No, I’m not Nurse Ratchet from One Flew Over the Cuckoo’s Nest.
Yes, I worked 20 years as a behavioral health care nurse and technician and now refer others to the role of nurse in inpatient units for people with mental illness.
No, the management of these patients is not an authoritarian and unique approach and, yes, I see patients leaving better able to manage their diagnosis and therefore their life.
Much advocacy has been done to dispel the stigma and misinformation around mental illness in recent years, but less about the misconceptions that linger in the minds of the public and that I hear frequently about perceptions of nursing in behavioral health units.
Nursing in such a unit is not about altercations with patients. These are not imposed routines. It is not about ticking boxes for tasks performed.
It is about listening to patients, sitting down with them, contributing our clinical expertise and, above all, our empathy, to support them at a very vulnerable time in their lives. I sang with patients. I danced with patients. I’ve been stupid and cried with patients.
We try to help them see mental illness as a treatable medical condition for which there should be no feelings of guilt or embarrassment in seeking treatment for their diagnosis.
It is the nursing profession that has been called both a science and an art, and it is. We are not the patient’s therapist. We are neither the patient’s psychiatrist nor pharmacist. Nor are we at the bedside just to take vital signs.
We are often there when patients are most mentally vulnerable. We can support them and allow them to speak their truth without judgement.
What I repeat to staff, old and new, is that all behavior is a form of communication. What is the patient trying to communicate that he is unable to verbalize? Are they anxious about being in the hospital, do they want to leave, did they have a bad phone call with family or a loved one?
It is nursing that requires critical thinking, problem solving and detective work to determine what is behind the behavior and to address it in a way that recognizes the person is upset, allows time to eliminate everything that happens from his system and the space to talk. about it calmly. When a person needs a lot of support, it is the nurse who tries to determine the best way to help them overcome their thoughts and behaviors.
Behavioral health nurses work to make patients feel good about receiving care for their mental illness and normalize what they experience while receiving that care. It’s no different than hospital care for any other serious medical condition that won’t get better on its own, and it’s regularly multi-faceted care involving education about lifestyle, medications, and therapy.
There are times when you will have a patient who is completely decompensated, that is, their mental health is seriously deteriorating to the point where they have no interest in living or functioning. Yet once they start taking medication and you form a relationship, their recovery is amazing to watch. They begin to interact, take care of themselves, and feel well enough in no time to leave the unit.
Seeing such improvement with individualized, trauma-informed care is what is so rewarding about what we do as nurses in a behavioral health unit and it is what feeds my soul.
We also work with families, teaching them what mental illness means, what the warning signs and symptoms are, and how they can support their loved ones as they go through really difficult times.
My choice of career specialty as a registered nurse began in my early twenties, working, at the suggestion of my mother who is a nurse, as a certified practical nurse with dementia patients and expanded since to receive my bachelor’s degree in nursing and patient support. of all ages with a range of mental and behavioral health diagnoses.
It is nursing that is needed more than ever today to ensure that people with acute mental illness benefit from their hospitalization and return with hope and healing to their families and to their lives in their communities.
Research and better imaging technology have contributed to a growing understanding of how the brain communicates with itself, how it molds to experience, and responds to treatment aimed at modifying behavior impacted by trauma or trauma. injury and that this reorganization continues for much of our lives.
I have seen lives changed for the better and in the long term because of the measurable and meaningful difference one nurse has made. Yes, there are staff shortages. However, those of us who work in this field are not lacking in compassion and caring.
Erica L. Trudell is Director of Nursing for Behavioral Health Services and Inpatient Education at MiraVista Behavioral Health Center in Holyoke.
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