A week on Inpatient Psychiatry.
Monday
- Monday Morning: I like to get in a little early, around 7:40, 7:45 a.m. just so I can start chart checking and prepping my notes for the day before rounding. I’ve found this really helps me stay efficient and not fall behind even on those wild days where time seems to escape me. I grab a snack from the resident room because I forgot to eat breakfast and settle into my cubicle in the resident room to dive into some charts. After some perusing, I go see all my follow-up patients with my medical student. She’s carrying two patients out of our six total today, so after her interviews I give her on-the-fly verbal feedback. We attend treatment team with our attending at 9:45 a.m. and get a chance to touch base with our wonderful nurses, social workers, therapists, and pharmacists about each of our patients. Since we managed to see all our patients, the team finds a nice quiet place to run the list together and finalize our treatment plans. Our team likes sitting on the patio and taking this chance to warm up – it’s quite cold on the unit! After we’ve staffed the list, it’s time for lunch. I’ve brought lunch today, as I like to meal prep on the weekends, so I find the microwave in the breakroom and then take my hot lunch back to my cubicle to get crunching on notes.
- Monday Afternoon: The afternoon is primarily spent working on my notes, attending to any calls I get from my nurses about a specific patient, and catching up with my co-residents in between it all. One of my co-residents, who is on his Internal Medicine rotation, stops by to say hello to me because he got consulted on a patient on our unit! After my medical student finishes her notes and signs them over to me, we go over her notes and make adjustments together. She asks some great questions about patients we’ve seen today, and we take a few minutes to address some learning points that we may discussed with our attending while staffing before she leaves for home.
- Monday Evening: I’ve run back to the unit a few times today to see a few of my patients that had some concerns come up, so I’ve still got a note left to crank out. I wrap that note up, and then sign off for the day shortly after 5 p.m. I live about ~30-35 minutes away from BUMC-S, on the Eastside so I use the drive home to call my best friend who’s a resident in CA. When I finally make it home, I jump in the shower right away and heat up some dinner after. I like to unwind by throwing on some Rick & Morty while I eat! After dinner, I get some cleaning done around the house (as I inevitably left my room looking like tornado ran through it this morning) and then settle in for the night. I try to get to bed pretty early, around 9 p.m. so that I can be up early the next morning.
Tuesday
Tuesday Morning: We start our day around 8 a.m. with chart checking and prepping our notes. We still don’t have any new patients, but we are discharging a few patients today which requires a little more planning and efficiency than the progress note alone. Once we’re ready to hit rounds, my med student and I prioritize seeing our patients who are discharging first this morning. After our discharge evaluations, we run back to the resident room, and I start to get their discharge paperwork, med-recs, and discharge orders in place. We run back to the unit, and finish seeing our follow-up patients before treatment team. We attend the meeting at 9:45 a.m. and then staff our patients with my attending. - Tuesday Afternoon: I had a complicated patient call come up shortly after staffing today, so lunch came a little late. I do manage to heat up my food and sit down to start notes by 1:30 p.m. today, but I feel better knowing I’ve already taken care of my discharges for the day. My attending comes by mid-afternoon to check in about some patients and make some changes to our previous plans after doing her own rounds. We discuss a few learning points as a team and give our medical student some feedback together today. Shortly after, I go over notes with the student and send her home. I run down to get a snack from the resident room to power through my last couple notes and end up leaving shortly after 5 p.m. again today.
- Tuesday Evening: I catch up with family on the way home from work today and can’t help but miss home a little! My post-work schedule is largely the same as yesterday – shower, eat, and Rick & Morty. I do like to try and make some time to read during the week, so before bed I dive into a new book series I just started called “A Court of Thorns and Roses.” The Tucson monsoon season is in full swing and there is nothing like reading, lighting a candle, and wrapping up in your favorite blanket while the storms are going.
Wednesday
- Wednesday Morning: I get in a few minutes late this morning, as I stayed up too late reading my book last night and snoozed too many times. Thankfully, I grabbed a Celsius on my way out the door so I’m feeling ready to tackle the day. Wednesday in particular is quite rushed because it is a half clinical day, so I have to see my follow-up patients, discharges, and complete my notes before I leave for didactics at noon. The morning is always a blur!
- Wednesday Afternoon: I usually eat lunch while attending a virtual residency-wide meeting with my co-residents in our group room. It’s nice to see my cohort and catch up in between sessions. Today, we have a lecture about
psychiatric agitation medications and how to de-escalate an aggressive patient. It’s particularly helpful as the need for PRN medications comes up frequently on both our psych units at BHP, and we commonly get calls for agitation recommendations on the consult service. Following lecture, we have our Mind-Body-Skills group for the last two hours. This is a favorite amongst many of us, and we start this time by checking in and giving one another space to share the good/bad/ugly. It has been a large proponent in bringing us closer as cohort. This week’s group is about our relationship with food, and identifying how that relationship has changed over the course of time. Our instructor guides us through a sensory exercise on how we experience food, and there is chocolate involved! - Wednesday Evening: I catch up with a one of my co-residents after group today. We make our way to a local favorite – Oregano’s – to enjoy a Guaca-tony, some za, and a pizookie together!
Thursday
- Thursday Morning: We have a few new faces on our patient list today, so I set aside a little extra time to chart check this morning. After a deep dive into their records, I round on my follow-ups with both the attending and my student today. We make it to treatment team just in time, and then start to introduce ourselves and get acquainted with our new patients one-by-one. After we finish rounding, we staff in our regular spot on the patio and then set aside about 30 minutes to focus on a topic of my choosing. This week, I wanted to learn more about treating bipolar depression. My attending brough a helpful handout from a textbook she favors, and we discuss in detail how it applies to any of the cases we may have seen. This teaching time is incredibly valuable and allows me to ask any questions that I have or identify extra learning gaps that I want to focus on independently or with the team next week. We break after teaching to eat lunch and start notes.
- Thursday Afternoon: I eat and write my notes simultaneously and attend to any of my nurses’ calls as needed. I also make my way back to a few patients’ rooms to update them on the final plan and what medications I think we should proceed with after staffing. I find this extra go-around incredibly helpful in building rapport with patients and giving them a chance to voice any concerns that may not have come up this morning. Plus, I get some extra steps in! I wrap up notes and sign out around 5:30 p.m. this evening.
- Thursday Evening: The drive home today is dedicated to listening to music and having some time with my thoughts. I get home, shower, make dinner and settle in with my book. After dinner, I have an urge to bake. I gather some ingredients together and make my favorite recipe for brownies (setting aside some batter for myself, of course). I love baking and taking some treats to my co-residents and students in the resident room on Fridays when I can!
Friday
- Friday Morning: It’s Friday! We have no new patients today, so I round on my follow-up patients with my medical student and manage to see them all before treatment team. We attend the meeting, and then get back to the resident room to work on notes so that my attending can see the rest of the patients before we staff. I get a note done and run down for snack before it’s time to staff. I run the list with the attending and my student, and finalize our plans for the weekend, making special note of anything I will have to sign out to the weekend team. After staffing everyone, we spend some time on feedback for the week. My attending checks in with me, and gives me some great pointers on things I did well this week with specific examples and also identifies areas that I could use some extra practice in. We do the same for our medical student together. This is immensely helpful in identifying the big and little wins of the week, and what my personal goals for the next week might be.
Friday Afternoon: We break for lunch and I’m always in the mood for fries on Fridays, so I run down to the cafeteria for some grub. I eat while I make some progress on the rest of my notes and attend to my nursing calls. I make my second-round visits to any patients whom I need to discuss plan changes with and use this chance to let them know that I won’t be around this weekend, but they’ll see me again bright and early on Monday. I end up wrapping up just after 5 p.m. today. My co-residents and I have to complete a CPR training before the end of the month, so we decide to run by the automated workstation together on our way out of work and get our CPR refresher checked off!Friday Evening: I stop and pick up some food on my way home. I guess I’m homesick today, so dinner is going to be Whataburger (the superior burger establishment). I shower and then settle down to eat dinner while I FaceTime my best friend in California again. We have a cute little virtual dinner date and share how our weeks went and our plans for the weekend. She’s on call this weekend – so she’s living vicariously through me this weekend!
Saturday
Today, I’m feeling energized after sleeping in. I made plans to hike Blackett’s Ridge with my co-resident Thomas during the week. We meet up pretty early, around 6 a.m. and spend some quality time in the great AZ outdoors. I’m pretty exhausted after the hike, so I come home, shower, and take a nap. After I wake up, I get a list of errands together and hit the road to make a productive day. I like to 
grocery shop on Saturdays and leave all my cooking and meal-prep for Sundays. I end up getting home after running all my errands around 6 p.m. and settle in with some frozen pizza and a good movie. I make some time to practice the acoustic too, but my calluses aren’t big enough yet so I may or may not have given up after 30 minutes. I retreat back to the sofa and turn on the new season of Black Mirror.
Sunday
I wake up early this morning to get the most out of my Sunday. I try to set aside one day out of my golden weekend for all my chores, and today is that day. I spend most of the day running laundry loads, cleaning around the house, and then finally cooking all my meal preps for the week. This week I wanted to make some sun-dried tomato and basil chicken orzo – it’s a favorite of mine that is super easy to throw together! I get everything done around 5 p.m. and take the rest of the afternoon to relax and mentally prepare for Monday. I’m back to six-day weeks with call on the weekends for the rest of the month, so I enjoy the downtime as much as I can.