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Issues Ment Health Nurs · Jul 2004
The experience of gatekeeping: a psychiatric nurse in an emergency department.
- Margaret McArthur and Phyllis Montgomery.
- School of Nursing, Laurentian University, Sudbury, Ontario, Canada.
- Issues Ment Health Nurs. 2004 Jul 1;25(5):487-501.
AbstractEmergency departments are increasingly identified as the entry point to mental health services. In the hope of facilitating the flow of psychiatric patients through a general hospital's emergency department, experienced psychiatric nurses were asked to participate in a pilot project in a general hospital in Canada. This paper is a reflection of one emergency psychiatric nurse's (EPN) experience of her role being transformed into that of a gatekeeper. The notion of "gatekeeper" as a metaphor highlights "keeping psychiatric patients out" of an already strained emergency system. As a means to balance fiscal demands with patient care, the EPN inadvertently served to obscure entry for patients with mental illness who were seeking emergency services.
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