What Is A PICU Mental Health Nurse?

"1 in 4 people in the UK suffer from a mental health illness which is described as a ‘’ mental disorder’’ in legislation terminology."

Plaxedes Makonise talks us through what life as a PICU Mental Health Nurse looks like and gives us an idea of what you can expect from a job in Mental Health Nursing

Topics covered in this article

Introduction

Training To Be A PICU Mental Health Nurse

Job Overview

What Does A PICU Environment Look Like?

A Day In The Life Of A PICU Mental Health Nurse

Introduction

Ever wondered what PICU Nursing is all about?

This article is going to enlighten you about PICU the Role of a PICU Nurse and what does it mean working in PICU?

PICU stands for Psychiatry Intensive Care Unit.

In other words, this is mental health emergency unit or ward.

This is the initial entry point to admission following a mental health crisis.

1 in 4 people in the UK suffer from a mental health illness which is described as a ‘’ mental disorder’’ in legislation terminology.

Training To Be A PICU Mental Health Nurse

A PICU Mental Health Nurse is a Nurse who is specifically trained in the Mental Health field to take care of people with mental health issues.

One has to be trained at University for 3 years and earn a Degree.

The Training will include placements in the Clinical and Community Settings to gain more experience.

They have to be registered with the NMC part 3 to practice in the UK.

They will need to have knowledge of the Mental Health Act 2003(Revised 2007).

The PICU Mental Health Nurse takes charge of Shifts, is allocated a caseload of service users to care for, formulates care plans, reviews risk assessment, is involved in admissions and acts as an advocate for the service users, ensuring their safety and others on the unit.

They take responsibility for Mandatory and further Training for Personal and Continuing development.

They support people with mental health problem through Compassion, Empathy being non-judgemental, Candour and follow the Nurses Code and NMC Standards of Practice which have now been reviewed due to Covid 19 Pandemic.

The PICU Mental Nurse follows local Policy mainly Infection Control and Prevention and takes responsibility of their health and the public.

However, the PICU Mental Health Nurse does not work single-handedly.

They work with other multidisciplinary and multi-professionals in order to achieve the goal of people’s mental state improving.

These include within the unit the Doctors, Nursing Assistants, Administrators, Mental Health Office Staff, House-keeping and Domestic Staff Occupational Therapists and Activities Co-ordinator.

From outside the Clinical area the PICU Mental Health Nurse works in liaison with the Police, Social Workers, Solicitors, the Courts, Ministry of Justice, family, carers, relatives and other units for continuity of care.

Job Overview

The PICU Mental Health Nurse’s job is embedded in the job description and person‘s person specification on right from employment which they have to follow.

The PICU Nurse meets the service user right at point of entry and immediately start the admission process.

The PICU Mental Health Nurse immediately checks the Section Papers and ensure that the service user has been detained legally.

They have to read thoroughly the reasons for detention and note that the Service Users have been seen by the Doctors and Approved Social Workers and signed and dated.

The Nurse also has to check if the patients’ names have been spelt correctly and have correct address and Nearest Relative have been identified.

The Mental Health Nurse will immediately present the service user with the Section 132 Rights and ensure they understand their Rights under the Mental Health Act before giving them a copy.

They will assure them that they can appeal against their Section and this will depend on Section.

The Nurse will advise them on the Section Expiry date and about the Advocacy Team and List of Solicitors should they consider appealing at some point and remind them for Sections like Section 2 they would have to apply within 14 days of admission.

The Nurse is required to complete a Record of Detention Form and complete the Section Checklist Forms before sending to the local Mental Health Office which is usually based in the unit. You can also read about Journey To Becoming A Mental Health Nurse.

The Nurse has to welcome the service user and assure them of their safety, offer a drink and assure them that they will be supported throughout their admission.

The Mental Health Nurse has to ensure patients’ property and valuable have been listed and placed in Storeroom and Safe respectively.

They also need to notify the Family or Relatives about the admission.

Some service users may not wish to do so and the Mental Health Nurse will explain that it’s important to do so.

The PICU Mental Health Nurse will proceed to discuss the service user care and formulation of Care Plans and Risk Assessments and how they are going to be involved.

They will also tell them on the Ward Routine or Day Planner and that they will be looked after or work alongside various team members and the Ward Consultant and Doctors will be available and they can discuss their care in Ward Rounds on a designated date or should they have any concerns.

They will nominate a colleague usually the Safety Nurse who is responsible for locking patient Valuables to show the service user the unit environment which includes the Dining Room, Clinical Room, Toilets, Storeroom for their belongings, Activities Room, Day Room and their Bedroom.

The PICU Mental Health Nurse will inform the service user about their allocated Primary Nurse who is also a qualified Nurse will have 1:1 sessions and allocated daily staff member who will attend to their needs each day.

The PICU Nurse will advise that the Primary Nurse will have more responsibilities which include preparing reports for Tribunals and Managers Meetings and will support then facilitate calls to other professionals.

The PICU Mental Health Nurse will discuss medication compliance and that it is the service user’s best interest to take their medication and get better and also reassure them that the aim was to ensure their hospital is as short as possible.

The PICU Mental Nurse will explain that they will be monitoring the Service user’s mental state, their sleep pattern, eating habits, their interaction with others and how they care for themselves and they will be handing over their progress to the Team in Ward Round.

What Does A PICU Environment look like?

A PICU unit is a secure setting which is a restricted area in mental health settings.

They usually hold smaller bed capacities of up to 10 beds.

A PICU ward has a Seclusion Room which is utilised in case it becomes unsafe to nurse a service user on the ward.

Seclusion Room has to be used strictly as directed by Policy and usage should be brief as possible and all efforts should be made to ensure service user safety and wellbeing at all times all care documented clearly in the notes entries.

The PICU environment has to be safe with less furniture and staff to be wary of ligature points and any concerns about harmful items should be reported immediately.

A qualified Nurse is allocated to observe the Service User and any changes in physical health status should be reported urgently.

The PICU consists of 10 beds with a firm base-static, a Clinical Room for medication dispensing, Emergency Resuscitation Equipment and a Controlled Drugs Cupboard which should be kept locked at all times.

2 Registered Mental Health Nurses are responsible for checking and signing for any dispensed and stock medication.

There is also a large Dining Room with fixed comfortable leather stools to ensure safety of everyone, A Day Area and a Quiet TV Room for servicer users to watch television, Physical Health Examination Room where vital signs are checked daily and Doctors conduct physical examinations on admission or any physical health concerns raised.

There is also a Sensory Room where some service users can relax when they wish.

There is also an Activities Room with Video Games, Music Equipment and laptops which are supervised and a big white board for writing daily positive messages and displaying artwork.

The Ward Manager and Nurses Office are opposite and easily accessible by service users.

There are loads of Posters, Liaison information LGBTQ, Pals Care Quality Commission, Lead Nurses, Advocates contact details, Mental and Physical Wellbeing and Police Messages against Staff Violence.

PICU settings are identified as the most secure by Ministry of Justice hence they admit services users from the Courts and other secure units.

A PICU unit is also restricted not only to the public but professionals from community teams have to make appointments to visit or bookings to attend multidisciplinary meetings and have to present their identification badges before they are allowed in.

A Day In The Life Of A PICU Mental Health Nurse?

A day in the Life of a PICU nurse is never straightforward and its always a multidisciplinary approach!

The planned routine is subject to disruption any time The PICU Mental Health Nurse works 3 Shifts.

These are Early Shift which starts at 07:00-15:00.

Late Shift-13:00-21:00

And Night Shift-20:30pm-07:30 following morning.

In this article I am going to write about the E-Shift.

07:00-The PICU Mental Health Nurse receives the Night Handover.

This is the most important point especially when in Charge of the Shift.

The first thing to be aware of is staffing numbers then acuity.

You have to confirm if there is anyone running late and they contacted the ward.

The Night Co-ordinator will hand over each patient using the SBAR tool which is Situation, Background, Assessment, Recommendation after mentioning the Admission Section, Level of Enhanced observations and DASA Score and NEWS Score.

The Night Co-ordinator will report where the service user was at the start of the Shift, if they attended Supper, took their Night Medication and what time they finally settled, and they were any concerns.

Handover takes about 30 minutes and you have to receive Handover for 10 service users.

07:30-The Night and Day Co-ordinator will go around to check on the patients before the Day Shift Allocation.

They have to ensure every service user is breathing before they both sign the Hourly Observation Chart.

Handover takes about 20- 30 minutes and you have to receive Handover for 10 service users.

Soon after Handover the Shift Co-ordinator allocates Day staff to take over enhanced.

07:45-The Morning Co-ordinator complete the Shift Allocation as per Designations, 2 RMNs are allocated to dispense medication.

The Safety Nurse will issue staff with Panic Alarms before checking the Kitchen to prepare for Breakfast.

08:30-Breakfast Time-this protected time and all staff have to attend including the Shift Co-ordinator if they have finished the allocation.

The Safety Nurse is usually in charge of preparing Breakfast but can be supported at times.

One member of staff will ensure every service user attends Breakfast by knocking at their bedroom doors and at times they can opt not to attend.

They are encouraged to ask staff later so they can have something to eat.

09:00-Medication Time-Again this is protected time.

No activities or phone calls during medication time.

2 RMNs will dispense medication and one or 2 staff if available will remain in the corridors to ensure the service users are taking their medication.

The Shift Co-ordinator will remain in the Nursing Office to receive calls and Handover to the Manager and Doctors who start at 09:00hrs.

10:00-Attends Morning Planning usually facilitated by Ward Administrator or Shift Co-ordinator or relieves colleagues on Enhanced observations.

11:00-Joins Hurdle for briefing on patient progress, reviewing enhanced observations and any behaviour observations for Risk Assessment Reviews before Shift Co-ordinator starts preparing the Morning Handover.

12:00-Lunch time! Protected Time and all staff have to attend.

Again, another colleague goes to encourage the service users to join peers for lunch.

13:00-Afternoon medication.

2 RMNs are involved and Safety Nurse will call out service users again as some tend to return to their bedrooms after lunch.

14:00-Late Shift staff take over from Morning Shift colleagues to attend Case Studies or any Corporate, Business or Zoom Meetings.

Some staff finish up their note’s entries.

15:00-Early Shift ends and Late shift continues to 21:00hrs.

Night Shift has a slightly different Shift Planner for tasks.

It’s a 24-hour cycle shift for the PICU Mental Health Nurse! Read more on How To Change Your Career And Become A Mental Health Nurse.