Crowley J J
St Nicholas Centre, 79b Tewson Road, London SE18 1BB, UK.
Accid Emerg Nurs. 2000 Jan;8(1):2-8. doi: 10.1054/aaen.1999.0061.
Accident and emergency (A&E) departments have attracted little attention from psychiatric services, with the exception of emergencies and the management of self harm. Emergency staff gravitate towards those attenders with concrete physical needs, typifying mental health attenders as low status. The aim of this project, which took place over a 12 month period, was to improve the quality of care provided to persons attending an A&E department with mental health needs, through a staff development programme. It was initiated for the generic A&E nurse with no formal training in mental health care. The programme was based on knowledge generated through a collaborative approach using an action research process. This article particularly focuses on the mindsets, values and strategies which evolved through the study. The project indicated that facets of the A&E culture such as staff values, technology, communication patterns and the environment give mental health a low status. Conflict is generated between the individual and the macro culture, dominated by the excitement of trauma care and the short-term, immediate nature of the work.
意外与急诊（A&E）科室很少受到精神科服务的关注，除了紧急情况和自残处理。急诊工作人员倾向于关注那些有具体身体需求的就诊者，将精神健康就诊者视为地位较低的群体。这个为期12个月的项目旨在通过一项员工发展计划，提高为有精神健康需求的A&E科室就诊者提供的护理质量。该计划是为没有精神健康护理方面正规培训的普通A&E护士发起的。该计划基于通过使用行动研究过程的协作方法产生的知识。本文特别关注通过该研究演变而来的思维模式、价值观和策略。该项目表明，A&E科室文化的一些方面，如员工价值观、技术、沟通模式和环境，使精神健康处于较低地位。个人与以创伤护理的刺激和工作的短期、即时性质为主导的宏观文化之间产生了冲突。
