March 2, 2011

BI-WINNING - aka "I just blinked and fixed my brain"

why the picture of Charlie Sheen? well, because when I watched this video today, recommended by the staff of people I work with because it is waaaaayyy too familiar.

here's a sorta breakdown of my day:

5:30 am: wake up because

7:30 am: arrive at inpatient psychiatry unit and begin "pre-rounds" with the nursing staff.
this involves going through all the new admissions files and try to figure out who is here because of what, what they have been diagnosed with, what medications they are on, and what problems they have to overcome in order to get their life in order.

8:45: greet the staff and patients as they begin to swarm around the central nursing station, plan for group that day, and handle any problem that arises.

9am: Patient Intakes. this involves sitting in a room off a holding cell where people who have been Baker Act'd or otherwise brought in are waiting - usually sleeping or pacing - and begin asking them questions (one by one) about what happened, why they're here, and what's going on. this initial assessment is designed to figure out if they are a danger to themselves or anyone else, if they are going through withdrawal, and get a basic history of their entire lives so far.

10 am: Community Meeting: all the patients who are on the inpatient unit will sit in one room and introduce themselves, say how they're doing today, and one goal for the day. Sometimes this also becomes a Medication Meeting, where the other medical student I work with and I talk about the biological basis of psychiatric illness and try to explain how treatments, including medication work. We also make it one of our main goals to talk about side effects and help patients be better advocates for themselves when they are put on a medication. Ask about side effects, ask about WHY you're on the medication, ask about what doses are normal to start on, how fast you can increase, what are the long term consequences, etc.

11 am: Rounds with the treatment team, including the psychiatrist
see all 35-45 patients who are in the inpatient treatment center, beginning with most immediately pressing problems (people who are decompensating, or getting worse) and new admissions

2:30 pm: break for a ten to twenty minute lunch of PB&J plus orange juice

3:00 pm: depending on the day, attend group sessions with the inpatient patients or outpatient clinic with our attending psychiatrist where today he saw 64 patients in an afternoon.

somewhere around 7pm: return home to the condo, try to work out and make a delicious dinner

add into this mix that we have lectures twice a week that we are supposedly video-conferencing into so that we can be with the rest of our clerkship, and spend all day Friday at a drug and alcohol rehabilitation center working with a completely different psychiatrist and group of patients. but no night or weekend call, so when we leave work, we only have to vigorously look up drug names, diagnoses, how to write good notes, how to do assessments, and all the other millions of things we need to know already.

I'm pretty exhausted but so excited to be really in the hospital instead of in lectures and studying all the time.

Charlie Sheen on Whether or not he is worried about relapsing:

"No. Not going to. Period. The end. I blinked and I cured my brain. Can't is the cancer of happen"

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