The Psychiatric Emergency Room: Staff Subculture

Abstract

In recent years, psychiatric emergency services have become a major resource for the deinstitutionalized mentally ill. This paper focuses on one such emergency room as an example of some issues that arise in providing care for this population. Based on participant observation, we describe the staff subculture that has emerged in response to the highly demanding nature of this kind of clinical work, as well as to such external factors as recently reduced funding, inadequate community resources, and media attention to problems with psychiatric services. We suggest that psychiatric nurses who work in such settings direct some of their energy toward self-care as well as helping to work toward change in the larger system.