P-838 - From Modena to Norwich: a medical student journey through systems of psychiatry

Abstract

Introduction There is little published literature on medical student exchanges in psychiatry. Aims, objectives and methods To use a two-week student exchange between Modena, Italy and Norwich, UK to highlight some of the meaningful differences in psychiatric practice between the centers. Results White coats - English doctors in general and especially psychiatrists do not wear white coats; in Italy these are almost always worn. Psychiatric nurses in English hospitals likewise do not wear any uniform. Locations of services - Italian acute psychiatric wards are sited in general hospitals; in England they are usually in a separate location. Nursing role - Psychiatric nurses in English hospitals are required to play a significant role in decision making around patient care. For example, nurses make almost all decisions regarding admission to hospital. It is also common for nurses to challenge doctors on decisions regarding patient treatments. The role of nurses in Italy is often not a decision-making one, but rather following doctors' orders and providing information. Conclusions Wearing white coats can promote a sense of professionalism and help orient patients in a hospital environment, but without these the ward may look less like a hospital and be more comfortable for patients. Locating psychiatric wards within general hospitals makes consultation between specialties straightforward and may help reduce stigma, but psychiatry-only hospitals may create opportunities for economic efficiencies and improved facilities. Enhanced nursing roles may be perceived as a possible threat by psychiatrists, yet may strengthen mental health teams and enhance quality of care.