RT1-PSY-Site Evaluation summary

Summary of evaluation

Present materials: two H&Ps, ten pharm cards and one article

In the mid-rotation evaluation site visit, I present a patient with major depression disorder. This is the first patient I interviewed without attending doctor or PAs around. The patient is in her mid 40s, and she is depressed, and she presented with suicidal attempts that she cut her wrist. She also had issues with her apartment, which may be a trigger to her suicidal attempts as well. This case allows me to explore all signs and presentations a patient with major depressive disorder may have, like fatigue, insomnia, loss appetite, anhedonia, feelings of hopelessness and helplessness.

In the final evaluation site visit, I present a case with a patient who overdose on Tylenol. This is different from the first case, this patient is minimizing the event, and denies suicidal attempts. However, she is guarded and tearful, she has depressed mood and constrict affect, and she has poor insight and judgment of her endangering behavior. She ends up being admit to ICU because increasing acetaminophen levels, INR, and liver functions levels. In plan of care notes, the nurse noted that patient is nausea and vomit twice during the NAC treatment. The article I found is examining whether modified NAC treatment will reduce adverse effects, like vomiting.

Feedback received:

  • For psychiatric rotation, pharms card not only include psychiatric medications, also need psychotherapy, which is also important in patient care
  • For patients with suicidal attempts, it is very important to ask about previous attempts
  • For patients with previous suicidal ideations, and after discharge, need to make an appointment and follow up with outpatient psychiatric services in 24 hours
  • Social services are needed for patients who have stressors

Need to improve:

  • For patients that from different culture, I need to ask more about their background, sometimes, it will reveal some triggers or causes that are responsible for patient’s mental illness
  • Generally, need to work harder on differential diagnosis
This entry was posted in RT1-PSY. Bookmark the permalink.

Leave a Reply

Your email address will not be published. Required fields are marked *