Psychopharmcology
Started by Farcus
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I had a VA psych rotation that was one of my favorites. We rounded every day with the whole team (nursing, MD, psych, pharmacy). It was really interesting. I would guess the positions are pretty scarce and you can't sit for the BCPP unless you work in that field for a few years (can't remember the qualifications off the top of my head).
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I just finished an APPE at at acute care psych hospital. What do you want to know?
Everything you think that is meaningful. A run of your basic day would be nice.
Got there about 8 a.m. to prep for rounds (either 9AM or 1030AM depending on attending). Reviewed my patient list, noted any medication changes, checked the MAR for compliance issues and looked for new lab work. Rounds were about an hour and were multi-disciplinary. After rounds I sometimes saw patients with the attending, participated in family meetings or participated in conference calls with next of kin, etc.
In the afternoon I worked up my new patients (we had multiple admits every day) and checked all of the stuff above (meds, labs, compliance) plus read the chart to get HPI and see if they'd had an previous admits, etc.
Every day I worked on our monitoring program for metabolic syndrome (all patients on atypicals. For our initial work up we tracked BMI, waist circumference, triglycerides, HDL, BP and FBG. If a patient had 3+ positive markers, we sent recommendations to the attending. If there was information missing, we asked the attending to order labs, etc.
Tuesdays and Fridays we did high risk/targeted medication reviews for lithium, phenytoin, warfarin, digoxin, and clozapine. On Tuesdays and Fridays we did antibiotic surveillance. On Fridays we did diabetes monitoring, abnormal lab monitoring, drug/disease state interaction reviews (plus high risk/targeted meds and antibiotics). On Wednesdays we did 90 day chart reviews for the ICF/MR facility that was attached to the hospital.
The hospital pharmacy also supplied the state psychiatric prison that was about 20 minutes away, so sometimes we went there for cart fill and ward inspections.
I attended P&T meetings, medical staff meetings and care plan meetings for the ICF/MR facility.
