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The reality of Christmas in a psychiatric unit by a psychiatric nurse

Written by a psychiatric nurse working in a psychiatric unit in South West Ireland, this piece shares some thoughts and insight into the realities of working in the mental health services at this time of year. It’s important to remember that those who work extra hard this time of year to support vulnerable people and try to bring a little cheer to what can be a lonely time.

When you decide to become a nurse, you do not think about the inconvenient hours and holidays that you will most likely have to work; instead, you just become a nurse because you want to be one regardless. The Christmas roster is always met with anticipation, but the reality is that all of us in acute psychiatry will have to work a few major holidays each year.

Some dedicated nurses put up garlands, wreaths and a tree, but Christmas time is not “peace on earth” in the mental health services. For some other healthcare units, it can be a quieter time, but in the mental health services, it is invariably demanding and hectic. We nearly always have an influx of admissions before and during Christmas.

For our long-term patients, seeing them with no one at this time is difficult. So too is seeing the lonely older people with small pensions trying to keep their lights on and the younger people with psychotic illnesses who, despite their wishes, cannot go home for Christmas.

It is easy to fall into the mindset of “how awful, I have to work for Christmas,” but this is not principally true. For one, it can be a great excuse for not spending time with extended family that you may not be too keen on! But more importantly, for as much as we do not really want to spend Christmas in a hospital, you can bet our patients are feeling that same sentiment at least ten times more.

Our team ignores the beds in the corridors, the lack of staff and the limited resources and instead we try to provide much-needed solace to our patients and their family members.

It could be challenging for some to imagine how exactly an acute psychiatric unit could be “Christmassy,” but for me, it is not. I can see it in the neatly decorated tables laid out by the multitask assistants, in the giddy staff excited for the Christmas party and in the faces of patients when they get an unexpected visitor.

And even still, if the thought of spending thirteen hours at work on Christmas Day does not sound like the perfect day. At least at the end of it all, you get to go home to a warm house with people who love you, which is unfortunately something I know that we are very lucky to have. 

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