The nurse working in the ED of an urban hospital notifies the manager that there are several clients with mental health disorders still present in the ED that have been there over 48 hours. Which issue related to this phenomenon does the nurse discuss with the manager?

Boarding refers to the practice of holding patients, including those with mental health disorders, in the emergency department (ED) for extended periods due to the unavailability of appropriate psychiatric or mental health treatment facilities. This situation often occurs when there is a lack of inpatient psychiatric beds or insufficient community-based mental health resources.

When the nurse notifies the manager about clients with mental health disorders still present in the ED for over 48 hours, they are likely raising concerns about the practice of boarding. The nurse is highlighting the issue of keeping individuals with mental health disorders in an inappropriate setting for an extended duration, which can have negative implications for both the clients and the ED.

The other options are not directly related to the phenomenon of clients with mental health disorders staying in the ED for an extended period:

1. Temporary detaining orders for clients: Temporary detaining orders refer to legal provisions that allow for the involuntary detention of individuals who are at risk to themselves or others due to mental health concerns. While this may be relevant in certain situations, it does not address the broader issue of clients staying in the ED beyond 48 hours.

2. The revolving door for clients: The revolving door phenomenon refers to individuals repeatedly seeking care in the ED due to ongoing or recurrent health issues. While this may be a concern in the context of mental health, it does not specifically address the issue of clients with mental health disorders staying in the ED for over 48 hours.

3. The cost of holding clients in the ED for over 48 hours: While the cost of providing care and resources to clients staying in the ED for an extended period is a valid consideration, it does not encompass the broader issue of the appropriateness of this practice for clients with mental health disorders.

This definition highlights the importance of positive relationships, effective coping strategies, a positive self-concept, and emotional stability in determining mental health.

The others are incorrect:

1. It is not easy to determine if a person is mentally healthy or mentally ill: Assessing mental health and diagnosing mental illness requires a comprehensive evaluation by trained professionals. Mental health is a complex and multifaceted aspect of overall well-being that involves various factors, and determining someone's mental health status is not a simple or straightforward process.

2. Persons who engage in fantasies are mentally ill: Engaging in fantasies is not necessarily indicative of mental illness. Fantasies can be a normal part of human imagination and creativity. However, the context and intensity of fantasies, along with other psychological and behavioral indicators, would need to be considered in a comprehensive assessment to determine if there are any underlying mental health concerns.

3. Behavior that may be viewed as acceptable in one culture is always unacceptable in other cultures: Cultural norms and values vary across societies, and what may be deemed acceptable or unacceptable behavior can differ significantly. There is no

universal standard for judging the acceptability of behavior across all cultures. Cultural relativism recognizes that behaviors and norms should be understood within their cultural context.