The Power of Positivity
How is my Psychiatry block treating me? Well, I’m enjoying it more than I thought I would! I mentioned in my last blog about the clinical skills lab; well now I can report back as to what it was like. The skills lab is basically a simulated practice of how we would manage a psychiatric patient. The Medical School get professional actors to act out a “character” and we get a chance to practice taking a history from them as if they were a real patient. The “character” I got to talk to was a patient who had MUS (Medically unexplained symptoms). This is an interesting condition as the character was convinced they had stomach cancer and were experiencing symptoms. However, they had been investigated by specialists and there was no sign of cancer, so the symptoms were suspected to be psychiatric in nature. This doesn’t mean that the patient is making it up at all – in this condition, the patient experiences these symptoms as if they were real. However, they were not due to cancer, and could be eased by psychological talking therapies and psychiatric treatment. It was a difficult one to do as you have to be very careful to listen carefully and acknowledge that the patient IS experiencing these symptoms but also have in the back of your mind that the patient doesn’t have cancer. I wasn’t sure how to do this, but went for something reassuring such as “I can see that the symptoms you are experiencing are distressing for you”. Overall it was a very useful learning experience as psychiatric histories can be difficult.
This week I also had some stressful news – I’ve been hacked! Someone was trying to log into my personal email addresses and social media accounts. Luckily, they didn’t access anything, but it still scared me into changing all my passwords and wiping my laptop and phone etc in case they were bugged. I always think you can’t be too paranoid about these things so I changed everything. I think my paranoia about being hacked in that week probably met the diagnostic criteria for Paranoid Personality Disorder, but hopefully everything is okay now I’ve changed my passwords!
Every Tuesday we have small group teaching on psychiatric topics to help pad out and support the clinical experiences we are getting. This week it was on the topic of psychopharmacology (drugs used in mental health). It was exciting as a lot of the teaching was on how to use these drugs and side effects, considerations etc, which makes it very clear that we need to be stepping up our knowledge into actually managing patients ourselves. It is slightly scary that in a year’s time exactly we will be sitting our final exams and soon after be qualified doctors…yikes! The safety blanket of being a student, where it is perfectly acceptable to say “I don’t know” will be replaced by actually having to look after patients (albeit with support).
On Wednesday of this week we also had a CAMHS clinic (Child and Adolescent Mental Health), where we sat in with a consultant who was seeing children and teenagers. I enjoyed this as the child side of mental health focuses around development and family issues which means that you are not only dealing with the patient, but often parents, school, social services. I really enjoyed this clinic and our consultant was fantastic and very good at explaining what was going on. I think we must have done okay as the consultant then contacted the Psychiatry coordinator and gave some lovely positive feedback about us. Often a lot of feedback in medicine is negative or neutral and rarely given at all, so it really does mean a lot to get some positive feedback. It reassures us that we are doing everything right and gives us a morale boost. At a time of generally low morale in the NHS, positive feedback can be a very powerful tool to tell us when something goes right. One consultant who I worked with in my gap year between my first degree and medicine pioneered “Learning from Excellence” which formalises positive feedback in the same way that incident reporting is formalised. Positivity can be a powerful tool against burn-out and understaffing. Google “Learning from Excellence” to learn more about the philosophy – it may change your perspective and encourage you to offer positive feedback for a good experience. That’s all for this week – remember to say so if you have a good experience!