Austen Riggs held a blog competition among staff members where we asked them to answer the question: “What does the open setting mean to you?” The entry below comes from Barbara Turner Hart, R.N., M.A., Nurse Educator.
“Reflections on The Open Setting ” by staff psychologist John Muller, Ph.D. was one of several articles disseminated to patients and staff in advance of the recent open setting seminar at Riggs, where staff and patients gathered together to discuss the meaning of the open setting. Participation in the open setting seminar was voluntary and available to all employees and patients at Riggs, evidence of our awareness that all people here, patients and staff, have the responsibility and privilege to engage as active members of our therapeutic community.
As the nurse educator at Riggs, I was reminded of nursing’s commitment to and intimate relationship with the open setting. At Riggs, the responsibility of the nurse is to provide a living, creative boundary that patients are given the authority and permission to struggle against. This struggle is an important element of the treatment work patients engage in at Riggs.
Patients here experience nursing in so many aspects of their daily lives: informally at meals or coffee hour, in process groups, individually for one-on-one assistance, or as advocates to reinforce positive coping skills, identify alternative choices, identify or express feelings and think about attachment patterns. Patients who come to Riggs will likely find an unusually engaged and involved nursing staff, committed to the open setting and engaged in the act of examined living.
Nurses at Riggs must do more than simply articulate institutional policies and procedures in order to help patients fully access the depth of treatment available in our open setting. Nursing in this context is genuine, engaged and directive. It is based on mediating and adjudicating the therapeutic process between patients as well as the patient and the open setting itself.
This concludes our “What Does the Open Setting Mean to You?” series. Thank you to all those who submitted entries and thank you for tuning in.