Internship in ED this fall

During our 3rd (of 4) semester, my class was given the opportunity to apply for internships with some of our local hospitals. We get 1 unit of course credit for the experience, and it's a good networking opportunity as well as a way to get more hands on skills and experience.

We put in our application (a cover letter, a resume) to a person in the education department of a group of hospitals, told her which unit was our 1st, 2nd, 3rd preference, etc and then waited to hear back. I said emergency department first, NICU second, ICU third. We've gotten to do "outrotations" from clinical to some other areas in the department. So, so far, I've seen med surg, ICU, ED, Peds, mother-baby, NICU, L&D and OR. The outrotations that I was the most excited about so far have been the emergency dept and NICU. I was torn about which to put first, however the hospital that was offering a NICU internship was quite a bit farther away. Also, I thought I'd get a better broad experience and wider variety of skills in the ED.

I had an interview with the ED department manager over the summer. I believe ED was the only department that actually had us students come in person for an interview; the others were phone interviews. Three of us got placed in the ED at this hospital. During our third semester of the RN program, we have 2 days of regular school clinical every other week, so I'm doing one day per week at the internship only on the weeks I don't have normal clinical. The requirement for the course credit is that we do 54 hours of hands on time, but with the department director's consent, we can do more. It's unpaid.

 I had my first day there this past Monday. What a blast. I was there for about 8 hours, and had about that many patients. I was working directly with an ER nurse that is a graduate of my program. I got to see a dressing type I hadn't done before on a finger wound, do lots of glucoscans, discontinue IV's, do assessments on a wide variety of patients, lots of urinalysis, talk with someone who had just tried to commit suicide, prime IV lines (we are not allowed to actually *give* any medications at the internship), do patient education.

I left really excited about becoming a nurse, and hopeful that maybe at some point I could become an ED nurse. It think the variety is really the excitement for me. And the faster pace. On the med surg floor, it can sometimes feel like babysitting. Morning assessment, morning meds, hygiene care, morning treatments, nursing interventions, noon meds, more hygiene care. Some people really like it because it's a more wholistic experience with the patient. At this point in my student life though it feels really good to just be exposed to *a lot* of different situations, even if I don't get the same depth I would if I were following the same 3 patients all day.

I'm sad I won't be going back for another week and a half; I've got a lot of stuff to do in the mean time. Had a quiz today, an exam is tomorrow in my neuro class, we're covering IV push meds in lab on Friday, and I'm back at normal clinical for two days in a row at the beginning of next week. So I'll stay busy. But I'm really excited about going back to intern again!

A guy walks into the hospital lobby....

No, I'm not about to tell a joke. He came in, limping, dripping blood, and he and his friend wanted to be pointed toward the ER. I ran for a wheelchair, which he didn't want to use, but I was glad I talked him into it. He was acting like he was going into shock, and with the limp, I knew we could get there faster with him in the chair.

He was biking on the road with no helmet, somehow fell, and skidded across a large swath of asphalt. Basically, ouch. He was all trembly and kept saying he felt "tingly all over", which the ER personnel told me was a result of hyperventilating (Oops, I had told him to take deep, slow breaths to help with the pain and calm down...guess he didn't hear the slow part or wasn't able to calm himself enough).

The nurse thanked me for bringing him --- and I stood there like an idiot -- do I stay? do I go? I want my wheelchair back! (in my head) -- but it turned out it was good I was there because she asked me to stay with him a little longer while she went for a gurney.

He looked young & healthy; I'm sure he'll be fine.

Carrying squicky things in buckets

When I'm volunteering at the hospital, I get many, many calls to transport specimens to the lab. Usually it is just blood in tubes, and occasionally a urine.

But this weekend, there were two things that I admit made my stomach turn just a tad:
a lumpy looking greenish stool sample (meconium maybe? it came from labor and delivery), and a big, round clear bucket with a placenta inside.

I'm not disgusted by placentas, per se, it's just that when I think of them, I think of what I've read / heard about, that some cultures *eat* the placenta for nutrition and or spiritual reasons. Yucka.

To each his own.

Why I need to beef up my Spanish

Last weekend I was volunteering at the hospital and a guy came to the front desk trying to explain something to me. I gathered that his recently pregnant wife was out in the car, that she needed help getting up to the NICU where her baby was, and that his two friends would bring the breast milk in a bit. I got mom in a wheelchair and took her up to the premie section. She only spoke Mixteco (I hope I spelled that right) so dad was speaking for her.

First, the embarrassment of the ward clerk... I have mom and dad there with me, I show her the cards that they have brought with them which have the baby's name on them. I explain the situation, that they want to see their baby and that someone's on the way with some breast milk (dad's holding a pump). And she panics.

She brought out this translater phone thing, and spent 20 minutes trying to get it to work. Mom and dad look exhausted, and are getting irritable. They just want to see their baby.

Then, this brilliant nurse comes in, says forget the translator, let's have them scrub in and come on back... but then she turns to them, mimes washing her hands and said "washo your handso!"

I was mortified on her behalf.

Volunteer shift at the Hospital yesterday

Yesterday was my 3rd time volunteering at the hospital. It felt a lot more relaxed than usual. I had someone there working with me again, and almost all of the calls were to ferry lab specimens around form various departments, with very few other situations to take care of.

I started feeling like I could even bring some studying to do with me some days. And now that Jenny is back from vacation (the woman who usually does Saturdays), we can switch off weekends, so I'll have the option of having some Saturdays to myself.

That feels good. Especially going into Fall semester where things could get crazy! I'm sure I'll be thankful for an extra Saturday here and there.

Awesome Volunteer Shift at the Hospital Today!

Today was supposed to be my second volunteer shift training at the hospital, but as it turned out, no one was able to train me, so after calling to see if anyone was coming in, I went ahead and did it on my own!

I spent the whole day running and answering questions and helping people. Two different emergency patients accidentally came into the main lobby instead of the ER, and one of them was a pregnant, Spanish-speaking lady and her husband. I struggled, but I was able to communicate enough with them to verify that she was pregnant, 2 months along, and that they suspected a problem with the baby, and that they weren't sure where to go. I called the necessary folks and then brought them to the ER.

I also got to talk briefly with a monitor tech, who told me that the hospital I volunteer at has just started offering basic cardiac arrhythmia classes -- the one for summer has already started, but there should be another one coming up starting in September. I was thinking about doing that course online for about 100 bucks, but wasn't sure if the hospitals would consider it legitimate. I also signed up for the class at a community college campus about 50 miles from here but I would rather not take the time off work and drive there once a week. If I could do it at the local hospital that would be great!

Lots to think about. Hmm.... I just thought that maybe I should have written those 2 ER patients in a log somewhere, other than just bringing them there.... will have to ask next week.

First Volunteer Shift at the Hospital

I finally got my volunteer uniform jacket, paperwork, immunizations, training, and all the little details checked off and finished, so yesterday was my first "shadowing" shift at the hospital as part of the volunteer auxiliary. The lady who usually works Saturdays is out of town for a couple of weeks, so she has a couple different subs lined up to train me over the next two weeks.

Note to self--- this gig requires a lot of walking, so bring a water bottle. At the volunteer desk I'll be working at, we have coffee available (for ourselves and waiting families), and I ended up drinking more coffee than I should have because I was thirsty and it was there. Didn't get much sleep last night.

2nd note to self --- Keep tissues nearby. Nosebleeds on white scrubs in a healthcare setting don't look great (this actually didn't happen, but it was near miss in the morning on the way out the door).

Some of my duties included:

(1) Various units around the hospital would call the volunteer desk and ask us to transport a urine/blood/whatever sample to the lab, sometimes on a STAT basis. I'd go pick it up, take it to the lab, time-stamp it, put it in their inbox, and let whoever was handy know if it was a stat.

(2) Deliver newspapers to patients and nurse stations. We had a cart full of newspapers and walked around the entire building offering newspapers to patients one at a time and leaving copies on nursing units that I suppose had requested them. The hospital was unusually full yesterday, so we ran out of papers before we ran out of patients, and there weren't any left for the front lobby. My hands were black by the end.

(3) Deliver gifts from the gift shop to patients. This was probably my favorite part, because the patients were so happy to see the balloons and things coming in the door. Plus, I got to deliver things to the labor and delivery section, where brand new infants were being gazed adoringly at by their proud mamas and papas.

(4) Handle questions and comments of all types at the front desk. Most commonly, can you tell me which room my family member or friend is in. Some patients are inmates or have chosen not to make their room number public to maintain privacy. Some people who come in are upset because they have an issue that is urgent to them that the hospital can't deal with on the weekend (I'm thinking of a lady that needed a check stamped before she could cash it and none of the departments that could help her were there on the weekend).

(5) Try to be a helpful, comforting presence to anyone who needs it. When I went to the cardiovascular ICU, there was a woman in the waiting room who was looking out the window and sobbing. I think her dad was in with a heart attack or something. I asked her if I could bring her anything, and she said some water would be great, and wanted to know when she could go inside and find out what was going on. I got her a glass of water, and checked with the nurses station for an update. That's a rough spot to be in and I could really empathize with what she was going through.

I think it's going to be a really good experience, overall. Six hour shifts on a Saturday might be a little brutal, but I probably won't have to do every Saturday...and it will all work out.

More updates in a few days.

The process of joining the volunteer team at the hospital

I was surprised how long it took the hospital volunteer auxiliary to get back to me about my application. I turned in applications to both major hospitals in town on March 28th. I never heard from one, and the other finally called me on May 11th to set up an appointment for an interview, 2 weeks later.

Most of the people that work there are little old ladies who want to do something good with their time now that they are retired. I know that some other classmates of mine from last year also volunteer there or other places but I haven't seen anyone wearing the volunteer uniform --- white pants, white close toed shoes, and a blue jacket --- under the age of oh, say 60, yet. I think this actually impressed the CEO at a recent interview I did, that I would do volunteer work that had me hanging out with little old ladies all day (I recently had 2 interviews to be a receptionist at a senior living community, more about that in another blog).

At my interview, the head volunteer lady did most of the talking, telling me about the various rules and regulations, and what to expect. She was dressed in her volunteer uniform (elastic around the bottom of her white pants) and was pretty energetic, talkative, and enthusiastic. She had lots of pins and buttons on her uniform, rewards, I'd guess from all the volunteering she has done. Oh, and she warned me not to sign anything other than... what was it? I'd better check with her. She said the nurses and doctors will sometimes ask the volunteers to be a witness to something on a form, and there are some things it's okay to sign and others it is better to stay away from. She actually had to go be a witness in a court hearing once because she signed something that usually wouldn't be her job to help out with.

My next step was to go for an appointment with the human resources office. There was a large sheaf of papers to fill out and read, with a quiz (no kidding) at the end. The process took about an hour and a half. Then they did a TB test (I'd had one about 8 months ago, but they needed it to be a 2 step test, and I guess I'd had a different kind). And they walked me over to the lab to get blood drawn for titers to check my immunity to various viruses, to see if I needed updated vaccines on anything. That's great, because both the testing and the vaccines, if I need them, are free through their volunteer program, and I will need to do all that anyways once I start nursing school, so it will be good to have it already done at their expense.

While I was filling out my paperwork, there were a couple of nursing students that came in to take care of some stuff for their clinical rotation over the summer. I talked to one of them a little while she was waiting. She's going to a program about an hour south of here, but lives 20 minutes north of here, so she's been commuting about an hour and a half to attend the nursing program down there. She said it was easier to get in there than the school locally, and she was tired of waiting so long. She was glad to be able to do her summer externship closer to home.

The next step in the volunteer sign up process is an all day long orientation, on a Wednesday about 2 weeks from now. I will have to take the day off from work (at my tutoring job) which is frustrating because that's the day I have the fullest schedule. Hopefully I can reschedule some of them to Monday. I will get the results of my lab tests then, and should be able to sign up for shifts soon afterward.

I think it will be a good thing. I hope I don't feel over committed; they require you to volunteer at least 4 hours per week for a year if they are going to go through the process of "hiring" you. It will be too late to get the 200 hours I need for the nursing school application, but I hope that at some point in the future it will help me land a job, having had that experience.

Hospital Volunteering Options

So I have some options to choose from when I volunteer:

(1) I could help at the Information Desk, directing or escorting people to certain areas of the hospital and answering questions. This one doesn't appeal to me as much and probably wouldn't get me much credit in the eyes of the admissions people, though who knows.
(2) Gift shop. Again, not much appeal there.
(3) Cuddler program, help out in the neonatal intensive care unit, be a "gentle, loving presence" and hold premature infants. This one appeals to me, and would give me some patient contact, though not a wide variety of patient contact.
(4) Hostess cart. Serve coffee and tea to visitors. Not much appeal there.
(5) Emergency department. Provide support and compassionate care to patients and their families. Probably the best choice for a pre-health student in my mind. Sounds more taxing to me than the cuddler program but maybe I could do some of both.
(6) Special Projects. Helping with blood drives, making baby hats for the NICU, helping with clerical needs, delivering newspapers and flowers, making welcoming cards, etc. I could probably do some of this but it doesn't sound like a whole lot of patient contact.
(7) Evening Shift. Doesn't specify what they do but also might be a good choice.

When I interview I will probably tell them I am interested in both the emergency department and the cuddler program and see what happens from there. Maybe I can try out all of the various types of volunteer services.

Turning to Volunteer Work

About a week and a half ago now, I applied for another job, working front desk at an assisted living home. One of my walking buddies who works there let me know that the part time position was opening up, and I hoped that having that personal connection would get me an in, but apparently it didn't.

So I'm coming up on the end of March already (gasp! it's already the 23rd). If I want to show that I have some medical experience before the nursing school application process begins I need to get on that now, regardless of having an actual paid job in the field or not. It also is starting to seem like volunteer work may be necessary to get a foot in the door to a paid job. There was another opening at United Blood Services in the last couple of weeks but they specified that you could have no other time commitments (strike 1 against me, I'm a part time student) and that you needed a minimum of 6 months previous medical experience. No luck there for me.

One of the local hospitals has a formal volunteer program set up. I figure if I apply now, and I get lucky in terms of the whole orientation process going through in a timely manner (which it might not), it still will be quite a push to get 200 hours done by July 1st. If they do the scheduling like the humane society I used to volunteer with did it (all online, sign up for whatever shifts you want that are available), I could easily do 40ish hours over spring break, but they might not do it that way at all. We'll see.

I am going to go to the hospital and pick up an application tonight.

The nursing school I am applying to gives more credit in the application process for hours *worked* than for hours *volunteered* but there's not much I can do about that at this point other than keep applying, and in the mean time I should start the volunteer as a backup.