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Nurses play a vital role in just about any setting where medical care is administered. The same is true in a mental health and addiction treatment facility, where nurses often have more contact with patients and patients’ families than other medical or clinical staff.
One might think, then, that the role of nurses in rehab and recovery outcomes is well-understood, yet that is frequently not the case. For help demystifying the important function of psychiatric nurses, we reached out to Chief Nursing Officer Nicola Gagliano, MSN, PMHNP-BC. Gagliano is a board-certified psychiatric nurse practitioner. She has extensive experience in psychiatric nursing and as a leader and mentor in patient-centered care for a wide variety of behavioral health needs. You can catch Gagliano’s insights in the below Q&A….
The General Role of Nurses in Mental Health and Addiction Rehab
Q: What are the primary responsibilities of nurses in mental health and addiction rehab settings?
A: Nursing plays a core role in delivering patient-centered care. This includes assessing the patient, monitoring their mental and physical health, dispensing medications and monitoring side effects, providing emotional support, coordinating care with other members of the treatment team, educating patients and their families about their condition, and creating that therapeutic environment conducive to recovery.
Q: How do nurses collaborate with other healthcare professionals (e.g., psychologists, psychiatrists, social workers) in the treatment of individuals with mental health and addiction disorders?
A: Psychiatric nurses work as members of a multidisciplinary team that also includes doctors, psychiatrists, licensed mental health social workers, and mid-level board-certified family nurse practitioners. We discuss daily patient care, evaluate challenging cases, and work collaboratively, both with the patient and one another, so that we can cohesively implement the best therapeutic interventions.
Q: What is the role of nurses in developing and implementing care plans for patients with mental health or substance use disorders?
A: Nursing will perform a comprehensive assessment of the patient’s mental and physical health, and at that point they will identify short and long-term goals based on the patient’s needs and objectives. They’ll also coordinate care with the team, whether that includes certain lifestyle modifications or other interventions, and will provide updates based on the patient’s response to the care plan.
Q: How do nurses assess and monitor the mental and physical health of individuals undergoing addiction treatment?
A: We use evidence-based screening tools for addiction and co-occurring disorders and monitor the patient’s vital signs. We also assess mental health status and identify withdrawal symptoms during the high-risk period of hospitalization, the first 72 hours, as well as during the entire duration of detox (typically 7-10 days).
How Nurses Support and Interact with Patients
Q: How do nurses build trust and rapport with patients in mental health or addiction rehab programs?
A: Establishing trust with patients is very important. As nurses, we seek to actively listen without a judgmental attitude; maintain consistent and transparent communication; and, while respecting the patient’s autonomy, collaborate with them around a treatment goal. This might be as simple as attending at least one group or getting out of bed and taking a shower, which for patients with depression can be a struggle.
Nurses also collaborate with patients about their medications. When a medication has undesirable side effects, we work with the patient and their doctors to modify the medication plan, so that it is better for the patient.
Q: What techniques do nurses use to help calm anxious or agitated patients?
A: All nurses are trained in “Crisis Prevention Intervention.” This is a de-escalation strategy that can help with verbal reassurance and active listening. We don’t touch the patients but use these de-escalation techniques to diffuse tension, stabilize a crisis, and minimize triggers. We also collaborate with the care team to adjust medications or provide therapeutic interventions.
Q: How do nurses support patients through detoxification and withdrawal symptoms in addiction treatment?
A: We monitor signs of withdrawal and provide appropriate interventions, dispense medications to ease withdrawal symptoms, provide emotional support, and educate the patient on what to expect during withdrawal.
The Role of Nurses in Medication Management
Q: What role do nurses play in administering and monitoring medications for individuals in mental health and addiction rehab programs? We provide safe medication administration, especially in cases where a patient is taking multiple medications. We also monitor for therapeutic effects and any potential adverse reactions when administering these medications — and we document the patient’s medication adherence.
Q: How do nurses educate patients about the potential side effects of medications prescribed for mental health or addiction recovery?
A: We help the patient understand the medication’s purpose, its potential side effects and how to manage them, and the importance of taking a medication to prevent any relapse.
Q: How do nurses manage potential medication interactions in patients who are on multiple medications?
A: We perform a thorough medication reconciliation, collaborate with our in-house pharmacist to monitor any interactions, and report any new interactions or changes in mental and physical status.
The Role of Nurses in Helping Patient Families
Q: What is the role of nurses in educating families and caregivers about mental health and addiction recovery?
A: Nursing provides information to the family about the patient’s condition and treatment plan; and, we educate families with tips for how to support the patient after discharge and manage any challenging behaviors.
We also provide tools for self-care to help prevent caregiver burnout. When a loved one has autism, schizophrenia, or another disabling condition, the caregiving burden falls almost entirely on families. They need support as they navigate life with a new diagnosis. Many families send their family member to treatment and now must learn a whole new way of living.
Q: How do nurses engage with support groups or community resources to help patients transition successfully into aftercare?
A: We encourage families affected by addiction to get involved in an Alanon group while their loved one participates in an AA or NA group (Alcoholics Anonymous or Narcotics Anonymous). (Alanon is a 12-step group for family members of those with addiction.)
For those facing a mental health condition, whether they are newly discharged patients or family members, NAMI (National Alliance on Mental Illness) and its support groups are a resource that we regularly recommend.
Nurses often act as a liaison between the patient and external resources to make sure they continue with their care. We also help patients transition to a lower level of care and ensure their medical and psychiatric needs are continuing to be met.
Conclusion
In talking with Gagliano, it soon becomes clear that nursing plays a critical role throughout treatment. From a patient’s admission to their discharge, nurses are on the frontlines of care. They’re a primary point of contact for patients, the key coordinator of care for the multidisciplinary team, and a vital source of information and education for worried and overwhelmed family members. It’s no wonder that nurses are in such high demand.
