Jobs that will drive you mad - psychiatric aide
Jul 11, 2011
MIDDLE-AGED Juliet Kyamwino, a psychiatric aide at Butabika National Referral Mental Hospital’s acute ward, goes about her daily routine calling out patients to receive their medication.
Today, we continue the series on ‘jobs that will drive you mad’. Alex Balimwikungu tackles psychiatric aides, those heroes who take care of our mentally ill patients. Find out what it takes to work in mental institution and the challenges encountered
By Alex Balimwikungu
MIDDLE-AGED Juliet Kyamwino, a psychiatric aide at Butabika National Referral Mental Hospital’s acute ward, goes about her daily routine calling out patients to receive their medication.
“Mutyaba…. Mutyaba,†she repeatedly calls out. Though surrounded by over 30 patients with in earshot and basking in the mid-morning sun, she is greeted with silence.
She is on her way back to the ward when a patient, draped in green, springs to his feet, rushes towards her and traces lewdly her visible panty line with his finger. He repeatedly runs his palms behind her neat uniform caressing her derriere, while suggestively licking his lips.
Kyamwino pretends nothing has happened and does not as much as try to thwart him off. Though visibly uncomfortable, she is hell-bent on having the patient take his medication. It takes a lot of cajoling to do this.
When she hands him his tablets for the day, he takes them but refuses to swallow. “I will only swallow them if you also swallow yours,†he vows.
It takes the intervention of the principal nursing officer, Angela Illakut and another five minutes of begging to have Mutyaba take his dose.
There is another one who is 100% positive that he is Jesus Christ. “Go and write that Jesus Christ is in Butabika!†he barks. He threatens violence when we try to empathise.
A first-timer at the acute male ward, I can tell the work of nursing psychiatrists is tedious, taxing and downright depressing, but they would like to think otherwise.
Taxing nature of work
Psychiatric nurses help care for physically or mentally ill individuals in mental health settings. They work with patients who need long-term care and are, therefore, specialised.
They provide hands-on care and perform routine tasks under the supervision of medical staff. They often help patients to eat, dress and bathe. They also answer calls for help, serve meals, make beds and tidy up rooms.
They also may help patients get out of bed and walk, escort them to operating and examining rooms, observe patients’ physical, mental and emotional conditions and report any changes to the superiors. Since patients need 24-hour care; some nurses work evenings, nights, weekends and holidays.
“It is a physically demanding job. We spend hours standing and walking. Besides, caring for disoriented, irritable or uncooperative patients whose illnesses may cause violent behaviour is tricky.
Although our work is emotionally demanding, we are trained and we get satisfaction from assisting them,†admits Deborah Kibikyo, the ward manager for acute patients ward.
She says before one can do that job, they need a defence mechanism. You have to put on a façade for as long as you are dealing with the patients. They have been trained not to show any stress since they are dealing with predominantly stressed people.
“These patients are good at reading our own emotions and can notice when something is amiss. They often study our moods and will be the first to inquire if you are suffering a breakdown. If you bark at them, they will bark back at you.
If ever we carry stress from home, we have learnt to leave it at the gate. It is mandatory to smile,†she admits.
Kibikyo admits that some psychiatric nurses face stigma from clinical nurses as they are identified with the patients they treat, yet in truth their background enables them be kind to patients.
For some nurses, it is a dream to get that job no matter how risky, but many feel that their pay is not commensurate with the risks involved. They feel undervalued and worst paid compared to their work load.
Urgent interventions needed
David Kyaligonza, the assistant commissioner Nursing Services at Butabika National Referral Hospital, says they have tried all possible ways to make the job less stressful.
He, however, admits that their work schedule is too demanding and yet they are under-staffed. The psychiatric nurses work in three shifts of eight hours and one nurse is supposed to see up to 120 patients, which is too much.
“The nurse to patient ratio at Butabika Hospital is one to every 120 patients, yet the internationally accepted ratio is one nurse per every five patients. In cases where the patients are aggressive, it is two nurses per patient, but we cannot afford that,†he says.
The 550-capacity hospital is overflowing with 750 patients and there has been no additional infrastructure or support staff to support the increasing numbers. The funds are fixed, yet they cannot stop admissions.
Kyaligonza says unlike medical doctors and clinical officers who do visits to wards and leave, psychiatric nursing is a full-time job. They work 24 hours. They work through unsocial hours and have no public holiday. Even then, there is no additional pay where they work the odd shift, they soldier on.
“We have introduced continuous professional development sessions and once every week, we meet. In these sessions, top management involves the nurses in decision making. This has instilled assertive skills and built their confidence to love the job.
We also have a clinical psychologist, just in case any nurse shows signs of strain. It is a precautionary measure,†he says.
Broken marriages
Angela Illakut, the principal nursing officer, says there is a general poor attitude from psychiatric nurses working the night shift, as their marriages are on the brink of failing.
“Much as we train the nurses not to get emotionally derailed with patients, their spouses pose the biggest challenge. We have had some storm here at night in a fit of rage demanding for their wives. It takes a toll on some marriages, and we have tried to talk to the men.
In some cases, we have put the nurses on day shift,†she says. She also says that during the course of their work, it is possible for psychiatric nurses to develop positive, caring relationships with their patients which bode on love. This is greatly discouraged.
“Even though love is blind, we caution our psychiatric nurses never to get emotionally involved with patients. They should keep it professional. What if a patient’s mental instability is hereditary? Would you like your children to inherit it?†she questions.
Their biggest disappointment is seeing previously rehabilitated and discharged patients being brought for re-admission owing to failure by society to integrate them when rehabilitated.
“On a daily basis, we get between five to 10 patients admitted to the hospital. Among these are re-admissions. For us it brings great heartache and makes us feel worthless, at times you question what you are doing,†she concludes.
By Alex Balimwikungu
MIDDLE-AGED Juliet Kyamwino, a psychiatric aide at Butabika National Referral Mental Hospital’s acute ward, goes about her daily routine calling out patients to receive their medication.
“Mutyaba…. Mutyaba,†she repeatedly calls out. Though surrounded by over 30 patients with in earshot and basking in the mid-morning sun, she is greeted with silence.
She is on her way back to the ward when a patient, draped in green, springs to his feet, rushes towards her and traces lewdly her visible panty line with his finger. He repeatedly runs his palms behind her neat uniform caressing her derriere, while suggestively licking his lips.
Kyamwino pretends nothing has happened and does not as much as try to thwart him off. Though visibly uncomfortable, she is hell-bent on having the patient take his medication. It takes a lot of cajoling to do this.
When she hands him his tablets for the day, he takes them but refuses to swallow. “I will only swallow them if you also swallow yours,†he vows.
It takes the intervention of the principal nursing officer, Angela Illakut and another five minutes of begging to have Mutyaba take his dose.
There is another one who is 100% positive that he is Jesus Christ. “Go and write that Jesus Christ is in Butabika!†he barks. He threatens violence when we try to empathise.
A first-timer at the acute male ward, I can tell the work of nursing psychiatrists is tedious, taxing and downright depressing, but they would like to think otherwise.
Taxing nature of work
Psychiatric nurses help care for physically or mentally ill individuals in mental health settings. They work with patients who need long-term care and are, therefore, specialised.
They provide hands-on care and perform routine tasks under the supervision of medical staff. They often help patients to eat, dress and bathe. They also answer calls for help, serve meals, make beds and tidy up rooms.
They also may help patients get out of bed and walk, escort them to operating and examining rooms, observe patients’ physical, mental and emotional conditions and report any changes to the superiors. Since patients need 24-hour care; some nurses work evenings, nights, weekends and holidays.
“It is a physically demanding job. We spend hours standing and walking. Besides, caring for disoriented, irritable or uncooperative patients whose illnesses may cause violent behaviour is tricky.
Although our work is emotionally demanding, we are trained and we get satisfaction from assisting them,†admits Deborah Kibikyo, the ward manager for acute patients ward.
She says before one can do that job, they need a defence mechanism. You have to put on a façade for as long as you are dealing with the patients. They have been trained not to show any stress since they are dealing with predominantly stressed people.
“These patients are good at reading our own emotions and can notice when something is amiss. They often study our moods and will be the first to inquire if you are suffering a breakdown. If you bark at them, they will bark back at you.
If ever we carry stress from home, we have learnt to leave it at the gate. It is mandatory to smile,†she admits.
Kibikyo admits that some psychiatric nurses face stigma from clinical nurses as they are identified with the patients they treat, yet in truth their background enables them be kind to patients.
For some nurses, it is a dream to get that job no matter how risky, but many feel that their pay is not commensurate with the risks involved. They feel undervalued and worst paid compared to their work load.
Urgent interventions needed
David Kyaligonza, the assistant commissioner Nursing Services at Butabika National Referral Hospital, says they have tried all possible ways to make the job less stressful.
He, however, admits that their work schedule is too demanding and yet they are under-staffed. The psychiatric nurses work in three shifts of eight hours and one nurse is supposed to see up to 120 patients, which is too much.
“The nurse to patient ratio at Butabika Hospital is one to every 120 patients, yet the internationally accepted ratio is one nurse per every five patients. In cases where the patients are aggressive, it is two nurses per patient, but we cannot afford that,†he says.
The 550-capacity hospital is overflowing with 750 patients and there has been no additional infrastructure or support staff to support the increasing numbers. The funds are fixed, yet they cannot stop admissions.
Kyaligonza says unlike medical doctors and clinical officers who do visits to wards and leave, psychiatric nursing is a full-time job. They work 24 hours. They work through unsocial hours and have no public holiday. Even then, there is no additional pay where they work the odd shift, they soldier on.
“We have introduced continuous professional development sessions and once every week, we meet. In these sessions, top management involves the nurses in decision making. This has instilled assertive skills and built their confidence to love the job.
We also have a clinical psychologist, just in case any nurse shows signs of strain. It is a precautionary measure,†he says.
Broken marriages
Angela Illakut, the principal nursing officer, says there is a general poor attitude from psychiatric nurses working the night shift, as their marriages are on the brink of failing.
“Much as we train the nurses not to get emotionally derailed with patients, their spouses pose the biggest challenge. We have had some storm here at night in a fit of rage demanding for their wives. It takes a toll on some marriages, and we have tried to talk to the men.
In some cases, we have put the nurses on day shift,†she says. She also says that during the course of their work, it is possible for psychiatric nurses to develop positive, caring relationships with their patients which bode on love. This is greatly discouraged.
“Even though love is blind, we caution our psychiatric nurses never to get emotionally involved with patients. They should keep it professional. What if a patient’s mental instability is hereditary? Would you like your children to inherit it?†she questions.
Their biggest disappointment is seeing previously rehabilitated and discharged patients being brought for re-admission owing to failure by society to integrate them when rehabilitated.
“On a daily basis, we get between five to 10 patients admitted to the hospital. Among these are re-admissions. For us it brings great heartache and makes us feel worthless, at times you question what you are doing,†she concludes.