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Bridging the chasm: incorporating the medically compromised patient into psychiatric practice.

1. In response to health care reform, psychiatric nursing has identified an expanded role that includes providing care to patients with complex health problems. 2. Conceptual changes of role responsibilities and time commitments to individual and milieu care are vital in supporting a change in the traditional psychiatric milieu. 3. Acknowledging and helping staff accept the unpredictability of certain medical conditions is key to success in providing quality integrated care to the medically compromised psychiatric patient.