C/O Rosie Merante

The Silhouette: Please introduce yourself.

Rosie Merante: I'm Rosie Merante. I'm doing nursing at McMaster [University] and it's just the basic Bachelor of Science for your RN [Registered Nurse certificate]. I've had placement every semester, except for one that got pushed to the summer because of [the COVID-19 pandemic]. But I've been in placement for the full three years. . . First year I was in long-term care, second year I was at Joseph Brant [Hospital] in Burlington and I was in the orthopedic surgical unit. Then I had Idlewyld Manor for long-term care. I was in the secure unit there, so it was kind of the [more agitated patients] with dementia or Alzheimer's. Now I'm [in] mental health and forensics.

What do you do [in that placement]?

I just started last week . . .but I got a really good grasp because I was there for 14 hours. Those are the shifts once a week. It's not as much physical head to toe assessment that I would have [done] last year because it's more focused on mental health and these patients have been there for a long time, years even. . .But the majority of it is vitals, doing rounds. It's high security. We have to watch them since they're all coming right from the court system and they weren't deemed fit to stand trial due to their mental illness. It's mostly just that and then most of the assessments we do are mental status examinations and things along [those lines]. We're making sure that they're not going to be a danger to themselves or others and that they're taking their meds and everything's okay.

Do you know how it would have been different if it weren't for COVID-19?

I think now that the regulations are lifting, I'm already noticing some differences from my past placements. We no longer have to wear face shields or get tested every other shift. One thing that I noticed is relationships with people. Obviously, with the pandemic, people are still always going to be paranoid about getting close together and having visitors. So the visiting policy is way restricted right now. They allow one visitor per day for each patient but it's still a big difference from what it was before. I think that's such an issue, especially for mental health. I feel they should lessen the restrictions or increase the amount of visitors allowed because these people are already going through so much, and even if a lot of them don't have family or friends, the ones that do and can receive that support. I feel it would be as beneficial as medical treatment if they could actually see people they love and care about. A lot of them are depressed too because they can't really go out as much and do things that they used to. And they're confined [and] they get privileges to go out, to go around the hospital, to go outside to do things if they're on good behaviour. There's obviously a lot of precautions we have to take but they're allowed to leave. And now, with [COVID-19], that's reduced a lot. A lot of them just end up at the front desk and they're like "Do I have my privileges? Yeah? Look, I want to leave. I'm so bored." That's also kind of what I noticed. At least in the mental health aspect, I think the biggest impact is on the visitor policy . . .At the long-term care homes, I was at three of them, I noticed a big shift with [COVID-19] because of the visitors, privileges to go outside, and for even people from outside to come in and do activities with them, as well as just the residents being close around each other, it's not as good as it used to be. There's a lot less socializing and togetherness, there's a lot more confusion because they don't necessarily understand what's going on and that actually increases some of their behavioural symptoms. They can be very agitated because they don't fully understand why they need to wear a mask, why they need to stay inside, why certain people can't come in [or] why their family stopped visiting. It's hard for them to grasp these concepts on top of the memory loss. That's also what I noticed at some long-term care placements. I'm seeing, just observationally, what seems to be a higher incidence of depression in the elderly.

Is there anything that you're really looking forward to in your current placement?

I'm really looking forward to getting to know [the patients]. The patients aren't in and out, they've been there, so knowing their stories, knowing them more personally, so I can help care for them better.

Do you have any big takeaways from your experiences in your program or your placements?

I don't know, there's so many of them. One of them is to treat the patient or think of them, not in an unprofessional way, as someone from your family or as a friend. Be empathetic. Remember that they're not just a patient. They're a person with dignity and they're your client. It could be your mother, your grandmother. You need to treat them with respect and dignity. I know that the culture of long-term care homes, at least, is very poor quality care. They [the patients] need so many more RNs and [personal support workers] so that they can be more valued and treated with more dignity and respect.