My psychiatry rotation was a great experience for me. I enjoyed the time that I spent working in the psych ED with a variety of health care providers ranging from caseworkers, nurses, NPs, PAs, and Doctors. I got to work closely with the different PAs and Doctors and see a variety of patients with issues ranging from things like depression, substance abuse, and adjustment disorder, to schizophrenia etc. I enjoyed the work environment as the providers got along quite well and there was mutual respect for each other. I think a good work environment makes it easier to promote teamwork and encourage the provision of quality care which I saw here.
One thing I like about working in the ED setting is that you can be the first contact for a patient and have the opportunity to work from the very start with each patient’s care. This includes collecting relevant HPI and patient data to create a differential and determine the goals for care for each patient. I find this most helpful when in a learning environment because you can formulate your own ideas and plans while working from the very beginning. Psychiatry and OB/Gyn were not my strongest subjects during the didactic year, so I was not sure what to expect for this rotation. However, during the weeks I was at the site I was able to learn from the other providers and interview patients. I was able to discuss patient care ideas with the other providers I worked with. I got the opportunity to work on things like performing a mental status exam on patients and being taught the protocols on how to put in admissions and discharges.
The only thing I found somewhat discouraging about the rotation was not being able to perform full physical exams on patients but of course, for very valid reasons as some of these patients could be quite unpredictable in their behaviours. While working with different Pas and doctors I also got to learn about each person’s note writing styles and their approach to patient care. I was able to apply somewhat I learned to my own approach to patient care. In terms of patient interaction, I got to assess a variety of patients with different conditions. A repeating pattern I noticed was the number of patients that were brought in for suicidal ideations and many being young and around my age or younger. It was a humbling experience to see how much some people were struggling and it made me empathize with patients but within the psych unit, I also had to remember to maintain professionalism between myself and patients, nevertheless. As the patient population in the psych units can be unpredictable and it is important to have one’s guard up when interacting with these patients. I also learned how important it was to have outpatient counselling, and rehabilitation services provided to patients. As PAs I know it is also important for us to help point our patients toward the right and helpful resources, they need.
Although I wish I could have had more opportunities to practice my full comprehensive physical exams on patients, I look forward to being able to do so at my other rotations. Nevertheless, my opinion on my psych rotation was great and I would be open to working in this field if such an opportunity presents itself.