6:00 am - alarm goes off. I hit snooze/lay around and allow myself the first few peaceful moments of the day. I get up and clean up, make coffee, and pack my lunch. I haven't been eating a good breakfast on this rotation, just because waking up this early and eating a substantial meal has always been a struggle for me. As always, makeup is kept to a minimum. I really limit my jewelry on this rotation because you never know what is going to happen that day on the psych ward.
7:15 am - leave the house and start my 40 minute drive to work.
7:50 am - arrive at the psychiatry hospital.
8:00 - 10:20 am - Rounds on patients admitted to the second floor of the hospital. These patients are usually more complex, may have psychotic features, and need more close observation and intense treatment regimens than the patients on the first floor. Because this is a psych rotation and our patients can be unpredictable, my preceptor does not have me see patients on my own. Today we had 9 patients upstairs and the staff had to call Code Orange (violent patient) on one of our patients. Never a dull day in psych y'all...
We usually go ahead and see the patients getting discharged first so that the staff can get a started on their paperwork. Then we see any new admissions that came in after we left the hospital the day before or the ones admitted overnight. Lastly we round on the patients that have been there for at least a day. Unless the patient has a history of being violent or inappropriate, my preceptor allows me to go and bring each patient back to our office and we do their daily evaluation together. During this time, we go over how the patients are doing, how the medications are working for them and if they have experienced any side effects, whether they've been able to make contact with family members with the help of the social workers, etc. We discuss any other ongoing concerns and re-address their goals for the duration of their stay here and also once they will be discharged. Every patient that is discharged is set up with outpatient psychiatry and counseling, which is something that's really important to make sure that someone is helping them stay on track and reach their goals and is also regularly managing their medications.
10: 30 am - 10:50 am: we have a meeting with a patient's family and social worker to discuss some things the patient wanted to discuss before she gets discharged that morning. It goes relatively well and we all agree on the plan and goals the patients wants to work on. This is not something we do daily but on a case by case basis.
10:55 - 11:30 am: we round on 6 patients on the first floor and discharge 3 of them. Then we go back up to our office and get cracking on those notes.
11:30 am - 12 pm: My preceptor dictates all the admitting and discharge summaries for the day and I write SOAP notes for each patient we see at the hospital after rounds. Sometimes we do this in between patients if we are not too busy but today we saved it for last.
12:00 - 1:00 pm - lunch break. Today I had a Cesar salad for lunch and had to resist the urge to get fries from the chick fil a I accidentally discovered by the clinic.
1 pm - 4:50 pm - In the afternoon we see patients at the clinic. My job is to read their chart before they come in, if we have the time I give my preceptor a quick rundown on each patient, and then bring them back. Most patients were here for a follow up today with only one new patient. The visits vary between 10 minutes and simple prescription refills with patients doing really well otherwise and 20-30 minute visits that are more complex. New patient visits are scheduled to be 40 mins long but can run longer of course.
4:55 pm - We are done for the day! In the clinic, my preceptor just dictates the SOAP notes so I usually don't chart. I drive back to Nashville in crazy traffic and almost get run over by a guy who thinks its cool to cut people off when there's bumper to bumper traffic on the interstate. No biggie.
6:00 pm - I jump straight in the shower after I get home. Even though I don't have to do physical exams or touch any patients on this rotation, just being in a hospital still makes me feel icky so I always shower and clean up after I get home.
6:30 pm: I eat dinner this early (like an old lady) because I'm starving and I know if I eat snacks now I'll ruin my appetite. Tonight I'm having mom's homemade Indian food that she brought me this weekend. Nothing like coming back at the end of the day with your dinner already waiting for you in your fridge. Thanks mom. :) I also catch up on social media and clean up the kitchen.
7:15 - 8:15 pm - I work on my study guide for this EOR exam even though its a month away. I was way too chill on the last rotation and didn't study like I usually do because the days were so long and I would be so drained when I got home. This time the topic list is really short so my goal is to finish going over everything once way in advance so I can focus on really learning the medications and doses/side effects. There are SO many meds in psych!!!
8:15 - 9:30pm - I'm currently reading Gone Girl since I have heard so many people say good things about it. I'm trying to get back into the habit of reading non-medical books since I have more time now and I really, really enjoy reading. It also gives my brain a break from thinking of medicine all day, which is definitely not a bad thing, but I love to keep a healthy balance of things in life.
9:35 pm - I start to get sleepy and decide it's a good time to call it a night. It's hard for me to put down the book but I know I will keep reading until the wee hours of the morning if I don't make myself stop. I get ready for bed and turn out the lights.
Day in Review
Hours worked: 8
Total patients seen: 15
Patients seen on my own: 0
Hours studied: 1
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