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"All In A Day's Work": A Reflection of My Experience as a Patient Relations Representative

During winter break, I was given the once-in-a-lifetime opportunity to shadow two supervisors in Jacobi Medical Center's Patient Relations Department. Jacobi Medical Center is a 457-bed level 1 trauma center located in Bronx, New York. Unlike the Department of Human Resources, Patient Relations requires knowledge and expertise of the key elements of patient engagement and patient recovery. Often called upon to advocate and listen to patients' demands in order to provide a voice when they are otherwise silenced. Upon my first day as a Patient Representative, I noticed that the role of spokesperson for the patient and their family entails more than just resolving a problem or addressing a complaint. This role also means being a support system through what appears to be a challenging time in these individuals’ lives. Patient Relations Representatives often must make a brisk and impartial evaluation of a situation to determine what will produce the best outcome. Stepping in more than once even after the initial issue is considered resolved. Mindful to act on behalf of a patient's needs over hospital bureaucracy. One of the first cases I dealt with during my first week at Jacobi cemented this view. My supervisor, Aisha, and I encountered an outraged mother whose sickle-cell-anemia-affected daughter was turned away from the pediatrics department and refused a flu shot. The mother and her daughter receive regular medical care at Jacobi Medical Center, often traveling a long distance to see the daughter's primary care physician. The family’s history with the hospital was a driving force for my supervisor to look closely at her concerns and take them directly to hospital administrators. The validation of her concerns as well as the attention to addressing her needs seems to make her feel confident that her daughter would receive the care that they were seeking. Holding the care providers accountable for implicit disregard for this family was of utmost importance to her as it would be most who are having health challenges.

Patient recovery, which intermingles with patient engagement, is the feature that I appreciated the most since it is personable and intimate on levels that I never experienced with strangers. During a highly isolating period (Covid-19) when visiting was prohibited unless there were exceptional circumstances such as labor and delivery, trauma, pediatrics, or end-of-life care, patients' families relied on us as patient relations representatives to bridge communications with their loved ones. That was the case when it came to a young mother whose teenage son suffered catastrophic injuries in a motor vehicle collision and was declared brain dead. After ongoing interaction with the family, this case became personal for me. As her son's life drew to a close and my internship came to an end, I began to see the emotional toll it had taken on me as a result of the enormous amount of interaction shared as the mother's main support system. Given my decision to attend law school and work in crisis management upon graduation in May, this case served as a primer on how to use crisis communication effectively. This case started in December and allowed me to follow my own growth from shadowing and observing my supervisor to taking initiative and providing collaborative solutions during the interactions. This case left me with a bittersweet feeling because while I felt that we offered a shoulder for the Mom to lean on, I think more could have been done for her son. Prior to his death in March, he remained critically ill with serious brain injuries, and yet the doctors in the Surgical Intensive Care Unit diagnosed him as brain dead early in his admission (December 2021). The Apnea test and other tests used in the declaration of brain death were not done initially and yet his mother felt pressured to decide to donate his organs. When we approached the physicians managing his care I didn’t sense the level of empathy I thought was required. My supervisor sensed my displeasure after the discussion with his treatment team and advised me to submit a formal grievance.

Since the beginning of this semester, I set goals that I aspired to fulfill by the end of my internship. I can firmly state that I have achieved those objectives and that I have come away from my internship with a greater level of self-assurance and a stronger desire to assist others who are unable to help themselves. I had the opportunity to work in multiple patient care units however, most of my experience was encountered in: Burn ICU, Acute Rehab, Pediatrics, Ambulatory Care and the Emergency Department, and Surgical Intensive Unit (ICU). I was fortunate to actually incorporate the knowledge that I have accumulated during my four years of studies at Old Dominion University and especially my communication courses, specifically public relations. Perhaps the most valuable lesson learned and one I would pass on to future interns considering this course is, regardless of field or position, one must transform oneself from an insensitive, perhaps self-centered point of view to one that is sympathetic toward others who may be affected by your decisions, attitude, and communication style. I implemented this lesson often by the end of my internship, especially during highly volatile situations when it was necessary to effectively interact with patients, families, and staff to de-escalate. Overall, I would attest that gaining the respect and trust of my supervisors during my internship at Jacobi Medical Center's Patient Relations Department is my major triumph. I was allowed to navigate and manage cases often assigned to seasoned Patient Representatives. I was even offered employment towards the end of the internship by the Director of the Patient Relations department.

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