One of the things that finally turned me off to psychiatry was, incidentally, exactly what I first enjoyed about it.

My resident and I were responsible for 8 patients between the two of us; 4 for me, 4 for her, with her signing off on any medications / changes in care I wanted to pursue. Over the course of a day, I would spend 20-30 minutes with each of my 4 patients.

This meant that I spent a maximum of 2 hours with my patients. The rest of the day? Paperwork. Luckily it was all on the computer (the VA has a fantastic electronic system), but JHACO requirements meant that my progress notes usually turned into 2-page long ramblings. Psychiatric inpatients don’t usually change from day to day - one of my schizophrenics was on the ward for 5 weeks, with notes that boiled down to “no change today. Will increase antipsychotic”. Daily documentations of 10-question suicide watch and minute changes in affect sucked up most of my time.

I would usually go home by 2 or 3 PM, which was fantastic (the ‘Psychation’ indeed!) but frankly, my time - and that of my resident - wasn’t exactly… optimised. Obviously this particular rotation was the extreme, but my time was literally split 2 hours patient contact, 4 hours paperwork. It’s a bit ridiculous.

By the way, loyal readers; my apologies for being so silent as of late. My personal life’s been a bit rocky, so finding the motivation to write has been difficult.