Learning Contract

 

 

General Information

Name: Ethan Walsh

Internship Hours: 40 hrs/wk

Internship Placement: The Miriam Hospital Cardiac Fitness Center

Internship Supervisor: Adam Mancini & Julianne DeAngelis

Internship Job Title: Cardiac Rehab Assistant

 

 

Background

 

The first time I was exposed to cardiac rehabilitation occurred when I spoke to a friend of mine who was placed at a cardiac rehab site for his internship.  I became interested in learning more about the field, and after meeting with an advisor and explaining my career goals to him, it was suggested that I pursue an internship at a cardiac rehab facility.  I want to become a Physician Assistant and part of what is required for being accepted to PA school is having direct hands on experience with patients.  That is what motivated me to pursue a position as an intern at The Miriam Hospital Cardiac Fitness Center, because interning there would give me patient care experience as well as give me an opportunity to gain knowledge about cardiology.  This experience will greatly enhance my resume and bring me closer to reaching my goal of becoming a PA.  The reason I decided to complete this internship in the summer is because it will allow me to enroll in more classes during my senior year.  This is something I have planned for in order to complete the requirements to graduate with two degrees, Kinesiology and Biology.  I am very pleased to be making progress towards my career goals and also learn how to help people recover from severe cardiac events; knowledge that will be valuable as I move forward towards becoming a medical professional.

 

 

Professional Objectives

 

Objective 1: Learn how to properly administer and evaluate a stress test.

Activities/Resources:

• Observe stress tests given to patient’s pre and post rehab.

• Assist with proper anatomical placement of EKG leads and monitoring of vital signs as well as interpretation of data during stress tests.

• Learn how to determine what protocol should be used based on the patient’s condition/ability as well as the termination criteria and contraindications.

Evidence:

• Discuss with my supervisor the progress I have made and receive feedback in my evaluations.

 

Objective 2: Learn how to monitor patient’s heart rhythms and be able to recognize abnormalities.

Activities/Resources:

• Gain knowledge about the heart’s conduction system and have an understanding of its anatomy and physiology by using text books, internet sources, and lectures.

• Practice reading telemetry data with supervisors.

Evidence:

• Present a section in my portfolio that discusses telemetry and display the knowledge I have gained.

• Include a bibliography of the sources I used in my studies.

 

Objective 3: Become familiar with risk stratification methods for patients entering the rehabilitation program, and be able to accurately determine risk stratification.

Activities/Resources:

• Observe intake sessions during which new patients are informed of the rehabilitation program’s purpose when they meet with a staff member who also reviews the patient’s medical history and decides what risk factors are present.

• Review medical charts on my own time as well as with a supervisor in order to become familiar with terminology.  Understanding the history presented regarding the patient’s medical conditions, social and emotional well-being, and nutritional health.

• Become familiar with the tools used to gather information about each patient, for example questionnaires that are distributed pertaining to nutritional habits, psychological health, and exercise tendencies.

Evidence:

• In my portfolio discuss the criteria used to determine if patients are considered to be high, moderate, or low risk.

 

Objective 4: Gain knowledge of the various kinds of medical conditions that involve the heart and understand the pathology associated with them as well as how exercise can be used as part of an individual’s treatment plan.

Activities/Resources:

• Research causes of heart disease along with the causes of other conditions that involve the cardiovascular system and the pulmonary system.

• Study the charts of patients and their past medical history.

• Observe the staff determining exercise prescriptions based on the risk factors of patients and their diagnosis.

Evidence:

• Include in my portfolio information regarding the various types of conditions that can be treated in part by exercise, as well as the pathology that causes them.

• Include a bibliography of the sources I used in my research.

 

 

Objective 5: Learn about the challenges people of all ages and backgrounds face when recovering from major cardiac events or are living with pulmonary disease.

Activities/Resources:

 

• Constantly communicate with the patients about their progress and obstacles they face throughout the course of the internship.

• Be involved with education classes and group discussions led by the staff psychologist and dietician to gain insight into how emotional and mental well-being along with proper nutrition affects individuals.

• Through observation and discussion, improve my understanding of the challenges people face that include the physical, mental, social, and financial aspects of dealing with acute and chronic medical conditions.

Evidence:

• Discuss in my journal entries the progress I make in understanding the obstacles people face throughout their rehabilitation experience.

 

Internship Details

 

Duties include:

• Monitor blood pressure, heart rate, RPE, and oxygen saturation while patients are exercising.

• Prep patient’s to apply EKG and also apply EKG electrodes and leads to patients

• Monitor heart rhythm of EKG’s.

• Explain to patients how to set up exercise equipment to proper setting such as speed, elevation, resistance, and time.

• Lead stretching and relaxation sessions at the end of exercise classes.

• Assist patients using free weights and using weight machines.

• Observe intake sessions in order to eventually be able to assist in the process, for example completing forms, assessing baseline vital signs, understanding risk factors based on patient history, and giving a tour of the facility.

• Assist in stress test administration, including applying a 12 lead EKG prep.

• Evaluate the 12 lead stress test results.