My psychiatry rotation consisted of being in an emergency room comprehensive psychiatric emergency program (CPEP) doing 12-hour shifts three days a week for five weeks. My shifts were during the day at 8am-8pm weekdays and also being there for a few weekends. I really enjoyed my five weeks working in CPEP seeing many different patients with many different pathologies. There were generally around 15-25 patients daily in CPEP.

CPEP consisted of many different areas. There was a triaging area where new patients would come in to talk to the psychiatrist, nurses, clerks, and others who were there. From there the patient would be led to an area where other patients were. There was a barrier inside of that patient area between the patients and the on-site staff that housed physicians, PAs, nurses, social workers, and other providers. We would have morning rounds with the providers and nurses at 7:45am/8am to discuss patient assignments and then to round on the patients themselves afterwards. It was great seeing how the patients were from the night before. Generally, after noon/1pm, new patients would come through CPEP and we would triage them.

The first week the students at CPEP just got used to the environment with the patients and how the flow was throughout the day. We saw how the providers triaged the patients and asked the pertinent information from them. Sometimes, we would get to go do consults in the Medical Emergency Room. Very quickly, I was asking the questions to new patients and to existing patients from the night before.

I saw many different types of patients from all different types of backgrounds. There were a lot of patients who had schizoaffective disorders and bipolar disorders. Others were activated to go to CPEP because of suicidal ideations due to longstanding depression or anxiety disorders. Seeing the different types of patients molded what type of differentials they would be given. Sometimes the patient was hyperverbal, could not be directed in the conversation properly, and was lacking sleep for over a week. Other patients said they were hearing voices and thought other people or objects were following them. Psychiatry is in every part of medicine, and I was happy to learn about the different types of people that I will encounter in the future and how I could help them.

I really enjoyed my time at my psychiatry rotation. A patient’s psychiatric history was vital in helping that patient now and in the future. I also learned that many different pathologies overlap, so eliciting a good history was tantamount. Timing, in psychiatry, is everything. A psychiatric event can be labeled a brief psychotic disorder versus schizophreniform versus schizophrenia. Medication adherence was also very important in the psychiatric setting, so it was very important in teaching the patients to take their medications daily to avoid relapsing. The physicians and PAs were very helpful on the psych floor because they finely tuned my thought processes on why one diagnosis was more prevalent than another one (like how Bipolar 1 disorder was at the top of the differentials for a patient versus the patient having Bipolar 2 disorder due to manic events, not hypomanic). I am very thankful for my time at CPEP and all of the providers and nurses that helped me and the other students.