"You will either step forward into growth or you will step backward into safety."
- Abraham Maslow
One Team, One Fight - Four words issued by our COL guaranteed to halt any disagreements among our team members. We are from different backgrounds, opinions, and viewpoints, but we're on the same team fighting the same battle. Like soldiers, nurses struggling to gain acknowledgement and respect from their interdisciplinary peers are one team with one fight yet we waste precious time and energy bickering among ourselves. With the precision reserved for describing decubitus ulcers, nurses differentiate among their own: ASN vs. BSN, MSN vs. DNP, DNP vs. DON, floor vs. clinic, clinic vs. academic, ICU vs. ED..... The ways to categorize are many and the separating of ranks is the reason MDs are able to pass legislature restricting DNP practice.
I was reminded of this simple truth this weekend during a group project exercise. Conflicting personalities and opinions hindered the group's efforts necessitating multiple phone calls, texts, and emails. During one exchange, a group member referred to me as a "psych nurse". I corrected him and asked why he thought I was in psych. He assumed I was a psych RN as I am pursuing the mental health nurse practitioner track and had an unspoken attitude regarding non-psych nurses specializing in mental health. Many teams, many fights. Psych nurses have the extensive background and experience to be mental health providers. Tactfully, (brownie points for the former Brownie!) I let that go.
I have yet to form an opinion whether having a strong background in psych makes a better mental health provider. There are pros and cons with this argument. A psych nurse works closely with the future patient population but in the scope of nursing practice, not advanced nursing practice. However, I firmly believe all patients are psych patients. The type of care received depends on the nurse. Does she treat only the physical symptoms or does she acknowledge and ameliorate the emotional ones? Does he pursue comments made and follow up with a referral to behavioral health when appropriate? The young woman newly diagnosed with breast cancer, in addition to physical diagnoses, may have inadequate coping mechanisms, fear, acute anxiety r/t her new diagnosis, and risk for situational low self esteem. The employee seen for transient elevated blood pressure c/o stressful commutes and long work hours. He may suffer from anxiety, ineffective coping mechanisms AEB elevated BP, and a disturbed sleeping pattern. The military wife at her newborn's two month check up is not the patient, but she has acute fatigue, impaired social interaction, loneliness, fear, anxiety and parenting role conflict r/t the prolonged absence of her deployed spouse and treatment of the baby involves emotional care of the parent.
Show me a patient and I'll show you a mental health referral. No, I'm not being flippant and certainly not lumping all patients together [patient individuality is huge in my PPN (personal philosophy of nursing)]. Being human means being subject to the human condition. None of us are immune to the very human state of human emotions, wants, needs, and desires. Maslow told me so. Emotions unexpressed, wants and needs unfulfilled lead to mental distress. No one has everything he desires; no one is exempt from mental or behavioral health issues. Every patient is a psych patient, even you & me.