COVID-19 Unprecedented Mental Health Nurse Education

We’re told to pack up tools and prepare to home work. IT gurus encourage us to get busy with Microsoft teams using blended approaches to introduce ever more online learning tools and tricks. We leave our desks at the University on March 20^th equipped with ideas about live sessions online, student blogging and  Twitter use, or should we be encouraging Linked-in for learning? Or would people find Skype easier?  After all they’re used to Skype or podcasts, a vlog that’s where it’s at and we‘ve heard Zoom’s fantastic. These fast ways of communicating, so efficient, so effective, time saving, I allow myself a thoughtful minute.

Yes a minute of thought  appears to be the fashion of late. Emails pinging away with new deadlines, reminders, a continual changing narrative, telling us that we need action to react to the inevitable rise in anxiety, depression and  visceral trauma that we are going through. The media reinforcing our state of alert through the use of militaristic language. Stay in flight, fight or freeze is the message. If you’re not fighting the virus on the “frontline” or fleeing through self isolating, there is a problem. I am uncomfortable, a little frozen maybe. My response, learnt, perhaps innate to heightened action of the limbic system and discourse that engenders panic and anxiety is to stop, contemplate and consider.

I am used to the guilt, a tightening around the lower diaphragm, that comes with splitting my attention between family and work.  Previously, as I have walked out of my front door at the beginning of the day, I soothed myself through knowing that my children’s wellbeing  is in the hands of their Dad, their Grandmother, teachers, school staff, peers, “I am one of many” I reassured myself, “it takes a village to raise a child” etc. This has now changed, what I was leaving behind is now in front of me in vivid technicolour. I am seeing the way my 12 year olds search for guidance around how to do the right thing, the struggle with writing that needs a nod of reassurance from an adult as the effort is made, or the praise for solving a maths or science problem previously thought to be insurmountable. There is the need to share a joke with a friend, a bit of fresh air, some variety and activity to intersperse the demands for concentration and attention. I notice our 18 year old, her spirit and tenacity to be fit, cook, study, debate, argue, family interaction enriched although not quite a substitute for friends.  Here they are, our children reflecting back the mental health needs of us all. This microcosm of life, working from home during a worldwide pandemic with a family, negotiating with a wider moveable system.

For mental health nurses these are not unprecedented times, our work brings us into contact with the impact of poverty, social exclusion, anxiety, panic, depression, psychosis and shortened life expectancy. Finding ways to meet mental health needs within many contexts is our profession. We come together, students, nurse educators and mental health nurses in practice with a recognition that we are seeking answers to new questions. Every person we work alongside is an opportunity for us to explore unchartered territory, to work with recovery and to consider what hope looks like for that person in that place. We are used to distilling time, taking more than a minute, looking for the unsaid, the nuances and the spaces where creative responses to complex problems can emerge. We use reflective spaces, appreciate the contributions of knowledge and research, assimilate codes of practice and guidelines, challenge discourses that can hinder recovery and move with assurance as we open to more learning.

This creates a strong argument for deeper approaches to learning in mental health nursing (Biggs 1999). Unafraid of experiential work, we appreciate the value of abstraction that allows us to make connections and foster new ideas that can be generalised. This means discussion and ambiguity:  safe spaces to explore. I do this through the use of self which includes an open posture, curiosity,  time boundaries, personal space and attention to what happens in the betwixt (between people, between organisations, between teams). I try to pay attention to the here and now, between educator and student (s), to body language, the “feel” of the group, the gauging of when it is time to listen and when it is time to challenge. Alongside this we all encourage students to  develop a critical mind that is able to consider the evidence for what we are doing. The move to an ever more dominant virtual learning environment invites us to rethink how we do this. After all, if we could learn how to facilitate mental health nurse education online we would have already have done that, wouldn’t we?

Blended learning brings its own pitfalls such as where we might have set a boundary like having students in our homes, even virtually,  has now changed (Lee and Reeves 2007). Communities of learning, a bedrock of our teaching and learning  practice has become a different shape. How we develop community without real time connection such as a nod in appreciation of effort well expended, praise for a problem solved, a shared joke in a mutual space brings with it some real challenge. Our own mental health lecturing team meet more frequently as we adjust and flex to new ways of working brought about by COVID-19.  Our invitations to colleagues to peer assess our online teaching have become calls for collaboration to work with the online chat, change assessment strategies and module designs. All the while, our academic pursuits run concurrently,  writing, journal reading and research. Our team is learning to  engender an attitude that acknowledges new possibilities alongside mourning the loss of human contact. I  await analysis of how this has impacted on ourselves, students and those who we care with.

For now, I sit with Microsoft teams, appreciating the input, contributions and efforts of students as opportunities for nods, appreciation and humour get missed. Their writing has a certain depth that may have not have been there before or maybe I am more sensitised to the importance of the work they do.  My heart swells, something akin to love, compassion and appreciation as I think of them  alongside those with COVID-19, working with and witnessing the impact of loss, many experiencing the isolation that comes with testing positive for the virus. Through it all, students pursue the knowledge that they will need to develop the wisdom to nurse with compassion and care. The loss of systems known and a future less known is the current climate, we have packed up and are working from home. There’s a knock on my bedroom door, I’m teaching with a fake background effect on that looks like a smart office, my son can’t find his Educake password for his science homework.

Lucy Colwell

Biggs, J. (1999). What the student does: teaching for enhanced learning. Higher Education Research & Development, 18(1), 57-75.

Lee, S. J., & Reeves, T. C. (2007). Edgar Dale: A significant contributor to the field of educational technology. Educational Technology, 47(6), 56.