PGY 1: Inpatient Psychiatry In NNAMHS

Student Handbook, Appendix A

PGY-1 Three Month Rotation In Inpatient Psychiatry In NNAMHS

Resident Expectations on NNAMHS Inpatient Unit

To attend morning nursing report daily and treatment team twice weekly (which starts at 9am) To be on hospital grounds from 8 am to 5 pm, with one hour lunch.

Patient load expectations:

  • PGY1-maximum of 6 patients
  • PGY2-maximum of 8 patients

Daily/Weekly Duties:

  • Psychiatric evaluations within 24 hours of admission
  • Along with psychiatric evaluations, a full H & P to be completed on weekend call
  • Sign charts weekly in medical records
  • Discharge summaries to be dictated within 72 hours of patient discharge
  • Daily notes in either DAP or SOAP format

Charts, in medical records, need to be complete (discharge summaries dictated and all required signatures completed) within 30 days of the end of the rotation. Failure to do so can lead to decreased professionalism scores for this rotation and report to the program director.

All admission, discharge and daily plans (ex: med changes) need to be discussed and approved by attending.

Answer pages promptly.

Patient Care

Residents will:

  1. Learn to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
  2. Have supervised experience in the evaluation and treatment of the general psychiatry patients who present to NNAMHS for treatment.
  3. Become familiar with Axis III conditions that can affect evaluation and care and will learn to screen for, recognize and manage these disorders.
  4. Develop competence in:
    1. Formulating a clinical diagnosis for patients by conducting patient interviews, eliciting a clear and accurate history; performing physical, neurological, and mental status examination, including appropriate diagnostic studies;
    2. Completing a systematic and timely recording of findings that is concise, coherent and legible and meets the needs of all relevant parties, including utilization review and third-party payers;
    3. Relating history and clinical findings to the relevant biological psychological, behavioral, and sociocultural issues associated with etiology and treatment;
    4. Developing a differential diagnosis and treatment plan for all presenting psychiatric
    5. disorders, taking into consideration all relevant data;
    6. Using pharmacological regimens, including the pharmacologic treatment of addictions;
    7. Participating in psychiatric administration, specifically leadership of interdisciplinary teams and experience working successfully with utilization review nurses;
    8. Working with non-medical therapists in coordinating and providing psychiatric care.

Medical Knowledge

Residents will:

  1. Demonstrate knowledge of established and evolving principles and practice of psychiatric phenomenology, including the recognition and diagnosis of both general psychiatric conditions and substance use disorders.
  2. Demonstrate knowledge of established and evolving principles and practice of psychopharmacology, including clinical indications, contraindications, side effects, and drug interactions.
  3. Demonstrate knowledge of established and evolving principles and practice of the pharmacotherapy of addictions.
  4. Demonstrate the applications of medical knowledge to patient care on a day-to-day basis.
  5. Spend each Wednesday afternoon completely free of clinical duties in order to attend and participate in the weekly didactic program.

Practice-based Learning and Improvement

Residents will demonstrate competency in the ability to:

  1. Identify their own strengths and weaknesses during periodic feedback sessions;
  2. Participate in setting their own goals for learning and improvement;
  3. Identify and perform appropriate learning activities, both for themselves as well as medical students;
  4. Incorporate evaluation feedback, both formal and informal, into daily practice;
  5. Locate, appraise, and assimilate evidence from scientific studies related to their patients' health problems;
  6. Use information technology to optimize learning;
  7. Participate in the education of patients, families and students, both individually and in group formats;
  8. Demonstrate a commitment to lifelong learning by attending all Wednesday afternoon conferences;

Interpersonal and Communication Skills

Residents will demonstrate competency in:

  1. Communicating effectively with patients, families and others across the broad range of socioeconomic and cultural backgrounds served at NNAMHS;
  2. Communicating effectively with physicians, other health professionals, and health related agencies;
  3. Working effectively as a member of an inpatient psychiatry treatment team;
  4. Maintaining comprehensive, timely, and legible medical records;
  5. Interviewing patients and family in an effective manner to facilitate accurate diagnosis and biological, psychological and social formulation.

Professionalism

Residents will demonstrate:

  1. Compassion, integrity, and respect for others, including patients, families, NNAMHS staff and administration, medical students and supervisors;
  2. Responsiveness to patient needs that supersedes self-interest;
  3. Respect for patient privacy and autonomy;
  4. Sensitivity and responsiveness to the diverse patient population served by NNAMHS.
  5. High standards of ethical behavior which include respect for patient privacy and autonomy, maintaining appropriate professional boundaries, and understanding the nuances specific to psychiatric practice

Systems-Based Practice

Residents will demonstrate competency in:

  1. working effectively in the private psychiatric hospital setting provided by NNAMHS;
  2. coordinating patient care within the public psychiatric hospital setting;
  3. incorporating considerations of cost awareness and risk-benefit analysis in patient care;
  4. practicing cost-effective health care and resource allocation that does not compromise quality of care
  5. advocating for quality patient care and assisting patients in dealing with system complexities, including disparity in mental health care;
  6. collaborating with psychologists, psychiatric nurses, social workers, and other professional and paraprofessional mental health personnel in the treatment of patients