Clinical Log

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Clinical log: Queens General Outpatient Clinic

College
02/24/19

Clinical log: Queens General Outpatient Clinic

I go to Queens General Outpatient clinic every Mondays as part of my course requirements and clinic rotation. My preceptor Nisha Pradeep NP, attends to 12-15 patients on a Mondays. Majority of patients that seek treatment do not have insurances or are illegal immigrants. Most of the patients are assigned to a therapist and they get to attend therapy sessions on the same day. For patients requiring medication, the NP or psychiatrist starts it or renews them and works collaboratively with the patient and therapist. I Co- leaded group therapy as part of the course requirement. They offer a variety of outpatient treatment options including individual, group or family therapy as well as marital and multi-family group therapy.

The following report is a write up of a patient that I took care of in the clinic. 27 year old single unemployed female, mother of a 2 year old son, with prior psychiatric h/o depression was sent to outpatient clinic from CPEP for worsening depression and anxiety. Patient described her mood as depressed and sad and reported difficulty initiating and maintaining sleep, feeling tired, loss of appetite and passive SI at times. Patient denies any plans or intent of SI. Patient reports frequent panic attacks, patient has h/o PCOS and ongoing pain related to that. She is unemployed and reports poor support system. Patient enjoys being with her son as her motivating factor to live. Patient stated that she takes Zoloft 50 mg from her primary care. Patient denied current SI/HI plan or intent. Patient reported that she has depressive symptoms as a teenager. Patient stated that she was taken to a clinic and was given Zoloft at that time. Patient also admits to cutting her wrist superficially in the past. Patient stated that it helps her relieve her emotional pain. Patient also reported h/o OD on pills as a teenager, as per her last cutting episode was prior to her pregnancy. Patient also reports sexual abuse by a family member at young age. Patient refused to talk about it any further. Patient denied any PTSD symptoms. Patient reported recurrent panic attacks (palpitation, SOB, shaking and dizziness). Patient reported getting panic attacks when she is very depressed. Denies AVH, no delusions elicited. PHQ-9 depression screening was performed and the score was 11(mild). Her Zoloft was increased to 100 mg daily and a follow up within 2 weeks was recommended. Patient was also referred to psychologist for therapy and dietitian for weight management.
Outpatient services are to help reduce symptoms, manage stress and improve the patient’s ability to function in the community. I find my clinic rotations very educational. I was very fortunate during this semester see a great variety of patients in the clinic. The wide mixture of patients and diagnoses has shown me that there are clinical guidelines for almost every diagnosis. Throughout the semester I have recognized that the formation of a trusting practitioner-patient relationship is one of the strengths that every student must observe. As a whole, my first clinical rotation was excellent and I am looking forward to the daily challenges of that second semester that await me.