Coffs Harbour Health Campus, Mental Health Unit, NSW

What I learned - Regular activities

Acute care handover meeting: How to deal with common issues in an acute care unit, such as how to manage difficult patients (e.g. behaviour management plans, transfer to another facility) and manage bed pressure (e.g. temporarily relocating low-risk patients to the rehabilitation unit).

Multidisciplinary team meetings: The contributions of Case Managers, Peer Support workers, Psychologists, Social Workers, external agencies (e.g. ACAT, New Horizons), etc to assisting with physical health problems, accommodation, addiction, employment, and social issues.

Regular inpatient consultations: Components of a standard psychiatric interview (e.g. events leading up to admission, collateral history, educational attainment, relationships, employment, previous diagnoses, etc), and observing the communication strategies used when dealing with uncooperative or cognitively impaired patients.

Patient discharges: The range of follow up activities with the RRS, their GP, registrar clinics, and case managers, psychologists, drug and alcohol, and social workers (depending on the patient) that are in place to support patients and ensure their safety following discharge.

Registrar clinics: We usually discussed how patients were managing with their symptoms, any side effects from medications, how they were managing with other life stressors, follow up with GP and other allied health staff, and ensuring their safely (feeling like hurting themselves or someone else?)


What I learned - Other activities

Mental Health Review Tribunal: Increased my awareness of how the Mental Health Act influences patient care. Mr Hislop (presiding lawyer) explained his questioning to me, making it clear he was ensuring the patient was receiving the most effective treatment in the least restrictive setting that ensured their safety.

ECT session: Dr Phil talked me through the procedure and how to interpret the print out. Being able to talk with patients before and after ECT sessions and directly observe their improvements was very educational.
 

Learning activities

Private study: I read “The Psychiatric Interview” (Carlat) to learn the basics of interviewing techniques and how to build rapport with patients. Other team members also recommended familiarising myself with the MSE, Schizophrenia, Bipolar and Depressive disorders.

Cognitive assessments: I was able to independently complete Montreal Cognitive Assessments and RUDAS assessments with patients as required.

Typing notes: The registrars allowed me to type progress notes during their interviews with patients (typically discharge interviews).

Patient interviews: Sometimes consultants permitted me to have one-on-one interviews with patients to get to know them better. These interviews were typically informal and unstructured, but allowed me to get comfortable talking to patients and asking about topics relevant to their care.