Were you ready? After more than four years of classes and clinical training, did you feel prepared for the real world of nurThis month's Pulse features a program that helps the mental health of nurses - many of whom are on the verge of losing perspective on their profession.

Using support meetings and retreats, Children's Healthcare of Atlanta's Care for the Caregiver program seeks to defuse burnout and what has been termed "compassion fatigue."

In a profession built upon caring for others, compassion fatigue is akin to battle fatigue - a weariness and numbness after seeing too many deaths or dealing with major stress. This condition can strip sufferers of all joy in their jobs, and leads to poor decision-making and loss of productivity.

The support group and retreat is part of an employee-wellness initiative at the hospital, and also at the critical heart of its retention and recruitment policy.

While the mental health of nurses needs to be addressed, there is also a critical shortage of facilities for the mentally ill - and that is causing another kind of fallout in emergency departments across the nation. Already swamped with patients who are using the ED as their only health care provider, EDs also are reporting a higher number of patients who need mental health services.

The problem is, those who can assess patients needing mental health treatment in the ED - and get them to the proper facility - are few and far between. So are the available beds.

DeKalb Medical Center is one of the few hospitals in metro Atlanta that still has a psychiatric unit. But in the past, the relationship between the ED and that unit has been chilly. Poor response times of case workers have left mentally ill individuals in the ED for up to 20 hours. With an average of 90 to 100 behavioral health patients a month, the burden needed to be shared.

A new program instituted through the collaboration of Penny Gringas, RN, assistant director of emergency services, and Paul Olander, director of behavioral health at the hospital, has reduced the wait time for these patients to four hours. While that wait still seems a bit lengthy, it includes a full assessment.

This program is only for people who pose no harm to themselves or others, and don't have an underlying medical problem that must be addressed immediately, Olander said.

Also in this issue is the story of an Emory nursing graduate who rode out Hurricane Charley with her patients in Punta Gorda, Fla.

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