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These patients can spend hours to days boarding in emergency departments waiting for placement. If one of these patients has a substance abuse problem or multiple diagnoses the length of stay could be longer. Often these patient board in our emergency departments without any real care being initiated. “unlike medical patients in the ED waiting for beds, mental health patients tend to wait without any therapeutic interventions, consultation from specialty services or initiation of appropriate medications” (Zun, 2017, p. 23).
Emergency department physicians and nurses do not routinely possess the specialty skills neededto care for this population. Often, they are uncomfortable or uninterested in this population due to a lack of knowledge, training, or even preconceived judgements. These patients are placed in a room to sit where they are forgotten about essentially because they are not perceived as being an emergent patient but rather an inconvenience or even a nuisance.Watson’s theory of caring would be useful in this setting using the 10 caritas. I specifically want to focus on the caritas of development of a helping-trusting human caring relationship and the promotion and acceptance of the expression of positive and negative feelings. Population: Behavioral health patients boarding in the emergency department.Problem: long length of stay without therapeutic interventionIntervention: The action of caring by the nurse using Watson’s theory of caring by being authentically present, acknowledging the patient and establishing that relationship of trust. This would require the nurse to spend time with the patient making that connection through active listening and if appropriate the use of therapeutic touch. By establishing this relationship of trustthe patient can express himself freely allowing the nurse to assess his physical and psychosocial needs. When the nurse is genuine and authentic in her caring attitude and behaviors, these patients tend to me more forthcoming with essential information such as medication use and compliance, recent therapies, substance abuse issues or even suicidal ideations. This informationis essential to establishing a plan of care or safety plan for the patient. This exchange of information is only possible if the nurse has established that relationship of caring and trust.Outcome: By utilizing Watson’s theory of caring through the building of relationships, patients can safely express themselves, nurses can assess their needs and advocate for a plan of care to help support the needs of the patient. This can include constructing a safety plan, addressing a medical issue, or initiating an appropriate medication regimen to stabilize the patient. Often once these patients have their needs met, are stabilized with psychotropic medications, they can be appropriately evaluated by a mental health professional and discharged home. By initiating therapeutic interventions early, length of stay could be substantially decreased.