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The purpose of acute care settings has been to provide intensive treatment to clients experiencing mental illness, who have been assessed as high risks for harming oneself and others, or are unable to care for their basic needs without treatment (Kunyk, 2019). Psychiatric nurses have a level of responsibility for every person residing on the unit, which contributes to the need to nurse the population on the unit as a whole (Cleary, Hunt, Horsfall, & Deacon, 2012). Therefore, psychiatric nurses have a dual role of providing care for individual clients and managing the demands of the unit. This dual role may lead to competing demands and difficulty with prioritizing care needs. Although much of the literature has focused on providing care on an individual basis, there is little in the literature regarding strategies to provide care for the entire unit (Delaney & Johnson, 2006; Thibeault, Trudeau, d'Entremont, & Brown, 2010). One strategy used to care for clients in acute care settings involves situational awareness. The current article adds additional knowledge regarding situational awareness in acute care psychiatric nursing.
Background
Psychiatric nursing involves being present with clients and caring for their immediate physical, psychological, social, emotional, and spiritual needs during life crises (Santangelo, Procter, & Fassett, 2018). Psychiatric nurses employed in acute care settings aim to balance the needs of particular clients with the demands of the unit as a whole. Caring for clients in the acute care unit requires advanced levels of awareness. Psychiatric nurses require self-awareness to apply the therapeutic use of self and develop a therapeutic relationship with clients (Eckroth-Bucher, 2010; Rasheed, 2015). Understanding or awareness of clients' needs is achieved through assessment skills and observation tasks. Assessment and observation have been identified as the foundation of psychiatric nursing practice and the groundwork for determining care needs and applying interventions (Higgins et al., 2016). Balancing unit safety and individual client care needs can be achieved through sophisticated assessment skills and observation of the tone and pace of the unit to gain an intuitive grasp of the situation and plan interventions (Delaney & Johnson, 2006).
To provide holistic care, psychiatric nurses aim to understand the ways that the environment impacts the health and well-being of clients. In acute care psychiatric nursing, the environment has...