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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003ETraining and support, in the form of both physical and human resources, are needed to assist emergency department (ED) nurses in meeting the needs of patients with mental illness. Individuals seeking assistance for a mental health crisis often present in the ED. This article presents results from a study that assessed whether ED nurses have adequate knowledge, resources, skills, and confidence to meet the needs of patients with mental illness, and reported the nurses\u0027 perceptions and experiences in this area.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eschizophrenia\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Emood disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecritical care\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003ETraining and support, in the form of both physical and human resources, are needed to assist emergency department (ED) nurses in meeting the needs of patients with mental illness. Nurses should be empowered through increased involvement in the decision-making process regarding both education-training and selection of the type of ongoing support they need.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EIndividuals seeking assistance for a mental health crisis often present in the ED. The nurses who care for these patients admit to a lack of clinical expertise and confidence in assessing such patients [Clarke DE et al. \u003Cem\u003EAccid Emerg Nurs.\u003C\/em\u003E 2006], as well as limited resources. Larry D. Plant, DNP, PMH-NP, BC, George Washington University School of Nursing, Ashburn, Virginia, USA, presented results from a study that assessed whether ED nurses have adequate knowledge, resources, skills, and confidence to meet the needs of patients with mental illness, and reported the nurses\u0027 perceptions and experiences in this area [Plant LD, White JH. \u003Cem\u003EIssues Ment Health Nurs.\u003C\/em\u003E 2013]\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EData were collected during 4 focus groups. The interview guide was based on methodology developed by Krueger and Casey [Krueger RA, Casey MA. \u003Cem\u003EFocus Groups: A Practical Guide for Applied Research.\u003C\/em\u003E 2009]. All interviews were audiotaped and field notes were recorded. A total of 10 registered nurses participated (41% of the ED of 1 general hospital). The majority held either an associate\u0027s (n = 5) or bachelor\u0027s degree (n = 3); 1 participant had a diploma, and the other had a master\u0027s degree. Phrases that arose from the interview were coded line by line, then categorized and compared among the groups. Similar categories were further reduced to identify a single overarching theme.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe overall theme that emerged was a feeling of powerlessness on the part of the nurses. Four subthemes emerged from 11 categories (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/44\/21.1\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Categories and Subthemes From Interview Results\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1797870334\u0022 data-figure-caption=\u0022Categories and Subthemes From Interview Results\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/44\/21.1\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/44\/21.1\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/44\/21.1\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15145\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003ECategories and Subthemes From Interview Results\u003C\/p\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EAdapted from \u003Cem\u003EIssues in Mental Health Nursing.\u003C\/em\u003E 2013;34 (4):240\u2013248, copyright \u00a92013, Informa Healthcare. Reproduced with permission of Informa Healthcare.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp\u003EThe following are representative statements for each category:\n\u003C\/p\u003E\u003Cul class=\u0022list-simple \u0022 id=\u0022list-1\u0022\u003E\u003Cli id=\u0022list-item-1\u0022\u003E\u003Cp id=\u0022p-8\u0022\u003E\u003Cspan class=\u0022list-label\u0022\u003E\u22a0 \u003C\/span\u003E\n                     \u003Cem\u003EKnowing and not knowing\u003C\/em\u003E: \u201cThere seems to be some type of clue as to how they speak, are they are trying to cut down on anxiety, or kill the pain of PTSD (posttraumatic stress disorder)? I don\u0027t know, we don\u0027t always have the answers to be effective with these patients and that bothers me.\u201d\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-2\u0022\u003E\u003Cp id=\u0022p-9\u0022\u003E\u003Cspan class=\u0022list-label\u0022\u003E\u22a0 \u003C\/span\u003E\n                     \u003Cem\u003ECommunication with patients\u003C\/em\u003E: \u201cI just struggle with saying the right thing or not knowing if I am doing the right thing for them without causing the situation to become worse. It is very frustrating to really not know how effective we are.\u201d\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-3\u0022\u003E\u003Cp id=\u0022p-10\u0022\u003E\u003Cspan class=\u0022list-label\u0022\u003E\u22a0 \u003C\/span\u003E\n                     \u003Cem\u003EResources:\u003C\/em\u003E \u201cWe recently hired a new nurse educator just for the ED, so I am hoping that one of the priorities is training on crisis management \u2026 I think having a psychiatric nurse on staff in our ED would also be helpful.\u201d\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-4\u0022\u003E\u003Cp id=\u0022p-11\u0022\u003E\u003Cspan class=\u0022list-label\u0022\u003E\u22a0 \u003C\/span\u003E\n                     \u003Cem\u003ELong-term stays:\u003C\/em\u003E \u201cIt seems as if we see them once, we tend to see them over and over again. I guess I\u0027d have to say it is a long-term process.\u201d\u003C\/p\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003Cp\u003E\n         \u003C\/p\u003E\u003Cp id=\u0022p-12\u0022\u003EMore training, as well as a variety of support tools for ED nurses, is necessary. Further studies on this topic are also warranted, given the scarcity of research.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/44\/21.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzlv01\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlv01\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}