Psychiatric consultation to the burn unit: the psychiatrist's perspective

A "hateful epileptic" patient in the burn unit

An interdisciplinary team discussed the case of a 31-year-old woman who sustained second- and third-degree burns while having a seizure. She was a difficult patient who elicited a good deal of negative feelings from the staff. The interview raised the possibility of this burn having been a suicidal attempt, and the subsequent discussion centered on effective ways of relating to her pathologic defense mechanisms. The need for a comprehensive approach that took into consideration the biologic, psychologic, and social aspects of her needs became evident to all the participants.

Consultation on the medical frontier. A preliminary survey of the attitudes of infant intensive care nurses

Advancing medical technology presents problems to medical professionals previously unforeseen. Psychiatric consultants are frequently called upon to assist staff, patients, and families in addressing these issues. The nursing staff of an infant intensive care unit was surveyed as to their perceptions of their work and their coping strategies. The results confirmed that in this technologically novel environment, staff were still attempting to acquire coping strategies to effectively meet demands placed upon them. The present study indicates that consultants need to be cognizant of such concerns to effectively assist such staff.

The burn victim--a review of psychosocial issues

Over recent decades, with the introduction of specialist units for the treatment of severely burnt patients, a volume of literature on psychological aspects of burns has accumulated, containing anecdote and opinion as well as research of varying quality. This literature is reviewed under three headings: epidemiology and prevention; reactions following acute hospitalisation; and long-term outcomes. Adverse personal, health, and social factors may predispose to burn injury. In hospital, the psychological course of the patient proceeds in stages that can be related to the well-recognised reactions to loss and overwhelming stress, modified by the major physiological insult. Reactions of family and staff are of great significance. In the longer term, rehabilitation prospects are generally good, although recovery may be complicated by a gradually subsiding level of neurotic symptoms and relationship difficulties.