I did my Master 1’s internship at the North Laennec Hospital in St Herblain in the Pneumology service. I was brought to intervene in different places : the Intensive Care Unit, the Intensive Care Unit of Thoracic and Cardiovascular Surgery, the Resource and Competence Centre for Cystic Fibrosis and conventional Pneumology clinics. Thanks to this intership, I saw the clinicals psychologist’s missions in Pneumology service wich are around three main axes : the clinical activity, the institutional work as well as the FIR (of Formation, Information and Research) activity.
Concerning the clinical activity, psychological consultations are part of the global care of the patients and of the care project established by the establishement. Psychologists participate in the announcement of the diagnosis with the doctors. Their presence reassures the doctors who are sometimes helpless when faced with difficult situations. Psychologists are called upon to perform pre-transplant assessments. This is a special consultation that lasts longer than the so-called classic consultations, about 1h30 with the patient. The same amount of time is given to the patient’s family and friends. The pre-transplant asssessment is a time of evaluation in prepation for lung transplantation that takes place before the patient is put ont the transplant waiting list.
The work of the psychologists involves different times that oscillate and are directed towards the patient and towards the medical team assigned to this same patient in order to follow the temporality of the satff but also and above all of the patient and his entourage. In the context of transplantation, the psychologist provides emotional support over the long term because transplantation is part of real life project impacting all facets of the patient (family, friends, professionnal …) The support of future transplant recipients is linked to the representations they have of the disease and their own emotional experience. Transplantation is an « adventure » that mobilizes the physical and psychological energy of the patient and those around him. It is essential that the psychologist is available for the patient who is waiting for a transplant because the mobilization of psychological ressources and the questioning of the limits between life and death constitute a real vulnerability/fragility for subjects already affected corporeally by the disease. The psychologist sometimes makes telephone calls to support the person when the organization of the consultations and the reality of the schedules mean that a discussion can be held. The aim here is to support the person and to show them attention, so that they do not feel alone in this adventure. In order to work in Pneumology department, it is necessary to take into account the medical context. Some defensive behaviors could be read as pathological in another situation. The work of the psychologist is at the crossroads of the illness, the emotional experience and the representations of death. His job is to support and help the patient to overcome the various narcissistic wounds he is confronted with and to allow him to live the best way possible the identificatory readjustements he needs to make.
Another part of the psychologist’s work is devoted to institutional work. His main objective is to create a link between the patients and the medical teams. It allows the psychologist to hightlight certain explanations about the patient’s psychological functioning, thus allowing the doctors to better understand the patient’s reactions. Although the psychologist provides the medical team with information about the patient, he or she never forgets professional secrecy and never divulges information that could undermine this principle. This is the notion of shared secrecy, where the psychologist must provide the team with the information needed for better medical care.
During this Master’s intership, I was able to begin to position myself as a professional, in particular by appropriating knowledge such as listening, discernement, distancing myself and reflection during meetings with professionals and patients.I found this internship to be very formative,both in terms of discovering the population and the problems encountered, as well as at the institutional level and in terms of building my own identity as a clinician. This internship confirmed my desire to work with adults in a hospital setting. This professional experience at the Laennec CHU gave me the opportunity to apply the theoretial-clinical articulation wich can appear as a real obstacle for us, psychology students. In spite of these fears, I was able to foresee the work to be done in order to acquire this skill ans I was able to realize that I already had the necessary skills. This intership gave me the opportunity to take the measure of the institutional richness that it offered with its share of difficulties but always tending to a reflection and a clear positioning ( as a psychologist evolving in a place where a great number of professionals rubs shoulders and must work in the best possible conditions).
It seems essential to me to never forget, no matter what speciality we work in, whether we are psychologists, social workers, nurses or doctors, that our common goal is the well-being and optimal care of the patients. It is by keeping in mind what brings us together that we can overcome what separates us.
In short, it was a very formative experience that I was able to live. It was rich, in terms of the encounters with the patients and the nursing staff ans in terms of my own experience. Everything that I could feel ans sense during the internship remains engraved in my memory and I hope that I will always remember the beauty and richness of this profession and all that it brings us. And of all that it is possible to do in a clinic.