What are your thoughts 

When following and discussing problems with my preceptor we both had similar problems in common within our facilities. One of the major problems is readmission rates. Patients on the behavioral health unit have poor follow up care. In Texas there is not a lot of options for mental health outpatient, especially for those who are indigent. So case managers and social workers struggle to find good follow up care. “Medicare states that certain diseases will have decreased funds if patients are readmitted within 30 days, behavioral health patients somewhat fall under that umbrella.”(CMS,2020). These patients reimbursements are lowed if they are readmitted. The facilities can often struggle finically from these lower rates. One nurse implication for this would be to make sure to start teaching the patient about medication management as soon as the patient is admitted. If patients feel that they can manage their symptoms and understand depression and suicide and go to therapy to get to the core of what is going on then they can manage these problems at home and find support from family or friends they have a lower readmission rate. Also involving the family in the care and medication management helps with managing behaviors. Reaching out to the patients primary care physicians can also help with follow up treatments. 

Another problem that we discussed is one that I feel happens everywhere, nurse burnout causing a shortage. On our units we often have to work overtime due to not having enough staff. When we are working over our three 12 hour shifts most of us start to get burnout and eventually change departments or quit. This happen throughout most units in a facility. Another nursing implication for this is to help build team moral, the nurses who start to experience burnout should go to the team leads and be able to express their feelings. The managers in the units should utilize PRN employees or hire more PRN staff to help fill in the holes in the schedule. Funding doesn’t always allow for this but as the advocator for the unit they can reach out to the float pool and help so full time nurses can have the days off that are needed sometimes.