Day 6: Self Discovery in Diabetes

Journal Entry#7 Monday 11/13/2012
Having completed the first week and the first day of your internship, what are you goals for the last four days? 

For the last 4 days, I'd like to create some final questions and create a doc board outside of my internship office hours. I really need to hunker down and decide with my expert what my final product is going to be. I'm not entirely sure what it even could be at this point.

I would like to keep up with my hours at the hospital and logging outside of there at home in notes, and worksheets and this electronic journal, and the class at Yale.

Lastly, I'd like to start talking about how much different this experience is from what I thought it was going to be. It's a whole new world, really.
______________________________________________________

Today wasn't much different than the others. I'm really getting into the routine now. I went to Managed Care, where phone consultations are held and today was a 'Peer Mentoring' Diabetes brainstorming session. The key themes of the session were really Self Motivation, Self Reliance, and Autonomy. There was so much I wanted to say, and since RMSEL really stresses Socratic Questioning and Socratic Seminar, I wanted to ask questions to guide the participants in the 'right' direction, but I was thinking about it all wrong. We, as facilitators were only there to take in the information and store it and condense it for them. We were not 'looking' for specific answers. We needed answers from people who live and deal with diabetes every day of their lives. They make the coping mechanisms for themselves. They create the structures. I learned a lot about what it must be like to be a teacher, especially in a place like RMSEL, or even how it is to be a parent; you can't take the conversation in the direction you want, because it's not your right to take it in that direction; I needed to go with the wind and trust the participants. This gave greater insight to my own life. I appreciated that I recognized this because this internship isn't solely about learning about how being a psychologist is, it's about self discovery; learning about what I want to do, about myself, about the world around me and how it works.

I truly value this opportunity.

We later had a staff meeting which was about 90 min and that was really boring.

That's all for today. 

Day 5. One Week Down, One More to Go

Journal Entry#6 Friday 11/12/2012
Kurt Hahn was also quoted to say,
"...I regard it as the foremost task of education to insure the survival of these qualities: an enterprising curiosity, an undefeatable spirit, tenacity in pursuit, readiness for sensible self denial, and above all, compassion."

Reflecting on your first week of your internship, how has this experience allowed you the opportunity to exhibit these tenants of education?

I will list each and say how I am showcasing each tenant of education!:

Enterprising Curiosity: Curiosity is showcased in my learning thus far as evidenced my all that I've done and explored to get here. This field is unfathomably large, and I am exploring many options of it, letting my mind wander and my heart (along with logic) decide if this is a path I might take for the foreseeable future, and make a goal out of it. I am enjoying making an expedition out of finding out all the pathways I might choose.  

Undefeatable Spirit: It's always been a struggle for me to ask for help or admit I'm wrong, or even ask 'stupid' questions. At the hospital, there really aren't any dumb questions to be asked, and when they seem simple, I swallow my pride and keep going! I haven't let anything slow me down and I am very proud for doing so, because I often become bogged down in my shortcomings. My spirits have been high, and there's no turning back now!

Tenacity in Pursuit: I think this is very similar to undefeatable spirit, but I appreciate how I have been so on top of doing all of this on my own, without any help from anyone but the people at the hospital. 

Readiness for Sensible Self Denial (Which means undergoing personal trials for the increased good of another): Since I'm only in high school and I've never actually taken a psychology course, nor am I clinically certified, I can't personally treat patients, but had I been in the situation where I had to face my own fear to help a patient, I would do so in a heartbeat. 

Compassion: Compassion is really important when treating and listening to patients, especially when dealing with mental health because a lot of mental issues can come from trauma or events that have happened in peoples' lives. I've learned more about compassion in this week, as I see that all the people I've worked with have showcased compassion to me and everyone around them continually. There is no margin for a psychologist or doctor to treat their patients or colleagues in a not friendly or compassionate way, whatsoever. I hold myself to the same standard that they do, especially in that environment. It can be a test, especially when patients get angry or lash out at you, but you always have to remember compassion above all. Empathy really goes with this tenant, and empathy is a major component to the ethics that psychologists subscribe to.   

____________________________________________________________

Today I did mostly the same thing that I did last Wednesday in Primary Care, just with different patients. I'll post more notes tomorrow, but I have a long day tomorrow and need to go to sleep. 

Day FOUR: Outpatient

Journal Entry#5 Thursday 11/9/2012
Kurt Hahn was also quoted to say,
“...There are three ways of trying to win the young. There is persuasion. There is compulsion and there is attraction. You can preach at them; that is a hook without a worm. You can say "you must volunteer." That is the devil. And you can tell them, "you are needed" that hardly ever fails.”

Reflect on each stage of this internship experience. What was your perspective of your involvement of the process. Have you taken ownership of this experience and if you have, when did you make this leap?

The stages of my internship have been very layered to look as such:

• Summer Brainstorm/Reading
• Essay Research and Writing
• Acquiring and meeting with an expert/experts
• Actual Internship Process

Now; In my brainstorming summer process, the world was my oyster. I could research or learn about anything in the whole wide world, and I wasn't pressed on time to get down to brass tax. This part was purely for fun (until the last few weeks of summer where I cram read 4 heavy texts, but that's beside the point). I picked a topic successfully, completed a annotated bibliography, and four read anchor texts which were also annotated. Check!

Next, was essay writing and research. I was a little slow to start on this one because a negative incentive was given. If your draft wasn't in by the deadline, no Costa Rica for you. I got the paper in though. I wasn't too worried about it; though my library books were awfully late. Ha! Still, done, but not as motivated. Check!

Acquiring and meeting with an expert? Done! I got this step done way ahead of the game, and was majorly prepared. Dr. Sheldon (my expert) was well informed about how it worked and what I wanted to do. I had a proposal written and finished. Motivation was high and I used no help from teachers, parents or students for any steps so far. 

Internship Process? I've had impeccable drive, if you ask me, but I'm quite biased. I take myself there every day. I'm not usually late, despite some early hours. I go from building to building and have not gotten lost. I signed up through the volunteer system, had blood drawn and multiple tests done so that I was able to work at the hospital, signed so many papers I could have sworn I was purchasing a house, and I am still motivated every day to continually take notes. I ask what I can do to help, and actively sponge up all the information I can get. I've abided by dress code, hours, and confidentiality rules and I am having a wonderful experience. I love this internship.  I have done a lot of work inside and outside the office to learn as much as I can. I would say CHECK!

I've continually made the leap for myself and pushed out of my comfort zone but still remaining in the realm of sanity and safety. Thank goodness. 

__________________________________________________

Wheew. Well... Today I had a short day at the office but lots of housekeeping (paper work) to do. Readings galore and writing all this down on paper. (Sorry I'm only now getting it to you electronically!)

I was in the Adult-Out-Patient today and only saw one client. 

Nothing very notable here because everything was too personal to share because it might give away the identity of the patient. 

Thanks for reading any who!

Until Tomorrow~

Tallon

Day 3: In-Patient Mix Up

Journal Entry#4 Wednesday 11/8/2012
Kurt Hahn was also quoted to say,
"Without self-discovery, a person may still have self confidence, but it is a self confidence built on ignorance and it melts in the face of heavy burdens. Self discovery is the end product of a great challenge mastered, when the mind commands the body to do the seemingly impossible, when courage and strength are summoned to extraordinary limits for the sake of something outside the self--a principle, an onerous task, another human life."

Reflect on this quote using your experience with your internship.

I believe that this quote is extremely relevant to my internship in a multitude of ways. I will discuss points as they come chronologically in the quote.

1. Self Discovery: A lot of In/Out patient is a new beginning and many mentally ill patients will go to recovery centers where they can discover themselves and self actualize. In my own light, I am discovering myself by doing this process. Is helping people mentally what I should do? Is that where I am best put to use? I'm not sure, but I am figuring that out day by day. It's why I picked this field! The mastery of challenges can be found in many places; from going to rehab, to the challenges I discussed in yesterday's post.

2. "When the mind commands the body...": YES!! That's what this is about! Mental illnesses are problems with mind AND body and they effect each other! This is awesome and perfectly ties in! I am seeing it from a bit different light than my peers probably will, but hey, c'est la vie. Mind and body together can create help or a solution for personal problems, or solving patients' problems, creating techniques and environments where they can over come what they think might be impossible, over coming their fears and ailments. This takes courage, strength, and extraordinary limits by the patient and healthcare provider. The rest of the quote really falls into place with everything else I have already said.

____________________________________________________


Today, I sat in to help facilitate two group therapies in both wings of the Mental Health In-Patient Facility.


The more acute side was first, and the meeting went very well. Patients had goals for when they were released and were happy and excited to be leaving soon. Conversation began between patients, and not limited to facilitators asking questions, but only towards the end of the session. It lasted a full hour, and only two participants fell asleep. Everyone seemed fairly mentally stable, until the end when one patient was talking about having to leave and go to space soon because the world was ending. He reported that he had been to the moon and mars before and he was going back after he left his halfway house.


The less acute side was not so peaceful. A woman with unexplained migraines came in crying and was pulled out halfway through the meeting. Later, two patients started flirting. Two other patients were acting as conspirators against the hospital. A few others were completely ambivalent towards therapy. It was a mess and very hard to contain. There was most definitely not a positive environment there.


Another Day, another Dollar... wait, I'm not getting paid! Just another wonderful day being a sponge of knowledge!

Day 2: Integration

I'll be starting out most of my posts by doing a required journal entry by my school, but then I will go on and talk about my day at the hospital, my questions, new findings, etc etc. So, look for the bold line and that will divide topic sections-- If you lose interest in one thing, I urge you to go to the next bold line and there will be something hopefully more to your liking and most assuredly new and different!

Journal Entry#3 Wednesday 11/7/12

Use this entry to communicate anything you would like to say to teachers of RMSEL about how this experience has/will exemplify your commitment to find your unique potential and push yourself beyond the comfort of what is easy for you.


Dear Teachers of Rocky Mountain School of Expeditionary Learning,

My time at Denver Health so far has already been majorly informative and I continue to expand my knowledge and skill set in the field of psychology. I'm enjoying getting to know all the sections of the field of work and am happy that I have pursued this option as a career path choice. I would like to keep the door open, and learned so by this experience, so to me, I would say that in an of itself is exemplifying my commitment and interest in this work. I have potential in this line of work because of it's changing manor and my ability to constantly problem solve. I would never get bored because every day is different and there is always something I can tackle and think about and view from a million different perspectives. Psychology incorporates right and left brained thinking, as well as Eastern and Western medicine methods.


This line of work has and will continue to push me out of my comfort zone while I am dealing with patients that talk about uncomfortable things, or while I must face my own fears while speaking with people. It's not easy because I do have to ask for help and ask hundreds of questions because I am in no way shape or form medically certified. This also pushes me as a learner and as a person because I am the sort of person who loves doing things on my own and honestly, I can be sort of a know-it-all. This is something that could challenge me every day mentally, physically (as you have to go with the ebb and flow of the different programs and patients), as a problem solver, as a student, and ultimately as a human being. The psychology field also challenges me to have perfect timing and empathy with people, neither of which I have mastered yet.

I have many plans for the rest of my time here at the hospital and I can't wait to keep moving forward with all the things I know I can do. I want to keep pushing myself and I will continue to assist and learn here as much as I can!

Thanks for Listening-

Tallon VanNoy

__________________________________________________

Today I was working in the Primary Care Facility, where integrated care is being implemented of mental health and physical health working together in one system. It's a very new system, but the psychology field is leaning this way because it's more practical to keep the mind healthy with the body.


Mental health seems to have some sort of stigma around it, and people are less inclined to see a professional about mental health concerns because in the general public's mind, 'we' tend to think that people who are mentally unhealthy are crazy. And no one wants to be crazy, right?


Primary care integration specifically hones in on the normality of common mental health issues and targets problems early on before they become worse. Common problems include:

Stress, Depression, Mania, Suicidal Thoughts, ADD, ADHD, OCD, and many more.


It's important to have consultations implemented along with primary care physicians because regular practitioners are not certified to diagnose mental illnesses, but every day hundreds of thousands of people are diagnosed by primary practitioners, who prescribe their patients anti-depressants, medications for ADD, and ADHD, and many other medications, when that should be a psychologist or psychiatrist's job to diagnose mental illnesses.

____________________________________________________

I was able to see three patients today, which I learned a lot about the actual integrated process. It's standard to have 10-30 min sessions, rather than 50, like most psychologists do in private practices. Also, consultations/meetings happen once every one to two months and you meet 1-5 times, rather than meeting once a week for 6 months. 

Hectic Day: Day One

Journal Entry#2 Monday 11/6/2012
Reflect on your first day. How did your first day live up to your expectations for your experience? What must you do in the next two weeks to make this the best possible experience?


Today was not exactly what I expected. I showed up to complete my volunteer training/orientation at 10:00 am, and successfully completed that, working until 11:30 am. I then met my expert and we took a tour of the entire hospital, inclusive of 5 (?) buildings. I was then passed off to a psychology resident who was working on phone consultations in health coaching for patients. That was quickly followed by a psychology resident staff meeting, where residents discussed 1 success patient story and 1 challenging patient story from their week. Finally, I closed the day out with part 4 of a 4 part support/help seminar for patients with CHF (Chronic Heart Failure). The day drew to a close around 5:00 pm. I am drained! Wheew.


I learned a lot about support systems in place in hospitals, but this is so much different than I thought it would be. I would most definitely say that it 'lives up to my expectations', though because it's pretty fast paced and it evolves often. I wouldn't ever get bored in this profession, that's for sure.


I know in the next two weeks that I will have to take every opportunity possible:



Sit in with every patient I can


Work all the hours I can


Move quickly


Think quickly


Take notes


Stay present in meetings, even if they seem boring


Take lunch meetings, they are a good way to learn new things and meet people


And lots more.




Hopefully I will do a bit better tomorrow, as today was a little scrambled for me.



Some nuggets of knowledge I picked up along the way:


1. The hospital I'm working at is a Safety Net hospital, meaning they won't turn anyone away, regardless on their income or ability to pay.
2. Patient confidentiality is VERY important, and I need to be as vague as possible when talking about a patient.
3. The hospital I'm working at, along with psychologists in general abide by similar core values to RMSEL, such as:

Empathy
Respect
Compassion
Dress Code
Confidentiality

I received a packet to learn about Ethics for Psychologists, because it's so important for psychologists to be ethical in such a vulnerable situation for patients. Three of the main points of the Ethics of Psychology include:


1. Informed consent: The agreement about what the two of you (patient and doctor) will be doing over the course of treatment. Spell out everything clearly. 'What do I expect as a doctor?' 'What do you expect as a patient?' This basically is a trust agreement between the doctor and patient creating social norms for the environment and treatment.

2. Multiple(Dual) Relationships: This basically outlines that the patient and doctor will only have clinical contact. There will be no relationship of business or contract from Doctor to patient or vice versa. This part of the psychologist's ethical contract is to set boundaries.

3. Privileged Communication: is a promise that the psychologist will not tell anyone the patient's stories or thoughts no matter what*. This is the same idea as lawyers who know the full story, but do not have to disclose evidence against their client, legally. There are some exceptions (hence the asterisk). These exceptions can vary state by state, but generally they include:

Patient in direct danger to themselves


Patient saying they will hurt or murder someone else*(Only in some states, others cannot say anything, even at this point).


Patient admitting to or planning to hurt a child


Patient admitting to or planning to hurt an elderly person

______________________________________________________________________________________


Some of the things the residents were doing that I shadowed for in the later half of the day included:

Group Therapy
Phone Council
Prevention Therapy
Health Coaching
Life Management Skills


Generally they deal with issues like depression, anxiety, heart disease, obesity, and diabetes. The Residents help patients come up with S.M.A.R.T. Goals, which stands for:

Specific


Managable


Attainable


Realistic/Reasonable


Time-Based


Part of the issue with phone conversations, though and life coaching, though, that I noticed in the meeting of pros and cons, was that many patients have a tendency to stop helping themselves or talking about relevant information, and start complaining and ranting to residents, because they have no one else to talk to.


__________________________________________________________________________________________


Lastly, for this post, I'm going to talk about the CHF seminar I sat in on.


This post was about medication and questions they had about medication.


It was sad to see that the first session had about 12 attendies and session 4 had 2 to begin with and 1 more showed up about 15 minutes later.


This meeting would have been very uncomfortable for someone who was new to this pain or disease, which may have only been that way because the residents and the practitioner knew that all the attendies were experienced in their illness, but there were so many complex terms and names of medication being thrown around, it was hard to keep up.


There was, though, an action plan, which seemed helpful. It was customizable to the patient's needs in a Safe Zone, a Caution Zone and a Danger Zone, ( all color coded)

___________________________________________________________________________________________


After this session, I walked home and relaxed a bit and did some readings and paperwork for the hospital while watching the debate. I'm excited to see how my second official day goes!

Entry 1, The Calm Before the Storm!

Journal Entry #1
Kurt Hahn once said,
“..As our society has become information rich, it has become action poor. It has become poor in the necessity and possibility for struggle against the environment. As affluence has increased, the young person's environment has become impoverished for responsible and productive action, or any action that tests and develops him.”

Reflecting on all your actions to this point and looking forward to your internship experience, how or how not have you exemplified the idea of exemplifying responsible action and productive action? When you answer this question again after you finish your internship, how can you create an experience that truly exemplifies this quote?:

Reflecting on the weeks and months preceding my internship, I can honestly say that I've read quite a bit, completed a research essay and was very concrete in my setting and experts needed. I'm jumping into tomorrow a little unaware of everything I'm getting into because I don't have a calendar quite set up yet, but I'm doing an orientation and meeting with Dr. Sheldon (my expert) to solidify my duties at the hospital. It's hard to say if I've done enough work, because psychology is such a broad topic, and I don't quite know what I need to zero in on yet, but so far for my background knowledge, I'm feeling prepared, I just wish I would have read it later or more spread out, so that the information was a bit more fresh.

I know that I really want to dive headfirst into this experience and do as many hours, as much work on the side, and as much I can in the field on my internship. I specify with this because in previous years I have not enriched my own experience as much as I should have, or would have liked to.

Time to go to bed so I can make it to work on time!

Goodnight and Wish me Goodluck!


(Whoops, didn't have my laptop, so I posted this late, but I hand wrote it the night before).

Introduction

Hello! 

I'm Tallon VanNoy, a student of Rocky Mountain School of Expeditionary Learning (RMSEL), Arapahoe Community College, and a psychology intern at a *local hospital! 

Every year, students of RMSEL have the amazing opportunity to plan their own learning experience for two weeks. Prior to jumping into the experience, students must create a proposal, read multiple anchor texts, write a research paper, and gather experts and information pertaining to their topic to help them learn the most about their interest. I decided to delve into the world of psychology; as it's been an interest of mine for quite some time.

Aka, I did a lot of work, and I'm FINALLY out in the field. 

I will be logging my experience on this electronic journal for any one to read, if they so please!
Good night/day and happy reading, folks.

*Local Hospital: For confidentiality purposes, I'm saying local hospital, so that patients' information is more secure.