I am currently a graduate student and work on a very busy inpatient acute psychiatric unit. We regularly see patients from eleven different counties. My job consists of discharge planning and conducting insurance reviews. I am constantly feeling the pressure from hospital administration and insurance companies to reduce inpatient length of stay while struggling to find suitable follow up care for patients. Many of our patients are covered by Medicaid, are uninsured or underinsured. Many counties lack resources to provide consistent or timely care to these people.
The article in the May/June 2013 APNA journal focusing on recovery-oriented practices of psychiatric mental health nursing staff in the acute hospital setting caught my attention. The introduction to the article stated that “recovery is cited as the single most important goal for the mental health services delivery system” based on recommendations from the President’s New Freedom Commission on Mental Health and that “behavioral health disciplines are being challenged to integrate recovery into their practices” (McLoughlin, Du Wick, Collazzi, & Puntil, 2013). The Substance Abuse and Mental Health Services Administration define recovery as “a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her potential” (as cited in McLoughlin, et al., 2013).
I feel that inpatient care providers are often working with the goal of recovery in mind, but are discouraged by the pressure to stabilize and discharge patients. I am curious as to what the concept of recovery means to those who work in the outpatient setting? It seems to me that although the bulk of our curriculum as psychiatric nurse practitioners focuses on therapy, which is a valuable tool on the road to recovery, the shortage of prescribers and time constraints often have psychiatric nurse practitioners functioning only in the prescriber role. Do most of you find this to be true? If so, how can we as psychiatric nurse practitioners better advocate for our patients and their recovery?
McLoughlin, K.A., Du Wick, A., Collazzi, C.M., & Puntil, C. (2013). Recovery-oriented practices of psychiatric-mental health nursing staff in acute hospital setting. Journal of the American Psychiatric Nurses Association, 19(3), 152-159. doi: 10.1177/1078390313490025