For our first Psych site evaluation I presented 1 H and P and 5 pharm cards. The evaluation took place via facetime, and I had emailed my write up a day in advance. We first reviewed my pharm cards and then I presented my case. I presented the case of a 38 year old, Caucasian, female, married with 4 kids, employed as an accountant, lives with her husband and children, with a reported past psych history of general anxiety disorder, with a reported past medical history of migraines, who presented to Mindful Urgent Care secondary to increased anxiety symptoms and depressive symptoms. Dr. Saint Martin was familiar with the case before we started, so after I presented the case, and went over my differentials he asked questions about my differentials, plan and s/e of the medications, which I had chosen. Once he agreed with my plan, we then talked about the different types of therapy, and which were the types my patient could benefit from the most.
The second evaluation was at York College with all three students who had Psych during this rotation. Each of us presented 3 H and P’s, one journal article, and 5 pharm cards. Dr. Saint Martin went over relevant information about each of our cases. The article I presented was focused on how to manage a patient with Somatic symptom disorder. I chose this patient because I always felt I wouldn’t know how to approach a patient with this type of disorder. So, when I encountered a patient with this disorder at Mindful urgent care, I decided to look up an article that would help me manage the patient. Dr. Saint Martin agreed with the articles recommendations and we discussed some alternative meds that could be used if the one mentioned by the article failed.
One thing I really like about Dr. Saint Martin was he stayed up to date with the most current research on most of the psych interventions. He shared some of the most current evidence on the efficacy of Prazosin in terms of being prescribed for nightmares. He explained the new study found it is not effective at all in treating nightmares associated with PTSD when compared to placebo. Since all of our sites were still prescribing this medication for nightmares it showed me how important it is to stay up to date with studies. As he explained most providers are not in the habit of keeping up with the new studies. I really appreciated this during the evaluation, since it inspired me to be more proactive in the future.
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