Pre-Med Core Fieldwork Experience:

Observation and Reflection Process

Name: ​Cassandra Mann A/B Day: ​A-Day

Advisory Teacher: ​Mrs. Fitzgerald Junior/Senior: ​Junior

Location or Agency: ​Santa Rosa Memorial Hospital

Prepare:
Prior to your first visit to your fieldwork location, please answer and reflect on the following
questions:
1. What do you know of the location you will be visiting? What services does the
organization provide? What do you understand your purpose of the fieldwork trip to be?

I know that many people go to SRMH for treatment. They provide all sorts of care for
all sorts of conditions.

2. If you are visiting a specific department, what is their primary focus?

I am visiting the oncology department, where their primary focus is to treat cancer
patients.

3. What aspects of mental health do you imagine you will see during your observations?

Some aspects of mental health that I expect to see in the oncology department will be
depression, considering the situation many patients may be in.

4. What bias (or preconceived ideas) might you have about the location you will be visiting?

I feel that a preconceived idea I may have about SRMH is that a majority of their
patients are from the homeless community.

5. Please do some brief research on your location. Cite your sources as you look for
information on their mission statement, stated services and clientele supported.
 Santa Rosa Memorial Hospital is “home to the region’s Level II Trauma Center that
serves the entire Coastal Valleys area, including Sonoma, Napa, Mendocino and Lake
counties, as well as coastal Marin county,”(stjoesonoma.org).

Observe:
During your FIRST visit​:
- Take a look at your surroundings and read them as if close reading a text. Record your
observations in this section

- Pay attention to sensory details: signs posted, languages you hear, colors of the offices
and uniforms. Does your location have a certain smell or feel? What sounds do you
hear? Etc.

Shadowing Date: Response:

January 17, 2018 The oncology unit I was in had a slightly cool temperature, and had a
faint chemical smell in the air. Every patient room had two separate
disposable bins; there was one for biohazardous materials (such as
blood), and another for non-hazardous materials (gloves, wipes, etc.).
Every nurse in that unit wore dark blue scrubs, and their identification
had a special sticker that labeled them as an oncology nurse.

February 15, 2018 Similar to the oncology unit, the radiology department had relatively
the same temperature, albeit without the chemical scent in the air (for
which I was thankful for). There were few nurses and radiology techs
in the department at that time, maybe four or five. Like the nurses in
the oncology unit, everyone for scrubs, however they were a pale
shade of blue compared to the dark blue oncology nurses wear.

- Try to take notice of your reactions (emotional and physical) to different elements of your
department and reflect on why you might be reacting this way.

Shadowing Date: Response:

January 17, 2018 When we would go into a patient’s room, I felt uncomfortable just
observing a patient, especially when another patient is sleeping. I don’t
know why I felt this way. I also didn’t feel an impending sadness as I
observed the cancer patients being worked on, I’m not sure why. During
certain situations that would cause some people to be upset, I have
always been able to sort of block any strong emotions in order to deal
with a problem. I’m sure that if I had more of a personal connection with
cancer then I would have reacted slightly differently.
 During my visit to the radiology department, my reactions/emotions were
February 15, drastically different. The situations I was put in had me experience a
2018 feeling of fascination and curiosity. I found myself genuinely wanting to
learn more about radiology and the aspects of this type of work. Due to
this newfound curiosity, I found myself asking more questions and
becoming more involved.

- Ask questions of your department contacts. Record your questions and answers here.

Shadowing Date: Response:

January 17, 2018 Q: What does an IV do exactly?
A: An IV transfers fluids into the patient via a vein. Saline is a type of
IV fluid, and is the only IV fluid that is compatible with blood. That’s
why when performing a blood transfusion, we can only use saline

Q: Why do you have to have another nurse watch you measuring out
medication?
A:We have to have another nurse observe us measuring out doses of
certain types of medication because the medications are considered
narcotics. They act as a witness in order to make sure that the doses
are measured out correctly and that nurses aren’t taking the drugs
themselves.

February 15, 2018 Q: What is the difference between a stroke and a seizure?
A: The difference between a stroke and a seizure is often based on
how it was caused. A stroke is triggered due to a blood clot in the
veins or arteries, preventing blood from getting to the brain, causing
tissues to die. Seizures are more vague, and often have different
symptoms than a stroke. Seizures also tend to occur in people (and
children) of all ages, whereas strokes tend to typically occur in older
people.

Q:What is contrast and what does it do?

A: Contrast is a type of saline that mixes with the IV and is only given
when we need to see tissues or vessels during a CT scan. It allows us
to see how dense the tissue is based on how white the contrast makes
it appear during the CT scan. The whiter it is, the denser.

Q:What are ventricles in the brain?

A:The ventricles in the brain are symmetrical cavities that
communicate with the rest of the brain and are filled with cerebrospinal
fluid. However, if there is too much fluid or if blood gets into the
ventricles, then a drain has to be inserted (surgically) in order to
remove the excess fluid.
 - Jot down notes as your fieldwork is happening or upon arrival back at school. Record
those answers here. For example: Who is your shadowing guide? What role do they play
in the department? Did the department feel busy? Empty? What were your observations
about work flow? Patient care? (Transcribe any notes you took in the section below)

Shadowing Date: Response:

January 17,2018 My shadowing guide was a staff nurse by the name of Trang. She
mostly just performed duties based on a patient’s needs at the time.
Then she would fill out any necessary paperwork regarding the patient.
The department itself didn’t feel empty, but it didn’t feel full either. The
workflow was pretty steady, albeit a little sparse. The patient care
revolved around being empathetic and patient.

February 15, 2018 The initial radiology department wasn’t as busy as they normally would
be, so they shuffled me through the different aspects of radiology (MRI
and CT scans), so I had several guides based on what they do. For the
visit to the OR, an SRJC nursing student guided me (along with an
experienced radiology tech) before I was transferred to the CT unit,
where Jessica (another tech) showed me what she did on a routine
basis. Then, in the MRI unit, a MRI tech showed me how the MRI
works.

- Ask questions of the industry people you encounter relating to your potential career
choices and mental health issues they'd see as important to consider.

Shadowing Date: Response:

January 17, 2018 Because we didn’t do anymore than ‘going through the motion’, I did
not have many questions to ask, as I felt I understood why they did
what they did.

February 15, 2018 Something that I found interesting when I was witnessing a CT scan
was that they would ‘flush’ the patients IV before they introduced the
contrast in order to make sure that the IV was hooked up properly to
the machine.

Reflect:
After your return from shadowing each day, take a few minutes to reflect and answer the
following questions.
1. Describe a few specific highlights or observations from each day and a lesson (big or
small) you took away from each. Consider lessons that may be taken away from
negative experiences or challenges in your day as well as positive ones.
Shadowing Date: Response:
January 17, There was only one highlight from my first visit in the oncology
2018 department, and that was how a blood transfusion was performed. I didn’t
realize just how much paperwork a nurse had to do for just one patient.
February 15,
2018 During my second visit in the radiology department, I was able to have a
lot more takeaways than I did in the oncology department. I had the
opportunity to witness how an epidural was given ( in the OR), as well as
how a CT scan and an MRI worked. The CT scan is a slightly more
advanced version of the x-ray, giving a slightly for detailed view of the
inside of a person’s body. However, an MRI is on a whole new level. The
detail is amazing, and it’s basically a giant magnet that has to be on 24/7,
7 days a week. It can take up to three hours to shut down, as it can
release cryogenic gas and cause asphyxiation if the machine is not shut
down properly.

2. A. After your ​first​ visit: How did the experience meet, exceed, or fall short of your
expectations? How does this inform your expectations or preparation for your next visit?
What can you do to enhance your experience next time, if applicable?

Shadowing Date: Response:

January 17, 2018 The first shadowing experience in the oncology department fell short of
my expectations. I had wanted to shadow an oncologist, to experience
how they perform their occupation, for that is what I thought I wanted to
be.

B. On ​subsequent​ visits: What connection(s) can you make between what you saw
and the role of mental health within this career path or mental health needs within your
community.

Shadowing Date: Response:

February 15, 2018 The biggest connection I was able to make between mental health
and health care is the quality of a drug addict’s brain. I found that the
shape and function of a drug addicts brain is vastly different than that
of a healthy brain.