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Improving the Response to Mental Health Emergencies

What is a mental health crisis?

Image by Petra Šolajová from Pixabay

As a psychiatric NP, I treat patients with mental illness through medication and therapy, but there are no guarantees treatment will work. It’s often a process to find a medication that both works to control the patient’s symptoms and doesn’t cause the unwanted side effects (such as sedation and weight gain) that can make a patient not want to continue taking it.

While this process is happening, the patient is living his or her life, coping with usual stressors such as working and navigating personal relationships, and possibly more intense stressors like poor living conditions or trauma. These factors can put someone at risk for a mental health crisis.

According to the National Alliance on Mental Illness (NAMI), “a mental health crisis is any situation in which a person’s behavior puts them at risk of hurting themselves or others and/or prevents them from being able to care for themselves or function effectively in the community.” When a person exhibits these types of behaviors, it’s common for 911 to be called and for police officers to arrive on the scene. This can have dangerous ramifications for the person with mental illness. However, there […]

2021-04-14T10:10:40-04:00April 14th, 2021|Nursing|0 Comments
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What Do Nurses Need?

“Covid-19 Is ‘Probably Going to End My Career’” is the title of my recent column in the New York Times. The nurse who made that statement spoke to me on the condition of anonymity because her hospital doesn’t like having nurses speak out. So—nurses are afraid to publicly complain about their difficulties on the job, struggle with a lack of PPE and short-staffing, and are overwhelmed by the number of deaths they are seeing. All this has led to the nursing profession being in crisis.

The six ideas below could help nurses drowning in difficulties imposed by Covid find their way back to solid ground.

  1. Staffing legislation. This could mean ratios, or some other way to insure that nurses are not expected to work short. The legislation should also require robust nursing float pools and keep secretarial and nursing assistant support at their usual levels. Units have to be staffed in a way that maximally benefits patients, not just to help balance a hospital’s bottom line.
  2. Mental health support. Nurses as a group are not always open to counseling, but during Covid nurses have spoken out about the emotional toll of the work and their ongoing PTSD. They have recognized their need for mental health support. Hospitals must give nurses health insurance that covers individual counseling, and have mental health resources available on the job for nurses. “Covid broke me” is being said by too many nurses, too often.

    3. […]

2021-03-05T09:52:27-05:00March 5th, 2021|COVID-19, Nursing|1 Comment
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Joy, Relief, Reverence: Positive Side Effects of a First COVID-19 Vaccination

A family’s long year, brushed by COVID-19.

Photo by Jon Tyson on Unsplash

On February 23, 2020, three days before a flight to Israel to speak at a nursing conference, I received a message from the host that the ministry of health had issued a restriction to stop all conferences and meetings in the health care system because of the coronavirus. I had other business scheduled, so I boarded the flight. While in Israel, I followed the global health news, and returned home a week later fully aware that COVID-19 was an emerging pandemic. But when I landed and entered the international arrivals terminal at Newark Airport, business was as usual and only a handful of us in line wore masks going through customs.

It’s been a hard year since that time. My son, a healthy 27-year-old, had COVID in late March, during the worst surge of positive cases and deaths in New York City. Testing wasn’t available. He lived a subway ride away. For 10 days, I monitored his symptoms by texts, along with his primary care provider. He fully recovered. My 95-year-old mother died in April in a  New York State assisted living facility. We don’t believe her death was COVID related. Restrictions prevented my visiting her for […]

2021-02-26T09:33:01-05:00February 26th, 2021|COVID-19, infection control, Nursing, patient experience, Public health|3 Comments
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With Severe Mental Illness, A Vicious Circle of Stigma and Lack of Support

Although psychiatric facilities no longer treat patients the way movies like The Snake Pit and One Flew Over the Cuckoo’s Nest depicted, society’s treatment of people with mental illness is still lacking.

As a psychiatric nurse practitioner, I provide care for patients coping with the challenges of mental illness. Symptoms are often painful, life altering, and frightening. Sadly, patients experience additional suffering from the guilt, shame, and social isolation that comes with having a psychiatric disorder. That’s because mental illness continues to carry a stigma that inhibits people from seeking help and limits the amount of services available for those who do seek it.

Had they received the support they needed….

In this month’s Viewpoint in AJN, Juliet Hegdal, a family nurse practitioner, discusses the impact severe mental illness has on patients and their family members. The author shares what it was like being raised by a mother with schizophrenia and the lack of resources available to her and her family. She posits that her mother and society would have been better off had she received the support she needed. […]

2021-02-23T13:48:16-05:00February 23rd, 2021|mental illness|0 Comments
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The ‘Clog Kick’: In Trying Times, Adapting to the Loss of a Palliative Care Team’s Essential Rituals

Palliative care, under optimal circumstances.

I work as a palliative care NP on an inpatient consult team at an academic medical center in Massachusetts. In the best of times, palliative care teams are exemplars of interdisciplinary functioning. According to nationally accepted consensus reports, since palliative care is holistic in nature, it must be administered by a team that can address the multidimensional elements of suffering for both patients and families in the setting of serious or life-limiting illness.

In my experiences on two interdisciplinary palliative care teams, we were damn strong together. We met each morning to divvy up the workload; around the crowded table were NPs, physicians, chaplains, social workers, sometimes a pharmacist or a librarian, and a bevy of rotating students of all disciplines. On the table was often food: from someone’s garden, our own kitchens, or the grocery store bakery.

A ‘thread of lightheartedness’ amidst the heaviness.

The work was seemingly endless (as many people as there were around the table, there were scores more patient consults), and the situations were heavy and complex. We took our work seriously because the situations we waded into day after day were often worst-case scenarios for our patients and their families.

But there was also a thread of lightheartedness that ran through the days and weeks. We prioritized team and clinician wellness, and often laughter was the centerpiece of the table. We strategized together, cried and fretted about our patients, roared or seared in frustration, and yes, we watched funny cat videos to keep the […]

2021-02-23T17:02:36-05:00February 18th, 2021|COVID-19, Nursing|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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