Weekly Internship Log (Appendix C)

EXAMPLE 1

Missy Stewart
Weekly Internship Log #5
Agency: Mental Health Agency (MHA)

Monday: 2/7/2017 
Hours: 8:00AM-3:00PM

Morning: This morning I was able to sit in on a MHA advisory board meeting that is held every other month. I met many influential individuals within the mental health field, including Mike Smith, the CEO of Mental Health Inc., the parent company of MHA. During the meeting we discussed the budget of the MHA and how we can make the MHA self-sustaining, or able to be run without the financial help of Skills, Inc. Different suggestions were made, but the primary suggestion was to start our own garden to cut down on food costs. This would be awesome, especially because it would serve as another unit in which members could work. During the meeting we also discussed political advocacy and the proposed budget cuts to mental health services. We discussed talking to our senators and sending letters, faxes, and emails to Governor Corbett’s office. The advisory meeting took up most of the morning.

Afternoon: During the afternoon, I worked primarily with members to complete the tasks of the work ordered day. I stayed in the kitchen and helped to clear tables and clean dishes. In the afternoon I worked with members in the Clerical Unit to complete filing tasks. To end the day, I helped staff write daily notes.

Tuesday: 2/8/2017
Hours: 8:00AM-4:00PM

Morning: Today I spent a lot of the day helping staff complete paper work. Every few months, staff members need to complete a recertification form to allow MHA members to continue to receive services. This morning I learned how to complete these recertification forms, which is really helpful since that is a big piece of staff responsibility. For example, MHA members can keep the MHA running smoothly without the help of staff, but staff are required to complete all of the necessary paperwork to comply with state and insurance regulations. I learned how to complete some of these forms today.

Afternoon: This afternoon passed like many other afternoons. I spent time with MHA members in the Kitchen Unit to help clean up after our meal. I helped to sweep the floors, clean the dishes, dry mop the floors, etc. Afterwards, I moved to the Clerical Unit where I talked with different members as they were completing their daily service records. Finally, I helped staff complete the daily notes after members were finished filling out their forms.


Wednesday: 2/9/2017
Hours: 8:00 AM-4:00PM

Morning: This morning was a very slow morning in the MHA. It was very challenging to get members to sign up for morning tasks during the AM unit meeting. As a result, I spent a majority of the morning facilitating the completion of tasks by encouraging members to get involved in the work ordered day by talking to members about following through with the tasks that they signed up for, and by helping members complete certain tasks when they did not understand what to do. Additionally, I spoke with a MHA member about updating his recovery goal plan. We had established a plan at an earlier date (sometime last week) and I needed the member to sign his paperwork stating that the goal was acceptable and complete. Upon further discussion the member informed me that he no longer liked his goal and that he no longer wished to attend MHA. After talking to another staff member, I decided that it would be best to reassess the member’s willingness to develop a goal plan at a later date since the member often changes his mind about his recovery process due to illness symptoms that he may be experiencing.

Afternoon: During the afternoon, I assisted with the PM cleaning of the MHA. Like usual, I helped out in the Kitchen Unit to clean dishes after the lunchtime meal. The primary event of the afternoon was our House Meeting, which typically takes place every Wednesday and Friday. During the House Meeting we discussed responsibility in the MHA. We emphasized that it is each member’s job to participate in the work ordered day and to keep the MHA running. This had been a problem earlier in the day when no members were signing up for AM tasks. After the House Meeting, I helped staff to complete daily service notes.


Thursday: 2/10/2017
Hours: 8:00AM-4:00PM

Morning: Today was a quiet day in the MHA. There were only five members in attendance for the majority of the day. Because no member wanted to lead the AM unit meeting, I led it. I spent most of the morning with a new MHA member who came in today. I helped her become oriented with the MHA and helped encourage members to interact with her and help her through the day. I also helped a member establish a goal to work on while he is attending MHA. It was the first time that I have done a goal plan myself.

Afternoon: This afternoon I finished writing the goal plan with the member. Afterwards, I interacted socially with the new member and another member. We discussed family, illnesses, and medication. It was nice to hear members opening up about their lived experiences. Finally I called a new referral to encourage her to stop into MHA for a tour. I finished my day by helping staff write daily service records.


Friday: 2/11/2017
Hours: 8:00 AM – 4:00PM

Morning: This morning was a very productive morning in the MHA! We had a good group of individuals came in. During the AM unit meeting, we had more volunteers for tasks than we did actual tasks. It was great to see members so willing to get involved in the work ordered day. At the MHA, we like to say that we are “working ourselves out of a job” because if members are truly in recovery they could run the MHA without the help of generalists. I really felt like this in the morning. Because everyone was so willing to complete tasks, I did not have a specific task to do. Instead, I socialized with members about their plans for the weekend. We discussed fun events that members were doing, such as seeing their family, that would decrease isolation and promote their recovery.

Afternoon: The afternoon, like the morning, flew by. During the PM unit meeting, members were not as active as they were this morning, however, every task got done. I encouraged members to get involved in the afternoon activities and helped members to complete activities when they were not sure what to do. Towards the end of the day, I helped staff complete daily paperwork, including writing daily service records.

General Feeling/Comments:

This was a very unique week! I feel really fortunate to have gotten to sit in on the advisory board meeting and am very excited to have met so many influential people. Additionally, this week was interesting because I am witnessing first-hand how important advocacy is in the mental health field. It is encouraging to hear that members are interested in writing to our representatives to bring about change. They do not want budget cuts, so they are using their democratic freedom and voice to bring about change! It is really an exciting thing to be a part of. It is inspiring me to do more research on the proposed budget cuts and to write a letter myself.

Total hours this week: 39
Total hours overall: 187.5

[This RHS student completed her internship at a program for adults living with mental illness.]

 

EXAMPLE 2

Student: Rebecca Wild
Agency: Smithfield Retirement Community and Walker Rehabilitation Hospital
Internship Log for Week 6

Agency: Smithfield Retirement Community                                                                                        
Monday:  2/14/17
Hours: 9:00-5:00

*I switched the location of my days this week (with prior consent from both supervisors) so that I could attend Smithfield’s big Valentine’s Day event.

Morning: I was able to participate in pet therapy for the first time today, so after helping with and leading part of today’s exercise I was able to take the puppy around to some of the residents. It was wonderful to see some of them light up. There are many residents who do not express emotions very often, but when they were able to hold the puppy, they had huge smiles on their faces! It was great to see. James and I also delivered Valentine’s Day mail and flowers to many of the residents.

Afternoon: Almost the entire afternoon was consumed with prepping for and actually attending the Valentine’s Day “dance.” We decorated all of the tables, invited all of the residents and their families, brought the food and drinks in, set up the piano player, and prepared for the crowning of the king and queen. Every year, the staff votes for a king and queen of the Fairways. The runners-up are also crowned prince and princess. Though it may sound juvenile, I do not think the residents or their families felt as though it was. They all seemed so happy, and delighted to be there. The woman who was crowned queen was crying because she was so honored. It’s helpful to see the planning involved, and afterwards we discussed ways to improve how they host future social events.


Tuesday: 2/15/17
Hours: 8:30-3:30 and 6:00-7:30

Morning: I came in early this morning because I knew I had to leave early today, so I was able to help deliver the newspapers to residents as well as post the signs for the activities for today. I also helped with exercise on the second floor today. We brought up musical instruments and that worked well for the residents to move their hands and wrists. We also had them tap their feet and legs to the music. After exercise, I attended a care plan meeting. Here I learned that one of the resident’s cognition level had decreased significantly so they had to reevaluate her goals. I think the care plans are interesting to see the various points of view on the resident’s care.

Afternoon: I was able to observe an assessment. I will be conducting my own assessment next week so I was glad I was able to observe one this week. Our supervisor asked the woman her opinion on various aspects of her care, to make sure that everyone working with her knew what was most important to her (ex: picking out her own clothes, being able to go outside when the weather is nice, being able to pick a shower, tub bath, or sponge bath). She also evaluated the resident’s memory by asking a specific set of questions. I thought this was interesting, and I appreciate that our supervisor trusts us enough to evaluate residents on our own. I also gave the idea for today’s activity to make THON dancer mail. There are many Penn State alumni at Smithfield, and I thought it would be a nice way for the residents to connect with their alma mater by giving back. I thought it went really well, and I am so excited to deliver the letters at THON this weekend.

Evening: I did more research for Walker’s “Article Club.” They asked me to present my article on the 23rd. The would like me to find information about Parkinson’s Disease and ways to help treat it using OT, but it is very difficult to find a great deal of information on this. Instead, I found information on OT and Huntington’s Disease. I think they may find aspects of this useful because Huntington’s Disease and Parkinson’s Disease affect the same area of the brain, but in reverse order. Therefore, I would assume that many of the symptoms are the same, they just progress is different ways. I hope they find the information to be helpful.


Wednesday: 2/16/17
Hours: 7:00-3:00

Morning: I observed ADLs. This morning I was able to observe a therapy with a patient who was in a veil bed. A veil bed is a form of a restraint to keep the patient safe, and it is a netted tent that surrounds the bed. During this internship the issue of safety versus independence occurs often. There is no right or wrong answer but it is difficult to see patients in veil beds, even though they are not extremely intrusive and I know they are to keep them safe. I also was able to review some charts this morning, and I looked through sections that include pictures and descriptions of wounds. I also attended team conference.

Afternoon: One of the OTs taught us more about FIMs (functional independence measures). These are important to understand how to calculate because the facility judges how much the patients have improved based on these numbers. Though I understand it will take me more practice, I feel much more comfortable calculating a FIM score. I believe this will help me in grad school. I also was able to observe a driving test today. This is another aspect of care that I find hard because it takes away people’s independence, though sometimes it’s necessary. The man who took the test today did not do very well, and his scores showed he had a 70% chance to fail the driving test if he took it today. The OT then passes that information on to the doctor, along with her personal recommendation as to what aspects of functioning may be lower. The doctor then reviews this information and, if he feels it is necessary, he can revoke the patient’s driver’s license. I honestly believe that this man will be safer if he doesn’t drive, but I can only imagine how hard it would be for him to hear that a large portion of his independence was taken away from him. At least the OT knows now what areas they can work on improving.


Agency: Walker Rehabilitation Hospital                                                                                             

Thursday:  2/17/17
Hours: 7:00-3:30

Morning: I observed ADLs. Today there was a new patient who was admitted who was 65. She had early onset dementia, and a brain bleed that caused aphasia. While the therapist worked with her she asked the patient a lot of questions about her past, and the woman had difficulty answering them. I also observed a woman who tripped over a cat toy and broke her femur. It turns out that she was taking prednisone and that can weaken bones significantly. I also attended treatment team today, which brought up an interesting question that no one has the correct answer for. There was an older woman who has made a great deal of progress as a patient, but she is still impulsive and at risk for falling. The facility is ready to discharge her because of her significant gains, but they are afraid to send her back to her apartment without any care. They  are recommending she hires 24/7 care or moves into an assisted living facility. This woman, however, has a caseworker who will do anything to maintain this woman’s independence for her and is very against moving her. Obviously this decision will be up to the woman, but after meeting her I’m not sure she would fully understand the issue. The doctor in team said something like “how can we let her go home knowing full well that she will probably fall,”  which is a good point. I think there are a lot of difficult situations like this, and it is hard to know what the right thing to do is.

Afternoon: I played rummy with some of the patients, James, and Erica. It’s interesting that even a game of cards can be therapy for many people. The patients had wrist weights on while they held their cards, while they also had to use their brain to play and keep score. They had so much personality and I had a great time playing with them. I also watched the woman with dementia and aphasia do word searches, and they were extremely difficult for her. I would like to learn more about what happens in the brain that causes these communication barriers.

 
Friday: 2/18/17
Hours: 7:00-3:00

Morning: I observed ADLs. The first man the OT helped was also in a veil bed. It took her and another nurse to help him get ready, because he was a big guy and somewhat impulsive. He had a brain tumor removed, which caused him to have problems with the left side of his body. Though he was able to move his left side, he couldn’t feel any of it. At one point his left hand was in his right hand, and he said to the therapist, “What’s this?” when referring to his left hand. He also only looked to the right side of him. When we left his room, the therapist asked me what types of things I noticed. I appreciate when some of them ask my thoughts first to see what I picked up on and what I missed.

Afternoon: I observed in the gym. The therapist I observed this morning worked on increasing awareness of the patient’s left side. She did this by using a mirror so he could see both sides of his body while they worked on moving his arm and leg. I made conversation with many of the residents while I watched them do puzzles, use thera-puddy, lift weights, put together pipe designs, play cards, fold towels, and match socks among many other things.

General Comments:

I feel much less overwhelmed about hours after speaking with you this week. Now that I know that most of the things I do relating to my future profession or human service work will count towards my hours, 600 hours is much more realistic.

Total Hours this week: 41 hours
Total overall hours: 234 hours

[This student did a split internship at two retirement facilities to prepare for an OT graduate program.]