00:01
So you might want
to ask yourself,
what is the role of the
nurse in this environment?
Well, we have multiple roles.
00:09
Of course, our first role
is going to be custodial,
taking care of the
needs of that patient.
00:18
We are also risk managers.
00:20
Remember we are assessing
that environment.
00:22
We are evaluating
risk at all times.
00:27
We're also providing
crisis prevention.
00:31
And crisis prevention is
part of that risk management,
it's part of that assessment
that we are continually doing.
00:39
And in that way, we're able to
identify a problem before it occurs
and then mitigate the problem and manage
it before it becomes an actual crisis.
00:52
Let's think about the custodial
responsibilities of the nurse.
00:57
What are the most important custodial
responsibilities the nurse has
is this formal of
admission to the unit.
01:06
And that includes orienting that patient
to the physical layout of the unit.
01:12
Remember, your patient may never have
been in a psychiatric unit before.
01:16
It's very different
from a medical unit.
01:20
People are walking around
in their street clothes.
01:24
People have no walkers or canes.
01:30
So as we are bringing the patient
the new patient into the unit,
we want to let them know
here is the nurse's station
where you'll be able to
get your medications.
01:41
Here is your bedroom.
01:44
Here is the day room.
01:45
Here is the dining room.
01:48
As you are orienting
the patient to the unit,
you also want to make sure
that you are orienting
the patient to the rules and
regulations in that unit.
02:00
Oftentimes, in the unit,
you'll have a board
that says what the rules
and regulations are
as a reminder to
all of the patients
so that everyone respects
the rules and regulations.
02:14
Usually there is a public phone or a
phone that can be used by the patients.
02:21
And that comes with its
own rules and regulations.
02:25
In some places,
if you are working in a unit
that has an ability to
have the patient's take on
more responsibilities over
the time they are there,
you might have someone walking
with you another patient
who is helping with
that orientation.
02:45
So we want to make sure as we are
walking the patient through the unit,
as we are giving that
orientation to the patient
that we are making sure
that they feel safe.
03:00
It is incredibly important.
03:04
Because as a new
person in a new unit,
we want to make sure that
if they have questions,
we can answer the questions.
03:15
If we notice that
they are anxious,
we can talk about that
anxiety and look at a way
that we can to help them to
take care of that anxiety.
03:28
These are what we consider
custodial responsibilities,
making sure that that
environment is safe
and assessing the
patient for risk.
03:41
And remember,
risk is personal risk
that they might be feeling
anxious and therefore perhaps
take steps that might
be self-harming.
03:54
But also that they don't feel as
though they are in harm's way.
04:01
We also want to make
sure that we are looking
at the way they are treating
other people on the unit
and making sure that there is no risk
for them in response to other people.
04:15
Also,
we want to assess basic needs.
04:18
And we want to make sure that
those basic needs are being met.
04:24
What do we mean by basic needs?
We're talking about food,
we're talking about adequate sleep,
and we're talking
about medications.
04:33
And we know that with a patient
with a psychiatric disorder,
food and sleep and medications are
of utmost importance for recovery.
04:45
We also want to think about the
fact that discharge planning
even for the psychiatric
patient begins at admission.
04:55
The moment that patient
comes on to the unit,
we are thinking about how
we are going to help them
to recover and
return to their life.