Helping students survive institutionalized patients and burn-out in staff in chronic psychiatric care facilities

In summary, we have discussed the problem of institutionalized patients and burn-out in staff as well as the effect they both have on nursing students during their mental health-psychiatric nursing rotation. The stages in which specific student behaviors occur during the psychiatric nursing rotation as a result of the students' perceptions, and the interventions faculty members can employ in decreasing the subjective aspects of these perceptions have also been presented. We conclude that nursing students will emerge from their experience with better understanding of institutionalization and burn-out, and better equipped to cope with reality shock if they are introduced to these concepts early in the lecture series and are sent to a variety of psychiatric care facilities for observational experience. The facilities selected should be those in which patients are coping with less chronic behavior problems than found in state hospitals and where observable behavioral changes in patients are measured in weeks or months, rather than years. Facilities such as outpatient clinics and crisis intervention centers where clients may be more stabilized, less overwhelming, and have more resources available to them would meet these criteria. Finally, we recommend that instructors be made more aware than they are of the institutionalization and burn-out process early in their teaching responsibilities; that faculty group discussions on institutionalization as maladaptive behavior be held; and that the faculty encourage an open atmosphere where students can discuss their reactions to institutionalization in patients and burn-out in staff freely.