routine at psych unit-morning gathering

Meriwhen, ASN, BSN, MSN, RN · Dec 25, 2013

A lot of facilities will have a "morning focus" or "morning group" where they'll be told what's going on that day and find out the name of the staff working that day. Patients aren't forced to attend but strongly encouraged. If they don't attend, it's considered a group that they missed and the doctor will address it with them later.

For what it's worth, all of the staff doesn't always make the meeting either.

Whispera, MSN, RN · Dec 25, 2013

I've worked in 3 psychiatric hospitals and on a variety of units within them. Every spot had what was called a community meeting each morning. Community meetings were for meeting staff, learning what happens on the unit, expectations, discussing problems that have arisen between patients and other patients or patients and staff, and setting goals for the day.

Patients who were able to attend were expected to attend. If they weren't able, they didn't attend. If they were able but didn't attend, they were encouraged and if they still didn't attend regularly, if they were voluntary patients they were discharged. After all, they could sleep at home and run up a much smaller bill. Also, their spot could be given to someone who would participate or someone who was sicker.

wingding · Jan 2, 2014

Our morning "Community Group" is held with whoever will attend. We hand out self assessment sheet to get a focus on any pt. & how they are sleeping, anxiety level, thoughts to harm self or others. Also the time we write current RNs' on duty, Doctors & techs, date, journal topic for the day & group ideas for the day. I like to go over what our unit is & is not --- (we are an acute care - 3-5 day stay, some more, some less) so pt. understand they are not there for months on end!!

marshmallowstar, BSN, RN · Jan 4, 2014

We have a morning goals group. Each pt discusses their goals or assignments they are working on that day, staff provide feedback on techniques that may be helpful or if we see a potential problem with a goal. If safety is a concern (self harming/suicidality) they prioritize that and list specific tools or assignments that will assist with safety throughout the day. At the end of goals group we make time for community issues and support. If someone is struggling with something or wants feed back from peers they can ask for it here. If a pt misses group because they were in an appointment with the MD or Tx they review their goals independently with staff and are provided feedback as if they were in group. If someone refuses group we discuss this with them. There are many possible reasons, some of the common ones we deal with are: Overstimulation, things are so busy internally that being in a room with 16 other people is pretty overwhelming. Difficulty with motivation/energy level, whether it's because of depression or poor sleep the night before this is probably this biggest reason. Working with the pt on opposite action and morning routines is really helpful. Fear due to anxiety about talking in a large group or receiving public feedback from staff. We work on separating past and present, reality testing and sx management techniques to reduce anxiety. If they continue to refuse goals group it's discussed in treatment team and an individual program that may involve having their door locked during group times goes into place or they may be put on a specialized group schedule. There is a pretty good book "Textbook of Hospital Psychiatry" by Steven Sharfstein that has info on the dynamics of the inpt unit and things that have been helpful on specific unit types (Trauma/Eating Disorders/Psychotic/Drug and Alcohol) I know the trauma section cites research based evidence for the importance of goals groups, unfortunately I don't have the citation available right now but it's worth checking out if your library has a copy.

TL;DR Yes we have morning group, if they don't attend we figure out why, if they still don't attend they have specialized treatment plan.