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Supporting those with mental illness

After reading Three Medication Pathways for Bipolar Disorder (May, 2012),* I'd like to comment on the most crucial aspect of a patient's recovery: support. Without community, workplace, and family support, all the therapeutic drug regimens in the world fail miserably. This aspect, or rather the absence of it, is something I know very well because I was diagnosed with bipolar disorder almost 28 years ago.

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Mental health centers chronically operate on overload. Underfunded and understaffed, they process an enormous amount of patients each year. After most psychiatric patients "graduate" from an inpatient stay, they're left to flounder or make it on their own. A pall descends on the house where a psychiatric patient resides, and everyone in the neighborhood soon learns to shun the "crazy" person.


If nurses and healthcare providers would devote as much time and effort to removing the stigma of psychiatric illness as they do to ensuring adherence to psychotropic drug regimens, perhaps social perceptions of these patients would start to improve. I urge those of you who care for psychiatric patients to consider that they deserve to be treated with kindness and respect, just like everyone else.


Early warning systems: Help or hindrance?

In your recent article, Early Warning Systems: The Next Level of Rapid Response (February, 2012),* you presented yet another technologic advance designed to improve nursing observation and judgment. Early warning systems (EWS) being implemented across the nation are praised as technologic saviors that alert nurses and rapid response teams to a patient's deteriorating condition earlier than ever, decreasing patient mortality and length of stay.


As a nurse with a background in informatics, I'm an avid proponent of any technology that improves efficiency of the nursing process. But whether the integration of technologies such as EWS has been a help or a hindrance is debatable. Some believe that greater reliance on technology reduces time devoted to nursing assessment and personal contact with patients.1


Though some elements of an EWS can be an enhancement for RNs, the effectiveness of EWS hasn't been validated.2 Systems that generate computerized scoring data may encourage nurses to focus on the data instead of their patients.


I see the value of alerts that help clinicians recognize deterioration in a patient's condition. But we must also ask ourselves what we're doing to quickly recognize the deterioration of our nursing assessment skills.








Arlington, Tex.




1. Harley S, Timmons S. Clinical assessment skills and the use of monitoring equipment. Paediatr Nurs. 2010;22(8):14-18. [Context Link]


2. Kyriacos U, Jelsma J, Jordan S. Monitoring vital signs using early warning scoring systems: a review of the literature. J Nurs Manag. 2011;19(3):311-330. [Context Link]


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