Psychiatric CNS Consultation Model in a Medical Setting

A MODEL FOR psychiatric CNS consultation services offered in a comprehensive cancer center is presented. The model combines inpatient and outpatient services; these services, described separately, are compared with and contrasted to those reported in the literature. Although many models of inpatient psychiatric CNS consultation-liaison activities have been published, the literature offers few descriptions of the psychiatric CNS in either independent or collaborative outpatient practice. CNSs, therefore, need to inform colleagues and consumers about the nature of their advanced practices. In the model described, the psychiatric CNSs receive direct referrals for both hospital and clinic patients as well as patients receiving cancer treatment outside the cancer center. CNSs evaluate patients independently, requesting medical psychiatric assessment and intervention when necessary. The independence with which the psychiatric CNSs function provides many patients with access to psychiatric services. The flexibility to follow patients in both in- and outpatient settings also offers continuity of care.