Should Psychiatric Nursing Stations Be Opened or Closed?

Psychiatric nurses who work at inpatient mental health facilities interact with many different types of clients. Some may be relatively subdued and withdrawn while others may be more outgoing. Facilities designed to address the needs of the severely mentally incapacitated treat individuals with extreme cognitive and behavioral problems, and constant supervision and precaution are necessary to ensure the safety of both the clinicians and the clients. Nursing stations within these facilities are designed to provide maximum accessibility and supervision while also providing safety and security to the staff members. Some stations are designed with glass barriers and locked doors and others are built with no walls or windows, allowing both the staff members and clients open access.

Kelly Southard, the Quality Outcomes Coordinator at the Cone Behavioral Health Hospital in Greensboro, North Carolina, recently conducted a study to determine how each type of nursing station design affected therapeutic outcomes. For her study, Southard assessed 25 nurses and 81 clients in an acute psychiatric unit of a hospital before the nursing station was renovated and after. Prior to renovation, the nursing station was closed and had window and door barriers. The nursing station was only modestly renovated with new paint and countertops and removal of the window and door.

Southard found no significant differences in the perceptions of the ward environment after the renovation compared to before the renovation. The staff members and the clients did not report an increase in therapeutic ambiance as a result of having an open nursing station. However, many clients did comment that they felt that that the nurses were more accessible in the open station. Another interesting finding and one that is of concern to staff members charged with the care of high-risk clients was that the open station did not increase the level of aggression or violence on the ward. In contrast, the staff members discovered that the clients actually exhibited less aggression and anger after the renovations. Southard added, “Although more research is needed, these desired trends could be related to nursing staff being more readily available to better meet patients’ needs.”

Southard, K., Jarrell, A., Shattell, M. M., McCoy, T. P., Bartlett, R. (2012). Enclosed versus open nursing stations in adult acute care psychiatric settings: Does the design affect the therapeutic milieu? Journal of Psychosocial Nursing & Mental Health Services, 50.5, 28-34.

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • lauren jay

    May 25th, 2012 at 4:26 PM

    Any time that care feels more accessible I think that the patients are going to feel better accomodated and respected. I don’t think that with all of the barriers like doors and walls, the patients probably felt very closed off. They think that the nurses and doctors saw them as a threat. How would that make you feel? I don’t think that most patients would want to hurt the doctors or nurses.

  • Adrian

    May 26th, 2012 at 12:23 AM

    Accessibility is a good thing. But the nurses are accessible to the clients at the places they are supposed to be, right? Then what is the need for nursing stations to be ‘open’? If anything, a closed nursing station will only give the nurses a place to kick back and be away from ‘work’ for sometime.

    It gives them a place and time to relax and rejuvenate and we all know how important it is for them to be relaxed for the betterment of the clients!

  • Helena

    May 26th, 2012 at 3:58 AM

    If the nurses are so afraid of the patients that they would prefer to be walled off from them, then perhaps they should find another place to practice their nursing skills?

  • S.L

    May 26th, 2012 at 4:59 AM

    Well it depends on the kind of patients and clients in the facility.Nursing station being an open one is alwyas good but sometimes even they have fears and threats that need to be addressed.

  • beth

    May 28th, 2012 at 4:40 AM

    Good grief! These are patients, people, not criminals. Leave the stations open so that the patients and their families know that they have access to these nurses who are so often theri very best line of contact into what is going on with their treatment.

  • Liza

    May 28th, 2012 at 3:54 PM

    Maybe I have a little bit of a different point of view, but I think that if they are at the end of their rope and have made it to a hospitalized facility, then we have to look out for their care providers. Therefore, if that means nurses stations that are closed off from the patients then that’s the way it needs to be. Who’s to say that they wouldn’t flip out at some point in time and go after this provider as a target. I know that maybe in this kind of case they may not be able to help themselves, but that’s no excuse for having someone who is innocent and who is just trying to offer help stand the chance of being hurt. I realize that especially at this site this is a probably an unpopular opinion, but that’s how I feel. If I or loved ones worked in this kind of setting I would want to know that they were protected and that there was not a chance that patients could get hurt either.

  • emma c

    May 29th, 2012 at 4:09 AM

    Don’t really have a dog in thid hunt so to speak, as I am not a nnurse nor do I have a family member who is in a hospital that would house mentally ill patients.

    But speaking as someone who is on the outside of this situation looking in, I personally feel that it is a horrible idea to keep the patients separated from their nurses by wall and doors. What good could this possibly do other than to keep those imaginary walls up and discourage talking to one another and learning from one another?

  • Michael

    June 11th, 2012 at 12:44 PM

    I guess that leaving these stations open would be the wise thing to do so that the patients have the access to these stations and the nurses can take care of their treatment. Here I would also like to share a website ( that should be useful for visitors of this post.

  • Christopher

    April 19th, 2022 at 2:42 PM

    As a psychiatric nurse for 40 years I have worked every type of setting there is. One thing I learned is that patient’s don’t hurt people they like. And I found patients really liked me when I aligned with them, related to their suffering, acknowledged that I shared their goals for treatment, and put my best effort forward to care for them. I have worked in many open nurses station. the only time I remember problems was when a nurse was ignoring or talking down to a patient who was asking for help. In one instance i recall, the patient felt that their issue was an emergency (it wasn’t) and the nurse thought the patient was too needy (she wasn’t) so the nurse ignored her. But it was a failure to communicate. that’s what I always see as the problem when aggression erupts, staff are not effectively communicating with their patient.

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