Utah Valley Regional Medical Center Emergency Department

Recently I was at a family gathering, and I was telling some of my cousins about all of the amazing experiences I’ve had while job shadowing a pharmacist in the Emergency Department at UVRMC. One of my cousins made a comment about how it was hard for her to believe that the girl sitting in front of her was the same girl who had passed out when she got her ears pierced. Looking back at who I was then and who I am now, I can easily see that she’s right.

When I started job shadowing in the ED, I was sixteen. Despite almost being through my Associates degree, I didn’t know which educational path I was going to pursue. I didn’t know where I was going to be in a year—which college, which major—let alone what job I was going to be doing in ten years. I was terrified of the future and everything that it held. I was mortified to make decisions about my future because I knew it would make me feel tied down and stuck in one career. I was scared I was going to have to settle into a profession or field that I hated.

Now, I know exactly what I want. I know who I am and where I’m going. Instead of looming uncertainty about my future, I see endless possibilities in a field I’ve fallen completely in love with. I know where I’ll be in a year, and while I don’t know exactly what job I’ll be working at in ten years, I know it’ll be one I love and am well trained to do.

It would be a lie if I said all the changes I’ve experienced are because I job shadowed. But a lot of them are because of the time I’ve spent in the Emergency Department. The ED was always something that I didn’t think I could do, and I definitely didn’t think I would like it, but since day one, I set out to prove to myself that I could thrive there, and I did. And pretty soon, existing in the ED wasn’t hard anymore—it was fun.

I’ve honestly never felt such a sense of belonging, outside the walls of my home, than I felt at the hospital. People there know and respect me. The ED staff would go out of their way to include me and make sure I had every learning experience possible. While I was there, I felt like a future medical professional, instead of a teenage girl who didn’t really know her place in the world.

Beyond that, I truly learned who I am as a person. I learned that I occasionally get queasy and dizzy in stressful situations. I learned that blood doesn’t bother me as much as the atmosphere in the room when a patient is fighting for their life. I learned that I don’t give up, and I fight for what I want, even if it’s hard or embarrassing or out of my comfort zone. I learned that I’m strong and smart and ready to enter the world as a professional.

Intermountain Healthcare

            My internship at Intermountain Healthcare was one of my strongest learning experiences I have had at BYU.  Through daily experience, the changing world of healthcare was explained effectively.  I saw what hospitals are doing to get ready for Obamacare, by preparing their staffs and programs to efficiently maintain the rules of Obamacare.  Without my internship, my knowledge of HCAPHS would be minimal. Now I know staff performance affects each hospital’s reimbursement rate.

            In my internship, my main responsibility was “rounding on” patients, asking questions about their care in the Emergency Department.  Hospitals will only receive full reimbursements from the government by improving their HCAPHS scores. The best way for hospitals to heighten their HCAPHS scores is by improving nurse communication consistency, responsiveness, and pain management.  Nurse communication is the biggest contributor to a hospital’s HCAPHS scores. So, my job, when I went “rounding on” patients would be to ask all important questions.  How is the medicine to take?  What did they expect from the information from their labs or tests?  What was their pain level?  For the most part in talking about their care, all of the patients had the best things to say about the nurses and staff members.

Truly, the nurses that work in the emergency department are some of the brightest nurses I have ever encountered. Several of the patients echoed that belief back to me.  I once saw a nurse helping a patient carry her belongings, including a baby, to the patient’s car.  A nurse’s ability to make a patient not only understand but care about a patient, I believe, makes them gain their health back more quickly.  I had a fantastic time rubbing elbows, and gaining wisdom from the nurses.

Next, the actual staff helped me to see the process of running a hospital.  Each has their part or specific job.  Those who take blood, those who give breathing treatments, those who take x-rays each have a specific task to accomplish that must be done properly to maintain the scores each hospital receives.   And the fact that those individuals all work independently throughout the day or night shift illustrates that a hospital would be a large undertaking for an administrator.   The doctors, though the directing part of the system by ordering labs, treatments and procedures, are only a small part of a much larger service.

It could seem daunting to manage a group as diverse as the staff at a hospital, or, at least highly problematic without a specific protocol of enforcement.  I was able to see this firsthand with the use of a program that all the interns were asked to work with, called AIDET.  AIDET stands for acknowledge, introduce, duration, explain, and thank you.  AIDET is one of the up and coming “best practices” programs that hospitals are starting to use.  Intermountain was one of the first to implement AIDET.  This program illustrates the quality a hospital can achieve with their patients.  It takes consistency to work through problems of duration with patients. The problem that Intermountain has been having is to get all staff members to commit to use AIDET with every patient under their care.  The nurses that were committed to AIDET performed efficiently with enhanced communication.  However, the nurses that didn’t commit to AIDET struggled with their communication skills and had inconsistent results.

My increase of knowledge of the health care system is something I needed not only for my professional life but my personal life as well.  This opportunity to do an internship at Intermountain Healthcare helped me plan for my professional career quite specifically.  If a person’s understanding of a future job can be enhanced through knowledge of how a system works, then the chances of a consistent, enjoyable job is also more likely.  This internship taught me so much about how hospitals operate and the problems hospitals face.  The depth and breadth of diverse problems a hospital can face took time to believe.  At one point I wondered if it were possible to overcome the budget and human communication problems I saw.  Yet, once I began to learn the various protocols that were used in the emergency department I could see that skills could increase if they were followed, especially by using the HCAPHS scoring system.

Further, the guest speakers we had throughout the internship became a highlight of my time by giving me insight into different fields within healthcare. There was one common theme from the guest speakers, and it was how they got to where they are now.  All of them had very different paths getting into healthcare, an assortment of varying degrees and jobs they worked in before coming to Intermountain.  Since I am now considering becoming a hospital administrator, the path of the speakers was of keen interest to me.  Do I go for an MBA or an MPA?  How many years of experience should I strive to get before I enter graduate school?  Each speaker helped me look at decisions I was about to make. The Intermountain internship was a great experience that I would definitely recommend to anyone thinking about looking to work in the healthcare career field.