Thursday, August 16, 2012

The End :(

      So my dream summer internship in California has come to an end... it hasn't quite sunken in just yet, and I have a feeling that it won't for a little while. I had the greatest time imaginable, and I learned so much more than I had anticipated. The challenge of moving across the country and tackling unfamilar tasks has taught me a lot about myself. I'm really pleased with my experience overall.
      My last two days were spent at the clinic, and they were pretty uneventful. I had gotten in touch with Kate of FAP on Monday morning, and she was extremely pleased with what I had left her. I spent the rest of Monday completing an "internship evaluation" for Dr. Estes. I just basically wrote and reflected on what I had done over the summer (quite similar to this blog actually, just a bit more formal). I'm really happy with how the paper turned out. I plan on sending it onto Tim & Kathy Statton, the Juniata trustee/alum family who set up my internship, in the near future. The paper also served as a great introduction/overview of the binder I put together containing all of the materials I had completed for the clinic. I printed and organized all of my work for the website, the clinic operations manual, and the annual fundraiser. Having actual printed documents makes my work seem all the more real. Poliana can refer to it whenever she needs to whether it be for editing purposes or anything else. I wrote quite a few more policies than she had thought so she was very pleased. :)
      After our little wine excursion didn't go so well, I decided to spend Monday afternoon contacting wineries by email. I drafted a formal email requesting the donation for the fundraiser and then attached an individualized letter for each establishment. I probably contacted about 15 wineries, including a few located here in Marin county. I was sort of operating on the "worst they can say is no" philosophy and just gave it a shot. Then, on Tuesday afternoon, Poliana received a call from one of the wineries. THEY'RE DONATING A CASE OF WINE! We were both so so so happy. She was so pleased that I took the time to do this as she doesn't have the time herself. I'm smiling just thinking about how happy we were. We hope to have at least 3 cases for the event so this is a huge contribution.
      Other than the wine excitement, Tuesday was nothing special. I continued to proofread my paper and other materials before handing them over to Poliana. At the end of the day, it sure didn't feel like I may never step foot in that office again. One of the physicians sent me off with some delicious red velvet cake from her dog's birthday party to ease the pain.
      Poliana and I didn't have to say goodbye just yet. I was dreading this moment more than anything. We had basically spent everyday for the past 7 weeks side by side, and it's already weird not having her to talk to. She is one of the kindest, smartest, most reliable people I have ever had the pleasure of meeting. At the end of the day, we ran an some errands together and then she dropped me off at home. Goodbyes are the worst!! It was so so sad. I kept it nice and short for fear of tears. If I ever make the trip out to Northern California again, she'll be the first person I visit.
      I know I said this already, but I really really cannot believe it's over. I am so thankful for the amazing opportunity, and I know I will never forget it. Thanks for reading!!!

Sunday, August 12, 2012

Week 7: Winding Down & Wrapping Up

      This past week was spent primarily wrapping things up. I've been editing my materials for both the clinic and JHS in an attempt to provide them with the most complete and perfect product. Poliana and I took a mid-week break to work on the annual fundraiser/explore wine country. 
      I completed all of the clinicians and Poliana's abbreviated bios for the TSC's website. I actually had a pretty good time with this task. It was both interesting and challenging to play back these twenty minute interviews with the staff members and then compile and compact the information into a short paragraph. The clinicians are all of similar age, and they were in the medical field when the HIV/AIDS epidemic began to emerge. It's really interesting for me to listen to their recollections of the time and how they got to where they are today. I also really love hearing about what they actually do for a living. Two of them work for pharmaceutical companies and another is a professor of medicine at UCSF. There's a lot of knowledge of HIV/AIDS at the Tom Steel Clinic, and it shows in the most advanced care they are able to provide to their patients. 
      Since the clinic is closed on Wednesdays, Poliana and I took the day to travel up to Sonoma County to inquire about wine donations for the annual fundraiser. We stopped by small, family-owned wineries and some big named ones as well, however their reaction was not as positive as the local businesses had been. It seems as though they get a lot of requests for this sort of thing. Many replied by saying they had already reached their donation quota for the year. We were a little bummed, but we had to give it a try. We probably visited about 20 wineries and 8 took our information. So all in all, it wasn't a complete fail. We enjoyed a nice lunch in the cutest town of Calistoga, and our way back to Marin we stopped by Grgich Hills Winery for my first wine tasting experience. We got a tour of the beautiful vineyard and cellar and sampled some really great wines. A great way to end the day! 
      I also wrapped up all of my work for Jail Health Services throughout the week. I needed to make a few edits to video script based on the feedback from Dr. Goldenson. I organized the materials into a binder: an outline of the video, notes from the meetings I had had, the script, and all of my transcribed interviews. I dropped the packet and electronic copies off at the FAP office on Thursday afternoon but neither Kate or Isela were around. I will probably call the office sometime soon to see if there is anything else they would like from me. 
      I can't believe I only have two days left. I have no idea where the time has gone. I'm extremely pleased with all that I've learned and accomplished in the short 7 weeks. I'll be sure to savor the next two days of work and life in Northern California. It'll be bittersweet to have to leave.

Sunday, August 5, 2012

I was able to get my hands on a few of the super staged photos of Poliana and myself at the clinic. These were a couple that didn't make the cut for the Juniata publication. 

We're smiling because we feel so silly :) It's also pretty ironic because the two of us would never normally be found in this room together. I'd also never pop a squat on the exam table. Looks kind of good though?

Photo props to Douglas Zimmerman

Week 6

      My weeks are starting to really blend together for whatever reason and recalling the past week of work is proving to be way more difficult than usual. Time continues to move astonishingly fast. Less than two weeks left! :(
      Monday was a pretty standard day at the clinic. I took some time to transcribe my interview from Friday afternoon, a task that I've come to despise. Poliana and myself also began to do some follow-up on the donations we had requested from local businesses. We have already heard back from one bakery and two grocery stores, Whole Foods and Safeway. Poliana is so so excited about the arrangements being made so far in advance. We have a plate 45 mini fruit tarts and $200 in gift cards for the fundraiser already! 
      Tuesday I spent the morning in the city. I had another interview with Tanya Mera, director of Jail Aftercare Services (JAS). JAS is a branch of Jail Psych Services that specializes in re-entry services and mental health care linkages with community clinics for severely mentally ill inmates being released. They mostly work with inmates who have been referred to them by the behavioral health court. She was extremely personable and informative and gave me a lot of input on what she would expect to see in the video. She made a really good suggestion of including a "how to stay healthy in jail" portion. 
      After the interview, I had a meeting with Kate and Isela of FAP on what my next steps should be, as I had reached a stand still and don't have too much time left. I was so nervous. I personally had felt that I could have done so much more in terms of the video. I went over all of the interviews with them, what I had learned, and the script I had for the video so far. They were so impressed with all that I had accomplished so far. They reassured me that compared to what they had at the beginning of my internship (nothing) that now they have a really solid basis from which this video can be created. Another meeting was scheduled with Kate and Dr. Goldenson for the end of the week, and then Isela took me into the jail to show me more of it. She took me through the intake process so I could get the idea how what the inmates have been through before they move into their housing pods for orientation. They go through two different medical intake screenings during intake. 
      The clinic's graphic designer is finally ready to take on updating the website with my material! He figured out the best way to make the changes I had suggested and is in the process of doing so. All of the material I had prepared thus far is now in his possession. I spent a good deal of time this week working on writing each clinician's bio. That will be the next thing I send onto him by the end of this next week. 
      In preparing for my meeting with Dr. Goldenson (director of JHS) and Kate on Friday, I worked extensively on my video script taking in the consideration the input Kate and Isela had given me earlier in the week. I was excited to get Dr. Goldenson's feedback as well as hear how he pictured this whole video panning out. He too was pleased with what I had accomplished. Our meeting focused on how to actually get the video produced. They are going to look into the possibility of partnering with one of the local universities' film production departments. I hope it can be done. 
      Despite there not being an actual video at the moment, I am really pleased with the information I was able to gather for JHS. In completing a great portion of the planning process, someone can just pick up with what I've done and run with it. Sometime this next week, I'll have one last meeting with Kate and hand everything over to her, all of my interviews and the edited script. All in all, it was a fantastic week. 

Sunday, July 29, 2012

Week 5: And It Continues...

      This past week was strangely similar to the week before with most of my time spent in the clinic in Mill Valley. A huge international AIDS conference in Washington D.C. left just Poliana and myself in the office. The personnel I've been reporting to at the Forensic AIDS Project in the city were also at the conference.       
      I attempted to trudge forward with my video. My interview with Joan Cairns, director of Jail Psychiatric Services (JPS), took place on Monday and was incredibly informative. I learned a great deal about their services as well as an introduction of Jail Aftercare Services (JAS), a subset of JPS. I was able to make contact with another nurse practitioner and the director of JAS for future meetings. I'm really happy with all of the information and opinions I've been able to gather, but I'm still not sure of the most efficient and effective way to organize it all. I also can't just go into the jails and start filming so I've been really limited with my lack of supervision. Hopefully at the start of this next week once everyone returns, I'll get some assistance.
      I also toyed around with the idea of contacting a professional video production company to film the video. I spent a lot of this week developing a pretty sound script of what I think should be covered. I'm excited to pass it on to others to be proofread. I contacted a few local companies just to inquire their thoughts on the project and if they ever do similar projects for very little or no cost. I received a few responses, and people seem curious. Again, I can't really move forward with any of this without talking to my superiors first. It may be more complicated than it's worth. Everyone doing the filming would have to get clearance to be inside the jail and so forth. Next week will be the true tell-all of what's going to happen next. I just wish the end of my time here wasn't breathing down my neck.
      In the office all week, I alternated working on the JHS video and organizing the contacts the Tom Steel Clinic is going to make for donations for the annual fundraiser. In order to make the planning process a breeze in the future, Poliana and I have gone ahead and created a "directory" of sorts of the local businesses we plan to contact. I've drafted up letters for the various caterers, bakeries, grocery stories, wineries, and party rental companies we'll be contacting. Poliana and I are visited a number of the establishments closest to the venue of the event (Room Gallery in Mill Valley) yesterday. People were so appreciative of us making this contact so early. All of the places we went to were willing to contribute. It was really nice to see more of the area. We're setting aside of whole day to visit the wineries. That should be a lot of fun! 
      Friday afternoon I went into the city to meet with Melissa Gore, NP in county jail 2. She had very similar opinions and stories of her work in the jails. She focused a great deal on what she would like to see in the video, and I appreciated that. Melissa took me into the medical clinic again and introduced me to a few more individuals I should get in contact with. 
      I'm really anxious for what this week will hold. I hope to definitely have my superiors accompany me into the jails and do some major filming. Can't wait! 

Monday, July 23, 2012

Week 4: More of the Same

      Another week has just flashed before my eyes. I'm just over half way through with my internship, and I cannot believe it.
      I spent the vast majority of last week at the clinic with Poliana. I have yet to receive any word from the clinic's graphic designer so no progress has been made on the website. I keep reading and rereading the materials I have prepared to send along to him. I want to be completely sure it's all ready to go when he finally gets the time to respond.
      I continued to draft more policies and more procedures. I'm really surprised that this task hasn't got old yet. There's so many different topics to cover that I'm constantly learning a different aspect of the clinic's operation. I worked on the "Advanced Care Directive" and "Urgent Care" policies just to name a few.
      I also made quite a few calls to Jail Health personnel to try and schedule some more interviews for my video. I was able to get in touch with nurse practitioner, John Poh, who I interviewed Friday, and Joan Cairns, director of Jail Psychiatric Services. I prepared my questions for both individuals throughout the week. My interview with Joan is scheduled for Monday morning.
My workbench at TSC
      Wednesday afternoon I got to have a little, entertaining break to be photographed for a Juniata article being written about my internship by John Wall, director of media relations back in Huntingdon. I was actually pretty nervous. I was terrified it would be too awkward to handle. However, the photographer (from a local newspaper) was incredibly friendly and made the session kind of fun actually. Since a great deal of my work is in front of a computer, we had a lot of fun trying to make it a bit look more interesting. He even got Poliana involved for some "candid" shots of her instructing me. I hope they turned out pretty well.
      Poliana, Dr. Estes, and the Board of Directors of the clinic are beginning to plan their annual fundraiser to be held in December. Usually each member of the board takes on various tasks and basically puts on the event themselves, but this year Poliana is sort of coordinating the whole thing so as to limit some confusion and frustration. As a non-profit organization, ideally everything for the event is to be donated by local businesses. Hence the reason it's essential to begin planning so early. I was ecstatic to have to opportunity to write the donation letter to request the items for the fundraiser. I have a ton of experience writing these for Relay for Life, and it really paid off! Poliana was extremely appreciative and impressed as she had never written a letter of that nature. We also began to develop a list of caterers, wineries, and coffee shops to request refreshments from.
      Friday I was at the clinic doing my regular thing in the morning and then went to the city in the afternoon to meet with John Poh. He was incredibly honest, friendly, and entertaining, and I absolutely loved listening to his stories. I could tell he genuinely enjoyed his work. I got to enter the jail again, and this time I paid a visit to the "felony floor" where John directs the medical clinic. The prisoners on this floor are awaiting their formal trial and sentencing. John disclosed a lot of great information for me on the medical services available at his clinic, the most common health issues he sees, and the frustration associated with pain management in jail among a number of other things. He gave me a number of new names of JHS professionals to contact.
      I'm really excited to meet with Joan Cairns on Monday. Jail Psych Services (JPS) is a completely different aspect of the health care available for inmates, and I do not possess much knowledge on their services. I'll be able to really get a handle on how I want to organize my video when I feel as though I have at least general information on all JHS has to offer.
     All in all, last week was a very successful and a lot was accomplished. I hope to schedule a number of interviews for this week and start filming as soon as possible. Once I've made initial contact with these various health professionals, I feel more comfortable asking them to be on camera. I also hope they'll feel more comfortable with me and be willing to help out. We'll see! :)

Friday, July 13, 2012

Week 3: Well On My Way

      At the conclusion of this week, I really feel as though I'm fully in the swing of things. I've been going back and forth between the clinic in Mill Valley and FAP in the city, and it's been great. As I become more acquainted with the staff of the Forensic AIDS Project, I continue to learn more and more about the organization. It's extremely impressive.
      Although I am technically working for Jail Health Services (JHS), FAP is my home base. As a subset of JHS, they have been extremely helpful in debriefing me with the health care services that are available to inmates in addition to HIV/AIDS care. Medical students are a regular part of the JHS/FAP team, and they hold numerous focus groups in the prisons to assess the prisoners' opinions of the care they receive. I pretty much spent my entire Monday reading the summaries, findings, and suggestions of these focus groups. The next step will be scheduling interviews will various JHS personnel.
      Tuesday morning I was at the clinic with Poliana. We have yet to receive any word from our web designer about the programming changes so I contacted him to follow up. I was able to draft a partial "Clinical Social Work Services: Basic Referral Guidelines" procedure before I had to head to the city.
     My afternoon at FAP was spent preparing for the interviews I mentioned previously. I scheduled interviews for today (Friday) with Dr. Joe Goldenson, Director of JHS, Isela Gonzalez, HIV Prevention Services Coordinator of FAP, and Isaiah Hurtado, Lead Case Manager of FAP. I drafted up a multitude of questions and then organized them according to the individual I would be interviewing. I am so thankful for the News & Professional Feature Writing course I just had this past semester. Having quite a few interviews under my belt from writing my stories is so helpful.
      Wednesday I was back at the clinic. The variety of work I'm doing is making the time go so fast. I spent most of my day there continuing to prepare for my interviews on Friday. The environment at the clinic is much more accommodating for efficient work. (There are about 7 staff members per room at FAP.) I really appreciate the flexibility Dr. Estes, Poliana, and Kate are allowing me. Once all of my interviews are conducted, I probably won't have to go into the city at all. I love the ownership I get to take in these projects. It's on me to develop a successful, beneficial end product.
      I also began to brush up on my iMovie skills. I've used the program before, but I want to be able to use it to its full potential for the orientation DVD. I plan on voice or film recording each interview on my iPhone so I've been practicing my steady hand at that as well. It's really quite amazing that I have all these tech resources right at my fingertips.
      Thursday I was at the clinic again, and I spent the day divided amongst a few things. Poliana and I spent a good amount of time editing some policies I had some questions about. She then gave me a bit of time to put the finishing touches of my final paper for the Gambia. One of the other clinicians, Dr. Jackie Tulsky just returned from vacation, and she, in a word, is amazing. She is the kindest, most down to earth physician I've ever interacted with. She spent an hour and a half with just one patient to answer all of her questions. Dr. Tusky is a professor of medicine at the University of California, San Francisco. She herself, went to med school at PITT so we bonded over Pennsylvania for a bit. I conducted my first interview with her for the clinicians' bios for the TSC website. I really appreciated the opportunity to ask her about her past training and experience and learn a bit about how she got to where she is today.
      And finally today, I conducted my interviews with the FAP staff members and Dr. Goldenson. They all went extremely well, but I'm quickly realizing there are SO many different topics and approaches I can take to the orientation video. Everyone I spoke to today had their own ideas about what should be highlighted. I'm going to schedule more interviews next week and then begin to develop my outline and script.
      I also got a tour of a few of the jails this afternoon. I was in the male and female housing units, the medical care unit, the psych unit, and the medical clinic. I sat in on an orientation for new female prisoners and heard the short presentation FAP staff gives about the opportunity to get tested. I was extremely impressed when about half the group expressed an interest in HIV, Hep B, and STD testing.
      I am completely dumbfounded by the amount of information that's coming at me on a daily basis. If you had asked me about the health services available in jails 3 weeks ago, I would have had absolutely nothing to say due to sheer ignorance. There is a whole other sector of health services that out there I hadn't ever considered being a part of. I absolutely cannot wait to talk to more people and continue to learn about what's available for prisoners. For a majority of those incarcerated, jail is the only place they receive medical care.