Buzzwords…

In my last blog I spoke about the change of pace when I started the Psychiatry block. There is certainly less urgency about the psychiatry block but the days are no less intense and most days at the end of placement I’m just as exhausted as any of the shifts I worked in A&E.

My clinical partner and I are currently assigned to a male adult inpatient psychiatric ward. Like any other ward most days there is a ward round, however instead of a group of people peering at a patient from the end of the bed, there is a ward round room where patients come to speak to the team about their care. Sometimes the doctors or nurses may request to see someone, other times there are prescheduled appointments. Some of these meetings can be brief, patients who have improved a lot who are discussing spending more time at home and are nearly ready for discharge. In contrast, some of the patients may be seen for over an hour, taking a complex history from a newly admitted patient, as well as a collateral history from family, followed by time to discuss the plan among the clinical team. In other areas of medicine while patient centred care and involvement of family and friends is preached, it isn’t always practiced. However, in psychiatry every consultation starts with the same, important question: how are you feeling? Often patients don’t know how to answer this, but their response is key. Key to knowing if they are ready for discharge, if their home leave was a success, or if their new medication is having side effects or if their symptoms have improved. The involvement of family and friends is strongly encouraged and where these are lacking other means of social support are utilised in the form of community psychiatric teams and social services as well as other members of the MDT or multidisciplinary team (a key buzzword for exam purposes!).

One of the things I really like about Psychiatry is that it takes a truly holistic approach to patient care. While a patient’s main reason for being in hospital may be their psychiatric condition the doctors know that treatment of this alone won’t solve the issue. Another key buzzword for medical school exams is treating patients using the “bio-psych-social model”. You need all three to treat any condition effectively, this applies to any medical condition but it is particularly pertinent in psychiatry. A psychiatric illness may require medication or even ECT treatment (the biological approach), but a patient may also benefit enormously from psychological support. The social approach can be very complex in psychiatric patients, patients may need help with housing if they are homeless or may not know how to claim all the benefits they are entitled too. They may need help finding a job or gaining work experience. These are things the doctors and nurses discuss at ward round with the patients, finding out what their hopes and ambitions are for when they are discharged.

Mental health services may be severely under pressure and underfunded, but it’s great to see the psychiatric team help a patient with every aspect of their lives to achieve the best management of their psychiatric illness. Perhaps psychiatry is where all the MDT and Bio-psycho-social magic really does happen!

Joshua Galvin : 22 Dec 2017 10:14 |  Tags: Joanne Mbchb Warwick Wms |  Comments (0) |  Report a problem