ABSTRACT
Scant literature exists regarding combined medical-psychiatric units for pediatric populations. The present article is the second in a two-part series describing issues relevant to the organization and development of such a unit within a tertiary-care children's hospital. Case examples of medical-psychiatry patients are presented, together with summary patient statistics for the first 3 years of operation. Additionally, issues regarding the physical layout, treatment program, and staffing are discussed.
Subject(s)
Child Psychiatry/organization & administration , Hospital Units/organization & administration , Pediatrics/organization & administration , Adolescent , Child , Child, Preschool , Diagnosis-Related Groups , Female , Georgia , Hospital Units/statistics & numerical data , Hospitals, Pediatric , Humans , Infant , Infant, Newborn , Insurance, Health/statistics & numerical data , Interior Design and Furnishings , Male , Nursing Staff, Hospital/education , Nursing Staff, Hospital/standards , Nursing Staff, Hospital/supply & distribution , Referral and Consultation/statistics & numerical data , Treatment Outcome , WorkforceABSTRACT
The growing literature regarding the development of medical-psychiatric units to facilitate diagnosis and treatment of patients with combined medical and psychiatric disorders is primarily limited to adult populations. Almost no published information is available concerning combined pediatric medical-psychiatric units. This article, the first in a two-part series, outlines the organization and development of a child and adolescent medical-psychiatric unit within a pediatric hospital. Various academic, administrative, political, financial, and clinical issues that must be considered during the developmental process are delineated and discussed. The second part of the series will address clinical management issues.
Subject(s)
Child Psychiatry/organization & administration , Patient Care Team/organization & administration , Pediatrics/organization & administration , Psychiatric Department, Hospital/organization & administration , Adolescent , Child , Combined Modality Therapy , Humans , Mental Disorders/psychology , Mental Disorders/therapy , Neurocognitive Disorders/psychology , Neurocognitive Disorders/therapy , Psychophysiologic Disorders/psychology , Psychophysiologic Disorders/therapy , Referral and Consultation/organization & administration , Social Environment , United StatesABSTRACT
Munchausen's syndrome by proxy (MSBP) is an emotional disorder in which the parent, almost always the mother, induces or fabricates illness in her child in order to gain medical attention. Although numerous case studies exist in pediatric and medical literature, most nurses are unaware of the warning signs of this disorder. Psychiatric consultation liaison nurses are in an ideal position to identify and intervene in MSBP situations and can also support the pediatric nursing staff through feelings of denial, shock, and guilt as they recognize the syndrome and its danger to the child.
