2 Months As A Psychiatry FY2 Doctor

It’s been nearly eight weeks since I rotated from GP land to Psychiatry, and in those eight weeks I have had normal day shifts, as well as eight very eye opening on call shifts. Some might even call them harrowing/low key traumatising to be honest, so here are 8 lessons I have learnt so far:

1. My least favourite words to hear when I’m on call are “new admission”.

2. I am much better at interpreting ECGs then actually doing them.

3. You must be able to prescribe rapid tranquilisation when needed- know your doses well. Rapid tranquilisation meds are given intramuscularly to quickly calm aggressive/violent patients, so they’re usually given ASAP in emergencies.

4. Following on from the point above, don’t let nurses pressure/intimidate you into prescribing anything you don’t feel comfortable prescribing. Yes, a lot of them are more experienced than you in Psychiatry, but remember that it is YOUR name that will be on the prescription, so if anything goes wrong, you’ll be the one in trouble, not the nurse. So always speak to your Consultant and DOCUMENT THIS before prescribing unfamiliar medication.

5. Racist hallucinations are a thing??? A patient I assessed last week told me the dead voices she was hearing and seeing were white, and because of this, they didn’t like me talking to her. I felt like I was in the Sixth Sense, your gal was SHOOK.

6. Suicidal patients can be very creative when it comes to ways to hurt themselves. Horrifyingly so. I’ve struggled with sleeping sometimes because images of some of these graphic foiled attempts, and the subsequent restraining required by staff, keep playing in my mind when I close my eyes.

7. Some patients will relapse shortly after you’ve discharged them as okay to go home, but you shouldn’t blame yourself for this. Sadly some patients will appear better and be deemed low risk, but because healthcare professionals aren’t mind readers, it is difficult to know if they’re just saying what we want to hear.

8. I am very sure that acute psychiatry is most definitely not for me. Nope. Only two more months to go…

A Much Needed Break From Psychiatry

Two weeks into my Psych rotation and I am feeling DRAINED.

When I’ve explained how it’s draining to people, I’ve been able to summarise it like this:

My time in Respiratory during the first wave of COVID on that awful COVID rota was physically draining because of the long shifts. GP was more mentally draining- I had shorter days but was using my brain a lot more because of how much more independently I was working/reviewing patients on my own.

So far, my time as a Psychiatry SHO has been emotionally draining. I work in an acute psych unit, where we have a lot of acutely unwell patients with psychotic symptoms, so I’ve felt more on edge.

We were told in our induction to constantly be on our guard- we carry alarms all the time, are never to have our backs to patients, should always sit closer to the doors, and should always review patients with a chaperone. So it can get pretty intense!

I have an oncall shift once a week, which involves me being the only doctor around to cover the acute site, as well as the elderly psych and eating disorder units. As my oncall shifts vary between 16 and 24 hours in length, I live too far away to go home, so I stay in the doctors’ rest rooms provided for us:

Sooo nice! It really does feel like a hotel, haha.

Anyway, I’m off this weekend and Boss and I have recently gotten into making and decorating gingerbread men, so much fun!