Sunday, September 27, 2009

new weekend, already?

Looks like I've been slacking on the blogging lately! Sorry about that. Well, maybe that's because there's just not that much exciting to write about in the psych rotation! I don't have any fun pictures, since that's sort of a HIPPA violation. And, although Spring Grove is a pretty nice looking campus, my particularly building is not much to look at. Their are old buildings that are rich with history and old architecture, and others that are just old and boring; mine is the latter. I'm currently up to 4 patients that I follow, which is keeping me pretty busy. I've interviewed my first three and written notes on all of them, but I still have to find time to interview the 4th. That's going to be a little more difficult, since tomorrow I have to do a full admissions report on a new admit we got on Thursday! Fortunately, I am finally comfortable with my role and what i'm supposed to be doing on this rotation. But, it's taken a month to really get there, and I leave in 2 weeks!

Speaking of 2 weeks, I can't believe that I am headed off to London in less than two weeks! I finish psych in the early afternoon and board the plane to london later that evening! I really have not the slightest idea of what to expect. I think it will be an interesting and educational opportunity, but AUC really could do a better job of giving more information. As it stands, you pretty much just show up and figure it out as you go. But, everyone else has been figuring it out, so I'm sure I will too.

Oh, and nice job to the Ravens again today, now 3 - 0 for the season! Given, the Browns are probably the worst team in the league, but 34-3 still isn't too shabby. To make things even better, Pittsburgh and Washington both lost!! What a great day of football!

Sunday, September 20, 2009

Weekend update

Congrats to the Ravens, who recently showed San Diego why you need to be afraid of the Raven's Defense! If I remember correctly, the Chargers made it within yards of the end zone 4 times, and once within inches, only to be denied touchdowns and have to settle for field goals. Yes, it's only 2 games in, but the Ravens are currently #1 in their division, and one of the best teams in the NFL! Hopefully, they'll be able to keep this going through the rest of the season.

In non-football news, I went to the MD Wine Festival with Heather, Nick, and Lizzy yesterday. It was $25 to get in, but you got a free wine glass, and I definitely drank my money's worth of free wine samples. You only get half an ounce per sample, but there had to be at least 30 or more vineyards there, and each gave 5-10 different samples. You could also get multiple samples if you wanted. Needless to say, I had plenty to drink and Heather wound up driving. Heather also wound up buying 4 bottles of delicious wine from Solomons Island Winery.

After a week of procrastinating, I also finished my psych rotation essay on schizophrenia....turned out to be 5 pages! I'm hoping this is the only one he gives us, but something tells me we'll be getting another. Tomorrow, I've got to finish up my second SOAP note, and hopefully interview and write on my 3rd patient. I'll also have to pick up a 4th patient this week, and then follow up with my current 3. Should be a busy week!

Thursday, September 17, 2009

The Second Coming of Jesus is here!!

By second, I mean sixth and by Jesus, I mean season of The Office!!!! Forget writing my first note or my first order...THE OFFICE IS BACK TONIGHT!! I was just laying in bed, minding my own business, when all of the sudden, I hit the "DVR" button and there is "The Office," staring right at me! Time to go watch!!!!

Health Insurance or Getting Drunk?

Thanks Ray, for the link

My first charting and orders!

Today, after interviewing my first patient yesterday, I finally made my first entry into a patient chart (a rather long SOAP note) and wrote my first orders! While I was writing the SOAP note, it just felt like any other assignment and write up I've ever done. But, I'd be lying if I didn't smile a little when I put it into the patient's chart. It's different when you're writing it as an assignment, or writing it after you've actually done an assessment, know what's going on, and are part of the treatment team.

As far as my first order goes, I've decided to try and get my patient off of daily anti-psychotics, and give them a long-acting, once a month injection instead. Before I can do that though, I had to get blood work to check how fast he metabolizes the medication, to make sure I get the dose right. So, writing an order for lab work was my first official order! After putting the SOAP note in the chart, Dr. Gray brought me the medication book (where orders are written) and told me I forgot to write the order. I told him that I hadn't forgotten, I was just waiting until I typed up the note first. What I did not tell him was that there was NO WAY I was going to forget to write my first order! So, it's there now (countersigned by him), and will be done sometime soon. Once it's back, I'll be able to write my second order, and first medication order. I don't quite feel like a doctor yet, but I'm getting there.

Monday, September 14, 2009

Good news and bad news

The bad news is that my attending was out sick today. Hopefully, he'll get better quickly and be back tomorrow. The good news is that since he was out, and the other part time doctor on the unit doesn't think we should be around with no attending, we got off at around 12:30! I do love getting off early! It also gave me the opportunity to go get blood drawn for titers to all sorts of fun diseases. This was something I was supposed to take care of along time ago, but somehow let slip my mind. Fortunately, Spring Grove didn't ask for proof of immunizations, but the UK peds rotation definitely will! I was worried about when I'd be able to make it to the office, since I'm at work whenever they're open, but this unexpected time off gave me the perfect opportunity! Also, very fortunately for me, Spring Grove gave me a copy of my background check that they run on all the students. This saves me almost a full day, which I do not have, running downtown, waiting in a long slow line, and paying lots of money, to get my own. All in all, a positive day!

Thursday, September 10, 2009

got my first two patients!

I technically got them yesterday, and I still haven't seen them yet, but I'm still pretty happy about it. We actually see patients every day, and I've been able to talk to any that I've felt like. But, these are the first two that I'm assigned to, and I'll be interacting with them more than any others. Each week, we'll be getting one more added to the list. So far, I've only read their charts. But, since the patients on my unit have usually spent years in and out of psych units, they have long charts! It's amazing how normal some of these people seem, until you get into their chart. With some of them, the psychosis comes out quickly, once you start talking to them. And, there are a couple that never seem normal, even when they're just walking around. The King of Africa guy has now changed his story...he is now the king of the world, an 8-zillionaire, and has white, black, chinese, and martian children. No, I am not lying about that last one and yes, he was serious. This is just a small sampling of what we hear in a day.

But, despite their psychosis, many of them are very friendly. When I walk in in the morning, I am almost always greeting by a couple of them, and many of them make sure to say goodbye when they see me walking out. Most of them are also usually more than willing to talk to you and answer just about anything you ask. Their answers may or may not make any sense, but they'll do their best.

I'm also liking my attending more. Although he does assign us homework nearly every night, it's not difficult or time consuming, and it seems like he's mostly concerned that you put a little effort into it, not so much if it's right or wrong. He also allows us more interaction with the patients than other attendings I've heard of. You do have to ask to do things and you kind of figure things out on your own, but he hasn't said no yet, and is always more than willing to answer questions or let you talk to patients. And, while I don't love any lecture, the few we've had so far have been useful and mostly interesting (we get 1 or 2 a week, and they're about 2 hrs).

Also, head on over to Trixie's site, to make sure she doesn't up and disappear!

Tuesday, September 8, 2009

I found shelf milk!!

It's the simple things in life that sometimes make me happy. Today, while shopping at Safeway, I came upon shelf of the only things I miss from SXM! It's real milk and I'm not exactly sure how they do it, but it lasts about a year in the pantry. Once you open it, it's good for about a week. My old roommate, who drank milk, said he could taste a difference. But, in cereal or protein shakes, it tastes exactly the same. I sure did miss that stuff, but I've got 4 cartons of it sitting in the pantry now!
40190 Parmalat Milk 1qt 3.jpg

Disney Pics

Yeah, it's been a while, but I've uploaded pics from my trip to Disney with Heather. If you're interested, you can check the rest out on my flickr site!
Disney 2009-0008Disney 2009-0013Disney 2009-0075Disney 2009-0082Disney 2009-0028

Monday, September 7, 2009

Happy Labor Day

I bet you didn't know that Labor Day was originated in Canada out of labor disputes which legalized and protected unions. Well, you may have, but I didn't. Again, Wikipedia proves the source of all things information.

Today, I've spent much of the day either working on psych homework, or procrastinating psych homework. I finished my write up on our new patient from last week, which took less time than I had expected. Now, I've just got to do the 20 questions that my attending assigned us. Don't worry, almost nobody but me and my partner get homework in a psych rotation. I will just leave it at that.

Unfortunately, not much interesting to write about lately. This week, I should be getting assigned my own patients (of course, under the close supervision of the attending). That will hopefully give me some more interesting things to write about. I haven't yet decided if I like psych. At the moment, I'm leaning towards "it's interesting, but definitely not a career for me." However, although it's only been one week so far, I don't mind going in to work each day and I enjoy most of the time I'm there. 1 week down, 5 more to go!

Thursday, September 3, 2009

Never a dull moment

I've only been on my unit for 3 days, and I've already seen plenty of craziness. It usually seems pretty calm, but it's usually not long before something happens to make me laugh. It may be a patient who decides to walk around with paper towels shoved up his nose, ears, and mouth, a schizophrenic patient who talks to walls but suddenly decides to scream at someone, or a guy who thinks he's a visiting doctor. We also have the King of Africa with us (if you listen to him). I've seen all that and more, and I haven't even really started talking to patients yet. I've walked around a little and had a few very short conversations, but I'll actually get my own patients next week. Then, the fun should really begin (I use fun as a relative term).

It would seem that getting my psychiatrist supervisor was both good and bad. On one hand, he doesn't really give us any direction (unless we ask for it) and he's the only doctor in the place that assigns his students homework! I've never heard of a clinical professor assigning daily homework and I'm really not all that happy about it. On the other hand, the assignments aren't really graded (the grading scale is happy face or frown face) and I've heard that students often call back after they get their shelf score, thanking him. He does like to teach, and he's good at it. And, while he doesn't give much direction, he is extremely willing to help if you ask anything specific or have a question. But, I've taken a little initiative, have spent some time with the nurses, and I'm starting to figure it all out. I'm looking forward to having patients assigned next week.

Oh, and as an aside, the Spring Grove Cafe is pretty damn awesome! I would have never expected good food from a state mental hospital cafe, but I was wrong! It's actually very nice looking inside, and the food is mostly delicious! They give huge portions, cheap prices, and it all tastes good. The chocolate peanut butter cake in the picture was as good as it looks. The $5 coupons they gave us (one for each day) don't hurt either.
Spring Grove Cafe

Vegas Pics

Took me a little while, but here are a few of the pics from Vegas. The rest can be found at my flickr site.
Las Vegas 2009-0091Las Vegas 2009-0099Las Vegas 2009-0109Las Vegas 2009-0116Las Vegas 2009-0131Las Vegas 2009-0148Las Vegas 2009-0150Las Vegas 2009-0158Las Vegas 2009-0178Las Vegas 2009-0172Las Vegas 2009-0179Las Vegas 2009-0184Las Vegas 2009-0196