Psychiatry

Students should be settling into school

With the new school year about a month old, stress levels for students should have dropped.

“We would expect stress to start about a week before the start of school and after a week into school,” said UNMC Child Psychologist Dr. Ryan Edwards. “If they last longer than a week indicative of something going on.”

UNMC Psychologist Dr. Jonathon Sikorski said that generally, students will have a transition period from a summer schedule to a school schedule.

“Anytime there is transition you may see an escalation in attention-seeking behavior,” Dr. Sikorski said. “A kid is anxious. You might see them not get out of bed in the morning, slow to start, clingy, all pretty common. Your adjusting sleep schedule provides less free time. After two weeks, they should be back into their routine. If you see they seem pretty low for more than two weeks. If you see  them fainting sick, complaining of stomach aches, not wanting to go to school, their sleeping and eating habits change, parents should talk to their child about what they are seeing.”

Dr. Sikorski said family dinner is a wonderful time to talk.

“I know it doesn’t exist as much anymore, but a chance to sit down as a family unit and just check in really helps,” Dr. Sikorski said. “Sometimes the most powerful words you can give someone is saying that sucks, and that it must be rough going through that. Simple words like that can build rapport.”

Parents should look for changes in behavior, especially if children and teenagers stop succeeding in school.

“If they’re really active high achieving student and all of a sudden they are grades are dropping concerns about them doing risky behaviors, drugs or alcohol, sex and that’s a big change, a big sign,” Dr. Sikorski said. “If a student feels like their life is careening out of control and they

are anxious about school, homework, sports and they feel like they are involved in everything and can’t handle everything. Having anxiety in middle school or high school puts you in ‘the everybody has it’ club. It’s just the degrees you have it.”

If the erratic behavior continues, parents should ask for help. Dr. Edwards said a school counselor can be a good intermediary. If the student still shows signs of depression, the student should see a doctor.

Elective helps students deal with stress

Fourth-year medical students Noah Hammond and Nick Anggelis, back row, signed up the Wellness elective this summer. Dr. Jonathon Sikoski and Dr. Bud Shaw teach the class.

UNMC offers students an elective to help them battle the stress.

A 2008 study by the Mayo Clinic found that 50 percent of medical students experience burnout and 10 percent experience suicidal ideation. In an effort to improve these sobering statistics, a UNMC Psychiatry elective, “Stress Reduction Techniques for the Practicing Clinician” exposes students to stress reduction techniques that are currently used in mental health and can be used in a variety of medical settings. Some of the practices include meditation, guided imagery, biofeedback as well as breathing, and movement. Students are given techniques to handle stress and hopefully utilize these techniques for their own personal stress reduction and introduce the techniques to future patients.

Fourth-year medical student Noah Hammond said before starting medical school four years ago little about studying bothered him.

“I used to be easy-going, but over the last three years, I haven’t done a good job of letting things go,” Hammond said.

This summer, Hammond registered for the stress reduction elective.

“It’s really helped. I’m surprised. If you would have suggested to me during my first year (at UNMC) that I would meditate or write, I would have laughed at you and not done it, and asked, ‘Why are you making me do it? I don’t want to do this. I should be studying right now.’ But if I could go back and tell my first-year self about this, I would have convinced him to do it,” Hammond said.
Fourth-year medical student Nick Anggelis came from a family of physicians. His parents are doctors in Kentucky.

“I’ve seen the effects that medicine can have on people. It’s a great field but at the same time it can bog you down at times.”

When Anggelis asked his dad if he should take the elective, his father highly recommended it. Anggelis said the class provided stress reduction techniques, which Anggelis said helps him deal with the stress of medical school.

“You feel great when you start (medical) school. Everything’s new and you have such a wonderful sense of accomplishment just getting into the program. But the newness wears off quickly, and then you aren’t treated like a baby anymore. It’s tough. It’s really too bad that this glass happens in your fourth year. It should happen in your first year. It’s disappointing that just now I’m learning these tools. I could have used them in my first year. They would be very useful at an earlier stage,” Anggelis said.

The elective was developed by Dr. Brent Khan. Dr. Steven Wengel has assisted Dr. Khan with the stress management elective since its inception, and now additional faculty members for the course include Dr. Byers “Bud” Shaw and Dr. Jonathon Sikorski.

 

 

Donations to Department of Psychiatry help news programs, clinics succeed

 

The UNMC Department of Psychiatry continues to grow with new and upcoming specialty clinics, an expanding addictions division, and an in-house psychiatry resident program.

To help grow the programs and clinics, UNMC has teamed with the University of Nebraska Foundation to provide a way for people to help the department and its clinics grow. The University of Nebraska Foundation is the designated fundraising affiliate for the University of Nebraska Medicinal Center (UNMC) and its clinical partner, Nebraska Medicine. In its role, the foundation works to support UNMC’s and Nebraska Medicine’s projects and programs to provide serious medicine and extraordinary care to its patients.

In 2018, the department of Psychiatry opened a Bridge Clinic to shorten the wait for patients to see health care providers. Additionally, an Intensive Outpatient Program (IOP) to help patients with dual diagnosis. This summer, an addictions department was created under the leadership of Dr. Kenneth Zoucha. In coming months, a new sub-specialty clinic will begin for patients suffering from anxiety. The new clinics and divisions would not be possible without UNMC supporters.

No gift is too small, and all gifts have the power to transform lives. To learn more about how you can help, please contact Edwin V. Lyons, Director of Development, at 402-504-3339 or edwin.lyons@nufoundation.

SPOTLIGHT: Phoebe Gearhart

Phoebe Gearhart started as a registered nurse at Nebraska Medicine in December 2015. She was promoted to Department of Psychiatry Clinic Nurse Lead in August. Phoebe is extremely active within the department. She sits on five different committees and is a liaison for the pharmacy. This fall, she was named a 40 Under 40 Nursing Leader.

What do you enjoy about working with the Department of Psychiatry?

I enjoy so many aspects about my position here with the department. I appreciate the ability to be autonomous, as well as to work with a team for the patients. I am privileged to be surrounded by such knowledgeable providers and staff who are superb, not only in their ability but also in their willingness, to answer any questions I may have. My knowledge has expanded tremendously in certain diagnoses and ages that I hadn’t had a lot of experience with previously. I’m so fortunate to have the opportunity to work with a wide variety of patient populations through age and diagnosis.

Could you discuss your new role as nurse lead?

Currently, I am expanding all of my current roles and responsibilities and have been welcomed as part of the leadership team. I feel that this role will help the nurses and MAs to become more vocal and engaged in department and team decisions. I will be providing clinical supervision of nurses and medical assistants. As a nurse lead, I will be continuously assessing clinic nursing work flow and making improvements as needed, as well as monitoring quality assurance and making changes as needed. This new position will allow me to serve as liaison between nurses and Department of Psychiatry Leadership, other Nebraska Medicine entities and outside entities. I will continue to serve on committees both within the Department of Psychiatry and Nebraska Medicine.

Why did you go into the area of Psychiatry?

Honestly, I am quite sure the area chose me. I have always been fascinated with how our minds work and the correlations between disease processes, significant life events, and people’s ability to manage their lives in the midst of mental health diagnosis. In school, it was obvious to me that psychiatry was what I should choose as a career path when, during those lectures, exams, and rotations, the content really excited me and made me ask questions that didn’t really interest me as strongly in the other fields. I also found how strong the stigma is of mental health problems, and I wanted to help in decreasing the negative beliefs surrounding these diagnoses.

How did you find out you’re a 2018 40 under 40 nursing leader honoree and what does it mean to you?

I was notified by email from the Nebraska Action Coalition that I had been selected in mid-September. I am so extremely thankful and humbled that the department recognizes my strengths and believes that I will be a great future leader in my career. I am honored that I was nominated by individuals that I believe are great leaders and am excited to partake in the opportunities this nomination will provide for me in the next year. Thank you to my department for allowing me to foster and build my strengths over the last three years to be able to attain this tremendous recognition!

What are some of your hobbies?

 I LOVE to read… A LOT, so going to the library is a must. I also love running and enjoy traveling to run races throughout the Midwest. I am a die-hard Chiefs fan and Iowa Hawkeyes fan (which is tricky in Husker nation), and enjoy going to football games with friends and family.  I also have an almost 5 year old, so apparently I also have a hobby in Disney movie watching, and arts and crafts- with many impressive Pinterest fails under my belt!

Psychiatry nurses attend BHECN Nursing Summit

Registered Nurses Michelle Fischer, Phoebe Gearhart, and Julie Griffin attended the third annual Psychiatric Nurse Workforce Summit last month.

Last month, several nurses from the Department of the Psychiatry attended the third annual Psychiatric Nurse Workforce Summit.

The conference, organized by the Behavioral Health Educational Center of Nebraska (BHECN), provides nurse practitioners, registered nurses, other health professionals, and students an opportunity to gather and discuss challenges and innovative strategies for psychiatric mental health nursing education, practice and policy to increase delivery of psychiatric mental health care in Nebraska.

Registered Nurse Phoebe Gearhart, nurse lead with the Department of Psychiatry, attended the conference for a second straight year. Gearhart said she pleased to hear discussions on nursing, and the focus of the summits wasn’t just on nurse practitioners. Julie Griffin, an RN with the psychiatry department, also attended last year and really enjoyed the topics, so she went again this year.

“There were a lot of good discussions on how to handle follow-up calls and what to do in common situations,” Griffin said. “Also, a lot of talk on office strategies. We’re always looking at ways to improve nursing interactions with providers and enhance proficiency in the office.”

The Department of Psychiatry also had numerous speakers and panel members at the summit, including Dr. Ken Zoucha, Maggie Milner and Brigitte Vaughan.

Michelle Fischer, an RN who works in the new addictions division, attended for the first time.

“I decided to go because everyone told me if I went I would learn a lot,” she said. “I was happy to see a lot of talk on addictions.”

The summit will return next fall, and Gearhart would like to see the summit increase from one day to two. The first day would be a discussion on increasing the psychiatric nurse workforce and the second day would provide continuing education opportunities for the nurses.

More than one hundred nurses from all across Nebraska attended the Psychiatric Nurse Workforce Summit.

German researcher discusses work on personality disorders

Dr. Soonjo Hwang welcomes Dr. Falk Mancke to UNMC for a discussion on his research into personality disorders.

UNMC Department of Psychiatry Research Director Dr. Soonjo Hwang invited German researcher Dr. Falk Mancke, University of Heidelberg, to share his research on aggression with UNMC faculty, students, residents, and staff.

Dr. Hwang said this year, the department plans to bring in a series of respected outside speakers, in addition to local expects. Dr. Hwang learned about Dr. Mancke’s research when the two worked together at Boys Town in Omaha. When Interim Department Chair Dr. Howard Liu asked for outside speakers, Dr. Hwang immediately thought of Dr. Mancke. On Thursday, Sept, 26, Dr. Mancke led a ground rounds discussion on the topic of “Bio Behavioral Mechanism of Aggression in Personality Disorders.”

The research was initiated to better understand aggression among patients (17 and older) diagnosed with a borderline personality disorder. Dr. Mancke said half of the people studied showed aggression and a quarter showed aggression with a weapon.

“I think it’s important to actually understand the new biological mechanisms and symptoms of aggression in these patients. We need to specifically target the mechanisms and treat the targets,” Dr. Mancke said.

Mancke’s research takes place in Heidelberg, Germany. While he has not specifically looked at U.S. patients, he believes his findings would be similar if he did the same study in Omaha.

The next grand rounds presentation will be at noon on Oct. 10 in room 2018 in the Michael Sorrell Center. Laura Flores will discuss challenges specific to under-represented populations in medical school.