Leader/Follower Relationships at Rhode Island Hospital
During my first week at Rhode Island Hospital, I was able to get a sense of the relationships between employees, interns, and even patients. So far, I have observed generally respectful and positive relationships between summer students, clinical research assistants, therapists and psychiatrists. The specific division of the hospital I am working in is a partial hospitalization program for mental health treatment, meaning patients come daily from 8 am to 2 pm. During this time they attend four group therapies and individual meetings with a therapist and a psychiatrist. Due to the structure of the program, it is vital that the doctors, therapists, and clinical research assistants have a respectful and communicative relationship.
On the patients’ first day they are evaluated with a structured clinical interview by a clinical RA. From that day forward they attend therapies and individual appointments. They are set up with a “treatment team” based on their individual needs. It is necessary that every employee be in the loop and in frequent contact, in order to determine how the treatment of a patient is going, when they should be discharged, or to solve any problems that may arise. While this is mostly done through individual meetings, phone calls, or emails, the weekly clinical staff meetings seem like a great way to make sure everyone is on the same page. These Thursday lunchtime meetings include conversations about patients who have been in the program longer than 20 days, to determine what needs to happen to get the patient ready for discharge. After that, any other clinical concerns are discussed before switching to clerical topics.
In these meetings, the head of the program, Dr. Mark Zimmerman, M.D. leads the group. He is very well respected as the head of the program. He boasts a 100% acceptance rate to PhD programs for RA’s, and is always pushing them to pursue research and write papers for publication, always willing to provide help. He holds a weekly morning journal club in which we dissect and discuss a recently published journal article, so that the team is up to date on current research. In these meetings, I sense that people can be afraid to share their opinions in fear of him disagreeing, and it seems like people can be nervous. However, everyone is always eager to hear his input on every situation.
As for the relationship between interns and the rest of the employees, I have felt included and respected. We are expected to attend every journal club and staff meeting, so that we can not only be up to date on the patients and the literature, we can see the ins and outs of the program and how it stays running from day to day. The five interns are on two week rotations, meaning each of us does one task for 2 weeks and then switches jobs. My first rotation is observing the intake interviews and helping to write the reports that get sent to the psychiatrists, which has been extremely interesting.
Wow, this sounds like an incredibly educational environment in which you are really going to learn a lot and be exposed to all sorts of things. Sounds like they use a variety of mechanisms to keep everyone (who needs to be) abreast of patients’ care and progress. Do you get to attend the Thursday staff meetings (I hope you do)? Given the way in which you describe Zimmerman (focus on education, providing assistance with research and writing, etc.) it seems odd that people are somewhat afraid to speak at the journal club; will be interesting to try to decipher whats going on there. Given the nature of the work, I imagine the vast majority of the work is standardized (to an extent) and follows protocols (though I recognize the each patient’s diagnosis and treatment does have to be individualized). What I’m saying is that there is probably less impromptu, winging-it kind of actions taken in this setting.