Nursing and psychiatry

The information I transmit to my readers  now is an early Christmas present.

The protagonist is a nurse in the Acute Psychiatry Unit of the Sta. Caterina Hospital. Girona

She's  Anna Parera Llorà

  First of all I would like to thank Dr. Javier Faura for trusting me to write this article that I have the great honor to know as a person, friend and great psychiatrist with whom I could share and learn by his side during the first years of my professional career in the world of psychiatry .

At first he asked me to explain what an acute care unit is where I have been working as a nurse for about eight years. But what I really think is interesting and I would like to pass on is the enormous and at the same time so unknown task of the specialist nurse in psychiatry, which I will share later.

The acute unit is a short-term inpatient unit designed to care for people over the age of eighteen who present a crisis situation in which it has not been possible to achieve improvement or control of symptoms at the level of other resources external and which, due to their severity and risk, require containment and intensive interventions in a hospital setting. This unit cares for people with early psychotic crises, people with a regularization of chronic processes, suicidal risk, intense behavioral disorders with social and/or family pressure (violent behavior, isolation,...) and people with pathology intensive organic with psychiatric symptoms. With the aim of being able to return the patient to his family, social and work habits in conditions of clinical remission that facilitate his connection to treatment in his mental health center of reference.

The acute unit is made up of a multidisciplinary team where there is a head of service, clinical head, psychiatrists, internist, psychologist, social worker, occupational therapist, head of nursing, nurses, nursing assistants, administrative and cleaners .

But as I told you earlier, what I would like to focus on is to make known the role of the nurse within the acute unit and the therapeutic relationship that we give meaning to our profession.

We spend our entire academic training hearing about the importance of the therapeutic bond, but I can tell you that until I worked in the mental health field, I couldn't understand what it really means.

Nursing is someone who cares for the patient twenty-four hours a day, and this link, especially in mental health, is necessary when starting a relationship of help and which will last over time.

This bond arises by talking to patients individually and offering care with the aim of building a therapeutic relationship of trust, encouraging them to discuss their problems and listening to their opinions to allow the patient to recognize the things or situations that negatively affect their mental health, to learn ways to deal with situations. Using maximum sensitivity, tact, patience, tolerance and above all a treatment free of prejudice.

During these conversations we are making a careful assessment of the patient's psychopathology. And only when this bond is established can we reassure and calm the person. Find out why the person may feel anxious or aggressive and be able to act and make decisions to reduce risks. At the same time we work on awareness of the disorder, the need for treatment and its adherence. We also evaluate side effects of the treatment and try to involve the family or carers so that they maintain the treatment and facilitate their autonomy. Aside from nursing tasks such as medication administration, techniques, research and teaching.

I would like to finally leave behind the unfortunate stigma that has accompanied us and continues to accompany us to the nurse specialist in psychiatry. Anchored in the insane asylum that functioned only by containment, custody and directionality with the inmates, and saw the sick as a threat or a danger. Therefore, today's nurse has nothing to do with the image that cinema or literature has projected on our profession. Therefore, when setting foot inside the treble unit, no one will feel like Clarise returning to the stone corridor to the last cell to meet Hannibal Lecter.