This psychiatry rotation was an enriching experience on many levels. I rotated in an inpatient psychiatry unit, which was a brand new experience compared to my previous exposure to the psychiatric emergency room while working emergency medical services. The average patient stay on this unit was a week, allowing for extensive interviews and observations.

The treatment team on the inpatient unit was made up of nurses, a psychiatrist, a social worker, and a psychologist. This approach to treatment appeared to be very beneficial to the patients, as each member was able to address different issues and concerns. It was great to see how the entire team was able to work together, from navigating medications as well as access to them, to choosing the right community resources as well as understanding why they will benefit the patient. Patients felt supported and always had their questions answered. Watching how the team navigated the toughest of cases to ensure the best outcome was inspiring to me and is a lesson I’ll carry into my future work as a healthcare provider. A team made up of many different specialties can address concerns better than just one individual.

Learning pharmacology in lectures during didactic year was difficult, with many names, mechanisms of action, and dozens of adverse effects feeling like an endless list. A common theme I see myself enjoying in clinical rotations is seeing the effects of medications in practice. Psychiatric medications are particularly fascinating to see at work. Having a patient endorse intrusive thoughts, hallucinations and paranoia one day and then report their absence within a week was really rewarding. Other times, it took the psychiatrist more trial and error to find the best medications for a patient. In both scenarios, the medications ended up helping patients with the debilitating symptoms they were experiencing and ensured a safe discharge. Watching these medications at work and how different combinations interact together helped me to learn about them more thoroughly and remember mechanisms of action and adverse effects.

This rotation also taught me how to perform a psychiatric interview. While taking a history and physical on a medical patient is usually straightforward depending on the complaint, a psychiatric interview is more complicated. Depending on the patients psychiatric condition, current mood, and personality, the approach can vary vastly. I learned how to approach patients with a history of abuse or trauma, and how to be sensitive with the language and gestures used. I also learned how to perform a mini mental status exam, evaluating cognition, insight, judgement, and perception. This rotation has helped me with interviewing patients with psychiatric conditions and to understand their thought process and content in order to treat them appropriately.

Through this rotation I also learned how the mental health system works. I got to see the process of qualifying for a state psychiatric hospital, how community response teams interact with patients with psychiatric illness in the community and check in on their progress, and how patients can utilize different types of therapists and counseling to aid with managing their conditions. I also learned about patient rights, how families can improve or worsen a patients progress, and how to build trust with patients during a complicated and lengthy stay that may not appear to the patient as beneficial, but is necessary.

I learned a lot during this rotation, especially things I was not expecting. Seeing how different psychiatric conditions present in real life was fascinating, with patients describing their experiences and thoughts and seeing how they change with therapy and medications. I saw presentations of disorders I never came across as an EMT, including antisocial and borderline personality disorders, and severe eating disorders. I learned new ways of communicating with patients and redirection techniques that I will apply not only in treating patients with psychiatric illness, but all patients in the future.