Austen Riggs held a blog competition among staff members where we asked them to write about what makes Riggs unique. This is the fourth blog in the series, written by Dianne Heckman , Primary Charge Nurse.
Florence Nightingale said "Nursing is an art, and if it is to be made an art, it requires as exclusive a devotion; as hard a preparation, as any painter or sculptor's work." At the Austen Riggs Center nursing  is an art, a chance to be creative using the unstructured time and space of relationships with patients, which can be challenging for staff and patients alike. The work is hard but there is an openness and freedom to do that work.
When I first came to Austen Riggs I was given a tour by two patients. As we walked to the Lavender door in beautiful "downtown" Stockbridge, I asked what was the best thing about Riggs (thinking they would rave about the food or some such thing). They replied – “Being a patient!” Astonished by their reply, I then asked what was the worst thing about Riggs, again thinking they would say something like that the food here is terrible. They replied, “Being a patient.” As time went by I reflected on their answers and realized they captured what it was like to be in the OPEN hospital setting. To be accountable for your actions can be hard work. There is a middle ground and trying to find that middle ground can be elusive, but here at ARC one has the freedom to try to do that.
Kris Kristofferson and Fred Foster wrote the lyric that Roger Miller, Kristofferson and, later, Janis Joplin sang suggesting that "Freedom’s just another word for nothing left to lose," The context of this line is the singer’s despair over having lost Bobby McGee to his quest for “freedom,” leaving her also “free” but bereft, with a broken heart and “nothing left to lose.” Our patients often come to Riggs feeling this way--bereft over losses, despairing and unable to value their lives or freedom. Part of our work as nurses is to help them discover the strength to take up the freedom to live their lives, risk loss, and yet still survive and move on.
The open setting is created through a set of commitments that recognize that people have freedom, but with it responsibility for themselves. Freedom is a central part of people’s rights and something that the treatment at Austen Riggs is focused on, and it is through that freedom that we find ways of working with each other. It is in this unstructured environment that the work can be so difficult, yet so rewarding for both patients and staff.