To Pam Haines, clinical manager of Carroll County General's psychiatric unit, psychiatric nursing presents a challenge that is lacking in other areas of medicine.
"Mental illness is very unique," Ms. Haines said. "It's not like looking at lab work to see if somebody's blood sugar levels are high. It takes a lot of in-depth assessment and observation skills to determine what's going on with a patient."
Ms. Haines, who has been the clinical manager of Carroll County General's psychiatric unit since shortly after it opened in 1991, was named Metropolitan Baltimore's Outstanding Nurse of the Year in the clinical manager category by the District Two division of the Maryland Nurses Association. The contest was open to nurses in hospitals in Carroll, Howard and Baltimore counties and Baltimore City.
Tricia Supik, Carroll County General's director of medical/surgical, psychiatric and maternal child health services, told the association in nominating Ms. Haines:
"Pam keeps our 20-bed inpatient program running smoothly and efficiently, with positive staff morale, excellent training programs and many opportunities for advancement within the unit. She is considered an invaluable resource by other units in the hospital when patients require mental health care."
As manager of the hospital's psychiatric unit, Ms. Haines supervises its 50 staff members, including nurses, licensed practical nurses and technicians. She's also responsible for budgeting and developing policies and standards of care for the unit.
"I have kind of a trouble-shooting role," Ms. Haines said. "I do a little bit of everything."
Ms. Haines, 38, has been a nurse for 17 years. She said she was drawn to the psychiatric field because of her interest in the reasons behind human behavior.
"I've always been interested in the effects that different kinds of life circumstances can have on people," she said.
In her opinion, education is the key to eliminating much of the fear surrounding mental illness. So she conducted a workshop on depression in March at the Carroll County Women's Fair and coordinated a free screening on depression for the Carroll County Health Fair in October.
"Mental illness is still stigmatized to some degree, but it can happen to anybody," she said. "It is an illness, and it's treatable, and people can get help."
Ms. Haines said it's crucial to develop more services in the community for mentally ill people for after their discharge from hospitals. She said the need for such outpatient and community programs is increasing as the movement toward managed health care shortens patients' hospital stays.
When Ms. Haines joined Carroll County General's psychiatric unit in November 1991, the average patient stay was 14 to 20 days. Now, the average stay is six or seven days.
"It's very difficult to get a treatment plan together in that amount of time," Ms. Haines said. "We have to do things much more quickly, in terms of teaching people about their illness and education for the family, and we try to use a lot of videos and handouts."
To compensate for the shorter hospital stays, Ms. Haines said Carroll County General is looking into developing a day hospital and outpatient services for mentally ill patients.
Although Ms. Haines holds a nursing management position, she said she makes an effort to maintain her clinical nursing skills.
"My feeling is, if you don't actually know how to do the nursing, how can you lead a group?" she said.
Before coming to Carroll County General, Ms. Haines worked at Springfield Hospital Center in Sykesville in a nursing and management position.
She received her nursing degree from the Maryland Hospital School of Nursing in 1978.
A graduate of South Carroll High School, she lives in Sykesville with her husband and three sons.