Internship Portfolio

Julia Botvinov

September 2017

To begin my internship experience, I attended

an orientation with some of my other fellow interns at
Hackensack Hospital (Pascack Valley). We met with
Ms. DePalma and she presented numerous things to
us. We learned about Emergency Codes, which is
what the first picture on the left depicts. When
working in the hospital we have to take protective
measures to keep everyone safe and calm. We
learned what each color code signifies and how to
react when we hear one. We also received a folder
with numerous papers to help familiarize ourselves
with the hospital and its ins and outs. We were taught
the dress code, how to speak to staff and patients,
parking, attendance and more. Afterwards we
followed Ms. DePalma on a tour of the building,
finishing off by getting our pictures taken for our
identification badges.
Due to working out scheduling and other
conflicts, my required attendance at my internship
site has been minimal. But, I have met with staff
members such as nurses and doctors at two
locations -- both HUMC and a Holy Name office -- who
all work with my mentor and have begun to develop a
friendly relationship with them. I have also sat in on a
few appointments with my mentor, watching him
diagnose his patients and providing them with
necessary care they require. I have also watched one
of the nurses remove staples from a patient as well.
Overall I have become accustomed to offices and
look forward to more experiences with my mentor and
others.
October 2017

This month has been eventful for me because I

had an interview with my new current mentor. I now
work for Dr. Varghese at Lifeline Urgent Care and
enjoy it very much. On the left there are two photos,
the top one being my office space, and the one below
being me in my scrubs! I had to buy navy blue scrubs
because the other assistants wear this color and the
Dr. wants everyone to look uniform and professional.
Along with this, I learned a little bit about marketing
because this facility is very young, therefore appeal to
customers is very important. I helped Dr. and her
husband, Mr. Varghese with arranging the furniture in
the waiting room, in order to make the facility as
comfortable and desirable as possible.
Another thing I learned about was how
the online filing system for patient history works, and
how to send x-rays to the radiologist. I also created a
spreadsheet for Mr. Varghese, who manages the
business aspect of the facility, in order to organize the
patient's’ insurance information, along with other
tasks in order to keep all aspects of the establishment
organized.
In addition to the business aspect, I also learned how
to take blood pressure, temperature, heart rate, and
pulse. I sat in on a few patient diagnosis as well and
watched someone get their blood drawn. Although
I’ve only been at this care facility for a short amount
of time, I’ve already gotten to know the Dr. and her
assistants, who I have a great relationship and have
already taught me a lot.
November 2017

This past month I have been able to sit in on

more appointments as well as learned how to clean
up and sterilize the equipment that has been in use. In
the first picture on the left you see a few droppers, a
sink, and a box. This is part of the lab room. Here I
have learned how to run a strep test and have been
able to set up and help the Dr. rule out strep as an
option for patients. I have been able to do multiple of
these tests myself over the past month. I have also
learned how to run a urine test and determine whether
the patient has an infection or not. The test works
similarly to a pH strip that one would use in a science
class lab. There are numerous different marking and I
was able to determine which ones matched up and
what they signified. I helped the assistant with the
patient’s chart after assessing this test and then
disposed of the urine.
I also was able to take two patients history on
a busy day (aka: smoking, drinking, family history,
medications) which was very exciting. On top of this I
looked at a patient’s x-ray and had the Dr. explain
what the issue was and how she went about treating
it.
I am enjoying my new internship site and am
looking forward learning new things here.
December 2017

This month the patient count has picked up

due to the cold weather. This meant I could do more
vitals like temperature, pulse, and blood pressure.
Since learning these things I’ve been practicing blood
pressure on my friends, family, and whoever else I can
try! I also took patient history a bit and learned about
how to do that. On top of this I have learned how to
become more comfortable around the patients, so
that I don’t come off nervous when speaking to them.
I also had a lot of good discussions with the staff.
The nurse practitioner who was getting hours here
along with Dr. Varghese herself were talking to me
about the medical field as a career and anatomy. I
also had a chance to look at an ear that had fluid in it
and listened to a heart murmur. The murmur sounded
like a ‘thump’ with a whooshing noise after it. This
was interesting considering I had never heard a heart
murmur before.
Lastly, I have scheduled a date to sit in on an
orthopedic surgery January 5th. It will be with Dr.
Alberta and I am looking forward to this because
orthopedics is something I have recently been
interested in due to what I am learning in my anatomy
class! This will hopefully give me a better
understanding of the field.
January 2018

The new year started off really well because I

had the opportunity to go in and see a surgery. On the
5th, I went to the Metropolitan Surgery Center with a
fellow intern -- Zamira -- and was able to shadow her
mentor for the afternoon. We went into the locker
room, changed into scrubs, sterilized, put our caps
and masks on and went into the operating room. I
walked into a labral repair and bicep tendon
procedure. I had to assimilate quickly for I literally
walked into the room while the procedure had already
began. I introduced myself to the physicians
assistants, surgeon, anesthesiologist and whoever
ever I could say hello to. I stood back and watched the
laparoscopic procedure take place as Zamira was
explaining everything that was going on. After that
first surgery ended, I briskly watched three meniscus
clean up procedures in a row afterwards and learned
about those as well. By the third one I was able to
explain exactly what was going on and the anatomy
of the knee thanks to my peers’ great teaching skills. I
overall really enjoyed going there with her and hope I
can see some more surgery throughout the rest of the
school year.
Back in the office I have ran vitals with more
patients, especially because patient count has risen
during the winter (of course). I have encountered
different scenarios and symptoms that are interesting
and good for experience.
February 2018

This month kicked off with a lot of busy hours at my

internship due to the flu! Due to the recent flood of
patients I was able to help by taking patient’s history
and running vitals so that I can quickly find out the
basics, give the doctor the information so that she
can diagnose the patient, and quickly start with the
next patient so that things move efficiently around the
office. By doing the pre-diagnosis work, the medical
assistant could handle charts faster and the doctor
didn’t have to waste her time taking history and blood
pressure. When taking patient history it is very
important to ask all the right questions so that
anything possibly related to their condition is noted
for diagnosis purposes. On the left is a picture of the
type of chart I fill out for a patient when I take them
into a room. I initially ask why they are there that day,
and take note of any symptomes they may have. Then
I ask if they have any past medical history such as
surgeries or conditions. Afterwords I ask if they are
currently on any medications (in which I try my very
best to spell them on the paper… ha ha.) Then I ask
about family history and finish off with social history
such as drinking and smoking. On top of this if the
patient demonstrates symptoms of something
specific I will usually dig deeper to see if there is an
underlying cause. For example flu-like symptoms lead
to the question of if they have received the flu shot,
stomach issues lead to if they have eaten something
out of their normal diet, and vomiting (if the patient is
a woman) leads to if they could be pregnant.
Questions like these are all pertinent when diagnosing
a patient, and they usually determine what lab tests
will be run during the visit.
Besides patient history I have witnessed a
nebulizer treatment, and seen lots of different
patients in different conditions throughout the month.
March 2018

This month was interesting because I

witnessed some new things and learned about topics
that tie into my anatomy class!
In the past month I was able to witness blood
work and a small laceration suture procedure. The
symptoms of the patient taken to draw blood were
compelling and to see the effects a person may have
after losing blood was a good experience. The
laceration was the first suturing operation I have been
able to witness so I was excited. I comforted the
young patient while he waited for the doctor, and
throughout the procedure along with the medical
assistant. The laceration was on his forehead and
only required three stitches. I also learned that using
medical glue would also be an option for fixing the
wound but aesthetically it's a better idea to get
stitches even though it hurts more.
I also discussed EKGs with the doctor, and -- as
seen on the bottom picture to the left -- we drew out a
sketch to label each component. I had an assignment
in my anatomy class that required me to read EKGs
and with some explanation from my mentor I was
able to not only successfully do that, but translate
what each abnormality signified. I learned about
ventricular fibrillation, ischemia, and tachycardia
which helped me have a stronger understanding of it
all.
April 2018

April was a relatively slow month compared to

my previous ones simply because flu season is over.
But, I was still exposed to a few different things here
and there.
For example I watched Dr. Varghese examine a
patient for meningitis. She checked their eyes, nose,
throat, ears, neck, skin, abdomen, arms, and legs. I
helped check the patient’s temperature and breathing
rate. She listened to their heart and lungs, checked
their neck for stiffness, muscle strength, and reflexes.
She also asked the patient a few basic questions to
see if the patient was confused (for an altered mental
state is a symptom of this infection). She also asked
them to lie on their back, bend their knees up to their
chest, and then stretch them out. This is because pain
during this movement may point to meningitis. On top
of this I also asked the doctor about the two
antibiotics Z-Pak and Augmentin, which are
commonly used to treat patients. She explained the
difference between them and in which circumstances
she uses one instead of the other. Another topic I
learned about was how to properly swab a patient’s
throat for a strep test. She demonstrated this for me
in greater depth then normal so that I could
understand exactly how to complete that sort of task.
I also held a tray as seen the photograph below under
an older patient’s ear while the doctor cleaned and
examined it for infection. Overall this month, although
slow, has still been filled with learning experiences.
May 2018

May was a very exciting month, and my last one at

Lifeline too! Although I am upset about leaving my
internship, I am happy to have obtained a relationship with
my mentor and many of the medical assistants that I have
gotten to know very well. The photograph on the bottom is
where Dr. Varghese posted my letter of gratitude and
makes me happy that she wants to keep there.
Besides the sadness of leaving my internship soon,
I have witnessed many cool things in the last 31 days!
Other than the usual patient history and vitals (which I
would like to say I’m a pro at by now), I assisted with a
man who had to get his hand sutured and learned how to
fill a syringe with vaccine. This was an interesting day
because I actually took part in helping the doctor and had
to help translate a few words in spanish because the
patient didn’t know that much english. This made me feel
glad that I took spanish my junior year! Another day I also
saw a foreign body removal, and later I enjoyed lunch with
staff to celebrate two medical assistants who are going off
to medical school. In the middle of the month I learned
how to properly run a pregnancy test and urine lab. I also
learned about the charting system, lab system, and
everything else involving the business aspect of Lifeline, so
that I could help with the new incoming staff members and
if the doctor ever calls me in to work for her throughout the
summer, because I already have so much experience.
Later in the month, I learned about Pityriasis Rosea
because a patient came in with it. (It is a skin rash that
sometimes begins as a large spot on the chest, belly, or
back followed by a pattern of smaller lesions. The exact
cause of pityriasis rosea is unclear. Some evidence
indicates the rash may be triggered by a viral infection,
particularly by certain strains of the herpes virus. But, it's
not related to the herpes virus that causes cold sores.
Pityriasis rosea isn't believed to be contagious and usually
goes away on its own. Steroid cream, antihistamines, and
in rare cases antiviral drugs can help). My last memorable
patient was one who came in with a dog bite wound. I
assisted the doctor in cleaning it and proceeded to assist
her with giving the patient a tetanus shot.
All in all, internship has been an amazing learning
experience and I am so glad I had the opportunity to do it.
It has given me a great advantage in the medical world and
taught me a lot important skills.