Pros
1. Talented, dedicated frontline staff who support each other through incredibly difficult conditions. 2. Opportunities to learn under pressure, though not in the way any professional would hope.
Cons
1. Management lacks clinical mental health knowledge and insight into psychiatric care, leading to decisions that are out of step with both ethical practice and current legislation. 2. Nurses are informally judged by how few PRN medications they administer, regardless of patient acuity or physician orders. Those who follow medical orders and provide appropriate symptom relief are implicitly labeled as “bad nurses.” 3. PRNs now require an extra call to the physician for additional permission, regardless of prior orders, delaying care and increasing suffering. 4. Unrelenting surveillance of nursing staff creates a culture of fear, not safety. 5. Critical nursing judgment is undermined by rigid, non-clinical metrics and arbitrary interpretations of “restraint” and capacity law. 6. Excessive focus on PRN statistics over clinical outcomes has led to unnecessary suffering for both staff and patients. 7. The decision to keep full overhead lighting on in the nursing station 24/7 has disrupted sleep, worsened circadian rhythm disorders, and escalated agitation among patients and fatigue among night staff. 8. Violent incidents have increased as patients in acute distress are denied timely pharmacological intervention, even in involuntary care settings.