Med/surg nurses not identifying mental health issues

Specialties Psychiatric


I am doing my practicum on a med/surg floor. I was surprised to see that a patient was not identified as having a mental health issue until he was there for 5 days. It is all documented as far as the behavior he was displaying and they even knew he was bi-polar. Have you seen this where you work? Is there not enough training available? I was told that there is an unpaid workshop available in this facility on how to deal with aggression but to me mental health is different.

I am thinking of doing an ethics paper about this and I have done searches in medline, cinhal, psyc, and on the net but I am not coming up with anything. I have seached under....ethics, psych, tertiary care, mental health, acute care, medical/surgical, general health system but not finding much of anything. The problem is out there are people just not writing about it?

I am not asking for help on my paper, just some direction might be helpful. I am really interested in learning about this.




239 Posts

Have you tried "dual diagnosis?"

Here are some references you might find useful, but I don't know if this is the direction you're interested in.

Sharma, T., & Antonova, L. (2003). Cognitive function in schizophrenia: Deficits, functional consequences, and future treatment. Psychiatric Clinics of North America, 26, 25-40.

Vieweg, V et al. (1995). Medical disorders in the schizophrenic patient. Int'l J. Psychiatry in Medicine. 25, 137-172.

Green, A. I. et al. (2003) Detection and management of comorbidity in patietns iwth schizophrenia. Psychiatric Clinics of North America 26, 115-139.

Stroup,T. S. et al. (2000). Management of medical illness in persons with schizophrenia. Psychiatric Annals, 30, 35-40.

good luck with your paper,



29 Posts

Good idea, I'll give it a go.

Thank you so much,



34 Posts

wouldn't want to offend anyone


29 Posts

Thank you! This is really interesting. I appreciate the information.

canoehead, BSN, RN

6,856 Posts

Specializes in ER.

Think about the the stereotypes associated with mental illness. Questions that come to mind for me are; if the nurse displays an interest and knowledge about mental illness how do her coworkers view her? Is time spent in therapeutic interaction seen as real work by coworkers? Is there someone else (social work, or psychiatry) who is seen as being the ones that deal with any non physical problems? Some psych meds can have pretty serious side effects if they are missed for even a day, and patients are often NPO, was that a factor? Did the patient have the ability to advocate for himself, or educate his caregivers? If not, did he have ANY advocate? For patients without family close by who is their advocate while in the hospital, and what are the ramifications of not having one?

Hope this helps.

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