Caring for Mental Health Patients with Coronavirus
Team at Hammersmith Hospital had to deal with a challenging situation
Hammersmith Hospital psychiatrist Roopak Khara
“The biggest lesson from coronavirus has been never to forget about vulnerable populations or vulnerable groups,” reflected hospital psychiatrist Roopak Khara about the challenges posed by the pandemic.
Together with her team at Hammersmith & Fulham Mental Health Unit at Hammersmith Hospital she worked through the height of the pandemic caring for patients with acute mental health conditions who also had coronavirus.
The Avonmore ward at West London NHS Trust, became the UK’s first mental health ward for people with coronavirus.
The staff were caring for people who were already seriously unwell when they were diagnosed with the virus – which created a challenge.
Overnight they transformed a mental health ward to care for these patients.
“The vast majority of patients that we worked with did not know why they were in hospital and didn’t know why they were unwell. They didn’t know why we were dressed like astronauts. It was a real big challenge because we couldn’t have that rational discussion when they were acutely unwell,” said Dr Khara.
So they made personalised welcome packs for patients at Avondale ward to explain what had happened and talk to them about the situation.
Some did not want to wear PPE which was also challenging.
Dr Khara makes a point of sitting down with patients and doing the crossword or reading the paper.
“It’s a chance to get to know the patient as a person because they’ve got a whole story. When you’re in hospital and you’re not sure why you’re there it can be difficult to get any semblance of normality.”
She added: “It forms a bridge and is a form of communication that is hard to do in mental health.”
She played sudoku with one patient and recalled “it was the first time she was able to sit for 10 or 15 minutes and talk about how it worked. It was lovely, it was a very calming time for otherwise what is a very fraught time for someone on the ward.”
And during the height of the pandemic family members could not visit.
So Dr Khara made a point of calling them after she’d seen patients and where possible kept in touch with family members by phone or Face Time.
The team also asked patients if they would like a special item of clothing from home – which was washed to keep it safe – to give them a sense of normality.
And she would stand outside the ward so it was safe for patients to see her put on her mask, so they could see her face underneath all the PPE.
She said PPE is a barrier – if essential – to communication and “after five minutes it’s so hot and sweaty. You find yourself shouting too, you can’t see expressions. You are trying to talk to people who can see just your eyelids.”
There were between 17 and 22 patients on the ward with enough space to keep them distanced – with a total of 50 to 60 being treated over the last four months.
Their symptoms ranged from loss of smell to breathing difficulties.
They have now all been discharged to other wards or gone home.
Dr Khara comes from a family of doctors and she said they had concerns about her being on a Covid ward.
But she said: “I did not think twice. I have a great responsibility towards the patients.”
And she told anxious colleagues: “We are quite lucky going out when everyone else is in lockdown.”
The 34-year-old doctor recalled it was such a busy time that “I do not think I have had a proper night’s sleep during this time.”
They also set up an autograph wall for every visitor and patient to sign.
Dr Khara is one of 12 NHS workers photographed by celebrity photographer Rankin to feature in posters to celebrate 72 years of the NHS and their work during the pandemic.
He is famous for portraits of the Queen, David Bowie and Kate Moss.
Dr Khara said: “I’m so incredibly proud and honoured to represent the team which set up Avonmore Ward to care for patients with severe mental illness who’ve tested positive for Covid-19. Everyone, from the porters to the domestic team to doctors and the nurses, came together to care for our patients in response to the national crisis. The team truly represents the spirit of the NHS in action.”
And she urged people to remember that “we are still very much in the middle of it. If we can all do our little bit it will contribute.”
Julia Gregory – Local Democracy Reporter
July 28, 2020