Partnering, scamming, and paperwork: Observations in a psychiatric emergency room

Psychiatric emergency room (PER) staff often serve as the first line responders for individuals in an acute psychiatric crisis of entering the community mental health system for the first time. These staff face the challenges of meeting diverse and often acute needs of patients and their families while coping with the pressures on health care systems to reduce costs. Little is known about the day-to-day experiences of staff working in this environment. As part of a larger study about PER staff perspectives of their work structured observations were conducted in the staff areas of an urban PER. A study staff observed interactions and conversations among staff across different shifts, days of the week, and times of the day. Qualitative notes from the observations were transcribed and analyzed. The findings provide perspectives into how staff think about patients with whom they interact and the community mental health system they inhabit, as well as techniques staff use to manage workflow. These findings will increase knowledge about staff work perspectives, be useful for generating additional research questions, and also be helpful in creating interventions to assist with staff burnout.