Where Did All the Psych Liaison Nurses Go?

by Laurie

in psych nurses, supportive workplace environment

These days, very few hospitals employ psych liaison nurses. We are told it’s because we’re expensive but the other reason is that much of our work is hidden and therefore unknown. How does an institution measure the cost of incidents in which patients injure themselves, leave against medical advice, verbally abuse or physically assault staff, damage property, burn out caregivers, and upset other patients and their families? How does an administrator balance these potential costs against paying for the time, experience, and skills that advance-practice psych nurses bring to bear in preventing critical incidents and supporting staff?

Like soldiers in war-zones, experienced psych nurses have a sharply honed ability to predict and prevent volatile situations. Sniffing trouble, we reflexively intervene before feelings escalate. In the general hospital unit this means spending time with troubled or troubling patients, using empathic listening skills to identify the cause of irritation, doing something to relieve the patient’s distress, setting compassionate but firm limits when necessary, organizing patient-care conferences, and putting a prevention plan in place for all treatment staff to follow.

Psych liaison nurses also spend time with patients who, while not homicidal or suicidal, nonetheless feel anxious, fearful, sad, depressed, frustrated, apprehensive, hopeless, distrustful, paranoid, depersonalized, dehumanized, demoralized, neglected, or abandoned. Medical-surgical nurses don’t have time to address these emotional issues directly with patients. But these feelings affect patients’ motivation and compliance which affects their health and recovery process.

During the hospital mergers and reorganizations of the 90s, many psychiatric liaison nursing positions were lost. A new generation of nurses has since been hired who have never even heard of the role. But here’s a glimmer of hope: shortly after publishing my book, I was contacted by an excellent Bay Area hospital about applying for a psych liaison nurse position they had just created. Had it been closer to home, I would have jumped at the chance. I hope someone else did.

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