I initially wrote this as part of the requirements for my music therapy internship credit at the University of Iowa. But I realized that it might have some useful information for new interns so why not share publicly? I’ve been out of internship for a while and into professional MT-BC life but hopefully this post will help shed some light on some of the things I realized at the beginning of my internship.
I did my internship at University of Iowa Hospitals and Clinics. When I did this internship it was set up as three different rotations: 1) pediatric inpatient units, 2) adult psychiatry & neonatal intensive care unit, and 3) adult palliative care and child psychiatry.
A little backstory before I start rambling on…when I originally wrote this, I had just finished my rotation on the inpatient pediatric units which included working with a variety of children with a variety of diagnoses. I saw patients on the burn unit, bone marrow transplant unit, in the pediatric intensive care unit, and the general inpatient units. I saw kids with cancer undergoing treatment, kids who had surgeries, kids undergoing stem cell transplants, kids being monitored for seizures, kids who had really bad respiratory illnesses, kids with intellectual disabilities who had comorbid illnesses, and many others!
For this post, I’ve decided to talk about some of the things that surprised me about being in internship, some of the things I wish someone had told me before I started, and some of the things I never thought I would need to know.
Alright…without further ado, my top 8 things about beginning internship:
1. Internship is hard
I thought being in school with a ton of jobs was difficult; I was trying to balance homework with my other responsibilities (teaching private lessons, music interning at a church, research assistant at the hospital, recreation aide at a retirement community, not to mention hanging out with my lonely husband). I was actually looking forward to only working a 40-hour work week and coming home at a regular time. When I left my first day at internship and didn’t take any work home with me, I felt GUILTY. As the weeks progressed, that feeling of guilt quickly wore off.
Internship is difficult in ways that I didn’t think it would be. I didn’t realize how difficult it would be to see kids who are in bad home situations. Or kids who don’t have supportive families. To see that situation play out day in and day out is heart breaking. And to realize that there is really nothing you can do to fix their family situation is humbling. Also to realize that you’re not there to fix their family situation, you’re there to provide only what you can provide and hope that is is impactful in some way.
Internship is difficult because I didn’t realize how many assignments there would be. I thought “I’m done with school! I can burn all my pencils.” Unfortunately, I still need pencils. And highlighters. And post-it notes. And my computer. On top of planning individual and group sessions for the week, there are additional readings and assignments. Add that on top of learning new songs, learning the charting system, documenting, filling out assessments, observing other disciplines, learning new names, new diagnoses, new ways around the hospital, etc. and you can very easily become overwhelmed. I often found myself taking reading assignments home and spending a lot of time planning my groups at home because I just didn’t have time to do it at work. I realized quickly that I couldn’t take a ton of work home every day (see #8) and that I needed to figure out a way to get it done at the hospital. A realization I have come to in this first rotation is that I am probably prone to compassion fatigue—I put 110% of myself into the things that I do. I will work from the time I get up to the time I go to bed if I’m not careful. And I don’t want to work all the time. That’s the reason I didn’t become a doctor! Eventually, I want to have a family. Therefore, I have set some boundaries. There are some assignments that I have to work on at home and my internship supervisor has allowed a specific number of hours for work at home, but for the most part, when I come home and take my badge off, I am at. home.
2. You’re going to be really tired
This one is especially true for those introverts out there. It took me a long time to realize that being an introvert doesn’t necessarily mean that you are shy and reserved. Being an introvert means that you expend energy when you are around people. Well…I am around a lot of people at the hospital. It takes a lot of my energy to work an 8 hour day. And it takes even more energy on the days where I have to lead groups. I found that I was coming home angry for no reason and I couldn’t figure out what it was. Finally, I took a step back and thought about what I was feeling and realized that I just needed 10 minutes to myself at the end of the day where I wasn’t thinking about anything, I wasn’t driving around, I wasn’t planning or reading. So every day when I come home from the hospital, I take my badge off and take my keys out of my pocket and that is my transition into being at home. Then, I take the next ten minutes and do something that doesn’t take any brain power—whether that be quietly listen to my music, rest without listening to any sound, watch a silly YouTube video, or practice mindfulness, whatever I feel like I need to do to unwind from the day and reenergize for the evening.
I also have some new habits that I am trying out to help set boundaries for myself. For example, when I am driving to work, I will listen to music that my patients enjoy so I can learn new songs and catch up on what is current. But when I am driving from work, I listen to what I like to listen to or, sometimes I don’t listen to anything at all if it’s been “one of those days”. My new favorite activity happens on Friday after I get off work. I get home, go upstairs, get into my PJs, and get into bed. I don’t necessarily go to sleep. But it’s a very peaceful time where I can unwind and celebrate that it is the weekend!
3. You’re going to spend a lot of time planning a really great intervention or group and then the patient will decline your service or nobody will show up.
Our professor does a great job selecting practicum sites. She tells you to set your clients up for success during your interventions. Well, she is also setting you up for success in your practicum setting! Sneaky little devil—we never even KNEW! Most of the time in your practicum setting, your clients will be there. And they will probably respond to the things that you do and the interventions that you bring. In my internship, I have spent quite a bit of time planning sessions that never actually come to fruition because the patient declined services, or discharged, or was sleeping. But hey! I have a really cool adapted piano version of Shake it Off if ever the time presents itself. And many more really cool things that I may never use.
For my last school-age group session, I planned an entire group around discussing change and feelings. Since the seasons are changing, I wanted to talk about what else changes in their lives, how they are different from last year to this year, how they are different from when they came into the hospital to now, and how the kids feel when they’re in the hospital. I had a TON of instruments with me, a fun game to play that talked about different feeling and emotion words, a really cool Orff group improvisation. I was ready. When it came time for my group…only one kid came. And he only spoke Hebrew. So, you can probably guess how that went. We didn’t really get to talk about change or our feelings. Also, although I had planned a lot of adaptations for this group, you bet your little tooshie I did not plan to have a kid who didn’t speak any English. So, don’t get discouraged if you spend time on a plan and don’t get to do it while you’re in internship. Chances are, you’ll use it one day. But that leads me to my next really important point.
4. You have to be really. flexible.
And I’m not talking about being able to do the splits. (Although, that’s a cool party trick.) I remember one day in my second or third week of internship, I was riding in the elevator with my supervisor on the way to see patients and she said “Alright, I’d like you to try the preschool protocol with Patient X when we get up to the unit.” And in my mind I thought “okay, I’ve played through those songs once, I don’t remember exactly what the preschool protocol is since I’ve only seen you do it once.” But on the outside I said “okay!” And I did it, and I learned from the session, and the next time I led the preschool protocol, I was much more comfortable with it.
I have learned that I have to be able to get out of my own head, be present in the moment, and react to situations that are happening in front of me. I am still working on this and will probably continue to work on this my entire professional life. But being flexible in many ways will help me become a better learner, a better musician, and a better therapist.
5. You’re going to see (and smell) some really gross things [WARNING: THIS SECTION MAY BE GRAPHIC TO SOME, IF YOU’RE SQUEAMISH, SKIP THIS SECTION. DON’T SAY I DIDN’T WARN YOU].
This mainly pertains to working in a hospital, I think. But I never thought about what exactly it means to provide procedural support. I mean, yeah, okay, we are in the room when a procedure is happening. But that means that we are in the room when a procedure is happening. When the nurses ask if you can come in and play music during a tracheotomy change, you’re going to see a hole in someone’s throat when they take the trach out and put a new one in. I played relaxation music for a patient in the PICU who was feeling very nauseous. I developed a strong enough rapport that he felt comfortable having me in the room while he was throwing up. And I felt comfortable enough that it didn’t bother me, because he told me the music helped him relax. We walked into a room after a colostomy bag had been changed, which did not smell like roses, and stayed for 35 minutes leading a session.
6. You need to have really solid music skills.
I know our professor talks about this until she’s blue in the face so I’m going to get up onto her soap box and reiterate! If you don’t have solid music skills, you will not be able to be present and in the moment with your clients or patients. If you are not confident in your music skills, you will not be able to focus on whatever group or 1:1 session you are leading. Internship is one of the first times you really get to practice your counseling skills, so if you’re confident with your music skills, you can spend a lot more time focusing on learning how to do the therapist part of the job.
7. At some point, you’re probably going to feel like you suck. A lot.
Learning a new skill is really difficult. And it doesn’t feel that great. When you’re around professionals who have been doing this for longer than you’ve been in school, you may feel like you’re a terrible music therapist. But that’s because you haven’t been practicing your skills for very long. Give yourself a break and really take in what could be one of the last long, supervised learning opportunities you have. Your supervisors will not expect you to be perfect. If they thought you were perfect, you probably wouldn’t even have to do an internship. Take in all of the learning opportunities that you can while you can. Observe as much as you can while you can. And know that when you feel like you’re failing, you’re growing into a strong, smart, passionate music therapist.
This has been especially difficult for me. I have felt a lot of challenge in this internship. I will say that this has been one of the most difficult learning experiences I have faced. That has been frustrating for me in some ways because I want to provide a quality therapeutic experience for my patients and sometimes I feel that they get the short end of the stick because they’re with a student. I see the amazing therapeutic work being done by the other music therapists in the hospital and I strive to do that quality work. But the reality is, I can’t. I don’t have the experience that they do, I don’t have the knowledge that they do. That experience and knowledge will come with time. And if I am kind to myself, and let myself experience the growing pains of becoming who I am as a therapist, one day, I will be able to provide those quality therapeutic experiences.
8. You need to take care of yourself
This is so important. YOU are important. Without you, your therapeutic work will not occur. But, you cannot spend all of your time worrying about the patients that you work with, completing the readings and assignments, working at your internship, learning new music, etc. You have to have some boundaries. There’s no better time to start setting boundaries than during internship. Especially if you’re not getting paid ;-). Initially, I had a difficult time getting all my work and assignments done in the allotted time, so I sat down with my supervisor and let her know and we scheduled some daily office time into our schedule. I hope that you all feel comfortable enough with your internship supervisor to let them know how you’re feeling. If you’re feeling overwhelmed, tell them! They want you to be successful and want you to participate in as many learning opportunities as are available. But it’s also a very short period of time. Six months will go by so. fast. Set boundaries, do things that you enjoy, have FUN, don’t spend all your time worrying about internship. It’s not realistic and it sets you up for failure in your future job. You’ll have to take care of yourself when you’re employed, so why not learn those habits while you’re learning everything else.
All that being said. What do I know. I’m just a lowly intern :)
I miss seeing all of you around the building! But I gotta admit, I don’t miss those Dr G tests ;)
If you ever want to chat or have questions about anything feel free to comment or drop me a line! My electronic door is always open.