Serving meals and mopping floors: the consultant psychiatrist working differently during the covid-19 pandemic

At the beginning of the covid-19 crisis, Janet Obeney-Williams was asked to convert her acute psychiatric assessment ward into a hybrid covid-19 isolation ward for patients with mental health disorders. “We had to make a plan to keep our inpatient unit safe,” she says. “We were happy to do it, but right from the beginning we wanted to be really clear that the people we worked with shouldn’t be forced to do it.”

In setting up the isolation ward, Obeney-Williams and her colleagues quickly had to develop new systems to monitor patients. “We wanted to give patients as good a standard of care as they would receive in primary care,” she says. “We’d never have looked after anyone beyond our competency, we just wanted to be as good as we could be.”

The ward was gifted staff from other parts of the trust, and Obeney-Williams was keen to understand what it felt like for the nurses working in such a different environment. “It was a lot of work for all of us coalescing as a new team,” she says. “I had to check myself every day—if I was having a day of feeling positive I had to make sure I was hearing if other people weren’t.”

Her approach to the challenge was to lead from the front with a can do attitude, this meant serving meals and mopping floors while the ward waited for the appropriate domestic staff. “All of us just got the mops out,” she says. “You would, wouldn’t you? Ensuring a clean environment for your patients is clinical care.”

The daughter of a dinner lady and an electrician, Obeney-Williams decided to become a doctor because she liked science and wanted a good job. Her comprehensive school in north Wales gave her lots of encouragement. “There was very much a sense that if you put in the work you could be anything you wanted to be, whatever your background,” she recalls.

Soon after obtaining her psychiatry qualifications, Obeney-Williams decided on a move into general practice as she was inspired by working in a “holistic and community” way. During her 15 years as a GP partner in Walthamstow, London, she kept in contact with psychiatry through regular continuing professional development. In 2010, feeling “a little envious of the happy staff grades” she met at psychiatry meetings, she successfully applied for a staff grade post in psychiatry at the Royal Free Hospital.

Retraining was a mammoth task, recalls Obeney-Williams. “I was able to use the skills I had from general practice,” she says, “but I had to retrain rigorously in order to diagnose people and understand modern psychiatry from a secondary care perspective.” In 2018 she became a consultant and now divides her time between an acute ward and the crisis team.

Obeney-Williams fosters good relationships with her colleagues, which have been highlighted during the pandemic. “People help each other, and the covid-19 crisis has really brought that out,” she says. “There’s been a lot of doing things differently, doing things flexibly. Everybody’s checking in with each other.”

While running the hybrid ward Obeney-Williams enjoyed having a different type of contact with patients. “We had a lot more casual contact with the patients because we were there more,” she says. “Yesterday I had my lunch in the garden with two psychotic patients, and that’s a privilege I haven’t had since I was a trainee in psychiatry.”

The ward is now converting back to an assessment unit, and Obeney-Williams says it has been an honour to serve. “It’s been very clear during the crisis that we’re like a little army who try and have each other’s backs so we can look after people.”