Analysis of psychiatric referrals and interventions in an oncology population.

PURPOSE/OBJECTIVES: To review nurse-generated, inpatient psychiatric referrals to the psychiatric consultation liaison nurse (PCLN) in a comprehensive cancer center.

DESIGN

Retrospective records review.

SETTING

National Cancer Institute-designated comprehensive cancer center in the eastern United States.

SAMPLE

102 psychiatric referrals/consults from an inpatient adult unit.

METHODS

Retrospective chart review of all referrals over a one-year period.

MAIN RESEARCH VARIABLES

Reason for referral, assessment data, and nursing interventions.

FINDINGS

Five major psychological problems constituted reasons for referrals: depression (31%), anxiety (26%), adjustment disorder (24%), "difficult to care for" (13%), and delirium (6%). Follow-up with a mental health care provider occurred with 84% of the patients. Interventions were directed at patients and staff members together, patients and family members, and staff members only.

CONCLUSIONS

Oncology nurses are the most consistent observers of patients' emotional responses. A PCLN can facilitate development of necessary skills for identifying and caring for patients at high risk for psychiatric problems.

IMPLICATIONS FOR NURSING PRACTICE

Oncology nurses may not always be able to identify specific psychiatric diagnoses, but they are skillful in the recognition of significant psychological distress in patients. Development of the PCLN role can facilitate assessment and intervention in patients needing additional help.