 They're asking for cocaine, they're asking for marijuana, like essentially from the drugs because it acts on the same receptors. And so you're like, wow, it's like your mind is like blown because, man, this guy knows so much. What's up you guys? It's Donna. Welcome back to my channel. So for those of you who are new, I do YouTube content that has videos about everything PA related and just being a mom and student and just kind of going through that journey of PA school. So if you are very new to this channel, this is the first video that you're seeing, go take a look at my channel, see if you like what you see. And if you do go ahead and subscribe. So this video is going to be the juicy details of everything that I did on my behavioral health or psych rotation. Psych has by far been my easiest, I guess you could say rotation. Like I don't even want to say easy. Like it's heavy topics that I was dealing with or, you know, when I did my initial intake of the patients, it was very heavy stories. And so like it was the easiest in terms of my day, like I would go to work from like nine to six or something along those lines nine to five, depending on which actual facility we were at. Apart from that, like it was emotionally draining. But let me just talk to you about that. So depending on the day, I worked on it at a different facility on Monday and Wednesday than I did on Tuesday and Thursday and Friday. So we had like every other Thursday off, I believe it was, but I would, you know, you're trying to get like your 10 hours, 40 hour week. That's what we're required to get for our rotations. We have to get at minimum 40 hours a week, but I would always like surpass that. So depending on the facility, I may have had to go in at eight or I may have had to go in at nine or at 10. It also depended on when our first actual client was scheduled. We don't really call them patients in behavioral health because I was outpatient. So they were all like clients. So I would get in there, you know, I'd go to the front desk, I would see ask the receptionist like, you know, for the schedule, she'd already have it printed out for me. I had an NP student with me as well. And for the majority of my rotation. So we would split initial intakes. And then literally my second day, the psychiatrist had me doing like follow ups as well. The initial intakes would essentially, I have to get like a full history, you know, their past medical histories as needed. What's bringing them in today, you know, had they been on any psych medication before? If so, what were they, did they work? Did you like, essentially like what was the trial of their medications and which, which ones work at what dosage and which ones didn't work? So we would do that. I would go through, you know, like abuse history, any substance abuse as well. So like physical verbal sexual abuse, and then also like substance abuse. So any type of alcohol or other illicit drugs, I would have to ask them about that because those play like they change the landscape of the treatment completely. If your patient used to have a substance abuse issue, then we have to make sure that that is teased out, that they're not dealing with that still, that they are going to therapy and dealing with their issues. And then that we're not giving them drugs that could kind of also act as a substance that they would be potentially abusing, like, you know, Adderall or Ritalin. So we did that. We would run through the whole thing. I would go obviously patient by patient there. They had to be evaluated every year. So if there was a patient that was not evaluated in like three years and sometimes that happens, then we have to do a whole new like initial eval just to make sure that nothing has changed, that they're still going to therapy that everything is still working fine for them. We always asked about like getting sleep disturbances or GI issues because that those are common things that happen with respect to like mental illness, but not just mental illness. A lot of the medications that they use for that can either be, you know, make them super sleepy or agitated to where they have insomnia. So we would always address those things as well. After I went through the schedule, be it a follow-up or initial eval, like, you know, we'd break for lunch at around 12 or one, depending on how busy the day was. Lunch would be an hour. And again, this is all outpatient, which is completely different than inpatient, but lunch would be an hour. And then we'd come back and I would run through the rest of my schedule. A lot of like the hardest part that I had, especially like in the first couple weeks of my rotation was teasing out like who is seeking drugs, like who's a drug seeking person that's coming to see us or like who actually needs help on their initial eval. A lot of times, you know, like the psychiatrist, they have access to CRISP, which is like the is it a PNP? So it's like where you can look up all the prescription drugs, you can see like where, you know, they got prescribed something in the past and where they felt it. And, you know, if they went to another physician that prescribed them something and where they felt that, how many were they prescribed that kind of stuff. So you can see if these clients have been abusing drugs. I didn't have access to that, right? So I'm just the student coming in. I have access to like what they're telling me, especially if it's an initial eval. Like we rarely get any of their like past records from any past like mental health areas that they had seen in the past before, like clinics or, you know, sites. So what it was like completely, completely just out of the blue, you're trying to figure out what's going on. They're telling you this stuff like, oh, yes, I've been abused or I've been fighting, you know, I can't sleep and like I need to get back on my Adderall and Concerta or, you know, these are the things that worked for me. And I'm like, okay, you know, so we, we write all this stuff down and then we like present it to the psychiatrist and then he, he will go and he'll see them and he comes back and he makes you feel like really stupid, not really stupid, but it's just like, oh man, like I have so much more learning to do. And this guy is like super brilliant because like he'll be like, what did you think of that patient? It was like, well, you know, like she's in there crying or he's in there. No, we didn't really have men that cried a little, but it was like, oh, she's crying and she's like, you know, searching for all this stuff. She said she's been abused and so it seems like she's had a rough life and these are the drugs that worked for her before she doesn't really want to try anything else. And he was like, exactly. He's like, those are like your red flags that you have to look at because a lot of times patients will come in and they'll tell you one thing. They'll tell me something different. But when you look at the drugs, like they're on a stimulant and you know, they're on an antidepressant. So he's like essentially breaking it down. Like, oh, they're asking for alcohol. They're asking for cocaine. They're asking for marijuana, like essentially from the drugs because it acts on the same receptors. And so you're like, wow, it's like your mind is like blown because man, this guy knows so much. So I would do that. We would do that. I mean, we got a little bit better at it as we went on in the weeks, but those initial evals were really, really tough. And so we would do that. We'd go through that day and then my day ended at either five or six p.m. at night, sometimes a little bit later, but it all depended on again, like the client. And after I would do that, like every, you know, every day, I'd have to drive to different centers. And some of them, you know, we had rougher like stories, you know, somebody like recently getting out of prison, you know, or there's, you know, young kids that are running away from home because they're in foster care. And so it's like really tough stores. And you're just trying to figure out like, what's the best way to help this person out? So that's one aspect that I really liked about it because you, you can really like see like, all right, you know, like I'm, I'm making a difference. And although it was a lot of like medication management, like these clients, like they really connect with you, you know, like I would see, I saw some of them because I was only on this rotation for four weeks. So I saw some of them twice in the time that I was there, which was cool because, you know, like, Oh my gosh, you know, hey, how are you? And I'm like, how are you doing? You know, how's things going at home? So you can build that relationship. And like, if you know me, you know, like I'm super like heavy on building relationships. So that was cool to see one thing I didn't necessarily like as much as just that this, the psych NP and the psychiatrist and I would imagine the psych PA would be like heavily involved in just medication management. You don't really do that much like kind of talking, that's more so the realm of the therapist. So if you were thinking of going into psych, that would be something that you might want to look into unless you are in inpatient psych, which we did a little bit more talking in that setting. I saw some inpatient psych when I was doing my emergency medicine rotation, but still it was still more so like heavy medication management. But that is it. I mean, that's everything that I did. It was literally a straightforward day. I'm telling you guys, it was like my easiest rotation because it was pretty much like nine to five, you know, for the most part, just four days a week type of thing. But it was cool. And I learned a lot. I got really, really good at the drugs, you know, understanding like what receptors they act on and how that would affect, you know, the client. So I think that it's a great rotation to have, especially since like the you there are people that are walking around, you have no idea, you know, what the issues that they're going through are. But like there are the majority of the patients that I saw were like major depressive disorder or, you know, like ADHD in the kids. So or depression with psychotic features. So those are things that you're like, okay, I want to make sure that I'm able to recognize these if I'm in primary care or emergency medicine or whatever the case may be, whatever specialty you're in, you're always going to get some bit of sight because patients that are coming into that specialty, they may have mental health issues that you just don't know about. They may be taking medications that you're kind of familiar with, but you're not truly familiar with. So understanding like how these medications will interact with medications that you may be trying to prescribe are important. But that is it, you guys. That is everything that I did on my psych rotation. I will keep doing these little juicy details for you as I continue on with my rotations. I have a couple more left. So I'm excited to share them with you. If you have any comments or questions for me, please leave them in the comment section below. And if you haven't already done so, go on to Instagram and follow me on Instagram at AdanaThePA. Thank you guys so much for watching and I will talk to you guys next time. Bye.