Stop these risks of a crowded waiting room

Treat psych patients like guests

Overcrowded EDs make it more important than ever that "triage nurses are on top of their game" with psychiatric patients, says Barbara Morgan, RN, director of emergency services at Cleveland Clinic.

"We have the ability to influence the care and outcome of these patients," she says. "Every patient is our responsibility as soon as they walk in our door." To reduce risks, do these two things:

  • Give the patient your undivided attention.

Constant interruptions might cause a psychiatric patient to feel they are not worthy of taking up your time. "It is our job to make sure each patient knows that we are here for them and we have time to listen," says Freda Lyon, RN, BSN, MHA, service line administrator at Bixler Emergency Center in Tallahassee, FL.

When patients feel they do not have your full attention, they might not tell you that they have a plan to carry out their suicidal thoughts or that they have already taken an overdose of acetaminophen. "The nurse needs to hear what made the patient come to the ED," says Lyon. "This may shed light on symptoms of a physical ailment."

At Vanderbilt University Medical Center's ED in Nashville, a depressed patient who had denied suicidal ideation admitted in confidence to a nurse she trusted that she had a plan to kill herself if released. "The patient was admitted for psychiatric evaluation as opposed to being discharged," says Corey Slovis, MD, professor and chairman of the Department of Emergency Medicine.

  • Provide comfort.

In addition to routine nursing assessments, concentrate on "making the patient comfortable," advises Mickey White, RN, BSN, MBA, director of the ED at Emory Johns Creek (GA) Hospital. Provide television, engage the patient in conversation, offer meals, and provide hygiene supplies such as toothbrushes, soap, and washcloths.

"Treating them like a guest rather than a psychiatric patient seems to reduce the anxiety often associated with the long wait for placement into a psychiatric facility," says White.