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My First Week In The Hospital

My First Week in the Hospital

Inpatient psychiatry is a really interesting place to start rotations.

The patients have to be physically stable to be placed on the psych floor, so I haven’t had to perform a physical exam. The psych version of a physical exam is called a mental status exam, which assesses a patient’s cognition, thought process, insight, etc. The diagnoses we’ve seen include schizophrenia, bipolar disorder, major depressive disorder, borderline personality disorder, and drug-induced psychosis.

We just shadowed our residents the first day. After that we were each assigned one patient each to follow, which includes pre-rounding in the morning and present to the attending. Some of our patients are difficult and at times dangerous, so we won’t always get to see them on our own. Doors and rooms are kept locked, so we have to stay with our residents pretty much constantly. Eventually we’ll get more patients as we get more efficient and figuring out what we’re doing!

How much we get to do depends on the day. Thursday we had grand rounds from 8-9am and lecture from 12-4pm, so I was barely at the hospital to see patients. Friday was a bit more normal, and I got to pre-round with my resident, present my patient to the attending, and happily discharge him. I’m still learning how to use the electronic medical record system, so for now the residents are walking us through how they write notes and discharge orders so we can start doing them on our own (with physician review and sign-off of course.)

There is SO much to learn! I feel like I spend lots of my time looking up different drugs and googling acronyms to try to follow conversations. Psychiatry involves a lot of figuring out which medication or combination of medication…

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