My seventh rotation was Psychiatry at Queens Hospital Center CPEP. I was looking forward to this rotation as I knew it would be very different from past rotations. Although in the setting of the emergency room which I had already experienced, I imagined that the psych ER, CPEP, would provide me with a very different experience and patient-focus. One of my favorite parts of rotating through CPEP as opposed to inpatient psych was being able to see many different types of patients, with a variety of presentations and chief complaints.
One patient that stands out to me was a Jewish Orthodox female with a history of polysubstance abuse who was brought to CPEP after an argument with her father. Upon seeing her in morning rounds, she expressed that she called the ambulance herself when she felt herself losing control after getting into an argument with her father. She admitted to a history of substance use including alcohol, marijuana and cocaine. Before we left her room, she asked us if we were able to get her a Jewish prayer book. While speaking to the peer counselor, she expressed that she was planning on joining a Jewish support group and was looking to grow in her spirituality. I felt it was amazing to see an individual struggling through a major challenge yet still showing interest and dedication to her religion and faith.
Something I feel I strongly improved in is my note writing skills for a psychiatric H&P which is different than the others I’ve practiced writing. These have a much longer HPI, require a lot more background information and collateral information and a history must be elicited whether the patient is giving reliable information or any information at all. The providers taught and expected us to write notes on the patients we saw, which gave me a lot of practice in composing various types of notes including admission notes, discharge notes and progress notes.
A difficult aspect of this rotation for me was having to speak to the families of patients to obtain collateral information or update them on the plan for their loved one. There were a few times where the family member on the phone was either upset about the situation of their relative or displeased as to what the provider’s decision was regarding admission or discharge and I felt it was uncomfortable and difficult to speak these maters through with the members of the patient’s family. As I spent more time in CPEP and saw more patients, I was able to get more comfortable with making these phone calls and got better at obtaining the necessary collateral information.
All the providers in the QHC CPEP including the attendings, PAs and NPs showed great interest in teaching the students and helped us learn a great deal while ensuring our safety throughout. My time in CPEP exposed me to many situations including violent outbursts, patients with acute psychosis and individuals in an acutely manic state, truly bringing me outside my comfort zone. I also experienced providers who truly care about their patients regardless of the way they’re treated, spoken to or interacted with. I will miss my time in CPEP!
