Introduction

I served my internship at Piedmont Healthcare, Henry campus in the emergency room,

shadowing a family nurse practitioner as she provided healthcare for those who entered.

Piedmont Henry is a 236 bed, not – for – profit, acute care community hospital located in

Stockbridge, GA. While not a designated trauma center, it is a stroke center, provides a wide

range of medical and surgical services including advanced cardiovascular and cancer care,

rehabilitation, pediatric and women’s services. Piedmont Henry has more than 1600 employees

and 700 physicians, not including advanced practice providers.

The mission statement of Piedmont Healthcare, which includes five hospitals, is to

provide healthcare marked by compassion and sustainable excellence in a progressive

environment, guided by physician, delivered by exceptional professionals and inspired by the

communities we serve. This mission is evidenced within our community benefit programs.

Piedmont advertises that it does not want to just make people healthier; they want to keep people

healthy.

Historically, Henry Medical Center was founded on July 9, 1979 as Henry General

Hospital with 104 beds. In 1995, the hospital renamed itself Henry Medical Center and in 2011,

the hospital became Piedmont Henry Hospital after it became affiliated with Piedmont

Healthcare. Renovations in 2016 to the ER were designed to increase the amount of space and

reduce the wait time for patients to be seen. They doubled the number of triage rooms, enlarged

nursing stations, upgraded the entrances for better access, added more parking spaces and

expanded the minor emergency area and waiting areas. Piedmont Henry has the busiest

emergency department in the seven – facility Piedmont Healthcare system. The 55 bed ER has
an annual patient volume of 90,000 with a 15% admission rate and 30% pediatrics in 2018.

Advantages in the ER are the presence of medical scribes, a fast track area, 80 hours of double

physician coverage, 60 hours of advanced practice clinician coverage and Hospitalists on site.

Description of Experiences

My role as an intern is to observe the patient population served by a busy urban emergency

room and the variety of public health concerns that are seen on a routine basis. After identifying

the types of public health concerns, I want to develop a resource pamphlet that will identify the

various healthcare services available in the area, what the qualifications and limitations are, and

how to better utilize the resources available. The medical providers and healthcare staff (nurses

and paramedics) do their best to provide the information to the patient population that they serve,

but are often too busy to look the data up, or to provide written documentation for the services

available. The patients themselves are either financially unable to afford a computer or smart

phone, or lack the technical know-how of how to access the information needed.

Looking into the world of the emergency room was an experience. I enjoyed the fast pace of

triage and the teamwork involved in the coordination of care necessary to provide aid. There was

a lot of variety – ethnicities, ages, sexes, situations, methods of coping, attitudes. After a while,

one could see a certain amount of repetition in the ER population with similar healthcare

concerns. I realized that my life situation was significantly different than the population seen

here – although some had health and / or dental insurance; many did not and therefore were

obligated to sit for potentially hours waiting to be seen for relatively minor aliments or minor

emergencies rather than going to their PCP or an urgent care center. My eyes were opened to a

multitude of public health concerns.

 I did not enjoy having to be an observer rather than an active participant. Obviously, I am not

legally able to assist with care, nor am I qualified to. It was somewhat awkward to always be

watching on the sidelines, but after a while, the staff was used to seeing me, and discussed

aspects of their jobs and what the pros and cons of their respective professions were. I wish I had

more clinical background to truly be a benefit to the healthcare team.

Perception and Evaluation of the Internship

I have always been interested in healthcare and in the medical aspects of public health and

how those health issues impact the community at large. I realized early that I am blessed to be

part of the minority of the people in that I have ready access to healthcare whenever I or my

family requires it and the financial means to provide that care. My grandmother lives next door

so I am exposed to her health care concerns. I interning in the ER seemed to be a good

opportunity to see how those two interests merge and what jobs are available to possibly

combine my interests.

I discussed many potential projects with my preceptor multiple times prior to finalizing my

project. I wanted to find a way to combine my interests in healthcare with a concentration in

health maintenance with those public health concerns that occur repeatedly in the ER. I wanted it

to be interesting to me, but also beneficial to the institution that was allowing me to observe the

urban population. I wanted to give back something tangible. Once we decided upon a project, the

ER staff was very interested in the completion of my project.

The CDC identifies ten categories of public health care concerns and I sought to identify

those aspects as well as how people experiencing those health concerns access help. Once
identified, I wanted to provide a means by which the healthcare providers could access

information for resources available. The healthcare providers I spoke with were enthusiastic

regarding a readily available resource guide.

My preceptor was very effective in providing the necessary medical care that is needed for

the patients in the urban ER. She routinely pointed out what the issues were that would inhibit

treatment and what should happen from this point forward. She knew the concerns of the

“regulars” and was willing to be blunt with the healthcare issues involved. She is plain spoken

and not easily misunderstood. She has a way of breaking down information into manageable

pieces that can be understood – no medical jargon or complex concepts. I enjoyed my time in the

ER and being able to experience in real time what the acute public health issues are. I wish I

could have had more clinical experience to function productively, but can eventually see myself

working in some capacity in the ER setting. Although I appreciated and valued my stint in the

ER, it is not an experience that would necessarily increase employment opportunities.

Internship Preparedness

I felt prepared academically for placement in the real world. We had discussed many varied

public health care issues in class, wrote papers, required reports, group projects, listened to

lectures, spoke of our opinions in person and on-line. I know what the issues are, but I was not

necessarily prepared to deal with them. I am not a naïve person – I believe that I have an accurate

perception of society at large. There were many issues that I saw in the ED that I had not

necessarily realized the scope of the problems.

There were many courses that helped me with my current clinical placement. Substance

abuse helped me to understand some of the struggles that those addicted must overcome and I
could recognize those addictive issues in the clinical setting. Methods of health promotion

offered me familiarity with different health services which helped to facilitate my own project.

There were multiple courses dealing with human sexuality and gender identification which

enabled me to address patients in a politically correct manner. The social skills I feel that are

most important are those of tolerance, understanding, patience, and respect of free will.

Judgement does not have place in dealing with the public. Patience, however, can be difficult to

hold onto in a busy ER when many people and situations are vying for your attention. Juggling

and time management are equally important skills.

In terms of what the School of Health and Human Performance can do to improve

preparedness, I believe that the business aspects should be started sooner. Certain

professionalism aspects, such as resume preparation, should be initiated sooner in the academic

process. The School of Business, for instance, hosts job fairs throughout the academic year and

their academic faculty are able to inform the business major students when a job fair is

happening or an interesting employment opportunity exists. Public health majors, on the other

hand, are left to their own devices and need to help one another navigate the process. Even the

internship process is confusing, and left to the end. More forewarning would have been

beneficial.

Internship Performance

The most important skill I learned during my internship was one of tolerance. In the ER, as

with any group of people that work closely, there is conflict. The conflict can be personal or

professional – not likely the persons work ethic or skill set or feeling they are doing too little or

too much, or dealing in gossip, back talking, disrespect, or insubordination. Unfortunately, you
still have to work with that person as part of your team. There are also constraints in the physical

environment and staffing issues that can impact attitudes and work flow. There is a difference in

group dynamics in business than with academia, sport teams or social assemblies like

fraternities. There is also a difference in gender groups and how they interact.

The obligatory assignments helped to focus attention onto the public health project and

slowly begin to evolve thoughts into actual documents. Time management, juggling of posts,

papers, and other requirements are a small sample of what is mandatory in the real world. The

project built upon itself in a logical manner, although I would have liked to have more time with

the presentation. I am not particularly skilled at public presentations and that was my most

concerning piece of the project. I feel that I performed well during my internship and was able to

gather a significant amount of data to assist the healthcare providers in the ER regarding

assistance with public health concerns. The problems discussed are not easily solved, but maybe

they can be mitigated to impact those individuals less.

Personal/Professional Insights/Benefits

I will graduate with an unclear vision regarding my future. I realize that many college

graduates do not have a definitive plan and start their first post grad year at an entry level job that

may not be professionally satisfying. That is my situation. I changed major to public health as a

junior with the plan of walking on time. I did. This internship helped to expose me to many

aspects of public health and to achieve a different point of view regarding those in an urban

society with different social values than myself. All experiences are valuable and they all serve

to improve clinical and professional skill sets. The internship experience serve d to demonstrate

to me different ways to cope and to deal with other professionals. I am confident, but realize that
I need to work harder to achieve my personal goals and to examine what I truly want out of life. I

realize that I may not have the personality to deal with other aggressive personalities and

tolerance to handle excuses for medical noncompliance.