The Nurse as a Psychiatric Consultation Team Member

A better understanding of the psychological aspects of illness and hospitalization necessitates increased attention to the patient's interpersonal transactions with care-givers in the general hospital setting. Ward nurses are key individuals in these transactions; they can play an important part in facilitating the patient's psychological adaptation in response to the stress of illness. To bring the nurse-patient relationship into the scope of the consultation process, the University of Virginia psychiatric consultation team includes a nurse as a member. As a participant observer in the general hospital milieu, the “consultation team nurse” is able to aid ward nurses in facilitating patients' psychological adaptations through reinforcing the therapeutic relationships and intervening in situations where antitherapeutic emotional responses to patients have developed. Her activities also include the gathering of information from ward nurses for diagnostic purposes, the giving of direct psychiatric care where appropriate, and the provision of perspective for the team from the viewpoint of the nurse. Her presence and activities encourage closer scrutiny of nurse-patient transactions, allowing insights into patients' interpersonal responses at times of stress, providing a self-awareness for care-givers, and enabling the consultation team to investigate and better understand the psychological aspects of nursing care. This approach serves to aid in the development of a psychologically therapeutic milieu in the general hospital.