Psychiatric intensive care nursing - psychoanalytic perspectives

Based on unobtrusive observations a parallel is drawn between general and psychiatric intensive care milieu. The correlation between the bedside skills and incidence of phyical contact is considered in each setting. The phenomena of physical attacks on nursing staff and other carers is considered, as is the process of restraint in the psychiatric intensive care unit (PICU). It is suggested that the attack and subsequent process of physical restraint is a re-enactment of a skin-on-skin object relation and can be functional in re-establishing a sense of bodily ego in the psychotic patient. Some thoughts are offered on how the intensive care of psychotic patients might be carried forward in the future.