Psychiatry - Inpatient

Updated: Nov 29, 2020

People with a mental illness especially schizophrenics come up with some bizarre hallucinations that are sometimes very entertaining, but in our amusement we have to keep in mind that these are just symptoms of a disease, and no different from someone with bronchitis having a cough.


The set up of Inpatient psyc is different from any other rotation I think I will ever do. Instead of the typical scenario of me going to the patient’s room and doing my thing, the resident or attending picks up a phone in their office calls a nurse and says “bring me so and so”. So you never leave your office and the patients come to you. So this is really all we did, sat in some room with a group of doctors while patients were escorted in by some large armed orderly. The patients were generally pretty sick, many were because of they were a danger to themselves and had made some kind of suicide gesture. Most had some grab bag mix of a mood disorder and actual psychosis not otherwise specified.


In addition to the one-on-one sessions with the resident doc, there were these firing range sessions the patients had to go through called “staffing”. In staffing the patient comes into a big room filled with a doc, and the treatment team which consists of about 5 nurses, a couple of social workers, and some scraggily med students. The idea is to access the patient as a group, and decide on the next step in management. If I was a paranoid schizophrenic and worried that FBI agents were after me, I think this would be a horrifying experience. But, periodically it is mandated that every patient must undergo this battery. Staffing only takes about 5-10 min per patients so this is where I saw most good cases. The best day was when this lady came in that was 100% on another planet, she sat down and instantly started going off on a tangent about nothing and everything at once. At one point she got up and started kicking the wall, all the while without breaking eye contact from the doctor. Then without warning she turns and looks at me and says “and by the way, my son was in the Air Force” and then mumbled some incoherent paragraph, then looked back at the doc. Needless to say I was very unnerved by this, she of course had no idea who I was, or that I was in the Air Force, and was surely some bizarre coincidence that she said that to me. But, I was convinced for the rest of my stay that she very well could see into my soul and I never felt comfortable around her again.


Hours after that we saw another patient that was extremely hyper-religious, she rambled on about how the nurses were characters from the bible and who was evil. She was however very sure that the lady I just mentioned was unquestionably possessed by the devil.

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