Mental Health Treatment Barriers to Emergency Nursing Care for Boarding Patients

Many patients seek mental health care through emergency departments. Emergency departments use many ways to care for mental health patients, however, one major challenge is boarding where medically cleared patients cannot be dispositioned from the emergency department because of inadequate health services. This study's goal was to determine emergency nurses' perceptions on mental health treatments in the emergency department in caring for mental health patients who were boarding. This qualitative descriptive study used one-on-one semi-structured interviews of bedside emergency nurses. Interviews took place remotely. Codes were derived from the data itself and then condensed into findings. Eighteen bedside emergency nurses participated. Four themes around mental health treatment for mental health patients who were boarding were discovered: safety precautions, basic medications, mental health team, and disposition for definitive care. With each aspect of care, benefits and barriers were dependent on resource adequacy or workflow challenges. To adequately care for mental health patients who are boarding, sufficient resource provision and efficient workflows for achieving good mental health care in the emergency department should be in place. Emergency nurses may be allies in supporting non-emergency department mental health services so that mental health patients can be adequately supported and boarding times decreases.