Behavioral emergencies on a non-psychiatric unit

Behavioral emergencies on a non-psychiatric unit

Introduction

In a non-psychiatric setting, nurses are expected often to provide care to their patients, in cases of mental health disorders or behavior management issues, with scenarios such as in the case-study occurring every day in an acute care setting. In 2007, approximately 46% of the population in U.S. experiences mental-health disorders, such as anxiety, impulse control, or substance abuse. Furthermore, people suffering from psychosis or substance abuse disorders are at the same risk for health problems as any other population subset. In addition, patients with no previous, preexisting mental disorders may be anxious and apprehensive during their hospitalization that may alter their behavior. As a consequence, abnormal social behaviors are likely to increase in the hospital setting (Nadler-Moodie, 2010).

There are multiple contributing factors having an impact on the abilities of nurses to provide effective intervention to patients suffering from behavioral issues in a non-psychiatric in-patient setting. Two primary factors consist of negative attitudes presented towards the patients suffering with mental illness, as well as, perceptions of nurses for inadequate competence and confidence in the identification and management of behavioral symptoms. In addition, the compounding nurses lack of confidence and fear in patients exhibiting mental illness symptoms, are perceived frequently as unpredictable and dangerous (Pestka, et al., 2012, p. 335).

Violence at the workplace is a significant concern. The Occupational Safety and Health Administration (OSHA) provide guidelines against prevention of workplace violence indicate a significant risk of job-related violence that the health care workers face. According to the OSHA guidelines, inadequate training of staff in recognizing and managing the rising incidence of hostile and assaultive behavior puts the health care workers at higher risk of work-associated assaults. In addition, the American Psychiatric Nurses Association advises the health care organizations, to develop comprehensive programs to prevent and manage violence in workplace (Pestka, et al., 2012, p. 335).

The exact numbers of injuries to health care workers associated with assaults by the patients are not known. This may be due to the underreported violence against the nurses for various reasons, including of view of nurses that are part of the job. Furthermore, literature also cites the impact beyond the possible immediate injuries, spreading distress among the nurses, and may lead to high turnover, as well as, deteriorating staff health. In 2010, Joint Commission identified the urgent need for health care organizations to reduce the risks involved in violence to nursing staff as there are increased rates of violence reported, consisting of assaults by the patients (Pestka, et al., 2012, p. 335).

Discussion

What is Behavioral emergency?

A behavioral emergency is also known as behavioral crisis or a psychiatric emergency, occurring when there are severe alterations in the mood, thoughts, or behavior of the patient, such that it is potentially life-threatening to the patient himself/herself, or the any of the staff members (The Merck Manual, 2013). Just like in the case study where Mr. X becomes a threat to himself, as well as, the ...