We are often contacted to conduct operations assessments and compliance reviews following sentinel events on inpatient psychiatric units and/or emergency departments in which a patient has committed suicide, seriously harmed themselves, other patients, or injured staff. The best safety policies, such as shift-to-shift communications, procedures, a safe physical plant and furnishings are crucial in keeping everyone safe. But we’ve learned those are the minimum requirements, the basics.
Beyond those basics is a higher level of care and safety that relies on a highly skilled psychiatric nursing staff. Having Psychiatric Mental Health Nurses (PMHN) that are on each shift in sufficient numbers enables them to do their job and work at the top of their license. Patient safety on inpatient behavioral health units requires a qualified team. A major key to the success of those teams are the psychiatric mental health nurses. Nurses run the units and care for the patients twenty-four hours a day, every day. The problem is, we’re running out of them and that is bad news for attaining optimal patient safety.
As we work around the country with behavioral health service lines, finding and keeping PMHNs is a huge challenge. Unfortunately, many of the hospitals and even academic medical centers, do not have enough “psych nurses”.
According to a 2016 American Psychiatric Nurses Association (APNA) survey there is not nearly enough Psychiatric Mental Health RNs to meet the demand. The APNA’s April 2019 report “Expanding Mental Health Care Services in America: The Pivotal Role of Psychiatric-Mental Health Nurses”, points out that between 2014 and 2015 there was a 58% increase in mental health RN job openings and a 17% increase in psychiatric Advanced Practice Registered Nurse job opportunities.
Keeping patients safe and the quality of care high – especially on Inpatient units and in emergency rooms – requires PMHNs. Without their experience, communication skills, compassion and knowledge both patients and staff are at higher risk.
The PMHN are trained to see and understand beyond patients’ obvious behaviors. They are intuitive. They are aware of the impact their tone of voice, volume, body language, and expressions have. They know what to say, how to say it, and what not to say or do. Those skills and sensitivities are not always in the immediate reach of staff without the knowledge, training, and experience of trained and experienced psychiatric nurses, the next level for inpatient behavioral health unit patient safety.