Registered Nurses' Experiences of Care for Individuals With Mental Health Issues in the Emergency Department
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Purpose: The main purpose of this study was to explore ED nurses' experiences in caring for individuals with mental health concerns and their thoughts of what contributes to or inhibits their ability to care for this patient population. Methodology: A qualitative study using a descriptive phenomenological tradition was guided by the following research questions: a) What are the participants' experiences of the care that is provided to the individual experiencing mental health issues in the ED?, b) What are the participants’ descriptions of elements that contribute to or inhibit their ability to effectively care for individuals with mental health issues in the ED?, c) What are the participants’ educational experiences related to mental health issues?, and d) What are the participants’ recommendations for the enhancement of mental health nursing care in the ED? Conclusion: Nurses practicing in the ED stated they lack psychiatric knowledge related to theory, and skills in assessment and least restraint interventions which are often utilized when providing care to mental health patients in the ED. Mental health education at the undergraduate and practical level relevant for practice in non-psychiatric settings needs to be enhanced and supported at an organizational level. The use of control interventions such as restraints and seclusion pose significant ethical issues for nurses. Interventions are often chosen based on the need to ensure the perceived safety for the patient and those within the ED and not necessarily on least restraint practices. Further barriers include a lack of time, role and responsibility confusion and a fast-paced environment that was not conducive to provide quality care for those with mental health issues. These factors detracted from care practices, and ED nurses thought their care did not meet the needs of the mental health patient. These findings will provide a platform for education and organizational efforts that support the ED nurse and optimize care of individuals with mental health issues seeking care in the ED.