Extreme Fellowship Makeover

It's pretty crazy how quickly a job can change in one week.

As of last Wednesday, NYCCD officially opened its Early Childhood Mental Health Consultation and Treatment program in the pediatric primary care clinic of NewYork-Presbyterian/Weill Cornell Medical Center. What this means is that one of three NYCCD psychologists and I (my title is the Primary Care Assistant) will be onsite in the clinic every afternoon administering a standard mental health screening to all children birth to five who are coming in for their well-baby visits. Let me break this down to give you a better idea of what my role looks like.

1. I arrive at the clinic after a morning of doing work at NYCCD's 62nd St. office at around 12:45 PM--enough time for me to check in and score a $5 meal voucher that NYP distributes to all of its volunteers (which technically I am because I am paid by my organization, not the hospital). I find this to be extremely exciting!

2. I head over to our clinic office in order to go over the schedule of children we are supposed to be screening that day, which I usually try to make the day before. I prepare all of the different screenings we will  be using according to the children's ages, and then I mentally prepare to enter the chaos that is a pediatric primary care waiting room--my workstation for the afternoon.

3. I distribute the schedule to each of the front-desk clerks (called registrants) who check in the families when they arrive for their appointments. They will help alert me to when one of our scheduled children arrives. Then, I get settled at a computer that I have been given permission to use behind the front desk, and I log into the hospital database. From there, I can track when the patients arrive and where they are during their appointment (getting their vitals, seeing the doctor, getting bloodwork, etc.)

4. I check the clinic schedule on the hospital database to see whether any of our scheduled children have already arrived. If one of them has, and their status in the database indicates that they may be in the waiting room, I call the child's name in order to find them in the waiting room.

5. I then head over to the parent, screening and clipboard in hand, and channel my best patient-friendly vibe (invoking all that is warm, approachable, and knowledgeable!) as I introduce myself and the purpose of the program. I assure the parent that we are asking all parents with children 5 and under to complete the questionnaire (some get a little defensive when I ask them to answer questions about their child's development and behavior). I then inform them that, should they have any questions or concerns regarding their child, we have a psychologist onsite who is available to talk to them at a time that is convenient for them. I ask them if they have any initial questions or concerns they would like to talk about, and then, after a few more instructions and a big "thank you" for participating, I leave the family to continue on with their appointment.

The rest of my afternoon escalates into a frenzied flurry of activity that defies linear numerical outline formatting. Between tracking down the families, explaining the screening, tracking them down again to get the screenings back from them, scoring the screenings, filling out the cover sheet for the NYCCD psychologists' review, tracking down yet again those families whose responses indicated that there may be some concern regarding the child's development, determining whether they would like to speak with the psychologist, and facilitating a warm hand-off or scheduling a later appointment with the psychologist onsite, I rarely have time to get a drink of water or use the restroom, let alone do the rest of work that goes along with the position--following up with the parents whose children are currently seeing our psychologists or who were referred for other services by our psychologists, writing my notes on each child who presented some sort of developmental or behavioral concern that day, and creating the schedule for next day! For now, as I am trying to adjust to the new routine, it is exhausting work. However, it is extremely rewarding to be interfacing directly with the parents, serving as the first person that parents can turn to if they have a concern about their child's development, and working with the NYCCD mental health team start up this exciting new program. I'm looking forward to seeing how it progresses in the coming months--and to helping make it happen.