Psychiatric Emergency Room: A Case Study

To fully understand a situation, it is important to understand the context in which it is occurring (Matei & Antonie, 2015). In the psychiatric emergency room where I work, there has been a high degree of staff turnover and change. We have a new nurse manager. Ten nurses simultaneously left full-time positions because they received a grant to attend SUNY Upstate full-time, and become psychiatric nurse practitioners, resulting in many nurses and psychiatric techs quitting, and many starting; thus the staff is mostly new. Relatively new employees (4-6 months) is now orienting newer staff. More senior staff (at least one year) is getting burned-out from orienting staff. The nurse manager is trying to address old patterns of behavior, which are …show more content…
A characteristic of complexity science is that the whole is analyzed in addition to analysis of parts (Butts & Rich, 2015) when we focus on looking at one part of a system, we neglect the connections between the parts (Matei & Antonie, 2015). Complexity science also draws from many theories, I utilized a social, ecological model that focuses on looking at factors within the environment that affect behavior, and seeks to cultivate an environment that promotes positive change (Butts & Rich, 2015). Social innovation theory can be used to address management, policy, labor issues, including performance and productivity of staff. This theory to change human behavior involves a feedback loop, where four stages are recycled: 1) evidence- identify a measurable target behavior that needs to change 2) identify relevant information or context related to target behavior, convey such to employees 3) consequence- identify information with possible outcomes. 4) action- implement a decision, this process is repeated as in a feedback system (Matei & Antonie, …show more content…
Is there something that is getting in the way of techs getting up and observing patients? Further, since all of the techs are engaging in this behavior, it is fruitless to “write up” each one. My solution is to get rid of the computer, and chair, and go to a paper checklist and clipboard. Nursing informatics integrates data, information, knowledge and wisdom (DIKW) to support healthcare professionals in the delivery of healthcare (Gee et al., 2012). Informatics can assist in the actualization of knowledge into nursing practice, but changing people, organizations or systems necessitates the cooperation of diverse disciplines (Ozbolt & Saba, 2008, historical citation). The cameras assisted in examining behavior, but the “cow” computer and chair are taking away from patient care, and affecting patient health outcomes. There is a 30-bed inpatient psychiatric unit in the same hospital, on this floor and other inpatient psychiatric units, every 15 min observations are done on paper that is attached to a clipboard. My boss commented that she did not think of this, and felt that it is a good idea, and would be bringing this idea to the