Building a Psychiatric Boarding Toolkit: An Emergency Nursing Perspective on a Collaborative Approach to Care

The boarding of psychiatric patients is a significant problem in the United States (US) and creates burden for both patients and emergency department (ED) staff. Most triage processes in US EDs rely on nurses, and triage is considered a fundamental core nursing skill. However, the triage and continuing care of behavioral health (BH) patients may require a more interdisciplinary approach.

To explore the perspective of emergency nurses to inform a collaborative interdisciplinary approach to the care of boarding BH patients.

After a presentation by an emergency physician, a guided discussion on ED behavioral health boarding and ED care led by a physician-nurse team was held in person in September 2024. Data were analyzed using content analysis to develop a set of recommendations for improving care for boarding BH patients.

Emergency nurses identified key points where appropriate care pathways may improve care for BH patients boarding in the ED. Education and cultural changes related to behavioral health assessments and care were also identified as critical needs for both physicians and nurses.

Emergency nurses recognize a need for standardized approaches to BH to improve care for BH patients boarding in the ED. This interdisciplinary approach, which includes emergency nurses at the first encounter, may allow for collaborative standardized approaches that could improve care for this patient population.