Insights from the Inpatient Ward: A Trainee Psychologist’s Journey

On my first day of placement, I was greeted by a curious group of women who hurried toward me as I stepped into the female inpatient wards, tucked away in a dimly lit corner of the hospital’s lower ground. I found myself in a bewildered state, wondering if all newcomers received a ‘Coming to America’ style reception as a rite of passage. However, reality quickly shattered that Hollywood fantasy. A patient, with a sparkle in her eye, asked, “Excuse me, are you the new Psychiatrist?” Despite feeling flattered by the assumption, given my petite stature and puzzled expression, I had to politely correct them: “No, I’m sorry. It’s my first day — I’m a Trainee Psychologist.” Their disappointed murmurs were barely audible as I internally pleaded, ‘Get me out of here.’

As a trainee beginning this journey, I carried many preconceptions inherited from past placements and unsolicited advice on how to ‘survive’ the ward environment. Over the ensuing weeks and months, I underwent a metamorphic process, re-evaluating and discarding some of the burdensome expectations I had shouldered, preparing for what had been depicted as a combative, survival-of-the-fittest endeavour.

This transformation was characterized by unconventional learning experiences and moments of vulnerability. I learned to challenge theoretical boundaries that sometimes distanced me from patients, recognizing my ‘blind spots’ that they astutely picked up on, especially in moments of fear and uncertainty. Confronting my inadequacies as a trainee, I acknowledged my complicity in a system of power dynamics that had affected these individuals’ lives, despite feeling powerless within the organizational hierarchy. Through this journey, I discovered that power, or the lack thereof, was contingent upon context and that each of us held a degree of influence within relational dynamics.

Six months later, as I reflected on my ‘survival’ in the tumult of inpatient work, I redefined my role through a narrative lens: ‘I’m an Inpatient Psychologist; I am here because I care.’ From this adjusted perspective, I distilled six key lessons learned, which hastened my growth and shaped the kind of Psychologist I aspired to be. Perhaps, someone might glean insights from my shallow learning curve (incidentally, the term ‘steep learning curve’ is inaccurately used colloquially — feel free to Google it!).

Lesson 1: Foster Relationships Across the Team Each morning, I engaged with the hospital’s staff, from the receptionist and security guard whose demeanour set the day’s tone, to the cleaners with whom I exchanged friendly greetings. I developed close bonds with the nurses, often sharing morning coffee and engaging in cultural exchanges that enriched my understanding of their perspectives. Deep discussions with psychiatrists challenged and broadened my views, emphasizing the collaborative nature of patient care.

Lesson 2: Embrace Vulnerability and Humility Many patients expected an ‘expert’ in therapy, yet I learned the power of admitting what I didn’t know, fostering authentic connections rooted in shared humanity.

Lesson 3: Meet People Where They Are Take time to connect with patients on a human level, acknowledging their individuality and unique experiences, and fostering trust and rapport.

Lesson 4: Accept the Inevitability of Death While we strive to help, we cannot save everyone. Accepting the limitations of our role is essential in maintaining emotional resilience.

Lesson 5: Separate the Person from the Problem Recognizing that the problem lies outside of the individual helps prevent stigmatization and fosters a collaborative approach to problem-solving.

Lesson 6: Navigate Diagnostic Language Thoughtfully While diagnostic language can limit identity, it also provides a framework for understanding and addressing mental health challenges. It’s essential not to dismiss its utility entirely.

Lesson 7: Prioritize Self-Care Caring for oneself is not a luxury but a necessity for maintaining emotional well-being, especially in demanding environments.

My placement concluded successfully, offering me a front-row seat to my vulnerabilities, insecurities, and blind spots in navigating a challenging and emotionally charged setting. I realised that much of the stigma surrounding serious mental illness stemmed from ignorance and lack of experience. Close proximity to those in psychological distress reinforced our shared humanity and the importance of compassion and empathy in times of crisis.

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