Under the administrative direction and supervision of the Director of Mental Health Services (MHS) and the clinical supervision of the attending psychiatrist, the Psychiatric Liaison Nurse, guided by the policies and procedures of the hospital, is responsible for the coordination of care and treatment of patients requiring psychiatric treatment, including those already admitted to the hospital and those presenting to the Emergency Department with psychiatric complaints; provides pre-admission psychiatric nursing assessments, interventions and aftercare planning for Emergency Department patients as well as inpatients as requested.
Essential Duties and Responsibilities:
A Psychiatric Liaison Nurse meets all essential duties and responsibilities of a Registered Nurse for MHS.
- Performs initial patient assessment to determine the appropriate level of psychiatric care needed.
- Obtains patients medical history.
- Provides psychiatric nursing assessment for patients who have Mental Health Evaluations (MHE) ordered by the Emergency Department (ED) provider.
- Assesses inpatients outside of the Mental Health Unit (MHU) for potential need for 5150 (72 hour hold).
- Completes Pre-Psychiatric Screening Interview and/or Pre-Admission Assessment (PAA) on appropriate patients within established one hour goal after notification of need for MHE on an ED patient.
- Reviews laboratory and radiological results on patients in the ED in addition to completing PAA.
- Completes reassessment of patients when necessary and required by hospital policy/procedure.
- Completes Suicide Assessment Tool on an initial basis on all patients; completes Suicide Assessment Tool prior to release of patient from the ED.
- Obtains a Family Questionnaire from patients families/visitors on an as needed basis on admitted patient to the MHU.
- Provides appropriate interventions for patients who have MHEs ordered by the ED provider.
- Implements seclusion/restraints per established policy/protocols.
- Coordinates medical transfer/transport of patients in the ED and completes necessary duties when needed, facilitating transitions of patients to the most appropriate level of care by providing pertinent clinical information to other health care providers.
- Provides appropriate aftercare planning and referrals for patients who have MHEs ordered by the ED provider and are not being admitted to the MHU or as an inpatient.
- Develops and maintains knowledge and understanding of hospital and community resources available to patients and their families.
- Provides patients with referrals to and education of community resources.
- Reviews and updates plan(s) of care on designated patients as assigned.
- Evaluates results of interventions.
- Evaluates the plan(s) of care developed and make revisions as needed based on patient current condition.
- Evaluates documentation of other Registered Nurses and provides peer review as assigned.
- Evaluates the medical record for documentation that supports the services provided to the patient.
- Completes 5150 in its entirety based on assessments completed.
- Maintains an accurate medical record for each patient seen.
- Documents in the medical record to facilitate the completion of arrangements to other acute or post-acute care facilities.
- Documents any and all patient teaching on established hospital form(s) or in the electronic health record.
- Documents all patients rights denials on appropriate hospital form(s) or in the electronic health record.
- Documents review of plan(s) of care and any revisions in the patients medical record.
- Completes debriefing conference notes following the use of seclusion/restraints to include maintenance of restraint log.
F. Patient Education
- Provides patient education on a routine basis.
- Provides Administrative Director, Mental Health Services, with an end of shift report.
- Completes electronic event reporting system for an adverse or unusual event that occurs in a timely manner.
- Aware of all Mental Health admissions, transfers and discharges that are occurring/expected to occur during the assigned shift or those after the assigned shift and reports this information to the ED Charge Nurse, MHU Charge Nurse, House Supervisor using the report format established in hospital policy.
H. Quality Management
- Participates in the Performance Improvement program of the MHS Department, including the review of ten (10) MHU charts monthly.
- Reviews 100% of the seclusion/restraint documentation with the MHU Charge Nurse.
I. Collaboration -
- Participates in Interdisciplinary Treatment Team meetings in MHS on a weekly basis at a minimum.
- Accepts responsibility for communicating with referral sources, third party payors, consultants, other departments that patients may be referred to for care.
- Responsible for understanding the Admission and Continued Care Criteria for the MHS Department, including knowledge and ability to review Interqual criteria.
- Acts as a liaison with the other floors and the ED for any difficult patients, patients needing special observations and/or restraint use.
- Collaborates with medical staff to ensure accuracy and completion of necessary documentation; interacts with medical staff on a professional level and assists in troubleshooting in relation to admission, placement or release of designated patients.
- Involves the Patient Care Coordination Social Worker with patients and families including bereavement counseling.
- Assists and functions as a Mental Health Staff Nurse in emergency situations.
- Submits a written report via e-mail system to the Administrative Director of Mental Health Services at the end of ones shift on requested information.
- Participates in self-scheduling.
- Assists in special projects and assignments.
- Assists in orienting new employees to the Mental Health Services Department as assigned.
- Supervises proper use of supplies, time, resources and equipment.
Knowledge, Skills and Abilities:
- Knowledge of the legal aspects of psychiatric/mental health nursing.
- Knowledge of current nursing practice and procedures including, but not limited to, the specific needs of psychiatric patients as generally acquired through the completion of a formalized nursing program culminating in the award of either an associate or baccalaureate degree in nursing.
- Knowledge of the practical workings of mental health programs, including chemical dependency treatment, as generally acquired through at least one (1) year of experience in a formalized inpatient mental health setting.
- Knowledge of psychiatric emergencies, including assessment and intervention, treatment, and community resources, as generally acquired through at least six (6) months experience in a psychiatric emergency setting.
- Thorough knowledge of mental health disorders and psychiatric nursing diagnoses.
- Meets all skills of a Mental Health Registered Nurse.
- Meets all abilities of a Mental Health Registered Nurs