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Closing Gaps in Access to Mental Healthcare: Lessons from a Rural, Forensic Psychiatric Nurse Practitioner (Part II)

By: Carolyn Buonomo | Updated on 5/26/2022

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According to the American Psychological Association, approximately 10-25% of prisoners in the U.S. suffer from a serious mental illness. That’s more than double the rate of the general population.

Monique Manderson, PMHNP, is a LocumTenens.com mental health nurse practitioner who is on assignment at a rural, forensic facility. She recognized the need for better access to mental healthcare, particularly in rural areas, and accepted an assignment at a forensic state hospital which receives patients from the local justice system. In the interview series installment that follows, she describes a typical day at her rural, forensic facility, security and whether she feels safe on assignment and more.

An Interview with Monique Manderson, PMHNP (Part II)

NOTE: Monique's interview is a three part blog series. Be sure to check out the rest of the series (Part I, Part III)
What does a typical day look like as a clinician at a forensic psychiatric hospital?

Typically, I come in and begin by reviewing anything left over from the previous day, so I’ll start by looking at charts that need to be reviewed and discuss upcoming court dates and review reports that are due for the courts with the office assistant. Then I go to treatment team meetings to discuss high-acuity patients and do treatment plan reviews. I see patients for their monthly treatment plan reviews and medication adjustments, and I’ll meet with patients who request to see me as needed throughout the day. Although I’m housed in one specific unit, I’m responsible for overall hospital coverage. So I cover the other four units as well by answering pages, doing admissions and more.

What have the COVID protocols and PPE supply been like?

The PPE supply has always been in abundance at this facility, and I’ve never felt the COVID protocols have been lacking. In fact, I wanted to be vaccinated before beginning this assignment because I was fearful of catching COVID, but I’ve always felt as though the facility was on top of it and have always felt safe here. We have different “levels” of outbreak status reported by the office manager, we’ve never had to reuse N95 masks and there’s a temperature and symptoms check before entering the facility.

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What is the security like at the hospital? Have you always felt safe on assignment?

Yes, I have always felt safe here. It is a maximum-security facility, so you have to check your keys in and out. When you sign in, you give your keys to the person working the security desk. Then you walk into a compartment that’s sealed off with a barrier that security has to let you in and out of. It’s hand operated by the person at the security desk, which is safer than simply pushing a button. Security staff are always present with me while I interact with patients. To be completely honest, both my family and I had concerns about safety before I started the assignment, but those worries quickly went away. I am never by myself here, and security is hypervigilant.

"To be completely honest, both my family and I had concerns about safety before I started the assignment, but those worries quickly went away. I am never by myself here, and security is hypervigilant."
What are you allowed/not allowed to take in with you? For example, are you allowed to bring your cell phone? How are you able to communicate with your recruiter while on assignment?

Our cell phones are not supposed to be out in patient care areas, but I am able to keep my cell phone in my office on vibrate. You can’t bring any contraband, of course, or metal objects. You’re able to bring bottled water and lunch. There are separate areas that house staff and provider break areas. There’s ample space to store your belongings, and there’s an employee cafeteria.

To read more of Monique’s story in the coming weeks, be sure to follow LocumTenens.com on LinkedIn, Facebook, Twitter and Instagram.