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Cecil County Department of Social Services- E-Portfolio. Kristen Berkowich AHS 8100 Fall 2013. Getting Started. As I begin my internship, my biggest concern is how I will handle the project given to me by the Director. I have never taken on a project this large before.
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Cecil County Department of Social Services-E-Portfolio Kristen Berkowich AHS 8100 Fall 2013
Getting Started As I begin my internship, my biggest concern is how I will handle the project given to me by the Director. I have never taken on a project this large before. I will be writing a plan to Reduce Child Maltreatment in Cecil County, MD. My primary interest is to work with my site supervisor, along with the Local Management Board and Child Maltreatment Task Force to implement a plan.
Getting Acquainted The Local Management Board (LMB) is made up of multiple business men and women from the community. They are primarily leaders within their industries. The President of the LMB is Nicholas Ricciuti, he is also the Director of Social Services. The LMB handles all human service issues within the community. Currently they are focusing on a reducing drug use, overdoses, and child maltreatment.
Getting Acquainted- cont. Like most citizens within Cecil County, I was not aware that we had a Local Management Board that handled Human Service issues. All counties within the State of Maryland have a LMB appointed.
Developing Ethical Competence During my years working in Geriatrics, I came into contact with many Physicians and worked very closely with them. Our relationship was very important, we had to work together for the best interest of the patient. Some of the Physicians were much better than others. However, at the end of the day, I had to maintain a working relationship with all of them.
Ethical Competence- cont. Earlier this year, I had an ethical dilemma with one of the Physicians in the facility I was working in. We already had a strained relationship because I had suspicions that he was not doing the assessments that he stated he was doing, because of this I would stay on him to complete the paperwork I needed.
Ethical Competence- cont. My dilemma started when I noticed that he had marked a resident with significant cognitive difficulties as capable of making his own medical decisions. The patient was also paranoid and delusional. I faxed the Physician a form to review the patient’s capability and he again faxed it back as “capable”. I sent him another fax asking him to please assess the patient before completing the form because his condition had significantly worsened since his last assessment 60 days earlier.
Ethical Competence- cont. I was standing in the front office when the Physician came in the front door. He went over to the unit; I grabbed the forms I needed and went over to the unit. I was maybe 2 minutes behind him. When I got to the unit, he was sitting at the nurse’s station completing his assessments. He was filling in vitals (for that day) and writing his assessment of the patient. He completed 4 charts while I stood there waiting for his attention. He DID NOT examine any of these patients that he was filling out assessments for. I finally knew that my suspicion was correct.
Ethical Competence- cont. I interrupted him to ask him to assess my patient for decision making capability. He looked up at me, pointed across the room at the patient and said “is that him?”. When I stated it was, his response was “he is fine, he looks fine to me”. I explained to him that I know that he looks fine, what I need is for him to assess his cognitive ability. The Physician again stated “he looks fine”. I had several issues with this interaction. First, he did not evaluate his patients but completed assessments. This is dangerous to them and Medicare fraud because he would bill for the evaluations.
Ethical Competence- cont. I finally had what I needed. I made copies of his assessments (they all said the exact same thing). I took this information, as well as my concerns that he was not evaluating his patients and my concern that he was not assessing the patient’s capabilities and I went to my Director. She suggested that we meet with the Medical Director together to present our concerns. Everything was handed over to him to address with this Physician. The Medical Director also completed the appropriate forms after determining that even though my patient looked “fine”, he was not capable of making his own decisions.
Using Supervision During this internship, I have learned that it is ok to go to my supervisor for help. Especially when I have concerns that I am going in the right direction. At first, I viewed this as a sign of not understanding my job. But now, I see that sometimes it can make the difference between a “good job” and a “great job”. My supervisor was very good at talking ideas through with me. Her door was open and she was interested in my ideas. She was very supportive and understanding about the difficulties of my project. I feel that I need someone that I am comfortable with and that I can talk to. Open communication is very important.
Learning to Learn from Experience Integrative Process Model Step 1- Gathering Objective Data from Concrete Experience The first day of my internship, I attended a meeting with LMB liaisons from across the state. It provided me with a better understanding of what other districts are working on and how they are achieving their goals. Step 2- Reflecting I was not prepared for the enormity of the project that I had been given. After attending some meetings and talking to other workers, it started to sink in how difficult my task was going to be. Step 3- Identifying Relevant Theory & Knowledge I realized that I needed to spend time gathering statistics and discussing my ideas with my supervisor. I also needed to get the thoughts from other workers within the agency, they know the population they are working with and what works.
Learning to Learn- cont. Step 4- Examining Dissonance My concerns were that the Director had attempted to get multiple people to write this plan and had been unsuccessful up until this point. It made me feel like I was in way over my head. I had no idea how to write something of this magnitude. Step 5- Articulating Learning Very quickly I learned that I would get the most help from districts that had already written a plan. I spent many hours reviewing plans from other states. I just had to figure out how to apply it to our community. I also learned that some ideas that seem great for other areas are not necessarily great for ours. Step 6- Developing a Plan I met with my supervisor to discuss my concerns, she was very understanding and stated that she expected me to feel that way because it was a large task. She provided me with support and ideas. I just started to research and build it from the bottom. Once I got started, the other ideas started to flow.
Communicating with Clients This was possibly one of the factors that may have been very helpful for me, but I did not have the benefit of communicating with the clients. It would have been very beneficial to interview the clients having difficulties and ask them what would work for them, what services they would like to see. It would also let me know what wouldn’t work that has been tried in the past. The time frame allowed and scope of my project unfortunately did not allow this. I did get to talk to other workers to see what they felt was working for their clients, however I did not get the first hand knowledge.
Developing Cultural Competence During my internship, I learned that culture plays a major role in social services. Especially when talking about family life. What may be appropriate to one culture, may be inappropriate to society. For example, when interviewing a family about an alleged abuse concern, you need to be able to speak to all members. In some cultures, it is normal for the man of the house to speak for everyone. The women and children are not consulted. It is a balancing act to explain to the male head of household that you must speak to all members. This is a law and a requirement of the investigation, however throwing a law in their face may get you more resistance. It could also place more tension within the household. So, getting the agreement of the father is very important.
Writing & Reporting within your Agency My placement focused mainly on researching and writing. My task was to write a plan to Reduce Child Maltreatment. This was very difficult for me, as I have never written a plan before. I reported to my site supervisor weekly and provided her with the most up to date plan at each meeting. This would allow her to see my progress and give me feedback. This worked very well for me.
Taking Care of Yourself During my internship, stress has been a factor that I had to work out from the very beginning. I am working full time, completing my internship, taking classes, and I still have a husband, children, and household chores to take care of. My husband has been great at picking up a lot of the household chores so that I can spend more free time with my family, instead of doing things around the house. I also try to spend at least one hour every evening with my family. No homework, no house work, just relaxing with my husband and children. Every weekend, we make sure to set aside family time and take our children to do something fun. This allows me to step away from everything and I look forward to this every week!
Ending My Internship I have submitted my official rough draft of my Plan to Reduce Child Maltreatment. My supervisor and the Child Maltreatment Task Force is reviewing it. After I receive their feedback, I will complete the final draft. This will most likely take me past the internship end date, however I knew from the beginning that this project would require more than 120 hours. I am determined to see this through to the end. I have put in too much work to walk away now! (Plus, I now work here and am at the mercy of the Director)
Planning Your Career Short Term Goal- I am right where I want to be. I finally have the career that I have wanted and am so excited to start my case load in 2 weeks! Long Term Goal- To be a Supervisor in Child Welfare and continue helping families. Questions- Do I go back to school for my MSW? This would help my career greatly, however I am burnt out!!!! My agency is very supportive and I could complete my internship within the agency, I am just not sure that I have another degree in me. Only time will tell!
