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Northern Zone’s virtual crisis liaison nurse pilot program supports Emergency Departments

Photo of Emily Ferguson, Virtual Crisis Liaison Nurse

By Janelle Aucoin

The opportunity to participate in a pilot program part time while studying full time was something Emily Ferguson was eager to do.

As a virtual crisis liaison nurse, Emily is providing crisis mental health support for patients who present with mental health concerns in two of the regional emergency departments in Northern Zone.

The Mental Health and Addictions program (MHAP) in Northern Zone has been piloting the virtual crisis assessment program at Cumberland Regional Health Care Centre in Amherst and Aberdeen Hospital in New Glasgow since May 2022. As part of the pilot, Ferguson offers virtual assessments on weekends which provides additional support for the emergency department doctors who have a patient presenting with a mental health concern.

“Having a mental health nurse available helps get the history and all the information to support the doctor to make a decision about treatment plans, if they need to be referred to the psychiatrist in Truro, for example,” said Ferguson.

“I do mental health assessments, formulate a diagnostic impression, complete suicide risk assessments, develop a safety plan with the patient and their supports, teach coping strategies and distress tolerance skills, and connect the patient with therapy or other community resources as needed.”

Ferguson is no stranger to offering mental health support. She started working with the inpatient mental health unit at Colchester East Hants Health Centre in 2017, then moved into an urgent care clinician role at Cumberland Regional Health Care Centre doing urgent care assessments in the ED and follow up appointments providing short term individual counselling at the Community Mental Health and Addictions clinic.

She is studying to be a nurse practitioner, so she stepped away from her role last year to focus on her studies and is set to graduate in May. When the opportunity to participate in the pilot project arose, Ferguson thought it was perfect timing. “I am in school right now so it worked out well that I could only work on weekends while I’m studying/doing class during the week!”

When asked about how virtual crisis mental health support came to be, Ferguson explains that in rural areas, especially on weekends, it can be challenging for ED doctors to access mental health supports.

“Observation beds fill up quickly at CEHHC in Truro so depending on what’s going on in the other hospitals, people can find themselves waiting for a while in the ED for an assessment,” she said.

Ferguson works closely with ED staff. “I collaborate with the ED doctor and nurse. When I’m done with my assessment, I review the case with them and run my suggestions by them, see what they think, make changes/revise if needed.”

“I also collaborate with Community Mental Health clinics in Amherst and New Glasgow to arrange follow up appointments for the patients I saw in ED and share my reports to ensure continuity of care.”

The feedback from ED staff and crisis teams has been positive, according to Kevin Fraser, MH&A Manager, Intake and Crisis in Northern Zone.

“It is rare for a week to go by without hearing appreciation for the mental health virtual liaison service. Emily’s role addresses mental health crisis assessment wait time gaps and continuity of care for those in mental health distress in EDs over the weekends to community urgent care teams.”

When asked if she thought other zones could benefit from having a Virtual Crisis Liaison Nurse, Ferguson said, “I think this service is beneficial for areas that have trouble getting staffing/coverage on weekends.”

People appreciate being connected to our services relatively quickly. “In terms of patient satisfaction, I hear patients say they appreciate they did not have to wait long for an assessment and generally don’t mind doing an assessment virtually! They are just happy to get connected with services, which at the end of the day, is our goal.”