Psychiatry (Unit 52)

Unit 52 Psychiatry is a locked 10 bed inpatient unit located on the 5th floor of the Patient Services Building. The unit typically treats adults but adolescents may be admitted if they require intensive evaluation or have an acute medical/surgical problem which cannot be treated in another psychiatric facility.

Unit 52 is designated as a private Baker Act Receiving Facility by the State of Florida. Patients may be voluntary admissions or involuntarily admitted for evaluation and treatment.
The unit consists of all private patient rooms. There are two day rooms, a staff office and staff lounge, a conference room, and a seclusion/restraint suite including a lobby area, quiet room and a bathroom. There are also two procedural rooms, a treatment area and a recovery room.  This suite is used primarily for administration of electroconvulsive therapy (ECT).

Monitoring capability is restricted to non-invasive vital signs monitoring.  There is no telemetry capability on the unit itself.  Continuous direct non-invasive cardiac and vital signs monitoring occurs during ECT procedure and recovery phase.

Care is provided 24 hours per day 7 days a week on the inpatient unit. ECT is given Monday, Wednesday and Friday mornings.

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Description of Patient Populations

Patients are admitted to Unit 52 from the Emergency Department, by direct admission, by referral via the consult team from other hospital units, and by hospital-to-hospital referrals and transfers. The care focus of the inpatient unit is treatment of individuals with psychiatric diagnoses and requiring electroconvulsive therapy and/or unstable medical or surgical problems or persons requiring neuro-psychiatric evaluation. Diagnoses most commonly treated include mood disorders such as major depression and bipolar disorder, dementia with psychosis or behavioral problems, schizophrenia, psychosis NOS.

Concurrent medical -surgical problems including delirium,  post suicide attempts such as gunshot wounds, hanging, overdoses, sharp object trauma, motor vehicle crashes, burns; infectious diseases, unstable diabetes, renal failure, respiratory problems, epilepsy, Parkinson’s Disease.

Individuals treated in the ECT Procedure area typically have a mood disorder including depression, schizoaffective disorder, bipolar disorder. These individuals may be inpatients on Unit 52, inpatients at UF Health Shands Psychiatric Hospital which is a distinct part of UF Health Shands Hospital, or they may be outpatients. These patients are usually adults. Adolescents may be treated with additional psychiatric consultation required as per the ECT policy.

Nursing Care

The nursing care model used is that of total patient care delivery by the assigned RN with assistance from coworkers, including mental health techs.  The RN focus is assessment, diagnosis using Gordon’s Functional Health Patterns with Problems, treatment planning, interventions, and evaluation of care.  The MHT and CNA staff work under the direction of the registered nurse.  UF Health, UF Health Shands Hospital general and nursing policies, plus unit specific policies help guide practice.

The nursing staff is very involved in maintaining a therapeutic milieu for patients and families. This includes the art of psychiatric nursing in providing an environment that is safe, secure and therapeutic.  Empathy, therapeutic listening, and de-escalation skills are practiced.

As required the nurses may call on the expertise of others in the Department of Nursing, e.g. Stat nurses, the SWAT Team, Lift Team, nurse specialists, nurse educators.

The Nurse Manager of the unit is a Master’s prepared RN.  An RN is designated each shift to be the Charge Nurse.  Team Coordinators serve in an advisory and assistive function to the unit.

Healthcare team

The Medical Director of Unit 52 is board-certified in psychiatry and privileged to provide ECT.  The College of Medicine Department of Psychiatry physicians and residents provide 24 hour per day, 7 days a week medical coverage on the unit. The Department of Psychiatry schedules rotations for this coverage.  Other members of the health care team are a social worker, registered nurses, mental health techs, recreation therapists, a secretary and a unit clerk on the day and evening shift.  Medical students and PA students do rotations on the unit. Other members of the multi-disciplinary team are rehab services (PT, OT, Speech), respiratory therapy, nutrition services, pastoral care, pharmacy, diagnostic services and other medical teams from the College of Medicine, such as Internal Medicine, Cardiology, Neurology, Nephrology.

In the ECT procedure area, there is a designated ECT nurse who coordinates the patient flow and pre and post procedure care.  RNs from the PACU staff come to the ECT recovery area to provide PACU level care. Depending upon patient volume in the area, a second nurse may assist and/or an MHT or CNA is assigned to assist under the direction of the ECT nurse. in addition to the nursing staff  there is a psychiatrist who is credentialed to administer the ECT treatment, an anesthesiologist and resident anesthesiologist.  Students, including residents, fellows, medical and nursing students,  may observe.