Introduction:

My name is Kathryn Nease, and I am interning at Hospice Savannah Inc. with the

Steward Center for Palliative Care. Hospice Savannah is a non-profit agency and serves four

southeastern counties in Georgia including Chatham, Effingham, Bryan, and Liberty. The history

of Hospice is very interesting, and it has been around since the 19th century. The word Hospice is

a medieval term meaning a waystation for travelers to rest. However, it became a place where

nuns cared for dying patrons. The first Hospice was St. Christopher’s Hospice which was

established in 1965 in London, England by Dame Cicely Saunders. Hospice care in Savannah

originated with the Memorial Medical Center’s chief radiologist, Dr. David E. Tanner. He

mentioned in an interview that he was bothered by the fact that dying patients had no place to go.

The Humanities Committee of the Georgia Medical Society agreed with him and thus Hospice

Savannah Inc. was established as a non-profit agency in 1979 under the leadership of Anne K.

Stewart, the first volunteer medical director.

The most important team members of Hospice Savannah are the patients, their family,

and their caregivers. The certified and trained professionals at Hospice work alongside these

team members to achieve maximum care and comfort. The staff is comprised of physicians,

nurses, social workers, chaplains, nursing assistants, volunteers, and allied therapists. The

clinicians such as the physicians, nurses, and nurse assistants, provide care when it comes to the

patient’s physical well-being and symptom management. The social workers assist both the

patient and family with emotional and social well-being when it comes to end-of-life care. The

chaplains are in place to aid in the spiritual well-being of the patient. Volunteers help the family

and caregivers by running errands, preparing meals, transportation aid, and other tasks that can
be hard when dealing with end-of-life care. The allied therapists provide palliative therapies such

as music therapy, massage therapy, story keeping, and pet therapy.

Hospice serves any clients that are Hospice appropriate with around 90% of the clients

receiving care within their home. Clients residing in assisted living facilities or nursing homes

are also served by Hospice Savannah. Lastly, clients that have difficult-to-manage symptoms can

be admitted to the Hospice Inpatient Unit (HIPU). Medicare will only cover a few days at HIPU,

but a plan for transitioning the patient back to home or an extended care facility will be put into

action. The mission statement of Hospice Savannah is “Founded by our community, we help

people live” and the vision of this agency is to provide the right care in the right place at the right

time.

Description of Experiences:

As a Palliative Care intern at Hospice Savannah, I completed many rewarding tasks and

gained knowledge that will be beneficial to me in the future. I was assigned to multiple projects

throughout my time at the Steward Center for Palliative Care. When I first started, my

supervisor’s, Melissa and Haley, walked me through the different responsibilities I would be

taking on during the semester. Some of these responsibilities included taking meeting minutes,

running errands, delivering materials to various partnership locations, answering the phone,

charting visit dates, entering provider’s billing, and much more. The meetings that I was invited

to sit in on were very informative and many interesting topics were discussed. I was included in

several of the Ethics Committee meetings where various cases were reviewed that involved

ethical issues such as patient autonomy, surrogacy issues, discharge, etc. These meetings

provided me with a better understanding of medical terminology and how ethical issues are

handled within the healthcare system.

and productivity, and keep up with new referrals we received. When I first started entering new

patients, Haley, one of my supervisors, would provide me with the patient and their start of care

date. These patients would come from the daily rounds list that she would print out and give to

me each morning. She would highlight the new patients and show me how to find their

demographics, emergency contacts, which hospital they were located at, and include a note in

their chart stating when they received their palliative care consult and what the reason for it was.

Some examples of reasons for a palliative care consult include symptom management, a positive

palliative screening, goal of care discussion, or end of life discussion.

The best part of my internship were the people I worked with every day and the

opportunities I was fortunate to experience. My supervisors were super helpful and made sure I

felt comfortable and up to date throughout my internship. They taught me various skills and

lessons that I will keep with me in the future. They also encouraged me by reminding me of my

capabilities and how much help I offered. I think the most challenging part was adapting to a 9-5

job in an office environment. It eventually became easier as I got into more of a routine, but it

was still a challenge. The only thing I wish I could have done more of is patient care experience.

Unfortunately, they wanted someone certified to be handling and interacting with patients. I

understand this, but I wish there was more I could have done. Hopefully, I will become a

certified nursing assistant (CNA) soon and come back to Hospice Savannah and work.

Perception and Evaluation of the Internship:

This internship met my personal expectations in various ways. When beginning this

internship, I was worried that they would not have much use for me. At the start, there was not

much for me to do. However, as time went on, I began to become very helpful to them and once
I got into the flow of things, it ended up being an amazing experience. I learned so much from

my time at this organization and it changed the way I present myself. My supervisors were very

open to my ideas and contributions, and they strongly encouraged me to voice my opinions about

things. When I would suggest something, they were always open minded and would listen to me.

My supervisor did an excellent job with overseeing my responsibilities. However, there would be

times when she would be busy or out of the office, but she was confident in my ability to work

without her assistance. I think my experience could have been improved if I were able to get

some patient care hours. Since COVID-19, they have only allowed certified professionals to

work with patients. However, I think I will be able to work with some patients here in the future.

I would definitely recommend this site to future interns because it was such a great

experience. There is actually a Georgia College alumni working at Hospice Savannah who

interned with them in 2020. I also was offered a position at this organization for after graduation.

That is another reason why I would recommend future interns to consider this site because they

actually care about building a relationship with you and present you with opportunities beyond

your internship. I originally did not consider a career in this setting, but as time went on and they

asked me if I would join them as an employee, I felt immediately inclined to continue my work

at this organization. Even though I am not a huge fan of working an office job, I am excited to

have more time learning from Hospice Savannah. I am still planning on attending PA school and

I feel like I am more compatible in a patient care job, but for now, I am enjoying my 9-5 office

job.

Internship Preparedness:

I believe I was very prepared for this internship placement. I had previously been

working at this internship site in the Fall 2021 semester for my Community Health course. This
experience gave me insight into what kind of tasks and responsibilities would be expected of me

as an intern. Academically, I felt very prepared going into this internship because of my

education in public health. When assignments were given to me, I was able to efficiently

complete them and conduct research without confusion. There were also times when my

supervisors would use terms that I had previous knowledge of because of my background. I felt

most confident in completing my tasks without assistance. Of course, there were times when I

needed clarification on things, but I was able to think critically. I felt least prepared for the 9-5

work schedule I operated on during my internship. Even though I eventually adapted to this

routine, it was difficult in the beginning. I had to figure out which times I was most productive

and allow myself breaks when I felt myself becoming burnt out. The courses that I used the most

information from during my internship were Epidemiology, Methods of Health Promotion,

Public Health Policy & Systems, Research Methods of Kinesiology, and Community Health.

There was one assignment in particular that was grounded in Epidemiology, Research Methods,

and the work I did in my Community Health course. This was an assignment where I was tasked

with researching mortality trends and determining the increase in the elderly population and how

that relates to Hospice utilization over the past two years. In Epidemiology, I was introduced to

mortality rates and cohort studies. This assignment was an example of a cohort study because I

was only focusing on the elderly cohort. During my Community Health course, I completed a

community health needs assessment of Chatham County and population trends were a key factor

to assist my findings. I also utilized information from Public Health Policy & Systems because

Hospice Savannah is a non-profit that is reimbursed for our services by Medicaid and Medicare.

I think that GSCU/School of Health and Human Performance did an excellent job at preparing

me for real life applications of public health concepts and for future employment. As previously
mentioned, through my internship, I drew on knowledge from several different areas of public

health to complete my tasks and feel confident in my place of work. Also, I was offered a job at

my internship site, and I accredit this mainly to my intelligence in the field of public health.

Internship Performance:

Throughout the duration of my internship, I feel as though I have gained many new skills

and knowledge that will be beneficial to me in the future. The main skill that I feel I acquired

was confidence and professionalism. When I first began at Hospice Savannah, I felt young and

like I was not cut out for certain tasks. However, I quickly adapted and showed my supervisors

my driven work ethic and my ability to complete assignments. They acknowledged this several

times by telling me they were thankful for my work and how much I do for them, which helped

increase my confidence. I was very satisfied with my performance at my internship site this past

semester. There were times when I would become stressed or feel like I may be doing something

incorrect, but I would go to my supervisors, and they would reassure me that I was doing great. I

also feel as though my professionalism has increased throughout this past semester. Wearing

business clothes, communicating with coworkers, and attending meetings with the CEO were all

new to me and I believe I will be able to carry myself in a more professional matter because of

this. I would rate the overall quality of my work as 9/10 because there were a couple of times

when I would fall behind on assignments. However, I think the majority of my work was great

and completed in a timely matter. I think the main skill I need to sharpen is my time

management. It was difficult at times to balance my internship, a part-time job, and a social life.

I tried to be patient with myself throughout the process, but I think time management is an

incredibly important skill that I need to work on in order to be successful after graduation.

Personal/Professional Insights/Benefits:
 This internship most certainly impacted my personal, professional, and academic goals. I

have always wanted to work in the healthcare field, and I am planning on applying to a PA

program after graduation. This internship gave me more insight to the responsibilities of

healthcare providers and being able to sit down and listen to them was very enlightening. Seeing

the palliative and hospice side of healthcare also gave me insight into different areas in the field.

I have always wanted to specialize in dermatology, but after working in both palliative and

hospice care, I have more of an open mind of where I might want to work in the future. My time

at Hospice Savannah impacted my personal growth significantly. Before, I was timid and would

not speak up about things that confused me. However, I now feel confident to speak up and ask

questions. As previously mentioned, I have gained insight into the hospice and palliative care

side of healthcare. I was unfamiliar with the difference of hospice and palliative care before I

started my internship. I had no previous knowledge of what palliative care really was and who

was eligible. I am now very familiar with both hospice and palliative care, and this will help me

in the future if I decide to become a Certified Nursing Assistant and work in services for seniors.

Overall, I am very grateful for this experience and I feel as though I have gained beneficial skills

and knowledge that I can use in my future professional career.