Hello, everyone! My name is Daniel Quintero, and I’m a PGY-1 currently rotating in the inpatient psychiatric unit at Banner South. Over the past couple of months, I’ve been learning to treat common inpatient conditions such as psychotic disorders, substance use disorders, and mood disorders, as well as navigating Arizona’s court-ordered treatment system. Our inpatient units admit both voluntary and involuntary patients, meaning there are a lot of fascinating pathology and learning opportunities.
Monday
- Morning. I woke up early to take my puppy, Maggie, out for a run. Afterward, I had breakfast and got ready for work. I like to get into the unit around 7:45 to catch up on the weekend’s events and patient progress. I also enjoy starting the day with some music in the resident room, chatting with my co-interns, and making myself a cup of green tea. Around 8 o’clock, the admissions over the weekend were assigned to treatment teams, which prompted us to start reviewing their charts. After chart reviewing, I rounded on the patients I had been following and then met with the treatment team to coordinate care and upcoming discharges.
- Afternoon. Later in the morning, my attending and I conducted longer interviews, including new patient assessments and court-ordered evaluations. These evaluations can be intense but are often crucial for getting patients needed help. Some patients may not be happy about being evaluated, leading to challenging interactions, but these situations are always great learning experiences. After lunch, my attending and I ran the list together to discuss treatment plans and upcoming discharges. I then submitted my orders and finished up my notes before signing out to the resident covering that evening and heading home.
- Evening. At home, I play a bit with Maggie in the backyard. She’s usually upset that I’ve been gone all day but quickly gets over it after a few minutes of pets. To end the night, I showered and wound down with some dinner and a few episodes of Bob’s Burgers to end the first day of the week.
Tuesday
- Morning. On Tuesday morning, I switched it up and hit the gym to lift some weights. I got ready for work at the gym and headed to the Behavioral Health Pavilion. I did not have time for breakfast at home this morning, so I stopped by the resident’s lounge for a mango parfait and an Uncrustable as an impromptu breakfast. Once I was in the resident room, I started the morning jams again, and the ball got rolling. We had a couple of expected discharges, so I checked in on these patients early and got started on the necessary paperwork.
- Afternoon. In the afternoon, I went down to the cafeteria for lunch and grabbed a hefty salad from the salad bar. Afterward, my attending physician and I reviewed the patient list and formulated treatment plans. This is often one of my favorite parts of the day, as I learn a lot by bouncing ideas off my attending physician and developing a personalized treatment plan that best fits each patient. After we finished staffing, I returned to the resident room to finish my notes and submit treatment orders before wrapping it up for the day.
- Evening. In the evening, Maggie greeted me with her usual scolding for being gone all day but quickly forgave me after I bribed her with some treats. We headed to Reid Park for a walk and enjoyed a beautiful Tucson sunset —monsoon season is nearing its end, and the sunsets have been especially stunning. After it got dark, we headed home, got ready for bed, and rested up for the next day.
Wednesday
- Morning. Wednesdays tend to be more action-packed since the afternoons are dedicated to didactics. That means we only have the morning to see patients and finish our notes, but our program takes this protected time seriously, and our attending physicians are great at helping us manage our workload. My list was shorter this week since I had discharged some patients the day before, but on busier Wednesdays, I use the time crunch to work on my efficiency.
- Afternoon. The weather wasn’t too hot today, so my co-interns and I had lunch on one of the hospital patios. We usually take this time to catch up and check-in, especially with those who are off service. This week, we also discussed some upcoming social events. We got funding from a resident wellness program for dinner at a great restaurant in town, so we were planning the logistics around that. Our program has many nature lovers, so we also got funding for a camping trip to Mt. Lemmon later in the month.
- Evening. After lunch, we had our weekly residency-wide meeting before splitting into cohorts for didactics. This week, we learned about managing patient agitation, a very useful topic as it comes up frequently in the inpatient unit and the consult service. The second part of didactics was our Mind-Body group lecture series, which consisted of learning techniques to help manage the challenges of residency. This lecture series has been a favorite for many interns throughout the years as it teaches skills that apply to residency and day-to-day life. It has also allowed us to learn about each other and support each other through the first few weeks of residency.
Thursday
- Morning. I started Thursday morning with another run with Maggie. Since I didn’t have time to make a proper meal, I grabbed a breakfast burrito and green tea from the cafeteria. Several new patients were on the list today, so I was glad I started charting early. I checked in on my follow-up patients and then headed to the treatment team meeting. The meeting today took longer than usual due to some discharge issues with a patient, but our amazing team of case managers was on it, and we got the patient to the next level of care.
- Afternoon. In the afternoon, my attending and I met with the new patients to discuss treatment goals and options. Thursdays also include a lecture from my attending physician on a topic relevant to current cases. This week, we discussed Clozapine, its common side effects, and how to manage them. The rest of the afternoon was spent writing notes and fielding nursing calls. Overall, it was a busy day, but I completed my notes, entered orders, and signed out to the evening resident before it got too late.
- Evening. On the way home, I picked up some In-n-Out as an end-of-the-day treat and stopped at Pet Smart to get Maggie an end-of-the-day treat as well. After we had dinner, we headed to University Boulevard for another walk and some tea from a local tea house before heading home and calling it a night.
Friday
- Morning. This morning, I was especially pumped for the day as my Golden Weekend was approaching, and I was ready for some well-earned R&R. I hit the gym again before heading to work to start the day strong. For breakfast today, I opted for a fruit smoothie from home and an Uncrustable from the resident’s lounge. After chatting with my co-residents and charting, I headed over to see my patients to be ready for the treatment team.
- Afternoon. In the afternoon, after running through the patient list with my attending physician, I performed neurocognitive testing on one of my patients, then called the pharmacy for help adjusting another patient’s medication. Fridays are also “Feedback Fridays” for my attending physician, so we discussed strengths, areas for improvement, and how to get there. This is an especially crucial part of the week as it gives me insight into how to grow as a psychiatrist and how to utilize my strengths best. The rest of the afternoon was a bit busier, as I had a full patient list and wanted to set a solid treatment plan for the weekend. But with the long weekend ahead and noting my patient’s progress throughout the week, I didn’t mind at all.
- Evening. After signing out, I headed home to pick up Maggie. We then met a fellow intern from another program at a dog-friendly restaurant and had a couple of burgers on their patio. After we swapped residency stories and finished dinner, Maggie and I headed home, ready to end the work week and start our Golden Weekend.
Saturday
- Morning. I woke up early Saturday morning to get a run-in before it got too hot. I had been running with some of the run clubs in Tucson for a couple of months, but today, I decided to go on a solo run with Maggie since she is still adjusting to larger groups and other dogs. After our run, I was craving a hefty breakfast, and since I had some free time, I used it to make some of my favorite breakfast dishes. I made scrambled eggs with chorizo and paired that with some refried beans and a quesadilla.
- Afternoon. In the afternoon, I headed to a friend’s house for a cookout and some swimming. After some much-needed pool and sun time, we enjoyed hot dogs and music and discussed the upcoming Civilization VII game. Pool days like these are always fun but leave me feeling tuckered out. In the evening, I retreated to my house to cuddle with Maggie in the cold A/C, and we spent the rest of the night watching movies.
Sunday
- Morning. I use Sundays to get my life together for the upcoming week. I started with laundry, took Maggie for a quick walk, and headed to the gym. I also had more time today, so I made another big breakfast—waffles with fried eggs, bacon, and a fruit smoothie to add some healthy stuff. Feeling energized, I cleaned the house, finished laundry, and even bathed Maggie.
- Evening. I am lucky to have many family members in Tucson, so on Sunday evening, I went to my sister’s house for dinner and to see my 5-month-old niece. After dinner and a couple of rounds of peek-a-boo with my niece, I went home to get Maggie. As the day ended, we took another walk around our neighborhood, allowing us to take in yet another beautiful Tucson sunset. We ended the night watching Parks and Recreation, winding down to prepare for the week ahead.