As physicians, it is imperative that we are aware of the interplay between social determinants of health and medical care and that we are familiar with the relevant resources available in our community. In this interview, I spoke with Megan Senftleben, BSN, Director of Crisis Services at Community Bridges Inc. (CBI), a local organization, hoping to highlight such a resource. With a holistic focus on behavioral health and addiction medicine, and centers across the valley, CBI is a valuable contact for any physician to have in order to more comprehensively address patients’ needs.
Could you describe the services offered by your organization? What is your particular role?
Community Bridges is the premier non-profit integrated behavioral health organization in Arizona, and we provide a wide continuum of services. We have many programs across Arizona including community outreach, crisis stabilization, inpatient psychiatric care, medical detox, patient centered medical homes, housing support, and many programs for special populations like pregnant and parenting mothers, veterans, and people experiencing homelessness. I am the newly appointed Senior Director of Crisis and Inpatient Nursing services. In this role I oversee the nursing care for all of our crisis and inpatient facilities. Through our newly developed nursing structure I will have the opportunity to lead our teams in a new model of care, delivering quality and assuring safety, identifying opportunities for improvement, and giving support to our patients and our staff in providing excellent care.
How do you, and CBI, interact with various healthcare professionals, especially physicians?
CBI employs a wide variety of healthcare professionals, including MDs, DOs, FNPs, and PMHNPs (Psychiatric Mental Health Nurse Practitioners). We believe in interprofessional collaboration, so our teams of physicians, nurse practitioners, nurses, social workers, counselors, case managers, and others form a complete team to care for our patients. As an integrated healthcare organization, we look for partners who can provide primary care, psychiatric care, or care for substance use disorders. CBI is an organization that is proud to have a “no wrong door” policy, so whatever need the patient presents with, we will connect them with the best level of care. Our physician team members are integral in identifying needs and facilitating the patients to the right services.
Is there anything that you wish physicians knew about your work? Do you wish for more or different collaboration?
I wish more physicians in Arizona knew of the comprehensive services we provide. CBI has been growing in Arizona for the past 38 years to be a leader in integrated behavioral health, and is furthering that growth trajectory with the newly developed Medical Model. I am personally interested in developing positive relationships between the nursing department, providers, and social services so that our continuum of care can be seamless and patient centered. My dream is that all members of the interprofessional team will feel supported and comfortable sharing their knowledge and experience for the sole purpose of improving patient outcomes.
Tell me about a typical day, or week? I know there’s a lot of variation!
In my new role I am working every day to identify areas of opportunity for care improvement and employee development. I also spend a good deal of my days identifying, recruiting, and training new nurse talent to grow our team. We continue to push forward with more medical interventions for our patient population, including serving more medically complex individuals in the psychiatric/detox setting, connecting patients with medically assisted treatment for substance use disorders, and improving the patient experience of care. We are currently in a period of rapid renewal and growth, and working on an exciting re-organization of the nursing department. I can’t say I have ever had a typical day, but each one so far has provided lessons to grow from, and hope for the future.
What led you to this career, and what do you see yourself doing in the future?
What a big question! I was drawn to nursing out of a desire to be at the forefront of need: I wanted to help those who are vulnerable, who are suffering, who are in need of an ally on the worst day of their lives. Psychiatric and behavioral health nursing drew me in for a variety of reasons, including a personal connection to a loved one with mental illness, and a separate one who sadly lost their life to an opioid use disorder. Behavioral health nursing is not always a glamorous branch of healthcare, but one that supplies plenty of moments of triumph for those who chose to take on its challenge. I see myself staying in this specialty, and in nursing leadership for my entire career.
What inspires you about your job, and what do you find challenging?
I am inspired by the personal connections our team forms with our patients. Getting a patient stabilized, connected with an outpatient team, or connected with some community support that I know will contribute to their long term success is very uplifting. The challenges are probably similar for other specialties: not being able to reach the patient who could benefit from interventions we have to offer, seeing a patient make choices that may lead to worse outcomes, losing a patient to their illness. These things hurt, but they also provide a fuel that I use with future patients. Every day on the job is a day I learn, and a day that I can improve the care my team provides.
Any other thoughts?
I encourage all future physicians to go into your psychiatric/behavioral health experiences with an open mind. This field is fascinating, mysterious, sometimes confusing, but ultimately very exciting and fulfilling in a very meaningful way.
Jessica Pirkle is a member of the Class of 2022 at the University of Arizona College of Medicine-Phoenix. She completed a BA in Spanish at ASU and worked for several years as a school teacher before switching gears and obtaining an MS in Health Care, also at ASU. When not studying the marvels of medicine, she enjoys making and eating delicious healthy food with her four children, and daydreaming about being a music festival groupie.