Mentally Ill
Treating mentally ill patients can be a challenge, as a
shortage of psychiatric hospital beds and reduced
mental health treatment capacity in communities has
resulted in an increase in the numbers who present to
the ED with a psychiatric issue, resulting in extremely
long treatment delays in the ED. NPs dealing with
mentally ill patients should be aware that: patients
may be suicidal, upset, lonely, cold, and hungry; the
loud, sterile, and clinical environment of an ED may
increase the patient’s emotional distress; and the patient
may hurt himself, as well as ED personnel.
Families waiting with patients for treatments also can
get frustrated with the delays.
As a result, in some EDs, NPs may face increasing
pressure to treat psychiatric patients. However, psychiatric
medications are highly specialized and create
specific problems and side effects. Prescribing these
drugs without a psychiatric NP certification or psychopharmacology
training and certification may
create serious scope-of-practice issues.