Clinical Rotation: Psychiatry

This post is a little overdue.   I finished my first clinical rotation last Friday (not yesterday) and let me tell you…  I LOVED IT SO MUCH!!  Maybe it was because it was my first clinical rotation and I was just super excited to start clinicals.  Maybe it was because my precepter was AMAZING and super-wonderful to learn from.  Maybe it was because the patients were incredibly interesting, some with complicated medical problems.  It was probably a combination of all those reasons, but whatever it was, I thoroughly enjoyed my first clinical rotation, Psychiatry.

In Psychiatry, a lot of my time was spent looking up the different prescriptions and checking for food-drug interactions.  (I mentioned this to one of my friends who’s a pharmacist at a different hospital and got a couple of things to watch out from him, but I still spent a lot of time looking up some medications.)  A lot of Psychiatry MNT also encompasses eating disorders, some of which are secondary to the drugs the patients are taking.  Some drugs cause weight gain, which can lead to patients being frustrated with their weight and this can sometimes spiral into an eating disorder.  And in addition to their mental illness, a lot of psychiatry patients have other medical issues such as cancer, renal disease, or cardiac problems.  So the MNT can get really tricky.

Since this was my first clinical rotation, I finally got to write notes!  Now, I had written notes in WIC, but that just didn’t feel like writing my clinical notes.  I felt like the only people who read the WIC notes were other RDs, but with my clinical notes, I know other healthcare professionals were reading them besides the other RDs.  The first day I wrote notes in psychiatry, I was oddly very, very happy.  I was so happy I called my parents and cheerfully proclaimed, “I wrote my first two patient notes!” to which I pretty much got a “Uhh….okay….?”  When I told friends who recently finished their internships, the response was a much more gratifying “Isn’t it a great feeling?!”   I wrote two notes on my first day, and for both notes, my preceptor had suggestions, but there was considerably fewer corrections needed for my second note.  I kept writing new assessment and follow-up notes every day, and a week later I was over the moon when my preceptor okayed a note without suggesting any corrections.  I don’t think my smile faded until I went to sleep that night.

I definitely love being in clinical rotations now.  I understand that many dietetic internships don’t get a psychiatry rotation and I’m very glad mine does.  In-patient psychiatry really involves every member of the healthcare team – I spent a lot of time talking with the nurses, the techs, the social workers, the MDs, the food service staff, the pharmacists…  It was truly a team effort approach to healthcare.  I loved it and I look forward to working with more health professionals.

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2 thoughts on “Clinical Rotation: Psychiatry

  1. It’s awesome that you get a psych rotation! You’re right–it’s rare and you are lucky! I am starting my elective rotation on Monday, for which I decided on eating disorders. There will of course be a psych component, but it’s a more narrow focus than just overall psych. Looking forward to hearing more about your journey! Any tips for maintaining a work/life balance when it comes to working with psych patients much appreciated! 😀

    • Working with primarily older male patients (~90% of the VA patient population) and only being in the rotation for 2 weeks, I didn’t think I’d work eating disorders, but I did! Not many and the eating disorders were always secondary to other psychiatric issues, but still there was some experience. If you had asked me prior to the start of the rotation if I wanted to work with eating disorders, it would’ve been a flat out “No” because I was afraid it might trigger one in me. I’ve heard of so many RDs developing eating disorders, that I’m wary. Now, I’d at least consider working with ED patients.

      As for tips… Do whatever you need to do to keep work at work and keep yourself happy. I’ve worked with psychiatrists in the past who specialized in PTSD and it always seemed like there was a high turnover because they’d get burnt out. The ones who stayed in the field learned to keep the things they heard at work out of their head when they were home. The same most likely applies to RDs working with ED patients – you gotta keep work at work. If you start getting stressed, talk to someone.

      Other tips we get told like “Don’t let the patient get between you and door” “Keep the door open” “Take someone with you if the patient has a history of violence toward healthcare team members” or “Immediately stop the assessment if the patient becomes agitated” probably don’t apply to your situtation since it doesn’t sound like you’ll be in a lock-down unit.

      I hope to read about your experience!

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