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

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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.


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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)

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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!