Nurses part of a tight-knit team on busy GPU-ACU

Nurses Maria Salken, Anmol Doomra and Julia So Young Kim treat a range of CAMH patients in the fast-paced General Psychiatric Unit-Acute Care Unit (GPU/ACU). The GPU is an inpatient unit with 22 beds, while the ACU has six impatient beds plus a seclusion room.

“We have patients with every diagnosis and in all age groups. I’m constantly learning,” explains Maria. “It’s a high-paced environment with multiple admissions and discharges per day.”

Maria is one of five new nurses on GPU-ACU hired in the last several months, joining a tightknit interprofessional team that includes nurses, a hospitalist, social worker, dietician, psychiatrist, recreation therapist, pharmacist, APC, as well as a range of students.

Nurses on the GPU are each assigned up to five patients each day, and two patients are assigned per nurse in the ACU. Each shift, Maria meets with each patient to do a basic mental health assessment, inputs notes from those conversations into the charts, and attends rounds where the team will discuss patients.

“I let patients know I am on their side and that their experiences are unique and valued,” says Maria, who worked at St. Joseph’s Healthcare Hamilton focusing on mental health before joining CAMH. “It is team-based nursing, so if you have a better rapport with a client you get the scoop and share information with your colleagues on how best to approach and help that patient.”

“I like working in mental health as you have time build relationships with the patients who are in crisis and get them to a point of stabilization,” she says. “I realized mental health was my fit and aligned with my values in health care. It uses the fundamentals of nursing to build up trust with patients.”

Maria’s colleague, RN Anmol Doomra, also came from St. Joseph’s Healthcare Hamilton’s nursing resource team before joining CAMH last December. He says that the team is close.

“I really love that about our unit—that sense of comradery. After work, it’s a lot of going to baseball and basketball games at the stadium or a bar,” he says. “Maria and I also have that Hamilton hospital connection so it’s easy for us to chat, ask for help and check-up on each other.”

 “Every nurse wants to help people, and on the GPU-ACU we help patients in their bleakest hour,” says Anmol. “I'm passionate about mental health nursing. I am constantly looking at ways to improve the care I provide because my patients truly deserve the very best."

He works on both ACU and GPU depending on his assignment. “Patients on the ACU require a lot more close observation and are some of the most vulnerable and ill people to work with.

“Patients on the GPU are a bit more stable compared to the ACU; however, it’s a very fast-paced unit with a lot more patients. We are a triage unit with a lot of transfers, admissions and discharges,” he explains.

“I help patients who are going through some of the most difficult time of their lives. I offer a lot of support, reassurance and health education to enhance the patient experience. I listen to my patients' concerns and communicate that to the care team to develop a care plan that provides client-centered care.”

RN Julia So Young Kim says communication with her colleagues helps make the team better.

“We have a strong team environment. They have my back. We do team rounds every morning, especially on the ACU—we go through plans for every patient and know the care plans for each of them,” says Julia, worked at Credit Valley Hospital before joining CAMH.

“Being in the loop is empowering. As nurses, our opinions are heard in team rounds and our input affects the care plans for patients,” adds Julia. “We communicate with each other about any safety issues and provide opportunities for clients to talk to us about their safety concerns or worries and then report those safety concerns back to the team.”

“Maria, Julia and Anmol are part of a group of five nurses that started in the last six months. They support each other, back each other up, give each other on-the-spot feedback, and recognize when someone does a good job,” explains Christine Butler, RN, Nurse Educator for GPU/ACU and the Women’s Inpatient Program. “Nurses on the GPU-ACU have to have a solid level of emotional intelligence and familiarity with different diagnoses.”

“We have very ill patients in GPU who may be affected by substance misuse or most perceptual disturbances, who were brought in by police, concerned members of their circle of care, or brought in from jail. These patients are on standard or close observation depending on their individual needs,” explains Christine. “Patients on the ACU need a higher level of observation from every fifteen minutes to continuous observation.”

“Staff on the GPU/ACU don’t just provide care for patients, they provide care for each other,” concludes Christine.