When you do inpatient work @ a regular hosptial (not a psychiatric one), I am curious how you were taught to document your assessment and treatment of the patient. When I was in graduate school in Louisiana, we would meet with the patient, staff, family, etc. and then formulate a diagnosis, plan for treatment, and submite a 2-3 page psychological report and place it in the patient's medical chart that was in the nursing station. The report had some fairly detailed information on it. For example, "Ms. X reported that she had feelings that her life would never improve and felt she would never meet anybody else."
At my internship, when we get trauma consults (acute stress disorder and PTSD kinds of stuff), we do this quick work-up and write something like "Patient experiencing hyperarousal and nightmares regarding the incident and is at moderate risk for PTSD, etc." The psychologists here say that it's unethical to put the whole psychological assessment report in the patient's chart upstairs (like I learned to do in Louisiana). Is that really unethical? It seems to me that writing themes of the assessment or brief interventions in the chart is only to help patients and to communicate to other providers about what is going on with the patient (i.e., continuity of care).
It's strange because psychology is so vital and important in Louisiana because it demonstrates that it is actually doing something and has something to contribute. In Michigan, psychologists seem like wimps who don't want to step on anybody's toes, and they wonder why the profession is all but dead up here. Writing 2-3 lines on a patient's medical chart that states "provided emotional support for patient. He is experiencing x and y symptoms and may develop PTSD" must make people wonder why we need a PhD to do this job.
Another thing I have noticed is how dead psychodynamic therapy is in LA but here, in Michigan, especially at my internship, they still do long-term psychodynamic treatment. It sucks because my internship sold itself as "strongly CBT" but when I got here, it was 99 percent dynamic in nature. Everything from hard-core drug abuse to obesity is viewed in dynamic terms. One of my fellow interns was even told to psychoanalyze a patient who was acutely manic (of course the pt. never came back)...
At my internship, when we get trauma consults (acute stress disorder and PTSD kinds of stuff), we do this quick work-up and write something like "Patient experiencing hyperarousal and nightmares regarding the incident and is at moderate risk for PTSD, etc." The psychologists here say that it's unethical to put the whole psychological assessment report in the patient's chart upstairs (like I learned to do in Louisiana). Is that really unethical? It seems to me that writing themes of the assessment or brief interventions in the chart is only to help patients and to communicate to other providers about what is going on with the patient (i.e., continuity of care).
It's strange because psychology is so vital and important in Louisiana because it demonstrates that it is actually doing something and has something to contribute. In Michigan, psychologists seem like wimps who don't want to step on anybody's toes, and they wonder why the profession is all but dead up here. Writing 2-3 lines on a patient's medical chart that states "provided emotional support for patient. He is experiencing x and y symptoms and may develop PTSD" must make people wonder why we need a PhD to do this job.
Another thing I have noticed is how dead psychodynamic therapy is in LA but here, in Michigan, especially at my internship, they still do long-term psychodynamic treatment. It sucks because my internship sold itself as "strongly CBT" but when I got here, it was 99 percent dynamic in nature. Everything from hard-core drug abuse to obesity is viewed in dynamic terms. One of my fellow interns was even told to psychoanalyze a patient who was acutely manic (of course the pt. never came back)...
