One Flew Over the CPEP Nest

July 17, 2010, 8:57 pmDoctor Psychobabble5 comments

Bird Bath Death

Today was my first call in the CPEP (Comprehensive Psychiatric Emergency Program). I left this morning at 7:15 a.m., and I just now got home, and it’s close to 10:00 p.m. I’m pooped to the max, but incredibly exhilarated by my first “call” in a psychiatric emergency room as a doctor. I learned so much today and had so many interesting experiences, but let me list just a few:

1. I learned again that my experience as a psych tech is oh so valuable. We had several “codes” called. I interacted with several aggressive, hostile, angry and threatening patients. Yet I managed to stay calm, and not be hurt. (And I think that my years of experience helps me with my countertransference…more on that soon.)

2. I “committed” my first patient. Well, to be specific, I admitted my patient to the hospital involuntarily (against their will). Of course, my attending also signed the paper, but I completed it and was the physician in charge of the case.

3. I am starting to remember what working long hours in psychiatry (and specifically, emergency psychiatry) can do to you. It’s very difficult to not be affected by the work that you do. And sometimes you start to feel a little crazy yourself. It’s challenging to explain, but it does something to your psyche to work with acutely psychotic patients for long periods of time.

4. I learned that as a psychiatric intern, my opinion matters, but it’s not the final word. I evaluated a patient and deemed them okay for discharge. But my attending (who has MUCH more experience than I) decided that my patient needed to be admitted. So we did so.

5. The ethical/legal/moral decisions, issues, and questions in psychiatry are endless and always at the forefront. I encountered approximately 8 billion of them today. It is very tricky work, indeed.

It’s now time for me to relax and perhaps have a bubble bath. I definitely think I earned it.

Photo: Part of My “Trash Talkin” Photo Series

  • Emmie

    mmm. Post call bubble baths are great! if only it werent so hot!! Glad things are going well for you Kendra. Im getting used to my calls too…Had my 4th night on OB call, finally felt like maybe I do know something!
    -Emmie

  • jorkers

    you and jeff will have to get together to compare some Defensive Tactics techniques sometime… hope you don’t have to use your crisis intervention training too much I guess. Don’t tell Paige, but we visited a dog at an adoption center the other day–another coonhound named Aspen…..hhmmm..congrats on passing the last test!

  • Brittany

    Hi Dr. Campbell! I love reading your blog and have been keeping up with you since you were a third year. :) I know how much you enjoyed your time in Dominica and some 4th semesters just finished a video that I thought you would probably enjoy. I posted it on my blog @ http://briandbritt.blogspot.com/ or I’m sure if you You Tube “Dominica Med School Baby” you can find it that way, too. :) Have a wonderful day!

  • Katie

    I find this fascinating. I’ve been on the other side – a psych patient (though never violent or psychotic, thankfully!) in nyc. I’ve had 3 hospitalizations for severe depression with one being through the psych ER and one through CPEP….the experiences have varied quite a bit. I’ve found the single most important factor was the treatment team; the time I went through CPEP, I had a wonderful resident with whom I felt extremely comfortable and safe; in fact, I told her something that I had not told anyone except my psychiatrist before! When I went through the psych ER (same hospital, just never made it to the CPEP before being admitted), I had a resident who lied about several little things, which made me not trust her at all. She was also very cold, disinterested, and demeaning (no eye contact, speaking very condescendingly, etc) hat added to the terror I was feeling as an Ivy League grad student in a scary psych ER, no matter how voluntarily I was there. It made my experience really bad.

    It’s really interesting to hear your perspective. I have no doubt that your experience as a psych tech is invaluable. I found in all three hospitalizations that the psych techs a huge part of my experience and I valued their input, friendliness, and conversation.

    Keep it coming!

  • Dr. Psychobabble

    Katie,

    Thanks SO much for your comment. Actually, I find your perspective so very interesting. I really try to treat all of my patients with the concept “do unto others as you would have them do unto you.” It is my primary objective to provide the best, most compassionate care that I can. And in my experience, this can and does have a profound effect on my patients.

    Anyway, thanks so much for your words. You have really motivated me to be a better doctor!

    Wishing you the very, very best!