[mtorra2811]

Dear Fellow RNs; I am an RN with 28 years' experience, most of it in the psychiatric field. I have worked in many different settings, and one of the things I have learned is that the institutions that provide the best patient care are the ones that properly supervise the work and nurture the growth of their employees. Something that may not have been brought to the attention of many nurses is that the quality of the supervision and in-facility education of employees in psychiatric care facilities has been spiraling straight downward in recent years. When I entered nursing in the 1970's, it was the standard for good psychiatric institutions to provide individual supervision on an ongoing basis to all workers who had direct contact with patients. At present, many institutions provide NO INDIVIDUAL SUPERVISION whatsoever. Of course, most of these institutions themselves would blame this on managed care and the resultant re-structuring of personnel practices. In fact, the small private facilities (which, in my opinion, are almost never among the "good facilities") have always cried poormouth regarding what they can provide for staff. The larger, more prestigious teaching institutions were already reducing what they have available for staff members before the financial impact of managed care really began to hit the industry. (In other words, the services meant to aid personnel were the first to go.) As public awareness and sympathy has been raised about the treatment of patients and as lawsuits and other forms of activism are nudging into existence a new perspective on how to treat patients and to track the quality of care, there has been almost nothing but deterioration in meaningful and useful attention to the supervisory and educational needs of staff. Unfortunately, in some facilities as the new philosphies of viewing the needs of patients have been embraced, a blaming attitude toward experienced psychiatric staff has been made part of the picture; you can imagine the impact this can have on the morale of experienced staff who have always been in the field because they care about what happens to people who have been labeled with a psychiatric illness. Facilities and individuals who abuse patients or allow the occurrence of abusive incidents must ALWAYS be tracked and dealt with; vigilance about this must be ongoing. But I have found to my horror that an internet search on "psychiatric workers rights and responsiblities", psychiatric workers' organizations", or mental health workers' organizations, produces literally nothing that relates directly to the rights of unlicensed workers, and extremely little that relates to the rights of psychiatric nurses. Do you know of ANY organization that tracks or promotes psychiatric workers' rights to reasonable and fair treatment by employers, ESPECIALLY vis a vis clinical supervision and support?

[oramar]

There are a lot of good questions posed by this poster. Perhaps you could break this down into smaller bites and post the questions posed in the paragraph one at a time. It is probably not you, it is probably me that is a little to slow picking up what your are trying to say. Many, many people on these boards are concerned about the decrease in mental health spending and what it means for society.

[mtorra2811]

Regarding my earlier posting about psych workers: There are already many organizations dedicated to the rights of patients. It is workers for whom there are literally no organizations listed on the net, and this complete lack of organized support is highly indicative of the fact that there is no one out there protecting psychiatric workers with regard to what supports institutions have for this often-traumatized group of people. Because of this lack, institutions have responded to the "restructuring" caused by managed care by eliminating the little bit of personal supervision and emotional support that was formerly being offered.