Consultation-liaison nursing:: A personal reflection
Gillian van der Watt
School of Psychiatry and Clinical Neurosciences
University of Western Australia, Perth WA, Australia.
PP: 167 - 176
Abstract
This paper summarises a consultation-liaison nurse's journey as a senior mental health clinician working within the general hospital setting. It begins with a brief history of Consultation-Liaison nursing (CL) and covers the CL nursing experience in both the general hospital and the emergency department showing how the role evolved to become more focused on the needs of the general hospital. It shares some experiences during a stimulating, challenging and rewarding career where clinical supervision is seen as essential not only to reflect on and improve practice but to assist the CL nurse in working through the emotional demands of the role. The paper aims to increase knowledge of the CL nursing experience and promote interest in this specialist area of mental health nursing which is developing rapidly internationally and in Australia.
Keywords
Consultation-Liaison, nursing, mental health, psychiatry, general hospital
Article Text
Psychiatric disorders occur co morbidly in the medical and surgical patient population at a significant rate with evidence of psychiatric symptoms in 30% to 50% of patients with primary medical diagnoses (Arolt and Driessen, 1996, Clarke et al., 1993, Mayou and Hawton, 1986, Saravay et al., 1991, Savoca, 1999, Saravay et al., 1996). Psychiatric consultation liaison nursing (PCLN) has evolved as a specialist area in mental health nursing in response to nurses working in the general hospital setting reporting that they lack the knowledge and skills necessary to assess and manage patients with mental health problems (Brinn, 2000, Sharrock and Happell, 2002, Bailey, 1998, Wand and Happell, 2001, Roberts, 1998). These two factors serve to underpin the significance of the PCLN role in assisting nurses working in non psychiatric settings to develop the skills and confidence to manage mental health problems in their patients.
This paper will provide a brief history of psychiatric consultation liaison nursing before focusing on the writer's experience of working in this specialist area in Western Australia which will cover a brief period of work in the emergency department (ED) and later in the general hospital. Clinical supervision will be discussed and a brief narrative provided relating to the 2002 Bali bombing aftermath. Finally there will be a brief discussion relating to some similarities and differences in the way nurses and doctors work to provide care for their patients in the area of Consultation Liaison Psychiatry.
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