The Plight of a Psychiatric Nurse

by Super User
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The 10th of October every year is set aside by the WHO to celebrate and draw attention to Mental Health issues and the need to direct policy maker’s attention to the appalling conditions in which suffers of mental conditions are made to live in. The results of these public awareness and other factors has culminated in the promulgation of the Mental Health Law, Act 846 of 2012. Currently, the various Legislative Instruments (LI) are being finalized and fine tuned to ensure the smooth implementation of the law. One group of key stakeholders whose very practice will ensure the successful implementation of the new law is the psychiatric nurse. Psychiatry as a branch of medicine has been neglected by successive governments in Ghana over the years and the psychiatric nurse is no exception.


Occasionally, the conditions under which psychiatric nurses work is brought to bear when the media get wind of physical aggression towards staff. Recently, nurses at the Accra Psychiatric Hospital had to embark on a number of demonstrations to draw attention to the lack of essential medications at the facility which exposes nurses to aggression from patients. The medication situation has worsened since there is acute shortage of major tranquilizers used to sedate and calm acutely agitated patients. This situation exposes the nurses especially female nurses to aggression on the wards. The situation at the hospital is such that, there are about six (6) female wards to about thirteen (13) male wards while the female nurses outnumber their male counterparts. As a consequence, there are female nurses stationed on all the wards. Most people would be surprised to learn that, aggressive behavior is not only confined to the male wards but it is also rampant and the effects are more serious on the female wards. The truth is that, aggressive behavior is meted out to nurses irrespective of the gender on almost daily bases. Aggression is defined by the Concise Oxford Dictionary as a hostile or violent behavior or attitudes.  Aggression here does not refer only to physical attacks on the staff but could take various forms which includes but not limited to verbal abuse, insults, spitting on staff and sexual harassment. This situation coupled with the fact that, the hospital is cash strapped and government subvention is not forthcoming, has compounded the difficult situation nurses have to work in. The quality and quantity of feeding of the patients in the hospital has also taken a nose dive. The feeding grant given for each patient by the state has not been reviewed upwards for decades now even though prizes of food stuffs keep escalating by the day. This has resulted in the provision of poor quality and quantity of food served to the patients. “A hungry man is an angry man” and this adage is enhanced when it comes to psychiatric conditions since most of the psychotropic medications increase the nutritional needs of patients. Just like politicians keep admonishing their counterparts in power to ensure that the conditions in the prisons are conducive for human habitation since any politician could spend some time there, the condition of the psychiatric hospital must be improved as a matter of urgency since psychiatric illness is no respecter of socioeconomic conditions and psychiatric conditions are predicted to increase due to the economic difficulties in and around the world presently.

These conditions, coupled with lack of key logistics such as emergency medications, oxygen cylinders, basic medications like Paracetamol tablets, anti-malaria medications among others has compounded the conditions under which psychiatric nurses work in Ghana. Most Psychiatric nurses are finding avenues to leave since to them, the future is bleak. Psychiatric nurses use to enjoy risk allowance but this is no more. The former Minister of Health, Hon. Shirley Aryitey, promised to institute an insurance scheme for psychiatric nurses who get injured during the course of their work but this is yet to materialize. As a psychiatric nurse, I would like to call for the immediate reinstitution of the risk allowance and the insurance scheme. This is because, how do we quantify and put value to slapping, spitting and sexual harassment. Currently, there are no institutionalized reporting and compensation systems for staff at all the psychiatric hospitals. Assaulted staffs are encouraged to document cases of assault but after documentation what next? There was a case of a staff who got injured while on duty. He applied by filling the workman compensation form. After following the compensation without success, he had to appeal to CHRAJ. Currently, the staff had passed on. Whether the compensation was paid, I cannot tell but why should he go through all that trouble. This is a disincentive for reporting such incidents. The issue of career progression has always been a headache for the psychiatric nurse. Previously, after the diploma course at the Training College, one either had to do the degree program for general practioners or Health Education to be able to teach. Some psychiatric nurses opted to do a degree program in psychology but the authorities in the psychiatric hospitals are refusing to recognize a psychiatric nurse with a first degree in psychology even though it is generally believed that, psychology is the physiology of psychiatry. Recently, there was a call on practitioners in the field to deemphasize the use of medications and focus more on “Talk” therapy and I wonder which group of professionals can do this “Talk” therapy effectively considering the fact that, there is acute shortage of psychologist in the country. Nobody can prove to me that, a psychiatric nurse with a first degree in psychology has diverted from his/her core practice of nursing and the knowledge acquired is completely irrelevant. These ills enumerated here are to be cured by the new law but I am afraid this law will suffer the fate of other promising laws if the government reneges on its responsibility to provide the much needed funds.   

The writer is a Nursing Officer and has been working at the Accra Psychiatric Hospital for fourteen (14) years now.