The article by Sara Barr Gilbert deals with treating patients with mental disorders in the context of the emergency department (ED) of a hospital. The author emphasizes that there is a lack of guidance regarding this issue, which is why sometimes unjustifiably cold attitude of the medical staff towards psychiatric patients only exacerbates their problem. Thus, Mrs. Gilbert present her own virtual “crash cart” for treating such patients.
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In this study the treatment depends on a type of a disease: borderline personality or bipolar disorder, psychosis/schizophrenia, depression and anxiety. Tables presenting common symptoms and offered nurse treatment of these conditions, as well as simple rules organized as “dos and don’ts” in conversation, are included into the article. Proper word choice with mental patients seems to be crucial. Diagnosis helps to choose between a pacifying and a discipline-oriented tactics. It should be also kept in mind that a patient may be subjected to several psychiatric diseases at once, for example, persons with depression may also experience personality disorders. The first step towards more results is establishing rapport, a kind of therapeutic relations; other important measures are becoming nonjudgmental and being eager to form alliances with the patients. The author warns that any kind of punishing behavior applied to mental patients is undesirable, although adds that a nurse must suppress violent behavior. Then every illness is examined separately with a comprehensive overview of the premises leading to these conditions. All the cases are exemplified by real stories from the medical practice.
Nursing is a difficult profession demanding much time and efforts, both physical and mental. Treating patients with psychiatric illnesses in ED may be exhausting, but medical staff should understand that the benefit of the patient is an ultimate goal. Ironically, poor treatment results in ever acuter reactions and causes more problems to people around. Thus, practical and simple explanations and directions by Sara Barr Gilbert, when applied in hospitals, can increase the level of service in health sphere. If earlier one psychiatric patient in the department could be a problem, with this knowledge a nurse would easily handle several of them.
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