The Experience of Gatekeeping: A Psychiatric Nurse in an Emergency Department

McArthur, Margaret; Montgomery, Phyllis

doi:10.1080/01612840490432925

Cited by 19 publications

(7 citation statements)

References 44 publications

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“…The trope of crisis induced by the abundance of medically non‐urgent cases has been documented in EDs throughout the world (see Buus , Guttman et al . , , McArthur and Montgomery ,, Peneff ). However, the definition of situation draws from peculiar local conditions which are only to a certain extent similar to those found in the countries where most previous works on non‐clinical evaluation have been conducted.…”

Section: Organisational Concernsmentioning

confidence: 99%

Reasonableness: legitimate reasons for illegitimate presentations at the ED

Wamsiedel

2018

Sociology Health & Illness

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Most studies on gatekeeping at the emergency department (ED) have emphasised the assessment of clients in terms of perceived legitimacy and deservingness, showing that lay considerations lead to exclusionary practices, and the ED contributes to the social reproduction of inequality. Some recent works have challenged this representation, providing compelling evidence of staff's concern for the access to care of the most vulnerable users. I extend this perspective by presenting the criterion of reasonableness of the visit to the ED that nurses in Romania commonly use during the triage admission interview. Reasonableness constitutes an acceptable departure from the mission of the ED that offsets the negative evaluation in terms of legitimacy. Patients deemed to have legitimate reasons for making illegitimate claims for admission escape staff's disciplining efforts. However, the staff-devised understanding of reasonableness is restrictive and does not attend to most cultural and structural barriers in access to quality health care. I argue that reasonableness indexes structural sensitivity, a fragmentary, tacit, and imperfectly consistent orientation to structural deficiencies in the organisation and provision of primary care.

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Section: Organisational Concernsmentioning

confidence: 99%

Reasonableness: legitimate reasons for illegitimate presentations at the ED

Wamsiedel

2018

Sociology Health & Illness

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“…The social and economic burden of mental ill health is vast and continues to grow. Thus, in regard to PER, it becomes apparent that the growing discrepancy between patients’ needs and emergency resources [ 8 , 9 ] contributes to both patients’ and staff members’ dissatisfaction which also could be a result of the lack of consensus concerning PER’s goals and resource allocation [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Frequent visitors at the psychiatric emergency room – A literature review

Schmidt

2017

Psychiatr Q

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Frequent visitors at the psychiatric emergency room (PER) constitute a small subgroup of patients, yet they are responsible for a disproportionate number of visits and thus claim considerable resources. Their needs are often left unmet and their repetitive visits reflect their dissatisfaction as well as that of PERs' staff. Motivated by these dilemmas, this study systematically reviews the literature about frequent visitors at PER and seeks to answer two questions: What characterizes frequent visitors at PER in the literature? and What characterizes PER in the literature? Based on 29 studies, this paper offers answers to the two questions based on a strength weakness opportunities and threats (SWOT) analysis. The results of the review and subsequent analysis of the literature revealed the multiplicity and complexity of frequent visitors' characteristics and how they appear to converge. Commonalities were more difficult to identify in PER characteristics. In some cases, this happened because the characteristics were poorly described or were context specific. As a result, it was not easy to compare the studies on PER. Based on SWOT and the findings of the analysis, the paper proposes new venues of research and suggests how the field of mental health might develop by taking into account its opportunities and threats.

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“…Results of a recent study indicate that most parents/caregivers present to the ED with vague expectations of receiving help and guidance for their child and for themselves (Cloutier et al, 2010). The ED is perceived as a place to receive information and advice, as well as a "gateway" for other MH services (Cloutier et al, 2010;McArthur & Montgomery, 2004;Solomon & Beck, 1989). Other times, mental health issues arise while the presenting medical complaint is being assessed.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Crisis Intervention Services for Youth within an Emergency Department: A View from Within

Dion¹,

Kennedy

Cloutier

et al. 2010

Child Care in Practice

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An innovative crisis intervention program was created at the Children's Hospital of Eastern Ontario in Canada in order to provide emergency assessments for youth presenting with mental health crises. The current investigation presents an overview of the program and examined the emergency staff's perception and satisfaction with it. Eighty-seven emergency department medical staff completed a survey. Overall, emergency department staff place high value on having access to emergency mental health services, are pleased with the quality of service and appreciate that the crisis intervention worker's presence allows them to spend more time with other patients. RésuméUn programme d'intervention de crise novateur a été développé au Centre hospitalier de l'est de l'Ontario du Canada pour évaluer les enfants et adolescents présentant des problèmes de santé mentale. La présente recherche présente un aperçu du programme et examine la perception et la satisfaction du personnel de l'urgence vis-à-vis celui-ci. Quatrevingt sept employés du personnel médical de l'urgence ont complété un sondage. De façon générale, les employés sont satisfaits de la qualité du service offert par ce programme. Ils apprécient la présence des intervenants de crise, ce qui leur permet de passer plus de temps avec d'autres patients.Crisis Intervention 3

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The Experience of Gatekeeping: A Psychiatric Nurse in an Emergency Department

Cited by 19 publications

References 44 publications

Reasonableness: legitimate reasons for illegitimate presentations at the ED

Reasonableness: legitimate reasons for illegitimate presentations at the ED

Frequent visitors at the psychiatric emergency room – A literature review

Evaluating Crisis Intervention Services for Youth within an Emergency Department: A View from Within

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