End of Internship/National Conference

My internship is over... and I passed!

I had so many bumps along the way, but it all worked out in the end. I am anticipating what my future holds. One thing I plan on doing is applying for graduate school for fall 2012.

I attended national conference a few weeks ago in Atlanta, Georgia. I learned so much and reunited with some of my peers. One session covered music therapy and social media. I realized now that some people look for answers about music therapy online. They may even come across a blog or facebook page. If we are creating something that gives a face to our profession we need to portray the information in a professional and informative way.

After creating this blog, it opened my eyes to other educational music therapy blogs. I wish to continue this blog to write about my journey and new path to a professional. Hopefully soon it will say "Keeping up with the MT-BC." :)

One. Week. Left.

A lot has happend since my last post. I completed my rotations on the Oncology Unit, Pediatric Intensive Care Unit, and now am running the whole hospital! I apologize for the amount of time since my last post.

Oncology- I learned so much about the different phases of treatment for cancer patients. I was also able to observe procedures such as: Lumbar puncture, radiation treatment, port access, re access, and suture removal.  I provided procedural support and collaborated with child life. This unit is very unique because patients have frequent hospitalizations and you follow them during their treatment process.

PICU- I loved my rotation on the PICU. The staff on this unit provide appropriate referrals and understand the purpose of the music therapy profession. I'm more included in rounds and have the opportunity to contribute to patients care.

I'm currently in charge of the whole hospital. It is very difficult to be one therapist in charge of four different units. I have learned a lot about prioritizing patients and time management. I don't know how my supervisor does it! I have so much respect for her and look up to her. She has accomplished so much with her position and I hope to be as successful as her one day.

Pediatrics Surgical Unit

I completed my rotation on the PSU last week. I worked with patients pre-op and post-op. One common goal was decreasing anxiety and pain. During rounds I identified who was going to surgery and assessed their coping prior to the procedure. I often used music as distraction or relaxation to decrease pre-op anxiety.

During post-operation I was there to help with pain management. I would educate patients with pain management techniques using music. I incorporated iso-principle and guided imagery during interventions. Upon arrival I asked the patient to rate their pain (using Wong Baker Faces or Likert Scale). I assessed music preference and a place they like to go to relax. With the Q-Chord, I provided patient preferred music using iso-principle and led into the guided imagery. In my experience, iso-principle and guided imagery was effective in decreasing pain as evidenced by a decreased pain level rating following the intervention.

I love the feeling of going into a patient's room and already having their preferred music. Music learning doesn't take up a majority of my time anymore, I can dedicate it to learning medical concepts and treatment plans. As Olivia put it, we are a personal pandora station to patients. :)

Mastering the Q-chord

I usually get sick at least once a semester. I was surprised that I've gone about four months without catching anything. Well, sadly I missed two days this week because of a sore throat. I actually tried to go to work today and my supervisor sent me home to rest.

With the extra time on my hands I went through the manual and learned all about the Q-chord. I already knew the basics and used the Q-chord once during procedural support with an older patient. The patient had very high anxiety and the Q-chord helped promote relaxation. Sometimes the guitar can be a barrier and having alternate interventions in your bag can make you stronger as a therapist. In a future blog (and once I feel better) I will reflect on how the Q-chord and skills I learned this week benefited me in future sessions. I might just post a video tutorial on the basics of the Q-chord, so stay tuned!

New Way of Thinking

My supervisor has helped me look at music therapy in a whole new way. When I go into a room I have to explain how what I did is different than a volunteer. Everything I do in a session must have a purpose. So the answer to patients or staff in the hall who ask us, "Oh, do you just play music for patients?" Is of course no. Or it can be bothersome when some people ask us if we are volunteers. We have to explain to inquirers that no, we don't just play music. When we have the time we go in depth of what we do and how it is different than a volunteer. It is tough when I get asked "Do you play music to patients?" I say, "Yes" because technically I do but it's much more than that.

At the hospital we have a lot of nursing students learning from the staff and doing case studies with the patients. It can be overwhelming with the amount of people at the nursing station. The other day I was in a room during a session and they asked that same question. I took the time to educate them about music therapy and the importance of it. It was refreshing that I could explain this concept to them because I remember one day when it wasn't so easy.

One exercise my supervisor had me do is write out two definitions for music therapy. One is written for staff using their language. Another is for patients/family with understandable terms. It's good to plan what to say beforehand so you sound confident and articulate in what you do.

Being Attentive

One skill I'm learning is to be attentive. Last week, I overheard an IV start was about to commence and I approached the nurse and said "I would love to help." Nurses don't always refer music therapy for a procedure so when I am on a unit I make sure to keep my ears peeled. IV starts happen almost every time the hospital receives a new patient. So I can see why nurses don't refer music therapy unless their patient seems to have high anxiety.

I have also learned how to advocate for music therapy on my first rotation. I gave my pager number to the secretary, built rapport with staff, and posted a flyer introducing myself on the unit. Now I can implement my knowledge sooner on the next unit. I am currently working only on the general pediatric unit and will soon transition to the pediatric surgical unit. After my rotation on each unit I will be in charge of the entire hospital for two weeks.

Midterm Evaluation

This week I completed my midterm evaluation! I can not believe I'm half way done. Time is starting to fly a little more each week. After my midterm, my supervisor commented on how much my music has improved. It was a nice time to reflect on how much I've grown as a therapist and has helped build my confidence for the final advance to the finish line.

The Path from Student to Professional

The path from student to professional is very unique to every music therapy student. I was on the same path as my fellow peers in my music therapy sequence while at FSU. I didn't really have to think much about it, if I had a question I asked my friends what they did for a course or an assignment. But here we are at the part of the path where we need to decide what internship to apply for, job to take, and population to work with. The scary part is we have to leave our peers behind and walk down the next part of the path alone. I knew I wouldn't be completely alone but metaphorically speaking, alone.

When I was at regional conference and a professional covered this topic, I was scared. I knew others were scared too when someone asked "What if I don't get an internship?" I personally felt like I was entering into some sort of limbo until finding a job. Now that I'm almost half way done with my internship (crazy)! I feel more at ease and now I question why I was scared in the first place. I now know why. I was about to enter a new chapter of my life and I didn't know what to expect. I was scared because I had to live by myself, live in a new place, and be with a new supervisor. The whole situation can be very overwhelming, but eventually you will see the light at the end of your path.

The moral of the story to all of you who haven't started internship yet is this. All you have to do is take one step at a time and everything works out on its own. It's like jumping into a cold pool. It's going to be very different and you will be anxious until you finally take that jump. But once you are in the water you will adjust quickly to the new environment.

Procedural Support with MT and Child Life

            I’ve had the opportunity to observe procedural support with music therapy and child life.  These professions obtain the same goal using different strategies.  I feel that both are equally successful and combining tactics from each will strengthen interventions.

            From my point of view, child life is more educational based. They prepare the patient by teaching what is going to happen during the procedure, why they need to do the procedure, and show the equipment that will be used so the patient is more comfortable.  One child life specialist I observed incorporated deep breaths, and narrated what was happening during the procedure while using distraction objects. If the patient’s attention was focused on the procedure, the specialist would explain what was happening and redirect the patient’s attention to the distraction object.

            Music Therapy is more distraction based. MT’s don’t associate themselves with the procedure or the equipment so they don’t appear threatening. The MT will start the session prior to the procedure and will distract the patient until after the procedure. When a painful part of the procedure is coming the MT will make sure distraction is at the highest. One reason music is beneficial is because it masks any sounds that would come off threatening to the patient.

            I believe that both methods of procedural support are effective and music therapists can learn a lot from child life. Combining some MT tactics with child life tactics will make procedural support stronger for music therapy. Patients with the cognitive ability to understand what is happening during a procedure will benefit from the education. Patients won’t feel as if they’re being punished if they understand what is happening.

Good Day

I've been meaning to blog about my amazing day on Friday! Here's the scoop..

Music therapy was referred for procedural support for an IV start with an infant. My supervisor let me lead the session and I will admit I was a little nervous. I started the session prior to the procedure and continued distraction techniques until the procedure was over. The wow moment was the comments received. The nurses said the patient was doing so well, one nurse said it was because of me :) The mother also said that the patient did so much better this time then the previous IV start (Mills canon suggests that music therapy is the reason for this) :) After the procedure I charted on the session and kept hearing a patient crying. I couldn't tell if it was coming from the room I just left as it was down the hall. I was packing up to leave the unit and noticed it was from the same room. I looked in and asked the parents if they wanted me to play some music to calm the patient down and they agreed. I used iso-principle (meeting the patient where he/she is and gradually leading them to where you want them to be), played louder music matching the patients crying then slowly transitioning to soft lullabies and was able to get a crying baby to sleep. I snuck out after that and the parents were so thankful. It was such a rush leaving that room. I was so happy to have helped them and calmed their child down. It’s magical watching how music can change everything right before your eyes. I was able to show this magic to the nurses as well as the parents.

Step Outside the Music Box

At my internship I've learned a good amount of music I'm not used too. It's been refreshing and introduces me to new styles that I now enjoy. I've never been a fan of hip hop but since it's a favorite genre of the patients here I've had to step outside my comfort zone and learn how to rap. Let me tell you... I'm not too bad! I actually enjoy rapping now. I get really into it and enjoy learning them. A tip about recreating hip hop is to use the Q-chord, not only does it give you a drum beat but it makes it easier to rap.

In my classes at FSU I never learned much hip hop. If your still a student, learn all of the different styles of music you can! Diversify your repertoire, especially if you're interested in working with adolescents. The two genres most requested at the hospital I intern at is country and hip hop.

Another challenge with working in a Children's hospital is having to constantly update yourself with what is popular on the radio. I frequently look at billboards.com top 100 to stay updated and better predict what patients will request. I can keep track of the top hits from day to day but we also have tons of outliers! I was super excited to learn a Blink 182 (one of my favorite bands) song a few weeks ago even though they haven't been on the radio in quite some time. If a song is older than a year it typically is not requested that much. Walking into a room is always an interesting experience because I never know what I'm going to get!
  

Staying Updated with MT

I wanted to pass on two resources that keep me updated with Music Therapy!

1. MusicTherapyEnews- I came across this because I was previously in an organization that used yahoo groups as a form of communication. You will need to have/make a yahoo account to add this, click on yahoo groups, and then search "MusicTherapyEnews" and it should pop up. Click subscribe, and you will get updates on MT. This resource is published by AMTA, and I have received updates about National conference that have been very useful. Another great thing about Yahoo is that you can forward the groups emails to your primary email. Just click on "edit membership" when you are a part of the group and click on what email you want them sent too.

2. Google Alerts- I want to give credit to Elisa Aven for showing me this. Google "Google alerts" and you can set up Google to email you any web results of Music Therapy. You can limit how often, and if the links are web, news, blog etc.

I hope this helps and if you have trouble accessing these just let me know!

Child Life

What is Child Life?

Child life specialists are trained professionals with expertise in helping children and their families overcome life’s most challenging events (the definition from the child life council website). I had no idea what a child life specialist was until this internship. During my practicum at the Tallahassee Memorial Healthcare I knew the child life specialist as the friendly lady that referred patients to music therapy, but they are much more than that.

I have had the opportunity to shadow most of the child life department. The child life department consists of six child life specialists, one school teacher, and one music therapist. A definition that clarified child life for me is that they have the same objectives as music therapy but the interventions are different. In future posts I will go into detail about interventions they use that can benefit music therapy. In particular, observing a child life specialist (CLS) during procedural support has been extremely helpful.

The child life major is heavy in psychology and child development. While music therapy is normalizing an environment with patient preferred music, child life (CL) does the same idea with patient preferred activities. During procedural support nurses turn to CL to assess if the patient needs sedation. CL act as support for the patients, one CLS stated that she feels like the middleman sometimes. CLS build rapport and trust with patients, and patients confide in them what they are scared to tell the physicians or nurses. During my meeting with the CL coordinator, she said that child life and music therapy are very complimentary. After observations, I can’t see how a children’s hospital functions without both of these fields.     

Building Relationships With Other Professionals

I love my field and how established it is. We have amazing research and work together to better our profession. Another thing I have noticed, which is something that isn't taught in the classroom is the amount of compassion, professionalism, and courtesy MT has. The professionals set the standard for this and it is passed down to all interns during the internship.

I am so lucky to have a supervisor that has worked very hard to build relationships with everyone that works in the hospital. She is a great model for me to observe. My supervisor treats everyone in the hospital with the utmost respect, from the physicians to the cleaning crew. She has really established the etiquette of professionalism when working in this setting. For example, whenever she receives a referral she makes sure to say thank you afterward and let's them know how the patient did.

Typically, (being the awkward person that I am) I pass people in the hallways and never know if I should make eye contact, say hi, etc. Now after observing my supervisor, I make sure to say Hi to everyone with a smile. Even in elevators I try to make a friendly conversation. You never know whom you encounter in the hallway; you could be passing someone that could put a good word in for you. So it is very important to make a good first impression the very first time they see you.

Building relationships is so important, not only for you but for everyone else in the field. You put a face to music therapy. When you are polite and courteous, physicians are more willing to make referrals. I have seen that once you receive a few referrals on a unit, they multiply when people see what you do. Word of mouth is another great way information can get passed for MT.

This is a great skill to attain, especially for new MT programs. Just remember, the little things really do count. It takes time to gain respect from all of your fellow employees, especially when they don't understand what music therapy is. But it is a whole lot easier to put your foot in the door when you show them courtesy and professionalism.

Chaplain Shadowing Experience

Today I had the wonderful opportunity to shadow Sue Crowley, the chaplain for the hospital. She started off by introducing what she does and gave me several informative articles about her field. Before we saw patients Sue showed me where the chapel of the hospital was. I must have passed the open door countless times and didn’t realize it was there! At the entrance there is a prayer box for patients and she collects the deposits.

Sue receives referrals for patients but mostly makes rotations on floors to see if she is needed. She tries to go to rounds three times a week to assess her priority as well. I observed her with many patients and I loved the sense of peace she gives off.

I think one thing that I liked most of this shadowing experience is the way she introduced herself. She is very open to all spiritualities and when she knocked on the door she said who she was and started a conversation about how everyone in the room was doing. She picked up on religious cues and knew when it was appropriate to offer to pray. I think Sue shows great compassion for all of the patients in the hospital and I enjoyed getting to know more about her job.

Getting Involved

I feel one of the bigger challenges in the beginning of an internship is being in a new town, living alone and not knowing anyone. It can be a hard transition when you're used to being surrounded by roommates and close friends. I had the opportunity to get involved in the community here and it has helped make this change not as difficult.

Prior to moving to Fort Myers I researched the community with my interests. I love to play soccer, so I researched an adult soccer league. It was pricey to join for a summer season. Luckily, that site led me to a soccer blog for south west Florida. I became a member and they send me emails with notifications of new pickup games. I try to play every Thursday and Friday but it's nice because I have the option to go. If I'm overwhelmed I can always go the next week.

Another interest I researched was finding a local church. I've always wanted to play an instrument or sing for the services. I found the website of a church and emailed the music director. He responded that they could always use people and I've been playing for services ever since. It's also really nice because I can go to church and not have to worry about sitting alone.

I honestly love playing in the church and being involved in the community at least a little bit. It's just the right amount to not feel overwhelmed. I think it's good to research early and have an idea of what you can do before you go. I can't count how many times I started something or was involved in a group and said "I wish I started this sooner."

This can easily be transferred to you! I know not everyone likes soccer. But if you like volleyball, running, volunteering, or anything, you can look it up wherever you intern or move to and their will definitely be something for you. You just have to find it and look in the right place!

Are you a current or past intern? What helped you with moving to a new place?

Finding the Right Internship

The internship application process can be very stressful and overwhelming. The purpose of this post is to share my experience, tips, and to answer common questions that may arise.

My Strategy

When I started looking for an internship I didn’t know what population I wanted to work with, I liked them all! I also didn’t know where I wanted to be located. I have lived in Florida all of my life and maybe I want a new state, a new city? Needless to say it was easy to put off applying since it was such a big decision. Big Mistake! Be proactive.

Everyone picks where they apply differently, but since I wasn't limited on location I wanted to look at all of my options. First thing I did was look at the AMTA Internship Roster and started eliminating the sites by:

1. Population

2. Location

3. Philosophy of Music Therapy (This requires some research).

Then I started emailing directors for more information and an application. After some research, I had an idea of my top choices, and I started applying to my top three sites.

 **Don't forget about university affiliated internships. I am currently at an internship affiliated with FSU. You will need to speak with your MT Director to find out about these internships.

Be Proactive

• Do the research early.
• Try to have an idea of where you want to go as soon as you can.
• Check due dates now- some internship applications are due 6 months-1 year before it starts. Know when your deadlines are.
• I had my applications proofread by a handful of people before I sent them off. In my opinion, the little things such as spelling and grammar are important.
• Emailing- When conversing with Internship directors, proofread your emails before you send them out. My supervisor said she looks at everything when deciding on interns, especially professionalism in emails.

The Interview

1. Dress appropriately
2. Be prompt, polite and professional
3. Be prepared

Questions

1. What if after my internship I want to work in a different population?

           That's okay! I thought it would be hard to find a job in a population you have not interned with. If you talk to professionals about past job experiences some have done it all! 

    2. What if I don't get an internship?

        

          This can be a scary question for students applying. I'm a firm believer in what is meant to happen will happen. If you get turned down by your top three choices, keep applying. Have backups and if you apply early then you will have time to apply to other sites before the deadline. A lot of internships also start in January so you can always reapply to your top choice. A good idea is that if you do get declined, to email the director and ask for things to work on for your next interview or application. I'm sure they will gladly give feedback. If you are worried and have asked this question, apply early so you have more chances to intern when you want to!

     3. What if I need help financially?

         There are scholarships out there for interns! You just need to find them! If you are an AMTA student member you can log onto the website and find scholarships you can apply for. Check it out!

I hope this helps, if you have questions or have anything to add please comment!

Orientation

Boy, I didn’t realize how big the Lee Memorial Health System is! LMHS has 76 locations in the Southwest Florida area and is home to more than 9,500 employees.

My general orientation on Monday was at Cape Coral Hospital, about a half hour away. I had to be there at 7:45am sharp to check in. This orientation was for future employees, I was sitting near nurses, security guards, and people working in transport. I learned about precautions I needed to know before working in the hospital such as infection control, risk management, corporate compliance, and customer service. It was refreshing to have an idea of what an actual job would feel like.

My second orientation was on Tuesday at the The Children's Hospital with my supervisor, Julie Avirett (who is very nice, I can tell everyone in the hospital loves her). I met her in the beautiful atrium at Health Park. The hospital lobby has glass elevators, a little pond area, and a grand piano where volunteers play throughout the week. She offered to buy me a coffee and had doughnuts waiting for me in the office which was very nice.

To start the day off I attended Pediatric Rounds, which are meetings for staff on the second floor to discuss the current patients’ status. After that, the majority of my day was devoted to paperwork and reading the hospital policies, AMTA code of ethics, professional competencies, and confidentiality agreements. Around noon, the whole child life department had lunch together to welcome me. I felt very fortunate to be around so many awesome people. At The Children’s Hospital the music therapist is a part of the child life department and is overseen by the child life coordinator. I’m excited to be a part of this department because I’m interested in Child Life and the similarities with MT (Future topic to coverJ).

The next six months are going to be a blast!

Introduction

Welcome to my blog! My name is Janelle and on May 16th I will begin my Music Therapy internship at the Children's Hospital of Southwest Florida in Fort Myers, Florida.

To start off, I want to briefly explain my reasons and goals for this blog.

This blog will act as my senior project for my undergraduate degree at the Florida State University. My goal is for this resource to be informative for all ages; from students looking for the right internship to professionals looking for new innovative ideas. As music therapists, we learn tremendously from each other. That's why MT blogs and events such as conference can be very beneficial.

The Path from Student to Professional

At the 2011 SER-AMTA Conference I was inspired by Natalie Mullis' session covering this topic. This transition can be very difficult, especially since every step is new and unique to each MT. In a future blog, I will discuss this topic in detail and possible goals for an intern.  

I have read some other MTI blogs and they were extremely helpful. My aim is to give back by recording as many of my experiences to help future interns as those blogs have helped me.

Feel free to comment with feedback and I look forward to future blogs!