burnout may occur.

In addition, competitive pressure at work is another important reason for nurses' psychological stress. From nurse to nurse practitioner to supervisor nurse and chief nurse, if you choose to engage in nursing work, you have to move forward non-stop and work hard to reach every step in your career.

"Working and studying are balanced, and practice and theory are grasped." Princess Wang, a spine surgery nurse at the Third Hospital of Nanjing Medical University, summed up her professional requirements. After graduating from college in 2018, the princess stayed in the hospital for one year for training. Then I went to study abroad for a year and came back to work in March this year.

She told reporters that the hospital assesses nurses every year, including not only skills training competitions, but also theoretical written examinations to consolidate textbook professional knowledge. Regarding her future career path, she plans to continue to apply for the nurse qualification certificate. Five years after passing the exam, she can apply for the supervisor nurse qualification, and then the chief nurse. ”

Photo provided by the unit of Nanjing Third Hospital’s nurse using B-ultrasound to check the location of the patient’s catheter

Response

A psychological counseling team is set up to “receive” patients at any time.

The reporter learned that many hospitals have responded to the mental health problems of nurses through pre- and post-event testing and post-event intervention.

The princess said that one of the physical examinations during the training stage is a psychological test. The Daily Care Department also distributes mental health questionnaires. "If there are difficult-to-resolve emotions at work, we will communicate with the head nurse, or take a temporary leave to recuperate. Generally, we can ease it."

"Nurses also work in a service industry, and there is definitely psychological pressure. Yes, there is fear of getting the wrong injection, dispensing the wrong medicine, and fear of patient complaints. "Li Li said that nurses at work usually complain to each other to adjust their mood. In recent years, Nanfang Hospital has also established a psychiatric and psychological care team to not only care for the "souls" of patients, but also to protect the physical and mental health of front-line medical staff.

"The Third Hospital of Nanjing Medical University has established a psychological counseling team for medical staff, which can accept 'consultations' at any time, and the nursing department will hold a nurse symposium every quarter to discuss the problems that exist in the work and life of nurses. Confusion and pressure can be relieved in time," Chen Xiaofang told reporters.

In order to better help medical staff resolve their "worries", the Affiliated Hospital of Guangdong Medical University and the hospital labor union have respectively established a co-worker psychological consultation group and a co-worker support committee. "As long as we have needs, we can seek help from the Colleague Psychological Consultation Group and the Colleague Support Committee. There are specialized doctors to help us relieve stress and solve difficulties." Nurse Chen Wenna said.

As the "native family" of the majority of employees, trade unions at all levels in Guangdong Province are also taking practical actions to care for the physical and mental health of medical staff. After the outbreak of the COVID-19 epidemic last year, in order to alleviate the physical and mental pressure faced by front-line medical staff and their families fighting the epidemic, the Provincial Federation of Trade Unions quickly established a team of psychological experts to give full play to the role of the union’s employees as a spiritual station and provide medical services to medical staff through the 12351 Guangdong employee hotline. Provide psychological counseling and difficulty assistance services to parents and their families. Every year during Nurses' Day, the Provincial Education, Science, Culture and Health Trade Union also organizes condolence activities to send the care and warmth of the union organization to the nurses. Various hospital unions have organized collective outdoor development activities to allow medical staff to relax after busy work.

Suggestions

Strengthen the vacation system and proactively carry out psychological adjustment

Chen Xiaofang, Director of the Nursing Department of Nanjing Third Hospital: The shortage of nurses should be the most existing confusion in the world , hoping that the country can provide some support and equip it with sufficient manpower. In addition, it is to improve the medical environment and promote a harmonious relationship between nurses and patients. In the past, society did not have high awareness of nursing work, and always thought it was a relatively low-level service job. In fact, nursing is a refined skill position. At the same time, we hope that the entire society will give more humanistic care to nursing staff and pay more attention to nurses. some understanding and support.

Well-known psychological expert Yang Jing: I believe that nurses are the profession most likely to cause burnout due to long-term work pressure, sleep disorders and lack of rest due to staying up late on duty. Coupled with the lack of time for childcare, emotional stress is transmitted into the family, leading to family conflicts. It is recommended that unit leaders should strengthen the leave system and implement fair performance appraisals, and at the same time provide psychological assistance services to medical staff. Individual nurses should also take the initiative to make psychological adjustments and provide timely psychological consultation when necessary.

The "Report" recommends: Strengthen the construction of the overall mental health service system for medical workers, maintain the mental health of medical workers, and improve their mental health literacy.

When maintaining the mental health of medical workers, it is necessary to reduce the adverse impact of work on family from both internal and external aspects. Internally, it is necessary to enhance medical staff's awareness of maintaining a balance between work and family and improve their coping skills through lectures, training, and publicity. From the outside, certain guarantees must be provided through systems and measures to reduce their worries.

Story

Chen Wenna, head nurse of the Department of Infectious Diseases: always tight on the string of epidemic prevention and control

When it comes to patients with infectious diseases, people are afraid to avoid them, but As the head nurse of the Department of Infectious Diseases at the Affiliated Hospital of Guangdong Medical University, Chen Wenna deals with such patients every day. She has been engaged in clinical nursing work for 33 years. She has participated in the treatment of various infectious diseases such as SARS, Japanese encephalitis, cholera, influenza A, hand, foot and mouth disease, dengue fever, and AIDS.

Chen Wenna (third from left) has always been on the frontline of epidemic prevention and control. Photo provided by interviewee

When the new coronavirus epidemic hit at the beginning of last year, she once again rushed to the front line and shouldered the responsibility of isolating the ward. and management of fever clinics. Preparing supplies, planning processes, ward layout, patient zoning, treatment and care, staff training, manpower arrangements, uploading and distributing hospital and department information, the work is intricate, and she has to do everything herself.

Today, the focus of epidemic prevention and control has shifted to imported personnel. Chen Wenna is also at the forefront, working in the most dangerous isolation and observation areas for imported foreign personnel to take care of these "potential cases." The foreign importers were not out of danger for a day, and Chen Wenna and her colleagues could not go home. "We are also ordinary people, and we will also be nervous and scared, but someone has to do the work. We are professional medical staff. No one is more suitable than us. We will not back down. We are duty-bound."

For front-line medical staff, various epidemic prevention and control tasks in a "combat" state have become their daily routine. They have always tightened the strings of epidemic prevention and control and dare not relax for a moment. "Last year, we might have been nervous at the beginning of the epidemic. Now we have knowledge in this area. As long as we protect ourselves scientifically, there will be no problems. We can Overcome the fear. ”

In order to thank the medical staff for their silent dedication since the epidemic, the hospital held a cultural evening on May 8 to relieve the work of the medical staff who work hard every day through a variety of cultural and entertainment programs. pressure.

Regarding the future work, Chen Wenna said: "On the one hand, we must do a good job in vaccination against the new crown virus; on the other hand, we must be prepared for a protracted war against the epidemic, be vigilant at all times, be highly vigilant, and stay vigilant. We must protect the barrier of epidemic prevention and control."

Zhong Liujuan, head nurse of the Geriatrics Department: To comfort patients, we must also protect our own safety

"The working status of nurses in the geriatrics department is constant. "In addition to ensuring the safety of patients, nurses also need to protect themselves." Zhong Liujuan, the head nurse of the Geriatrics Department of Guangdong Provincial Workers' Hospital, said frankly that because nurses take care of elderly patients and many of them have mental disorders, they may occasionally suffer from mental disorders. Throwing things, hitting people and other behaviors, as a nurse, you must not only comfort the patient, but also protect your own personal safety.

Zhong Liujuan, the head nurse of the Geriatrics Department of Guangdong Provincial Workers’ Hospital, provided pictures provided by the unit during the lecture

With the aging of society, the number of elderly patients with dementia or mental disorders has increased in recent years. . Zhong Liujuan said frankly that the work pressure of nurses in the geriatric department is reflected in the fact that family members send the elderly here with high expectations. However, elderly patients with mental disorders need to insist on taking medication for a long time during the recovery process. Once the medication is missing, It is easy to repeat and cannot achieve good therapeutic effects. On the other hand, due to financial pressure and other issues, some patients' family members will transfer the pressure to the nurses in the form of sharp words and impulsive behaviors, which can easily affect the nurses' normal work and daily life.

Because of the low social recognition and value recognition of nurses in the geriatric department, when asked about the department where she works, Zhong Liujuan was ashamed to say, "I am afraid that others will look at me differently and say that I am just a caregiver." Mother.

"In order to improve the social recognition of geriatric nurses, this year, when Zhong Liujuan was invited to participate in a knowledge education lecture, she specially shared the topic "Analysis and Intervention of Nurses' Negative Emotions", focusing on the analysis of the problems faced by geriatric nurses. Xie Ling, deputy director of the Nursing Department of Guangdong Workers' Hospital, said that the hospital encourages geriatric nurses to participate in knowledge education lectures and introduce them to the outside world. The hospital also regularly invites experts from inside and outside the hospital to give lectures on the theme of "Happy Work, Happy Life" to relieve the work pressure of nurses. Since the geriatric department is under semi-closed management, There are relatively few exchanges with other departments, but the hospital union has taken many care and care measures for geriatric nurses. It often organizes collective outdoor development activities, such as playing badminton and mountain climbing, to help geriatric nurses strive for more retraining and retraining. Educational opportunities, the hospital creates a platform to exchange and learn nursing knowledge with experts, and enhance their sense of professional honor, gain and identity.

Planning: Editorial Center

Coordinator: Liu Xiaodan