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A Typical Day in Year One

From Bushra Rizwan, First Year CAP fellow

Hi there! My name is Bushra and I am glad that you are considering Johns Hopkins for your Child and Adolescent Psychiatry training. I want to share with you my experience as a first year CAP fellow on the inpatient rotation.

A typical day on the inpatient rotation starts at 8:00 AM, and I usually get into the office by 7:45 AM to look at the patient list and review overnight nursing reports in EPIC. I make the short, one-minute walk from my office on Bloomberg 12 North to meet with the attending and psychiatry resident in the "Blurple" (blue-purple) rounds room on Bloomberg 12 South. I briefly check-in with my attending and coordinate assignment of patients with the on-service 2nd year psychiatry resident.

Our Child and Adolescent Inpatient Unit (Bloomberg 12 S) has a census of 15 patients, and each trainee has a case load of about five patients. We start rounding on our patients shortly after 8:00 AM, we see most of our patients in the Blurple rounds room, however there a few acute patients who we see in their individual rooms. All the patient rooms have views of the Harbor and provide a therapeutic milieu for our patients. We are usually done with rounds at around 9:30-9:45 AM.

Due to COVID-19 restrictions, we return to our offices to do interdisciplinary team rounds via Zoom from 9:45-11:00 AM, which includes nursing, psychology, occupational therapy & social work. During the team rounds we discuss new patients, treatment plans which includes medication changes and behavioral interventions, and team observations. After team rounds, I reach out to families with updates on the treatment plan. I also use the time between 11:00-11:45 AM after team rounds to sign-off on all my progress notes. I usually grab lunch quickly before starting didactics at noon.

We have didactics at noon every day from Monday to Thursday, and have process group on Fridays. After didactics, I have family meetings scheduled in the afternoon, which have been a mix of both in-person and zoom meetings. I utilize family therapy techniques during these sessions and will often lead the discussion on treatment goals, safety, and discharge planning. I am usually done with clinical duties by 2:00 PM.

Sometimes, we have admissions scheduled in the afternoon, which will take about 2 hours to complete. If we do not have an admission, I will return to the unit to spend time with the kids and talk about their interests and treatment goals. My inpatient day usually ends around 5:00 PM. The inpatient rotation gives me an opportunity to get to know my patients well, while learning to work with families, and the interdisciplinary team in managing complex patients.

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