Ashley Williams

Clinical Internship Comprehensive Narrative: Reflection

Baptist Memorial Hospital-DeSoto (Adult Intensive Care Unit)
Hours completed: 169 hours and 23 minutes
Learning Outcomes:
1. Demonstrate competent clinical application of basic and advanced therapeutic modalities
to advance skillsets when working with adult critical care patients.

2. Utilize assessment and diagnostic data effectively to demonstrate the ability to analyze,
and accurately explain assessment data in relation to patient status.

3. Formulate plans of care that take into consideration patient assessment data and
appropriate disease management strategies.

4. Collaborate with other healthcare providers and patients/families to provide education on

patient specific disease processes and disease management strategies.

As an intern in Respiratory Care at Baptist Memorial Hospital-DeSoto I was able to learn and

reinforce a variety of information, procedures, and skillsets while working with patients in the

intensive care unit. During my time as an intern not only did I push myself to learn new thing,

but my clinical preceptors and other healthcare professionals also pushed me. They pushed me to

gain new knowledge and helped me to close some knowledge gaps that I had coming into this

experience.

One of the first things that I recall gaining experience in and learning from during my

internship is gaining confidence in myself to speak with physicians. Before my clinical

internship I was always scared/nervous to speak with physicians about patients because I found

them to be intimidating. In the beginning of my clinical internship I still was not comfortable

speaking with physicians. Once my clinical preceptors saw this as being one of my weak areas,

we began to work on building my confidence to speak with physicians. Throughout my

internship both my clinical preceptors and I could tell that I had made significant improvement in

feeling comfortable speaking with physicians about clinical situations. My preceptors pushed me
daily to ask the physicians questions that I had, and would make me speak with physicians

about patient situations to determine what needed to be done. Spending 6 weeks with these

physicians allowed me the time to build relationships with each of them, and they became aware

of my areas of weakness. The physicians would take these moments to teach me and it allowed

me to gain a better understanding and fill knowledge gaps. I know that confidence cannot be

quantified, but I feel that I am more confident in myself and my knowledge now than I was

before this 6 week experience.

The second thing I recall about my internship and what I gained from it is the many

opportunities I had to reinforce skillsets needed when working in emergency situations.

Throughout my entire clinical internship I had many experiences that allowed me to critically

think and make decisions as if I were the therapist. I believe that by having these experiences it

further advanced my assessment skill sets and allowed me to also gain knowledge and

experience in critical thinking, and decision making skills. I remember one specific situation that

occurred towards the end of my internship. I was doing a ventilator assessment on a patient and a

nurse from another patients room called to me for help. As I made my way into the patients

room she began explaining to me the situation that had just occurred. The patient had previously

been on BiPAP for most of the morning and had been weaned off and onto a high flow nasal

cannula. She explained to me that she heard the patient vigorously coughing and came to check

on her. Upon assessing her she saw that the patients SpO2 levels were in the 60s and not

increasing even after coaching the patient to take slow deep breaths. As I entered the room I

quickly assessed the patient and saw that her oxygen saturation levels were still in the low 60s

and the patients work of breathing was increased. The patient also showed signs of using

accessory muscles. I quickly made the decision that the patient should be placed back on her
BiPAP machine. As I was getting the machine ready my clinical preceptor arrived and agreed

with my decision. I had many experiences like this throughout my internship that I believe

allowed me to advance my critical thinking and decision making skillsets.

The third thing I recall from my clinical internship is related more to patient and family

teaching. Throughout my clinical internship I had many concerned families. During this rotation

I was able to get to know these patients and families more and more each day. I truly believe that

I had never had the emotional connection to some families before because throughout school our

clinical rotations would change weekly. Being in my internship and coming to the same location

each day for 6 weeks allowed me the time to form relationships with patients and family

members. These families trusted in familiar faces and the care that was being provided to their

loved ones. For these families sometimes it can be hard seeing so many different faces on a daily

basis. I believe that seeing a familiar face each day allowed the patients and the families to relax

some knowing they have a healthcare provider they can trust. This also allowed me to become

more confident in my knowledge of therapeutic treatments strategies. I was able to advance my

knowledge and ability to educate patients and their families about different disease management

strategies.

During my clinical internship at Baptist Memorial Hospital- DeSoto I gained and reinforced

knowledge in many different procedures and skillsets. In the beginning of the semester I had a

hard time deciding where I wanted to do my internship. Going into this experience I do not think

I realized how much experience and knowledge I would gain. After having a 6 week specialized

rotation in the adult intensive care unit I feel confident that I made the right choice in picking the

rotation I did. From my clinical internship I was able to fill in gaps in my knowledge, and gain

new knowledge in certain areas. Not only was I able to gain new knowledge, I was also able to
reinforce information I learned in the past. Overall, I believe that my clinical internship allowed

me to become a more well-rounded entry level respiratory therapist. I will be forever grateful for

all of the situations I was able to experience, the knowledge gained, and the knowledge

reinforced. I believe that from this specialty rotation I will be a better therapist when I enter the

work field.