“Patient looks sad.” I have actually seen this one before. In all fairness, he had just had his RIGHT ARM AMPUTATED, but you know how it is. Some people take that kind of hard.
In defense of the doctor in this one, just because the source of trauma is *painfully* obvious, doesn't mean they don't need a therapist. Obvious trauma is indeed still trauma.
True, but that’s usually something best accomplished after discharge. It’s kind of like the good doctor said in the short. Some things are best treated through long-term (even years) of outpatient work, rather than a single afternoon consult. When someone is in crisis like that, often the best anyone can do acutely is to just listen for a while. Doesn’t need to be a specialist, though I’m still happy to be that person. At the time, it kind of felt like an “I don’t have time to talk to this patient, so let’s throw him to psych instead.”
@@wakelamp Either they're already utterly fed up with life and thus overlords of coping (which can be in a good way or a bad way, yet it's never really healthy) or they are still in denial. Frankly, when it comes to rural then that itself can be half a diagnosis.
I was asked to consult psychiatry for this exact thing recently. Shockingly hard to convince people that normal human emotions are normal. Another day another struggle.
Tbh I would love to have a patient like this here once in a while. Better than being yelled at, beat, bit, spit at or not getting any response from your patients at all. But a man can dream ( and probably aclosed/protected geriatric acute ward isn't for that kind of patients^^) @@zippity61
@@zippity61I think it's probably not so much that they think there's something *wrong* with the pt. But they want to *help* the pt. Like, pain itself isn't "wrong" but we give people pain relief. They are seeking pain relief for the PTs mental pain. Though perhaps psychology may have been the better consultant?
Because family medicine is 90% calming patients with symptoms that will go away under a week with OTC medicine and listening about their signs of aging and only 10% actual diagnosing...
I worked as consult liaison for a while at a hospital. This is 100% accurate. I can't tell how many times I was consulted for delirium induced by Medical condition! I can't fix the medical condition. That's your job, other specialties. Not to mention, the patient is depressed because they have been in the hospital for 3 weeks. Really? How strange!
“Patient is depressed after being hospitalized for 3 weeks.” Ok have you even tried to cheer them up at all? Have you considered not waking them up multiple times a night for rounds, opening a window so they can see sunlight and more than just a blank sterile hospital room, and encouraging more frequent visits from loved ones? What about making their environment more stimulating if their condition allows it like putting flowers in their room or giving them puzzles or games to play, or simply taking the time to wheel them outside so they don’t feel trapped in bed in a boring room? For the love of god, fix what’s wrong with their treatment plan that’s allowing them to be treated as an unfeeling checklist instead of actual people, Mr. Hospital Doctor with an MD.
The one that's wild to me is asking mothers how they're feeling after birth. I've just pushed a whole human being out of my body, I am actively bleeding from an internal dinner sized plate wound and you told my partner he couldn't stay and help, leaving me to take care of my newborn who won't let me sleep and we're now going on 72hrs without sleep and you've told me off multiple times tonight for doing something wrong. No, I'm not doing mentally well right now 🙄
@@riverstein7251I am thankful that the hospital I am likely to use should I ever need it has private rooms, most of which have windows, solid Internet, and a relaxed visitation policy. It greatly helped my wife through two stays (infection-induced DKA for one and COVID for the other).
My psychiatrist had to retire because he couldn't handle being on weekend call. There were like 5 or 6 psychiatrists working the northwest quarter of Iowa & parts of Nebraska & South Dakota. They all took turns for weekend call. At the time, Iowa Medicaid only paid for psych beds in Iowa. When beds filled up on the east side of the state, where there was a severe shortage, they had to send inpatients clear across the state by ambulance. Labor Day weekend, my psychiatrist is on call. He's getting admits from the entire state of Iowa plus some from Nebraska & South Dakota. He handled it but he knew it was time to go.
@@Asharra12"... but thanks for asking!" Oh my goodness, what an unholy mess. Is that from the US? Because, apologies, it does rather sound like a US brand of "We will continue to lead the world in churning out laws which totally prove how much we care about children" . Best wishes to you and your family.
Oh this is so true. This is why I won't do psychiatric hospital consults any more. I was called to treat a comatose terminally ill oncology pt for depression. How can you not tell the difference between a coma and depression? A psychiatrist friend of mine was called to the ER to "deal with a psychotic" patient. The patient was a deaf mute trying to communicate with staff using American Sign Language. Fortunately my friend knows ASL. The pt ended up having kidney stones not "psychosis".😊
Oh my goodness this is so angry-making (at the staff who didn't recognize friggin sign language) and simultaneously heartwarming (for your friend establishing communication and care in a difficult place).
I saw my dad's delirium disappear seconds after we stepped outside the hospital's front door. I could hardly believe it. Good call by his nephrologist to "get him out of this place."
Actually hospital psychosis is a real thing, especially in elderly patient - ripping someone out of environment and routines they've spent last 40+ years in and putting into completely different environment and regimes wreaks havoc on a brain that has it's adaptative capacity reduced by aging... So yes, it's not always hospital staff trying to 'get rid of the patient' as some families accuse us ;)
Or at an auto parts store "what part did you need for that car?" "Brakes" "Brake pads? Rotors? Front or back?" "I don't know, my mechanic asked me to grab them." "maybe you should ask *him*"
The ridiculous things is, they usually DO know the answer to that question, they just aren't doing the basic critical thinking necessary to put it together. What merch has your niece collected? Do they talk about dragons? Princesses? Do they like pictures in their books? How about monster fights? Romance? School kids Fighting ghosts? Generally, people talk about their hobby with the people around them. Just... What was the topic of conversation last time you saw them? Go with that and work your way up.
This was my life when I was a social worker at a SNF. “patient is agitated.” “Did you ask why?” “No, it’s your job.” “She’s bed bound and complaining of irritation when she pees. Would you be willing to test for a UTI?” “It’s a UTI.”
‘Late-onset schizophrenia. In an 85-year-old.’ I suspect poor Psychiatry would have consulted that patient anyway, just to spare them from having to deal with the far more situationally appropriate but far less tactful Neurology, indeed…
I was consulted for this by the ED several years ago. I tried to persuade the ER doctor to order an imaging study of the patient's head. He assured me the patient's exam was non-focal, but agreed. The ED doctor handed the case over to the next shift. Several weeks later, he asked how our patient had fared. I informed him the patient was sent home on hospice to peacefully die from metastatic cancer. I feel bad about this, but felt a certain satisfaction that the arrogant SOB ED doctor had to eat humble pie. I was never able to make him understand that it would be exceedingly unusual for an octogenarian to develop Schizophrenia.
@@Terrafire123 too many things in your body can destroy your mental health, and if some of those things are wrong, throwing psychiatric meds at the problem isn't going to be as effective. Take depression for example--that can be a symptom of hypothyroidism. Doctors will often order labs on this, and if you do have a thyroid issues they will often want to sort that out first. This way they have an idea whether your thyroid made you depressed or you have both thyroid issues and depression. Then they can go from there. Just one example.
@@Terrafire123 many diseases can induce "personality change". My uncle had low electrolytes, diabetes, and kidney stones. He didn't recognize his own mother and tried to hit/push her. He screamed at everyone and couldn't sleep. When his condition improved, he regained his calm.
Not really. Take for example if a man had a stroke, ofcourse his behavior will be off, that's not a psychiatric problem at all. It's not really about getting it less, it's a polite way of saying go make sure you have the right consult
My partner is a psychiatrist and he has seen all of these. He once got a consult for a person with "depression" because the Eagles lost. One of his [least] favorites was when he got a consult to "find out whether the patient is lying." 😮
@@flowersfrom7311 I think my partner's response was that as a psychiatrist he practices medicine and not the Force - psychiatrists don't get training in using the Jedi mind trick :)
@@fabricdragon Yes, not far from Philly. I think the patient had told a nurse he was feeling "kind of depressed" about the game, which prompted the psych consult 🤪 My partner tried to screen for depression and the patient was like, "I'm not depressed for real, I meant it just sucks about the game"
Had a consult last month because the patient was sad because their family member died while they were in the hospital. It's unreal how basic human emotions elude other specialties.
Unreal, and difficult because even when you know what's going on, the other specialties can't usually stay & help talk the patient through things, especially as a resident. The only two specialties who have "stay and chat" in their job description are psych and pastoral care/chaplain, so sometimes the best you can do is throw in a consult & hope the patient gets what they need. Or at least, that's how it feels sometimes
Oh, I feel every single one of those- I would laugh if it wasn'tso darn accurate. "Make the labs less red" is going to be my line when I get consulted for delirium next time.
@@caltheantirobotI need to know that code so I can ask my psychiatrist to use it in reference to my doctors. She said they caused medically induced trauma by delaying my diagnosis due to thinking my pernicious anemia symptoms were psychosomatic. The best code she could find was something about coping with an undiagnosed illness ...but the main reason it went undiagnosed was due to my terrible doctors.
Oh yeah, also when ED consultant. “They are psychotic, we want you to assess for a psych hold.” I have a Masters Degree, and have a specialty in addiction medicine. I glanced at the chart and noticed the ammonia level was sky high in this 70 year old man. “Would you be willing to consider getting the labs back to normal before I assess?” I wanted to yell at these MDs, not ask politely.
You'd be surprised how helpful it is to TALK TO THE PATIENT. Even a non-psychiatrist like me can tell the difference between a normal reaction to a stressful environment and an anxiety disorder by simply TALKING TO THE PATIENT.
@@VashdaCrash yep. And not just psychatric diseases, but any disease. When I was in medschool, we were told that "a good interview with a patient will give you 80% of the diagnosis"
Raises hand* This was me and I was the patient. I am an active person and when I don't go to the gym regularly and am homebound I could probably bounce out of a chair if I am made to sit too long. I do a lot on my parents farm and my neighbors farms so I am fairly physically active on a regular basis. I was in the hospital and it was like day 3 of being in a bed and I was "jittery" and I did not want to be in a bed anymore and my vitals were good and I could have gone on a mile walk. . . . . . .the nurses came in and asked if I had ever been diagnosed with anxiety issues before. No, I'm extremely physically active and I train horses, muck stalls, toss 70lb bales of hay on a daily basis and I have not even been allowed to barely move around for 3 days. . . . .my energy is so high I could vibrate out of the bed right now! No, sure, give me anxiety meds. . . . . . . .allowing me to walk would have been way to much work.
😂 my brother is an ortho-bro and does not like having to talk to patients. He's also super buff. Totally fits the stereotype. I didn't know there was one until watching these videos. Hilarious
As a psychiatrist, i see atleast one of these scenarios each day. Reason for referral "patient not willing to get operated for a recurrent brain tumor, the 4th time. Come and counsel the patient". Like dude, its your job to tell about the surgery.... and i was told by the patient, that treating doctor didn't explain it clearly🤷
@@KMx108 I am not a Dr, but I work in learning and change. Agree sometimes Drs don't explain things well. But people under stress don't necessarily remember, or find it scary to even look at a brochure. It's difficult. But taking notes, and confirming is this what the Dr meant can help (I live in a low litigation country, so maybe the US is different).
I always think about when my older sister had a lupus flair up and was hospitalized for 5 weeks and the doctors couldn’t seem to understand why she was deeply depressed.
Do those doctors know what a hospital bill _is_ ? Because if I had one of those heading towards me, for several weeks, of stay, I'd probably be closer to suicidal than to just depressed.
“Make them less red!” ❤ we can still consult on delirium management whilst you make them less red… just don’t expect psychotherapeutic benefit from our mere presence- the patient’s brain is angry about what’s happening to the rest of their body…
"Patient looks sad" in all fairness, I'm assuming that doctors don't have the time to type everything in to Epic if they ACTUALLY talk to someone. Private Equity would be all over that gross time mismanagement.
My doc is an older guy and a bad typist. Most of my appointment with him is spent watching him try to use Epic and do his write-up. It makes me want to have him dictate and I'll type for him.
On the "wants to talk" thing. I have legitimately proposed the idea of hospitals hiring staff for exactly that purpose. Have non medically trained staff whose job it is to just talk to patients who want to chat or ramble to somebody. It means the doctors and nurses don't have to spend their time listening to it, the patients can actually talk to people, and you have somebody who can potentially pick up clues and warning signs through the conversation that would otherwise be missed during a rushed introduction.
In our local hospital there's a mission and thus there was a lady that introduced herself for talking. Which personally did not suit me cause I do not stan religion but I still thought it's great they have someone there.
I'm not sure about this. I work as a home health aide/LPN (different system than the US one) and you'd think since we're the cheapest labour in the healthcare system and have the most facetime with patients they'd allow time for patients to just talk to us... including the ones that need a lot of extra time to get words out, can't talk while we do anything else, ramble a lot, are very very distraught... but no. Cause we're also the biggest group and our work on the biggest scale timewise, and we're "just" keeping seniors alive and not in abject misery, and senior population is getting very large proportionately, and talk of raising taxes on people with good incomes is political suicide today. So... nobody will ever tell you to cut them off and rush to the next person, but they will schedule & staff us so we have little choice. I could see a future where this is proposed as a solution - "we have hired Monica the Human Contact Tech who is paid even less than you and has expertise in the area of verbal patient interaction. From now on direct patients to Monica when conversation veers into social talk." So that's my fear. On the other hand... some people are black holes of conversational need and I'd be willing to personally pay Monica highest end call girl money to come and tag me out.
"Late onset schizophrenia...in an 85 year old?" I felt this in my soul. Only thing missing was the capacity consult for an intubated patient unconscious on propofol
During a week-long ICU stay, I broke down crying. A Dr. asked me "Are you upset? Why? Why are you crying?" I wish I made this up. I'll have to give the doc credit for at least asking.
Like when they wake patients up every damn second and are baffled why they’re cranky and exhausted. I get Doctors deal with a lot but once the basic concept of sleep goes out the window, they should be mandated to clock out
Isn't it better to ask someone why they are upset rather than just assuming ? Your breakdown could have had a specific cause that the Dr. could address.
Something similar happened to someone I know. They'd been in hospital for several days following concerning test results and the doctor basically said "we don't know what's wrong with you and we don't know how long you'll be in hospital for" then asked why they were crying. (They were 15 at the time and it was the middle of exam season.)
I'm officially mandating that every future resident coming through our program watches this video prior to starting their consult liaison rotation. You really hit it on the nail!
I have people comment on my corpse-like appearance numerous times as I walk around in day to day life. Weirdly enough, my doctors are the only ones who never have any questions about it. Makes me wonder how they would judge "looking sad".
WHEW!! The conversations that could be had behind this! 😢 Lots of folks remember what happened to Brittany Spears and shrug...but competency/capacity inquiries and conservatorships can, and _have,_ been readily weaponized against disabled, elderly, and chronically-ill people. This is an event that is likely increasing in the wake of long covid. Getting a person (often a vulnerable person) declared "dead to the law" is an awful way to violate a human being's autonomy; and it happens more frequently than it should. Mainly because there's money to be made: either by individuals who are then assigned to the patient as guardian (and who then get to control and exploit the patient's accounts and finances...even selling the patient's home or treasured personal possessions/heirlooms and pocketing the money); or, by institutions that earn money by placing that patient in substandard living arrangements and overcharging them. ...And all anyone has to do if the patient has anything to _say_ about that, is to have a drug prescribed to numb their minds and force them into a docile state of being...like entirely too much in our society, all considered perfectly legal. It's a problem.
I liked the public health assistant nurse trying to give me a depression screening while I was in the middle of an unbreakable migraine with aphasia. Gurlfriend, probably but I'm currently hallucinating rainbows and probably need triptans first.
My 85-year-old father was hospitalized last week. COVID and influenza at the same time leading to severe dehydration, combined with depression and anxiety because my wheelchair-bound mother didn’t have anyone to help her at home…this call to Psych was about my father, right? (I drove to the city where my parents live and spent 10 days with them. They’re OK. I, however, now have the flu…)
Lol! My first job the surgeons kept making us ward doctors refer our patients to psych because they were depressed.. Low and behold though our ward consisted of patients who had one or both of their legs amputated. Wonder why they were depressed 😅
“Treatment for this disorder typically requires years…but sure I’ll try to knock it out in an afternoon.” This is how I feel as a hospital dietitian consulted for high BMI.
Normally these videos feel very foreign to me, a non American. But this one hit so freaking close to home! There's a pretty good focus so far on bedside manners and patient care in my experience as a medical student. But I don't know if it's still very new, or a lot of practicing physicians just forget all of it when they graduate Or maybe the problem is micromanagement and journaling of everything making doctors need to "optimize" everything, with patient conversations being the first thing to fall behind. That coupled with a culture of making the patient "someone elses problem" as quick as possible...
So many of these situations are appropriate for Hospital chaplains! Especially the “patient looks sad” scenarios. I am a hospital chaplain and am learning to train chaplains. Most people don’t realize how versatile we are! We don’t just pray with people, we are the people who sit and talk when someone is having the worst day of their life. And I pride myself in training my students to care for all people, regardless of their beliefs, backgrounds, gender, identities, etc. we get called for all sorts of situations! Basically, We are trained to respond to emotional and spiritual needs of patients and families so that the healthcare providers can focus on providing healthcare. We also provide a lot of support for staff. If a staff member gets assaulted, for example, we show up to provide emotional support. It is sad how often that happens.
the very sad thing is? he would be one of the top psychiatrists i have met working in a hospital facility. *because he actually asks if its a medical issue*!!! i cant count how many of my friends have been dismissed with "anxiety" or "depression" because no one bothered to read A LAB RESULT!
Amen to this! I know of 2 people who were admitted to a psych ward, had all their rights taken away, and both were actually having a serious medical problem. Sadly one was a brain lymphoma and she passed away the same day they finally figured it out. I believe the other was liver related. And women with endometriosis, ESPECIALLY teenagers, are often told they have a mental health problem and are seeking attention. Or an eating disorder because they are vomiting from the pain. It is infuriating that doctors aren't more aware of a disease that affects 1 in 10 women.
My kidney disease was misdiagnosed as anxiety for 30 years lol. Turns out random muscle paralysis caused by chronic potassium wasting tends to make a person pretty anxious.
I was referred to a psychiatrist to cope with receiving a delayed diagnosis of pernicious anemia because all my doctors were convinced my symptoms were psychosomatic. I had been through a horrible time trying to get treatment and not being heard. When i saw the psychiatrist, she was very supportive and helpful but she then diagnosed me with a mental health disorder she hadn't mentioned in our appointment. When i asked about it at our next appointment, she said she thought i realized that if i saw her, i would be diagnosed with a mental disorder because otherwise, insurance wouldn't pay the bill. She diagnosed me with something that amounted to " not being able to cope with normal life." I argued that there's nothing normal about having doctors turn against you and delay proper medical care. I asked her to find a better billing code. She dug deep and found one for coping with an undiagnosed illness. Insurance still paid the bill. Who doles out mental illness diagnoses as an automatic just for having a consultation?? Is this the norm? Makes me want to avoid psychiatry.
Im Healthcare security-a patient minder. My job is to sit on one room with one patient that has been detained under the Mental Health Act. I basically sit there and talk to them if they want to chat to keep them calm. If they dont want to be calm, I call a code black and 4 of us make them calm with help from a wonderful DR who has all kinds of things that make a person calm, happy and then sleepy/unconscious. 😁😁 Half the time im not sure if Im security or a very under paid Psyc Doc.
Thank you for this, Dr. G. Speaking as a frequent flyer with chronic sui ideation, I'm impressed and gratified by your attitude. Thank you for your service.
"The patient had a bad thing happen to them, and you want me to treat their normal psychic reaction to that thin?" Well, if it doesn't describe the biggest question I have when going to a psychiatrist for over half a decade. I think if you took my raw answers to some of the evaluation questionnaires, I'd also have paranoia and agoraphobia, but I'm just queer in the Bible Belt. I was taught in Sunday school that I'm an abomination. I know the hatred is there, and I'm not comfy with it
"The patient had a bad thing fallen to them, and you want me to treat their normal psychic reaction..." "Late onset schizophrenia. On an 85 year old patient..." This all resonates so much with me... 😂
I once saw a gp who said, in an angry and bullying way, no less, "I can tell by looking at you that you're depressed!" and tried to force me to take antidepressants. I was just there looking for a primary care doc. He wasn't it. Still in practice. I had already learned nothing happens when you tell on these people.
Morning blood collections can sometimes feel confusing like this😬, waking a patient up at 6am and helping them get orientated enough so that you can draw their blood without getting clocked upside the head😂
I just love that the patient has horrible lab results indicating disease but it's definitely a psych problem and they need a psych eval. So tired of not getting proper Healthcare
Had a few patients involuntarily admitted to the crisis stabilization unit I worked at because the LEO’s felt the patients “wanted to talk” and it was “the best place for them”. They want to talk but to an outpatient specialist. Not held against their will for 3 days while being severely monitored and evaluated.
I worked as a nurse specialist in liaison psychiatry for the elderly. We had a referral of a recently bereaved pensioner with advanced dementia, querying whether bereavement counselling was appropriate.
I know you’re an ophthalmologist but your psychiatrist is _definitely_ my favourite character, and the doctor of yours I’d most like to see as a patient.
(I mean I actually do have psych issues so obviously he’d be the most useful, but I was talking in terms of seeing a doctor who I feel confident would nail the line between showing compassion and not taking any bovine faeces.)
All of these are very similar to neurology consults. Consults for delirium, consults for dementia (in an old person with sepsis), consults for altered mental status (on propofol and intubated)
I have two shows this weekend (March 23/24) in Hollywood and Irvine. Come check it out!
glaucomflecken.com/live
Please mask up and encourage the audience to do so as well. Proper masks, not baggy blues.
I would love to see Urgent Care skits! They see all kinds of illnesses and accidents
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@@RegisteredNurseL.A. maybe home visits as well - those can be Interesting
Yeah ... working and people just toss situations on you so they do not have to deal with it ... man this one hits hard.
“Patient looks sad.” I have actually seen this one before. In all fairness, he had just had his RIGHT ARM AMPUTATED, but you know how it is. Some people take that kind of hard.
In defense of the doctor in this one, just because the source of trauma is *painfully* obvious, doesn't mean they don't need a therapist. Obvious trauma is indeed still trauma.
True, but that’s usually something best accomplished after discharge. It’s kind of like the good doctor said in the short. Some things are best treated through long-term (even years) of outpatient work, rather than a single afternoon consult. When someone is in crisis like that, often the best anyone can do acutely is to just listen for a while. Doesn’t need to be a specialist, though I’m still happy to be that person. At the time, it kind of felt like an “I don’t have time to talk to this patient, so let’s throw him to psych instead.”
I grew up in a rural area. Out of interest, what would happen if the patient looked unworried?
@@wakelamp Either they're already utterly fed up with life and thus overlords of coping (which can be in a good way or a bad way, yet it's never really healthy) or they are still in denial. Frankly, when it comes to rural then that itself can be half a diagnosis.
Yeah thats completely natural, I mean his other arm was all that was left.
"We told the patient that he has terminal cancer, can you please have a look he has been crying ever since" - yep that happend.
That's the case where I want a full psych team to be ready if the patient needs it
I was asked to consult psychiatry for this exact thing recently. Shockingly hard to convince people that normal human emotions are normal.
Another day another struggle.
Tbh I would love to have a patient like this here once in a while. Better than being yelled at, beat, bit, spit at or not getting any response from your patients at all. But a man can dream ( and probably aclosed/protected geriatric acute ward isn't for that kind of patients^^) @@zippity61
How much you wanna bet "we" was the surgical team?
@@zippity61I think it's probably not so much that they think there's something *wrong* with the pt.
But they want to *help* the pt.
Like, pain itself isn't "wrong" but we give people pain relief. They are seeking pain relief for the PTs mental pain.
Though perhaps psychology may have been the better consultant?
A very great doctor once told this nurse, "When all else fails, talk to the patient" Truer words were ever spoken!
you think that they would effing start there
Nah, CT away
-sarcastically as a radiologist
But does that come before talking to a psychiatrist or after?
@@germsspiceswhilst
I say that all the time before going in a room! I thought I made it up, but I guess I must've heard it somewhere. Darn!
I love how the glasses looked more and more Family Medicine with each call.
That is a cool detail
Because family medicine is 90% calming patients with symptoms that will go away under a week with OTC medicine and listening about their signs of aging and only 10% actual diagnosing...
As a psychiatry resident, can confirm every single word of this. I was rolling 😂😂😂 although I was not laughing when I got a consult for “tearfulness.”
Drives me crazy when my consultants want me to call you guys for a teary pt the day after they found out they have cancer
I like to prescribe some tissues 😂
@@HildeTheOkayish 2 boxes of Puffs Plus, stat. No, no dispense as written. 😅
And 0.9% NaCl bolus to maintain F/E balance
And their favorite comfort food.
I’ll talk to him when his labs are less red! Love it👍👍👍👍👍👍!!!!!
"Sodium isn't red anymore, yes we fixed that in 3 hours. Can you come now?" :-/
As a Nephrologist, I take issue with this. A lot of our normal labs are red! 😂
@@lancedicker858Yeah that's why you gotta order 24 hour urine sample
@@uniayangThis LITERALLY happened to me. Sodium was 120 prior to rapid correction. Definitely asked to talk to the attending
@@reginaldlloyd4892 hope that the correction wasn’t too rapid.
I worked as consult liaison for a while at a hospital. This is 100% accurate. I can't tell how many times I was consulted for delirium induced by Medical condition! I can't fix the medical condition. That's your job, other specialties. Not to mention, the patient is depressed because they have been in the hospital for 3 weeks. Really? How strange!
“Patient is depressed after being hospitalized for 3 weeks.” Ok have you even tried to cheer them up at all? Have you considered not waking them up multiple times a night for rounds, opening a window so they can see sunlight and more than just a blank sterile hospital room, and encouraging more frequent visits from loved ones? What about making their environment more stimulating if their condition allows it like putting flowers in their room or giving them puzzles or games to play, or simply taking the time to wheel them outside so they don’t feel trapped in bed in a boring room? For the love of god, fix what’s wrong with their treatment plan that’s allowing them to be treated as an unfeeling checklist instead of actual people, Mr. Hospital Doctor with an MD.
The one that's wild to me is asking mothers how they're feeling after birth. I've just pushed a whole human being out of my body, I am actively bleeding from an internal dinner sized plate wound and you told my partner he couldn't stay and help, leaving me to take care of my newborn who won't let me sleep and we're now going on 72hrs without sleep and you've told me off multiple times tonight for doing something wrong. No, I'm not doing mentally well right now 🙄
@@riverstein7251I am thankful that the hospital I am likely to use should I ever need it has private rooms, most of which have windows, solid Internet, and a relaxed visitation policy. It greatly helped my wife through two stays (infection-induced DKA for one and COVID for the other).
My psychiatrist had to retire because he couldn't handle being on weekend call. There were like 5 or 6 psychiatrists working the northwest quarter of Iowa & parts of Nebraska & South Dakota. They all took turns for weekend call.
At the time, Iowa Medicaid only paid for psych beds in Iowa. When beds filled up on the east side of the state, where there was a severe shortage, they had to send inpatients clear across the state by ambulance.
Labor Day weekend, my psychiatrist is on call. He's getting admits from the entire state of Iowa plus some from Nebraska & South Dakota. He handled it but he knew it was time to go.
@@Asharra12"... but thanks for asking!"
Oh my goodness, what an unholy mess. Is that from the US? Because, apologies, it does rather sound like a US brand of "We will continue to lead the world in churning out laws which totally prove how much we care about children" .
Best wishes to you and your family.
Oh this is so true. This is why I won't do psychiatric hospital consults any more. I was called to treat a comatose terminally ill oncology pt for depression. How can you not tell the difference between a coma and depression? A psychiatrist friend of mine was called to the ER to "deal with a psychotic" patient. The patient was a deaf mute trying to communicate with staff using American Sign Language. Fortunately my friend knows ASL. The pt ended up having kidney stones not "psychosis".😊
Oh my goodness this is so angry-making (at the staff who didn't recognize friggin sign language) and simultaneously heartwarming (for your friend establishing communication and care in a difficult place).
😂😂😂
Psychosis?
Surprised they didn't call the cops for throwing up gang signs too.
"The patient looks sad." OF COURSE THEY LOOK SAD, THEY'RE A PATIENT.
I saw my dad's delirium disappear seconds after we stepped outside the hospital's front door. I could hardly believe it. Good call by his nephrologist to "get him out of this place."
Actually hospital psychosis is a real thing, especially in elderly patient - ripping someone out of environment and routines they've spent last 40+ years in and putting into completely different environment and regimes wreaks havoc on a brain that has it's adaptative capacity reduced by aging... So yes, it's not always hospital staff trying to 'get rid of the patient' as some families accuse us ;)
@@shaedlaer Yes, and giving an elderly patient Ativan makes the delirium worse.
Weirdly similar to working in a bookstore.
"A book for your niece, well what to they like to read? Her mom just said "books"? TRY ASKING THE NIECE."
Honestly sometimes you do ask the niece and they go “I don’t know” or just shrug. Like. Gee thanks 😅
Or at an auto parts store "what part did you need for that car?"
"Brakes"
"Brake pads? Rotors? Front or back?"
"I don't know, my mechanic asked me to grab them."
"maybe you should ask *him*"
@@dumchicanwater pump gasket for a 1997 Tacoma. Could you describe it to me just to make sure we get the right one?
The ridiculous things is, they usually DO know the answer to that question, they just aren't doing the basic critical thinking necessary to put it together.
What merch has your niece collected? Do they talk about dragons? Princesses? Do they like pictures in their books? How about monster fights? Romance? School kids Fighting ghosts?
Generally, people talk about their hobby with the people around them. Just... What was the topic of conversation last time you saw them? Go with that and work your way up.
This was my life when I was a social worker at a SNF. “patient is agitated.” “Did you ask why?” “No, it’s your job.” “She’s bed bound and complaining of irritation when she pees. Would you be willing to test for a UTI?” “It’s a UTI.”
‘Late-onset schizophrenia. In an 85-year-old.’ I suspect poor Psychiatry would have consulted that patient anyway, just to spare them from having to deal with the far more situationally appropriate but far less tactful Neurology, indeed…
How bad would it be if the neurology did the exam? They would forget about the burns in 5 minutes anyways
@@alperakyuz9702You're missing the point: Neurology is mean to his coworkers, but he genuinely cares for the well-being of his patients.
No geriatric care?
I was consulted for this by the ED several years ago. I tried to persuade the ER doctor to order an imaging study of the patient's head. He assured me the patient's exam was non-focal, but agreed. The ED doctor handed the case over to the next shift. Several weeks later, he asked how our patient had fared. I informed him the patient was sent home on hospice to peacefully die from metastatic cancer. I feel bad about this, but felt a certain satisfaction that the arrogant SOB ED doctor had to eat humble pie. I was never able to make him understand that it would be exceedingly unusual for an octogenarian to develop Schizophrenia.
Oddly this is most likely something that will need treatment by the urologist.
Psychiatrist is a bizzarro-world version of the Pathologist.
Atleast they got a pet microscope as a emotional support. I wonder how psychiatrists cope...
@@30pranaypawar17we talk to each other.
@@30pranaypawar17 by reading their textbooks JAJAJAJAJAajaj
@@30pranaypawar17free samples from the pharmaceutical industry
@@30pranaypawar17they don't :D
As a final year psych resident… this one nailed it. I have received every one of these consults multiple times over.
“All the lab values are red, make them less red and then we’ll talk” thats exactly how it is with psych and mental health consults lmao 😂
Why is that?
People are just sad when their lab results are red?
@@Terrafire123 too many things in your body can destroy your mental health, and if some of those things are wrong, throwing psychiatric meds at the problem isn't going to be as effective. Take depression for example--that can be a symptom of hypothyroidism. Doctors will often order labs on this, and if you do have a thyroid issues they will often want to sort that out first. This way they have an idea whether your thyroid made you depressed or you have both thyroid issues and depression. Then they can go from there. Just one example.
@@hbtried7818 I was wondering what that meant too. Thank you for explaining 😊
@@Terrafire123 many diseases can induce "personality change". My uncle had low electrolytes, diabetes, and kidney stones. He didn't recognize his own mother and tried to hit/push her. He screamed at everyone and couldn't sleep. When his condition improved, he regained his calm.
Not really. Take for example if a man had a stroke, ofcourse his behavior will be off, that's not a psychiatric problem at all. It's not really about getting it less, it's a polite way of saying go make sure you have the right consult
My partner is a psychiatrist and he has seen all of these. He once got a consult for a person with "depression" because the Eagles lost. One of his [least] favorites was when he got a consult to "find out whether the patient is lying." 😮
well, i mean... in Philadelphia? a lot of folks take their sports very very seriously (looks over at Gritty)
I need to know about the second one! Was he lying?
@@flowersfrom7311 I think my partner's response was that as a psychiatrist he practices medicine and not the Force - psychiatrists don't get training in using the Jedi mind trick :)
@@fabricdragon Yes, not far from Philly. I think the patient had told a nurse he was feeling "kind of depressed" about the game, which prompted the psych consult 🤪 My partner tried to screen for depression and the patient was like, "I'm not depressed for real, I meant it just sucks about the game"
At least they took it seriously 😂
Had a consult last month because the patient was sad because their family member died while they were in the hospital. It's unreal how basic human emotions elude other specialties.
Hell they elude most people. I remember growing up, all the adults seemed unable to fathom how a kid could be stressed beyond belief.
Pastoral care is an undervalued resource.
Unreal, and difficult because even when you know what's going on, the other specialties can't usually stay & help talk the patient through things, especially as a resident. The only two specialties who have "stay and chat" in their job description are psych and pastoral care/chaplain, so sometimes the best you can do is throw in a consult & hope the patient gets what they need.
Or at least, that's how it feels sometimes
Oh, I feel every single one of those- I would laugh if it wasn'tso darn accurate. "Make the labs less red" is going to be my line when I get consulted for delirium next time.
Haha.. me too 😅
Perfect! You only forgot to add the consult where the primary complaint is relationship problems between patient and healthcare team
There's a Z code for that and it cracks me up every time I'm flipping through the DSM. In my professional opinion the patient thinks I suck.
@@caltheantirobotI need to know that code so I can ask my psychiatrist to use it in reference to my doctors. She said they caused medically induced trauma by delaying my diagnosis due to thinking my pernicious anemia symptoms were psychosomatic. The best code she could find was something about coping with an undiagnosed illness ...but the main reason it went undiagnosed was due to my terrible doctors.
Oh yeah, also when ED consultant. “They are psychotic, we want you to assess for a psych hold.” I have a Masters Degree, and have a specialty in addiction medicine. I glanced at the chart and noticed the ammonia level was sky high in this 70 year old man. “Would you be willing to consider getting the labs back to normal before I assess?” I wanted to yell at these MDs, not ask politely.
You'd be surprised how helpful it is to TALK TO THE PATIENT.
Even a non-psychiatrist like me can tell the difference between a normal reaction to a stressful environment and an anxiety disorder by simply TALKING TO THE PATIENT.
Easier said than done?
@@jasondads9509 exactly
It gives context to the issue making it easier to discern?
@@VashdaCrash yep. And not just psychatric diseases, but any disease. When I was in medschool, we were told that "a good interview with a patient will give you 80% of the diagnosis"
Raises hand* This was me and I was the patient. I am an active person and when I don't go to the gym regularly and am homebound I could probably bounce out of a chair if I am made to sit too long. I do a lot on my parents farm and my neighbors farms so I am fairly physically active on a regular basis. I was in the hospital and it was like day 3 of being in a bed and I was "jittery" and I did not want to be in a bed anymore and my vitals were good and I could have gone on a mile walk. . . . . . .the nurses came in and asked if I had ever been diagnosed with anxiety issues before. No, I'm extremely physically active and I train horses, muck stalls, toss 70lb bales of hay on a daily basis and I have not even been allowed to barely move around for 3 days. . . . .my energy is so high I could vibrate out of the bed right now! No, sure, give me anxiety meds. . . . . . . .allowing me to walk would have been way to much work.
“You’re calling me because the patient wants to talk?”
Ortho-bro, is that you?
😂 my brother is an ortho-bro and does not like having to talk to patients. He's also super buff. Totally fits the stereotype. I didn't know there was one until watching these videos. Hilarious
As an attorney I appreciate his distinction between competency and capacity. ❤
In residency, I was forced to see a prophylactic depression consult on a multiple gun shot wound pt actively coding in the ER.
Psychiatrists build functional human beings and save lives. They're surgeons of self-esteem.
They're*
o7
thank you for editing your comment
@@NoNameAtAll2 It was just auto correct, no big deal.
Love my psychiatrists at SLU. It's a residency program, so they switch out every year or so, but both the guys I've had so far have been amazing.
@@gamemeister27 That's awesome, having teachers you like makes a huge difference. You got this, man.
As a psychiatrist, i see atleast one of these scenarios each day.
Reason for referral "patient not willing to get operated for a recurrent brain tumor, the 4th time. Come and counsel the patient".
Like dude, its your job to tell about the surgery.... and i was told by the patient, that treating doctor didn't explain it clearly🤷
Is it sometimes the family pushing for an operation and pressuring the patient and the surgeon?
Too many doctors don't explain things and can't comprehend why patients don't blindly do whatever they recommend.
@@KMx108 I am not a Dr, but I work in learning and change.
Agree sometimes Drs don't explain things well. But people under stress don't necessarily remember, or find it scary to even look at a brochure.
It's difficult. But taking notes, and confirming is this what the Dr meant can help (I live in a low litigation country, so maybe the US is different).
I always think about when my older sister had a lupus flair up and was hospitalized for 5 weeks and the doctors couldn’t seem to understand why she was deeply depressed.
Do those doctors know what a hospital bill _is_ ? Because if I had one of those heading towards me, for several weeks, of stay, I'd probably be closer to suicidal than to just depressed.
“Make them less red!” ❤ we can still consult on delirium management whilst you make them less red… just don’t expect psychotherapeutic benefit from our mere presence- the patient’s brain is angry about what’s happening to the rest of their body…
"Patient looks sad" in all fairness, I'm assuming that doctors don't have the time to type everything in to Epic if they ACTUALLY talk to someone. Private Equity would be all over that gross time mismanagement.
Can confirm
That's what the nurses are for!
My doc is an older guy and a bad typist. Most of my appointment with him is spent watching him try to use Epic and do his write-up. It makes me want to have him dictate and I'll type for him.
On the "wants to talk" thing. I have legitimately proposed the idea of hospitals hiring staff for exactly that purpose. Have non medically trained staff whose job it is to just talk to patients who want to chat or ramble to somebody. It means the doctors and nurses don't have to spend their time listening to it, the patients can actually talk to people, and you have somebody who can potentially pick up clues and warning signs through the conversation that would otherwise be missed during a rushed introduction.
In our local hospital there's a mission and thus there was a lady that introduced herself for talking. Which personally did not suit me cause I do not stan religion but I still thought it's great they have someone there.
That's why we have chaplains!
@@pbgandie sick people don't need proselytizing
Spiritual care is a thing.
I'm not sure about this. I work as a home health aide/LPN (different system than the US one) and you'd think since we're the cheapest labour in the healthcare system and have the most facetime with patients they'd allow time for patients to just talk to us... including the ones that need a lot of extra time to get words out, can't talk while we do anything else, ramble a lot, are very very distraught... but no. Cause we're also the biggest group and our work on the biggest scale timewise, and we're "just" keeping seniors alive and not in abject misery, and senior population is getting very large proportionately, and talk of raising taxes on people with good incomes is political suicide today. So... nobody will ever tell you to cut them off and rush to the next person, but they will schedule & staff us so we have little choice.
I could see a future where this is proposed as a solution - "we have hired Monica the Human Contact Tech who is paid even less than you and has expertise in the area of verbal patient interaction. From now on direct patients to Monica when conversation veers into social talk."
So that's my fear. On the other hand... some people are black holes of conversational need and I'd be willing to personally pay Monica highest end call girl money to come and tag me out.
Psychiatric resident here. This video healed my soul, today. Thank you so much.
"Late onset schizophrenia...in an 85 year old?"
I felt this in my soul.
Only thing missing was the capacity consult for an intubated patient unconscious on propofol
"All the lab values are red...make them less red and then we'll talk!" Love it.
Love the "late onset schizophrenia" in the 85yo! And extra credit for the capacity/competency rant!!!
I'm in my final year of psychiatry residency and I am crying from laughing so hard. Better call psych!
Bless Psychiatrist. I've legitimately bothered four versions of them during my chronic depressive disorder journey. (Thanks, docs.)
The exasperation and frustration in his voice and expressions for almost every response is both hilarious and painful to experience.
During a week-long ICU stay, I broke down crying. A Dr. asked me "Are you upset? Why? Why are you crying?" I wish I made this up. I'll have to give the doc credit for at least asking.
Like when they wake patients up every damn second and are baffled why they’re cranky and exhausted. I get Doctors deal with a lot but once the basic concept of sleep goes out the window, they should be mandated to clock out
in all fairness I suspect ICU doctors are probably the most numb to upsetting things, else they wouldn't have become critical care specialists
Isn't it better to ask someone why they are upset rather than just assuming ? Your breakdown could have had a specific cause that the Dr. could address.
@@user-ey6rc1uo3i Yes. You are correct. If you read the last line of my comment, it says that I credit the doctor for at least asking. 😉
Something similar happened to someone I know. They'd been in hospital for several days following concerning test results and the doctor basically said "we don't know what's wrong with you and we don't know how long you'll be in hospital for" then asked why they were crying. (They were 15 at the time and it was the middle of exam season.)
As a Psychiatrist this is so fucking accurate 😂😂😂
I'm officially mandating that every future resident coming through our program watches this video prior to starting their consult liaison rotation. You really hit it on the nail!
Therapist here, and you had me cackling. 😂
I have people comment on my corpse-like appearance numerous times as I walk around in day to day life.
Weirdly enough, my doctors are the only ones who never have any questions about it.
Makes me wonder how they would judge "looking sad".
WHEW!! The conversations that could be had behind this! 😢
Lots of folks remember what happened to Brittany Spears and shrug...but competency/capacity inquiries and conservatorships can, and _have,_ been readily weaponized against disabled, elderly, and chronically-ill people. This is an event that is likely increasing in the wake of long covid.
Getting a person (often a vulnerable person) declared "dead to the law" is an awful way to violate a human being's autonomy; and it happens more frequently than it should. Mainly because there's money to be made: either by individuals who are then assigned to the patient as guardian (and who then get to control and exploit the patient's accounts and finances...even selling the patient's home or treasured personal possessions/heirlooms and pocketing the money); or, by institutions that earn money by placing that patient in substandard living arrangements and overcharging them.
...And all anyone has to do if the patient has anything to _say_ about that, is to have a drug prescribed to numb their minds and force them into a docile state of being...like entirely too much in our society, all considered perfectly legal.
It's a problem.
"We occasionally have to talk to people"
The horror....
As an LCSW working in a correctional setting, the competency bit rang a little too true. 😂
Even in EMS my mentors have always told me to "JUST GO TALK TO THEM!!!!" True.
Well I have never felt more seen than this video... Spot on for call as a psychiatrist.
I liked the public health assistant nurse trying to give me a depression screening while I was in the middle of an unbreakable migraine with aphasia. Gurlfriend, probably but I'm currently hallucinating rainbows and probably need triptans first.
I’ve gotten psych consults for anxiety and agitation during LABOR (which miraculously resolved afterwards)!
There is an (un)surprising amount of overlap with Neurology in this one. Slightly more mild, but the same overall vibe.
We do share an organ of interest…
@@melaniescharrer7190The best organ, if I may say so (sorry eyes, skin).
My 85-year-old father was hospitalized last week. COVID and influenza at the same time leading to severe dehydration, combined with depression and anxiety because my wheelchair-bound mother didn’t have anyone to help her at home…this call to Psych was about my father, right?
(I drove to the city where my parents live and spent 10 days with them. They’re OK. I, however, now have the flu…)
Hey, I love your videos so much doctor ❤️. I love psychiatry and am hoping to match into it.
Love from Uzbekistan
"Make them less red and we'll talk." LOVE IT!
As a Therapist who worked in community mental health, I really love this one.
Psychiatry... Getting calls to fix other specialists more than actual patients...
Please...please fix the other specialists!
How many capacity and psych evals did the on-call psychiatrist order for the doctors calling him?
Lol! My first job the surgeons kept making us ward doctors refer our patients to psych because they were depressed.. Low and behold though our ward consisted of patients who had one or both of their legs amputated. Wonder why they were depressed 😅
How is this video so accurate? This is exactly what we go through! It’s scary how good this one came out. Thank you from this psychiatrist!
“Treatment for this disorder typically requires years…but sure I’ll try to knock it out in an afternoon.” This is how I feel as a hospital dietitian consulted for high BMI.
"The patient looks sad." That is usually the normal reaction to waiting in a hospital room/bed for many hours.
Normally these videos feel very foreign to me, a non American. But this one hit so freaking close to home! There's a pretty good focus so far on bedside manners and patient care in my experience as a medical student. But I don't know if it's still very new, or a lot of practicing physicians just forget all of it when they graduate
Or maybe the problem is micromanagement and journaling of everything making doctors need to "optimize" everything, with patient conversations being the first thing to fall behind. That coupled with a culture of making the patient "someone elses problem" as quick as possible...
Psychiatrist here. Thank you Ophthalmology for understanding our hospital consults perfectly!😂
So many of these situations are appropriate for Hospital chaplains! Especially the “patient looks sad” scenarios. I am a hospital chaplain and am learning to train chaplains. Most people don’t realize how versatile we are! We don’t just pray with people, we are the people who sit and talk when someone is having the worst day of their life. And I pride myself in training my students to care for all people, regardless of their beliefs, backgrounds, gender, identities, etc. we get called for all sorts of situations! Basically, We are trained to respond to emotional and spiritual needs of patients and families so that the healthcare providers can focus on providing healthcare. We also provide a lot of support for staff. If a staff member gets assaulted, for example, we show up to provide emotional support. It is sad how often that happens.
I often referred to pastoral care when I worked as a nurse in liaison psychiatry.
What you do is so necessary, and hard. Thank you!
This is my whole experience in Liaison Psychiatry so far xD
the very sad thing is? he would be one of the top psychiatrists i have met working in a hospital facility. *because he actually asks if its a medical issue*!!! i cant count how many of my friends have been dismissed with "anxiety" or "depression" because no one bothered to read A LAB RESULT!
Amen to this!
I know of 2 people who were admitted to a psych ward, had all their rights taken away, and both were actually having a serious medical problem. Sadly one was a brain lymphoma and she passed away the same day they finally figured it out. I believe the other was liver related.
And women with endometriosis, ESPECIALLY teenagers, are often told they have a mental health problem and are seeking attention. Or an eating disorder because they are vomiting from the pain. It is infuriating that doctors aren't more aware of a disease that affects 1 in 10 women.
My kidney disease was misdiagnosed as anxiety for 30 years lol. Turns out random muscle paralysis caused by chronic potassium wasting tends to make a person pretty anxious.
Hubby is a psych fellow. He has told me about calls almost exactly like all of these. This isn't an overdramatization!
I was referred to a psychiatrist to cope with receiving a delayed diagnosis of pernicious anemia because all my doctors were convinced my symptoms were psychosomatic. I had been through a horrible time trying to get treatment and not being heard. When i saw the psychiatrist, she was very supportive and helpful but she then diagnosed me with a mental health disorder she hadn't mentioned in our appointment. When i asked about it at our next appointment, she said she thought i realized that if i saw her, i would be diagnosed with a mental disorder because otherwise, insurance wouldn't pay the bill. She diagnosed me with something that amounted to " not being able to cope with normal life." I argued that there's nothing normal about having doctors turn against you and delay proper medical care. I asked her to find a better billing code. She dug deep and found one for coping with an undiagnosed illness. Insurance still paid the bill. Who doles out mental illness diagnoses as an automatic just for having a consultation?? Is this the norm? Makes me want to avoid psychiatry.
Lol I just finished on acute medical unit where they call psych if the patient gets emotional the day after they just had a stroke 🙄🙄🙄🙄🙄🙄
Im Healthcare security-a patient minder. My job is to sit on one room with one patient that has been detained under the Mental Health Act. I basically sit there and talk to them if they want to chat to keep them calm. If they dont want to be calm, I call a code black and 4 of us make them calm with help from a wonderful DR who has all kinds of things that make a person calm, happy and then sleepy/unconscious. 😁😁 Half the time im not sure if Im security or a very under paid Psyc Doc.
The competency evaluation was requested by neurology. But not for the patient. For his colleague.
Thank you for this, Dr. G. Speaking as a frequent flyer with chronic sui ideation, I'm impressed and gratified by your attitude.
Thank you for your service.
“You’re consulting me because the patient wants to talk” bet that was Bone Bro
"The patient had a bad thing happen to them, and you want me to treat their normal psychic reaction to that thin?"
Well, if it doesn't describe the biggest question I have when going to a psychiatrist for over half a decade. I think if you took my raw answers to some of the evaluation questionnaires, I'd also have paranoia and agoraphobia, but I'm just queer in the Bible Belt. I was taught in Sunday school that I'm an abomination. I know the hatred is there, and I'm not comfy with it
"The patient had a bad thing fallen to them, and you want me to treat their normal psychic reaction..."
"Late onset schizophrenia. On an 85 year old patient..."
This all resonates so much with me... 😂
Dr.G you nailed it!! Reminded me of my residency days!
All the lab results are red -- well make them less red and then we'll talk. That had me laugh out loud
I once saw a gp who said, in an angry and bullying way, no less, "I can tell by looking at you that you're depressed!" and tried to force me to take antidepressants. I was just there looking for a primary care doc. He wasn't it. Still in practice. I had already learned nothing happens when you tell on these people.
Morning blood collections can sometimes feel confusing like this😬, waking a patient up at 6am and helping them get orientated enough so that you can draw their blood without getting clocked upside the head😂
U are doing the lords work
I had to call on-call psych recently and am glad to see my reason wasn't on the list! They were very helpful.
Looks like Ortho isn't the only one who thinks of things in terms of "That's a Feelings Bro issue." 😂
Welcome to psychology! Everyday!!! Thank you for this , my friends and I are 😂
I'd love to see a water-cooler talk between the psychiatrist and neurologist.
If I could, I would give multiple thumbs up on this video!!! So spot on!!!
Thank you for brightening up my day with it!
👍👍👍👍👍👍👍😂❤
Bravo Dr. G 👏🏾👏🏾👏🏾
I just love that the patient has horrible lab results indicating disease but it's definitely a psych problem and they need a psych eval. So tired of not getting proper Healthcare
I’m with you there!
I would bet fifty dollars that said patient is a woman.
I LOVE YOU thank u for posting these videos❤❤❤
Me in Psych Rotation Right Now…. and this is 🏆🏆🏆
The fact that you are so insightful into every specialty shows how smart you are
ALL SO TRUE!!! 😂 You did leave out one of my favorites: “Patient taking Zoloft.” 🤔????
THE MOST HONEST CONSULT!
Drs don't engage with patients at all and are so aggressive and neglectful!
Feeling seen here in psychiatry. Thank you!
Had a few patients involuntarily admitted to the crisis stabilization unit I worked at because the LEO’s felt the patients “wanted to talk” and it was “the best place for them”. They want to talk but to an outpatient specialist. Not held against their will for 3 days while being severely monitored and evaluated.
As a former psych nurse this is spot on 😂
Psychiatrist here! I'm watching this just after finishing my on call. 😂😂😂 It's so relevant! Thank you for making my tiresome day little bright! 😊
I worked as a nurse specialist in liaison psychiatry for the elderly. We had a referral of a recently bereaved pensioner with advanced dementia, querying whether bereavement counselling was appropriate.
I know you’re an ophthalmologist but your psychiatrist is _definitely_ my favourite character, and the doctor of yours I’d most like to see as a patient.
(I mean I actually do have psych issues so obviously he’d be the most useful, but I was talking in terms of seeing a doctor who I feel confident would nail the line between showing compassion and not taking any bovine faeces.)
The red lab values got me.
We had a saying when we got the sentence "I don't like how the patient looks" response "have you tried some make-up"....
I'm stealing this joke 😂😂😂
All of these are very similar to neurology consults. Consults for delirium, consults for dementia (in an old person with sepsis), consults for altered mental status (on propofol and intubated)