Perspectives in Psychiatric Care Vol. 42, No. 2, May, 2006 137 Blackwell Publishing Inc Malden, USA PPC Perspectives in Psychiatric Care 0031-5990 © Blackwell Publishing 2006 April/June 2006 42 2 ORIGINAL ARTICLE Perspectives on Psychiatric Consultation Liaison Nursing Perspectives on Psychiatric Consultation Liaison Nursing A Perspective from the Southern Hemisphere Julie Sharrock, RN, BEd, MHSc (Psych.Nurs) Julie Sharrock, RN, BEd, MHSc (Psych. Nurs), is a psychiatric consultation-liaison nurse at St. Vincent’s Hospital in Melbourne, Australia, and is a member of the ISPCLN. St. Vincent’s is a busy inner city teaching hospital that provides general and specialist medical/surgical services to adults. Julie’s research activities include evaluation and development of the PCLN role. She has a keen interest in the development of this specialty within psychiatric/mental health nursing within Australia and with this aim in mind, she is committed to developing networks among PCLNs within Australia and with colleagues in other countries. It is very exciting to be a psychiatric consultation- liaison nurse (PCLN) in Australia because it is a speci- ality within psychiatric/mental health nursing that is currently generating a great deal of interest and is undergoing quite a substantial development. The evo- lution of the PCLN role in Australia has been similar to that which occurred in the United States, albeit at a later time in history. The introduction of PCLN roles has been stimulated by a recognition of the significant psychiatric comorbidity among patients with physical health problems and that nurses not specifically educated in psychiatric nursing can find it difficult to attend to their mental health needs. In addition, nurses caring for this group of patients can find the medically focused psychiatric consultation inadequate in meet- ing their needs for assistance in care delivery. The first documented discussion of psychiatric nurses taking up the role of mental health consultants to gen- eral hospitals in the North American nursing literature was by Johnson (1963) and Jackson (1969). This pio- neering work led to the development of a specialist field within psychiatric/mental health nursing (Robinson, 1991) and has influenced the development of similar specialities of mental health nursing in other countries including Australia (Hicks, 1989; Sharrock & Happell, 2000). The first documentation of psychiatric nurse con- sultation in the Australian literature was a description of the PCLN role as it developed at the Royal Prince Alfred Hospital in Sydney (Meredith & Weatherhead, 1980). Later, Anderson and Hicks (1986) outlined the psychiatric nurse specialist role at the Westmead Hospital in Sydney. Since these early papers, there has been sporadic documentation in the Australian nurs- ing literature but this has increased more recently (see for example, Happell & Sharrock, 2002; Harding, 1998; Pollard, 1996; Sharrock & Happell, 2001a, 2001b; Sharrock & Rickard, 2002; Sharrock & Happell, 2002; Sharrock, Grigg, Happell, Keeble-Devlin, & Jennings, 2006; Smart, Pollard, & Walpole, 1999; Summers & Happell, 2002; Usher, Foster, & McNamara, 2005; Wand, 2004; Wand & Happell, 2001). In North America, psychiatric emergency services have developed in parallel to the PCLN role (McIndoe, Harwood & Olmstead, 1994; Robinson, 1982; Yoder & Jones, 1982). These services operate within an emergency department and are staffed by psychiatric nurses who function in isolation or as part of a team. Even though the psychiatric nurse working in the context of the emergency department makes psychiatric nursing expertise available to patients and staff of that clinical setting in a similar way to the PCLN, Robinson tends to differentiate this role from a “classic liaison role.” She argues that the emergency department role is focused on the evaluation and disposition of patients presenting to the emergency department for psychiatric reasons (Robinson, 1982). In the United Kingdom, Roberts (2002) uses the title of mental health liaison nurse to include both psychi- atric nurses working in emergency departments, par- ticularly in the area of deliberate self-harm, and those working in general hospital settings in the PCLN role. Like the United Kingdom, the distinction between the two roles is less apparent within the Australian setting. Many of the stand-alone psychiatric services have closed and this has resulted in emergency departments becom- ing a key access point to emergency psychiatric service. In order to improve the response to people who present to the emergency department requiring psychiatric assistance, emergency psychiatric services are devel- oping. A number of psychiatric nursing roles are being