Thursday, November 14, 2013

Inpatient Psychiatry at Pine Rest Christian Mental Health Services

Posted by Silu at Thursday, November 14, 2013

What do you call an alligator wearing a vest?

…An investigator!

This and many other jokes brought to you by one of the psychiatrists I shadowed on a weekly basis, who told a corny joke Q 15 min while seeing patients. Welcome to the inpatient psychiatry rotation at Pine Rest.

A little bit of background information about this site, Pine Rest Christian Mental Health Services based in Grand Rapids is one of five largest mental health service providers in the nation and has over a 100 year history. Pine Rest not only has a 170-bed psychiatric hospital, but has several clinics in western Michigan and offers a number of unique behavioral health services.

The inpatient psych rotation at Pine Rest is definitely a unique one. Unlike typical inpatient rotations, I did not follow one group or one service of patients, since my preceptor, Dr. Kevin Furmaga, is the only pharmacist at the hospital. He works mostly on a consultation basis and receives requests from psychiatrists mainly for highly specialized or treatment-resistant cases. However, I did have numerous opportunities for patient care through attending multidisciplinary treatment team meetings, shadowing psychiatrists and following up with recommendations and questions, and interviewing patients for consultation.

I also taught a medication education class twice a week to patients in different units, as a part of the schedule/programming for patients during their stay. We discussed the classes of commonly-used psychiatric medications and answered questions for the patients. This was one of my favorite parts of the rotation. Though the material was the same each time, each class was very different depending on the patients there, and I gained a great deal of insight about their attitudes/perceptions about medications and treatment.

Besides patient care and teaching responsibilities, I also worked on a number of projects including (but not limited to) giving short topic presentations at treatment team meetings, creating a resource/guideline for therapeutic drug monitoring, and writing a drug monograph for formulary review for the P&T Committee.

This was definitely one of my favorite rotations to date. I learned so much more about not only psychiatric medications (oh yes, Dr. Furmaga will give you a personal lecture/review on psychopharmacology), but the complex spectrum of care that goes into mental health, including different types of behavioral and group therapy and even electroconvulsive therapy (ECT). I saw how, in a short period of time, a patient’s demeanor and mental status can change completely with treatment and also, unfortunately, patients who have had trials of over 17 medications with no response.

Overall, I'd recommend this rotation for anyone who is even a little bit interested in psychiatry. Dr. Furmaga is an excellent preceptor who is knowledgeable and well-respected. He is also flexible and will work with you on special requests you may have for the rotation. Be prepared to be work hard, manage your time wisely, and look for opportunities to learn in addition to or building on the ones already provided, but have fun and take advantage of your time there as a student. 

Sadly, this rotation marks the last of my clinical rotations. Looking forward to different experiences in drug information, community, and teaching skills for the next few rotations, but will definitely miss seeing patients!


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