How to waste your student’s hospital internship
I recently shared some advice for graduate students on how to waste their hospital internships, and while I stand by my tips as effective strategies, it is worth noting that these clinical rotations, like most things in life, are two way streets. Sure, students, through laziness, lack of professionalism and a bad attitude can minimize how much they learn in the acute care setting, but if the internship is to be blown, and I mean really rendered utterly pointless, there is going to need to be some involvement from the supervising SLP as well. Seasoned SLPs, if you please:
Start by forgetting what it was like to be a student
Forget how difficult it was to go to that hospital and do your best every day, all the while knowing that hours of studying and homework were waiting for you back home. Forget how overwhelming the scope of our practice can be. Put out of your mind that so many concepts, definitions, disease and procedures that have become familiar to you were completely confounding without real world experience. This bit of denial will allow you to set the bar sky-high in terms of your expectations. If your student is intuitive, she my even see that the bar is much too high and, with resignation, stop reaching for it.
Load her up with patients right off the bat
You know that second pair of hands you always wanted? There they are! This is it; your month to make an incentive bonus by having through-the-roof productivity. All you have to do is give her half the task list to complete. What is she going to do, refuse? Please. Give me a break. You’re grading her. Let her work. Let her flounder.
Don’t introduce her to anyone on staff unless they specifically ask
She will be gone in three months. There is no need to make her feel like part of the team. Sure, feeling like part of the team is an important aspect of work satisfaction, and yes, nurturing that sense of belonging may ignite in her some positive feelings toward the exciting work that takes place in hospitals, but you aren’t trying to ignite that.
Expect her charting to be word-for-word what you would have written
There is your way, and there is the wrong way. If this girl is going to make it in the real world, she had better learn to read minds. Yours, at least. And I don’t mean just the obvious important stuff like using the correct terms for symptoms or making sure that the data reported is accurate, I mean she needs to use abbreviations when you do and spell full words out when you do. I mean if you prefer the phrase “head of the bed elevated to 90 degrees,” she had better not say, “head of the bed raised to 90 degrees.” Spit. Those. Hairs.
Stick to showing her how, but don’t bother telling her why
Knowing why we use specific exercises, modalities and techniques with individual patients and not others goes a long way toward explaining what those exercises are working to accomplish, but since they take time to explain (and since the student might ask a question that you cannot answer) avoid explanations altogether. Allow her to blindly blindly imitate you. Have her ask the patients to say “guh, guh, guh,” but don’t get into which muscles she I attempting to strengthen. Get her to say, “Bite your tongue and swallow,” but feel no pressure to explain the purpose of the maneuver. You’re grooming this young clinician to give out the same generic oral motor exercise sheets to every patient; to throw everything at people on her caseload without discernable reason and hope something sticks. “Why am I putting a lemon swab in your mouth? Because this is speech therapy, and that is what we do.”
Bad Mouth Your Coworkers
If a nurse doesn’t disconnect your patient’s IV right away when you arrive to transfer him to radiology, roll your eyes to imply that said nurse is being lazy or difficult. When the respiratory therapist double checks with you about whether or not a specific patient’s trach cuff needs to be deflated, talk about her later as though she should know better. Say and do whatever you can to communicate to your student that you are smarter and more industrious than everyone else on the team. This misinformation, this total misrepresentation of where you fit in respect to your coworkers, will help her view the workplace a competition rather that a community of professionals with shared, patient-centered goals. Because life is middle school.
Or… try to put yourself in her shoes. This student of yours is still completing her course work. She is learning how very much there is to learn. It can be an exhausting prospect. Meet her in that overwhelming place, and reassure her that she, through work, study, a positive attitude, will find her way out. There are plenty of reasons why a new grad (maybe this student) will decide against working in the hospital, but fear and insecurity need not be one of them.
