Friday, October 3, 2008

Work, Work, All Day Long...

To make this easier on myself, I now present to you, my summary paper for FACS 497: GFCS Internship... (Beware: It's 5 pages double spaced in Microsoft Word.)


In order to graduate with a Bachelor of Science Degree in General Family and Consumer Sciences: Child, Family, and Social Services at Nicholls State University (GFCS), students must complete a 480-hour internship in a related area of their choice. Because I am currently interested in earning my certification as a Child Life Specialist, I chose to pursue an internship with an established Child Life Program. This internship is just one component in qualifying for certification as a Child Life Specialist; the others components include taking ten courses in an approved area of study such as child and family development, as well as passing a national certification exam.

Child Life Programs are available in an increasing number of hospitals, most frequently those located in larger cities. These programs are typically organized by Certified Child Life Specialists and consist of two primary objectives: to help the child cope with the stress and anxiety of the hospital experience, and to promote the child’s normal growth and development while in the health care setting and after returning home. In order to accomplish these objectives, Child Life Programs utilize the following interventions: providing materials for guidance and play, preparing children for hospitalization, surgery, and medical procedures, lending emotional support to parents and siblings, advocating the child’s point of view to hospital personnel, and maintaining a receptive environment for children and their families. Child Life Programs offer a “home away from home,” and are a wonderful resource for families.

To begin the certification process earlier this year, I applied for internships with Child Life Programs across the country—10 different programs in 8 different states, to be exact. I completed a number of phone interviews featuring topics such as child development, family centered care, and my experiences within the hospital setting, volunteering, and working with children. My first internship offer came from St. Luke’s Children’s Hospital in Boise, Idaho, and because I had a friend from Nicholls who was already planning to move to Boise, as well as a few native Idahoan friends, I decided to accept this offer.

Throughout the summer, I was in contact with the hospital staff, securing professional liability insurance, providing a national background check, and turning in the required paperwork. In July, my friend, her family, and I, drove 2,000 miles to Idaho, taking along with us a moving truck worth of apartment furnishings. We secured our apartment and got settled in while enjoying the humidity-free weather and gorgeous scenery along the way. A few days later, I flew home to begin work at Camp Bon Coeur, a camp for children with heart defects, as well as enjoy the rest of the summer and time at home with my family.

About two weeks before beginning my internship, I traveled to Ohio to meet with two potential graduate programs and reunite with some friends of mine. While in Ohio, Hurricane Gustav set his sights on Louisiana. After rearranging my flight schedule twice, I ended up cancelling my flight home out of concern for getting stuck in an airport with no way into Louisiana before the storm. Instead, I stayed in Ohio a bit longer and then spent a week in Michigan with a friend who attends Michigan State University. I then flew from Detroit to Boise, arriving two days later than originally scheduled.

Upon arrival in Boise, I had only two days to get settled before beginning my internship at St. Luke’s on September 8th. The Child Life staff was very understanding about the storm situation—I did not have any of my paperwork for the hospital, my school assignments, or more than a week’s worth of work-appropriate clothing. Thankfully, my suitcase filled with professional clothing was mailed before Hurricane Ike’s landfall, arriving about a week later, and I received my paperwork about a week later than that.

There are two interns here in the Child Life Department at St. Luke’s—myself, and Gina, a recent graduate from the University of Idaho. The internship is organized based on a schedule where Gina and I rotate through various departments of the hospital. My first rotation is primarily in the Emergency Department, or ED, where as Gina is working on the fourth floor, which is the pediatric floor, and includes general pediatric rooms, as well as oncology rooms and the Pediatric Intensive Care Unit (PICU). Later rotations will also include the Operating Room (OR) and the Mountain States Tumor Institute (MSTI), an outpatient pediatric oncology clinic.

In order to facilitate reflective learning, an intern meeting is held each week, usually on Fridays. The meetings include both interns, as well as their supervisors, and sometimes, other Child Life Specialists or guests such as the hospital schoolteacher or parent speakers. As interns, we discuss our weekly self-evaluations which feature “high” and “low” points for the week, our performance as interns, suggestions for how supervisors can help us better, progress toward accomplishing last week’s goals, and goals for the coming week. We also turn in assignments and our daily journals for our supervisors to read and add comments. Assignments include a “What to Do When” scenario worksheet, two 5-minute “What is Child Life” presentations, two Role Observation (ranking Child Life roles) assignments, seven therapeutic play session plans (one every two weeks), a personal philosophy statement, and a 5-8 page disease paper.

Working in the ED involves an unconventional schedule, to say the least. Most weeks, I work Thursday through Saturday from 1 p.m. to 12 a.m., Sunday from 5 p.m. to 12 a.m., and Monday from 6 p.m. to 12 a.m. However, every third week is a Monday through Friday schedule with some shorter days, so that the Child Life Specialist has one weekend off each month. For the most part, I work a total of forty hours each week, regardless of the schedule.

Typically, I begin my day on the pediatric floor of the hospital and finish it in the pediatric emergency department. My supervisor and I start by getting an updated copy of the fourth floor census sheet (list of patients, their ages, room assignments, doctors, and medical conditions). Then we meet with the other Child Life Specialists who have been working with patients throughout the morning. We discuss which patients have been seen, which need to be seen, who is allowed to go to the playroom, and any special notes such as upcoming procedures. By the time we arrive, most patients have generally been seen by a Child Life Specialist already. Sometimes, however, the floor is rather busy, so my supervisor and I help the other specialists with visiting patients, assessing their level of coping, explaining about child life services, and just making sure we are doing everything possible to make their stay in the hospital the best that it can be.

Because I only spend a couple of hours each day working on the pediatric floor, and it is not my official rotation at this time, I have not been able to build relationships with very many patients yet. The other intern and some of the Child Life Specialists spend more time on the floor working with the same children each day, where as I stop in only to say “hi” every now and then. For this reason, I have found it difficult to develop a sense of confidence for working on the pediatric floor up to this point. I have, however, completed a few patient assessments, usually with the supervision of a specialist, and a few times on my own. The assessments document important information about the patient and their family, helping us to know them a little bit better. Some topics include the patient’s age and grade in school, parents’ names, siblings’ names and ages, pets, and general interests or other information.

The majority of my time, about six hours each day, is spent in the pediatric ED. When patients come into the ED, we review their medical history, chief complaints, and acuity level. We then predict the medical course of action and services we can offer through Child Life. If a child is going to be waiting for a while, we go in and introduce ourselves and offer play materials such as books, toys, crayons, or movies. In cases where procedures are necessary (sutures, CT scans, X-rays, IVs, etc.), we prepare children for the procedures based on their age, previous hospital experience, and level of understanding. We also offer distraction and support during procedures, using spinning lights, find-it books, view-finder toys, breathing and visualization techniques, and much more.

Throughout my time in the ED, I have seen many interesting situations. My very first night, there was a little boy who came in with a fishing hook stuck in his eyelid, and on a different instance, a teenage boy was kicked in the face by a horse, resulting in a broken nose and lacerations. There have since been plenty of lacerations needing suture repairs, as well as abdominal pain requiring emergency appendectomies.

Probably the most difficult situation that I have dealt with in my internship experience has been sexual assault. In my first two weeks, there were four female patients with complaints of sexual assault. The girls ranged in age from thirteen months through fifteen years old. Sure, I knew sexual assault occurred more frequently than I was willing to admit, but now I see that it is an epidemic.

Though it has just begun, the whole internship experience has already opened my eyes in ways I never expected. Looking toward the future, I am sad about concluding my time in the ED, but excited about moving on to new experiences in other parts of the hospital. In the end, my ultimate goal is making the most of this opportunity in every way. It is my hope that experience will have afforded me the knowledge and skills necessary to succeed at a career within the helping profession, regardless of where life takes me.


There. Now you know about work. :)
Feel free to comment/ask questions.


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