Emily Cottrell

1526 Kewalo St, Honolulu, HI 96822

(904) 652-5089
FSHN 492

Children’s Orthopedics of Hawaii

Dr. Byron Izuka,
98-1247 Ka’ahumanu St, Aiea, HI 96701
(808) 485-8985
Jamie@drizuka.com
Introduction

My name is Emily Cottrell and I am currently a senior studying Nutrition at the

University of Hawaii. When I graduate college, I plan on attending nursing school to become a

RN. My field experience site was a clinic working under a doctor and with his staff. I was lucky

enough to find a site that was willing to let me learn as much as I could about their daily tasks

and all that pertains to their job. I got a good look at how this branch of nursing works with

patients and directly with the doctor. I have had a wonderful experience working with the nurses

and the doctor and it has pushed me even more into pursuing a career in nursing.

Field Experience Site

My field experience site is located at a clinic in Aiea. They focus on diagnosing, treating,

and managing orthopedic problems that are present in infants, children, and teenagers. Their goal

is to help children’s bones grow properly and make sure that they remain healthy and strong .

Many of the people that I see come in are children and teenagers, however, Dr. Izuka also treats

adults who have remained loyal patients since first seeing him. A lot of the treatments Dr. Izuka

deals with are castings, surgeries, and bone growth/development. I have assisted him in many

castings of hands, feet, and legs. I have also seen him take care of many patients with hip

dysplasia and scoliosis. He treats them with braces to help straighten and align, as well as keep

track at each visit of how their growth is changing. He cares about his patients and wants them to

recover as fast as possible, but most importantly, as best as possible.

Expenses and Income

Most of the expenses that the office must deal with would be supplies for casting,

crutches, braces, and the x-rays they take as well as surgeries. The other part of it would be the
rent for the private practice. Surgeries and patients coming in to be seen provide a major source

of income.

Facilities

The clinic is in an office center located in Aiea. It is easily accessible and very kid

friendly, having decorations for children of all ages. There are three rooms used to treat patients,

each decorated with Marvel or Disney pictures, and one with photos of MMA fighters Dr. Izuka

has worked with. They also have a location at Kapiolani Women’s and Children’s hospital where

they treat patients on Tuesday and Thursdays, as well as where they perform the surgeries.

Description of Personnel

Dr. Izuka is originally from Hawaiʻi, attending high school in Aiea. He attended UH for

his undergraduate and then completed his residency at UH. He specializes in pediatric

orthopedics and undertook a fellowship in Florida at Nemours Children’s Hospital before

opening his own practice. He focuses mostly on limb deformities such as hip dysplasia and

scoliosis, as well as musculoskeletal disorders. Dr. Izuka has accomplished a lot of research in

his field. He discussed with me his study in setting bones in children. He found that children with

broken arms, up until the age of about 10, don’t need their bones to be set depending on the

circumstances. It was found that the bone would straighten out itself as the child grows. He

continues to adapt with technology and new techniques as medicine evolves.

Within his clinic he has two nurses and an office manager. The nurses focus on preparing

charts, communicating with patients, taking vitals, and assisting the doctor in any way necessary.

They also deal with administrative work such as insurance eligibility of patients. The office
manager helps with scheduling and checking patients into their appointments, as well as ordering

resources for the office and doctor. Both the nurses and the office manager deal with insurance

and communications with doctors.

Learning Plan

Within my learning plan I decided to focus on skills that I knew I needed to work on and

specific skills that would relate to my future job. One of my objectives was practicing my

interpersonal skills. Since effective communication with coworkers, doctors, and patients will be

a crucial part of my job in the future, this skill was an area of focus for my field experience. To

achieve this, it was important for me to observe demonstrations from the other nurses, such as

taking vitals, asking patients questions, scheduling appointments, and making phone calls to

patients. After observing the nurses, I would be given the opportunity to take the lead. Each time

I would ask for feedback and try to fix my mistakes to be the most helpful and effective. Another

part of being able to communicate with coworkers is asking for help. I have a hard time asking

for help because I like to figure things out on my own, but this job requires attention to detail so

if there were times that I needed help I would have to ask. I would also have to pay attention and

effectively listen to what instructions were being given so that I could better assist the nurses and

doctor. For example, when making phone calls for appointment reminders, the patient's parents

would ask me questions that I may or may not have known the answer to. Instead of telling them

an answer I was only 80% sure of, I would always double check with the nurses, so that I was

correct, and even transfer the calls over to them. If there was ever something I didn’t know the

answer to or needed help with I would ask because I knew how important it was to be correct in

this job.
 My second objective was developing specific job competencies. At my field experience

site, there is a lot happening all at once and it can be hectic and distracting. My job was to help

the nurses and make things a little easier for them, while learning what it is they do. I would try

to focus on completing tasks with minimal errors so the nurses didn’t have to slow down or

backtrack too much to fix my mistakes. I planned on observing them while they were doing

administrative work, such as scanning, scheduling, and prepping patient charts. In doing so I

would be able to do it more properly. I eventually planned on going over medical histories and

physicals with patients by myself, so I could help the clinic run more efficiently. While working

with the doctor, I made it a priority to assist him properly while doing castings and making him

aware of patients coming in. These are all important aspects of what my future career will

require: working with doctors, being efficient and effective, and communicating with colleagues.

My last objective was concentrating on deciding if this career path is what I want to

continue to pursue. It was the perfect opportunity for me to shadow nurses and a doctor and see

how a clinic with patients runs. I planned on achieving this by observing the nurses doing their

daily tasks. As I observed them, I thought about if nursing was a career I could see myself

pursuing. I also wanted to know more about the nurse’s degrees and what schooling was like, as

well as how they liked their job and if they would do anything different. Just out of curiosity I

also wanted to know about the doctor's schooling and his job. I wanted to know more about what

he thought makes an office run smoothly and how useful the nurses are for him in this clinical

setting. I decided that if, after all that, I was still interested in nursing that this would have been a

great experience and I would continue my current path.

Achievement of Goals and Objectives

My goals and objectives were successfully accomplished. I would say that I exceeded my

own expectations and that I have improved in areas that I struggled in before. I had received

feedback from my supervisors and fixed what needed to be fixed. On multiple occasions I have

had the nurses thank me for my help on particularly busy days and how I had made their jobs

easier. I am now able to effectively schedule appointments, make phone calls, prep patient charts,

and assist the doctor. I didn’t think I would be capable of doing these things by myself because

they are such a big deal to do correctly. I think in that way, I was able to exceed my expectations,

because I was able to do it all on my own and if I ever needed anything to be double checked or

if I had questions I just had to ask.

My experience was very beneficial in helping me achieve my goals because it put me in

situations that made me uncomfortable and put me on the spot. The only way for me to learn was

to be put in those kinds of situations and they were helpful in achieving my objectives. One of

my most rewarding experiences was when the office was short of a nurse. It was only me and

another nurse working on a busy day. She was busy taking phone calls and returning messages so

it was my responsibility to take patients in, do vitals, and ask them questions of how they were

feeling, what happened, and/or why they came in. I was also in charge of scheduling all the

follow-up appointments and helping the doctor when he needed assistance with casting. It was a

very hectic day and I was worried about messing up and asking patients the wrong questions or

missing information that the doctor needed. However, the day ended up being a success. I was

proud of myself for not collapsing under the pressure and taking things in stride after being

thrown in the deep end. I would say it was the best way to put what I have learned to the test. My

most frustrating experience had to be at the beginning of my internship because I was really
struggling to do things right. They were easy tasks and for some reason I just couldn’t get it

down. I’m usually fast to pick things up, but in this case, I was struggling with asking the right

questions, scheduling appointments, and doing paperwork correctly. I just told myself not to

stress too much because this was something very new that I had to learn. I broke it down and

tried to focus on one thing at a time, get it down, then move to the next thing. I also asked for

feedback and took notes on what they had to say so that I could refer to it and do better the next

time.

My goals and objectives for my field experience site were realistic and challenging for

me. They aimed to mirror what my future career would consist of me doing and what I needed to

work on personally to be successful. I am a shy person and I have a hard time voicing my

thoughts. I focused on working on those, by communicating with patients and asking for help

from my supervisors. It was challenging and still is kind of challenging, but I can say that I have

gotten better at it, and hopefully I will continue to improve at it. I also think that these goals that

I set for myself will be beneficial in giving me a little head start for myself in the future when I

start my job.

Unanticipated Learning

My field experience site provided some unanticipated learning including making phone

calls, assisting the doctor directly with casting, and doing some administrative work. I didn’t

expect to be making phone calls because I didn’t think that it was something they would need me

to do in the case that patients had all these questions that needed to be answered. I think I

overthought making phone calls a little bit, because all I was doing was making appointment

reminders and if there were any questions that needed to be answered I’d either ask the nurses or
transfer the patients to one of them. I’m glad I learned how to do it though because it is another

thing that I was not very good at doing and now I am much better. I didn’t expect to assist the

doctor myself with casting because I wasn’t trained to do it. When I had the chance to do it, I

luckily walked through it with the doctor, and it just consisted of me holding the patient's arm or

leg in the correct position while the doctor casted them. The administrative work I didn’t expect

to learn was dealing with any payments that they had to get from patients and checking insurance

eligibility. I knew that was a part of the nurse’s job, but I didn’t think that it was something I

would do because it is very important not to mess that up and I wasn’t sure what I was looking

for. It turned out not to be difficult and anything that I couldn’t look up or do I just left for the

nurses. I am glad that I got to learn way more than I expected at my internship because it gave

me more experience that will hopefully help me in the future.

Strengths and Weaknesses

This work experience has been so much more beneficial to me than I could have

imagined. I am lucky to have done my internship at some place that was so willing to let me

learn. The strengths that I have learned more about while doing this job has been my ability to be

teachable. I made mistakes, I received feedback, and I learned from it and did better the next

time. I also learned that I can be flexible and take initiative when I need to. Whatever was thrown

my way I was able to adapt to it. If I recognized that something needed to be done, or if I was

just sitting around, I took the initiative in beginning to prep patient charts that still needed to be

done or scan documents that still needed to be scanned. The weakness I learned while working

here was that I lacked paying attention to details. I would miss small things I would need to put

on patient charts that were important to add. When I am going over questions with patients, I

forget to ask things that I should have easily noticed. When I am making phone calls, I would
forget to inform them of where their appointment is at. It’s just small things like that, that I have

noticed I need to focus closely on because they are important. I also have learned that I still

struggle to talk to patients when making phone calls, scheduling appointments, going over H &

Ps with them. I would say I have gotten better but it is definitely still a weakness of mine. Both

my strengths and weaknesses have room for improvement. I want to continue to learn and grow

and be better at tasks so that I can do the best I can at my job.

Importance of Professional Mentors

It is important for a professional to mentor or preceptor others because that is the best

way to teach someone who is beginning a job or interning. It is the best way for them to learn

because the only way they will learn is through the experience they get from working and

working with a mentor. The expectations a professional has when mentoring someone should be

average. They must understand that a mentee doesn’t have the same experience as they do and

that not everything will come second nature to them like it does for the mentor, because they

haven’t been doing it as long. However, they should expect the mentees to want to learn and try

hard, especially if it is something they are considering as a career. They should expect students to

learn from their mistakes so that they can properly do something. It will only help them in the

future. In the future, if I am a mentor, preceptor, or supervisor to a student or someone interested

in my field, I will focus on sharing my experiences with them. I would want them to know what

to expect, what not to expect, and what they should be doing in order to be successful. I would

know what it is like to be in their shoes and I would be understanding and patient. I think that is

the best way to give back to students who want field experience.
Preparation from Department Curriculum

The department curriculum that was helpful in preparing me for the type of work that I

did at my field experience site would be all of the supporting biology, chemistry, and physiology

classes I took. These classes are good for me to have background knowledge in because it helps

me understand a little more what the doctor discusses with patients and what I discuss with the

doctor. I would also say my Nutritional Assessment class was beneficial because we went over

medical abbreviations that are important to understand, as well as learning about collecting

anthropometry and biochemical data. I was able to integrate this knowledge into my

responsibilities at my internship by being able to collect height and weight correctly, telling

patients how to stand and measuring correctly. When taking notes through discussing what

patients are going over, I was able to use a few abbreviations in my notes to help me collect

information faster. My physiology classes allowed me to have some background knowledge of

the human body, which made me comfortable asking questions to the doctor and understanding a

little of what he is talking about. My biology and chemistry classes will be beneficial for me

when I attend nursing school. The other nutrition classes I took could be beneficial for me in the

future by knowing what signs and symptoms I could look out for in patients that come in. Just

being aware and having that background will be helpful in cases like those. I think because my

future career path is a little different than others, the curriculum I needed is a little different. As a

nutrition major, I think the curriculum was very beneficial for students continuing down that

path. I have learned a lot of useful information in my classes that I can continue to use.
Value to Other FSHN Students

My field experience site has been very useful to me since I want a future career as a

nurse. For students in our department of food science and human nutrition this site would not be

valuable to them if they are continuing with that path. I do, however, think that any time spent

with a doctor who wants to help you learn can be valuable to anyone. Any understanding of how

our body works is beneficial to anybody wanting to work in the health field. The doctor I work

with actually puts emphasis on certain nutrients that are beneficial to bone growth and health. It

could be valuable to students who are on a similar path to me, but it is not a top field experience

site for FSHN majors.

Conclusion

Time with Dr. Izuka and his nurses has been a real pleasure, and I am so glad I was able

to find this site as my work experience site. I have learned a lot, from what it consists of to get a

nursing degree, to how a doctor’s office operates with the people inside, and to what it’s like to

be a nurse. This experience has been helpful by encouraging me to continue on my career path as

a nurse and it made me start thinking of what kind of nurse I want to be. When thinking about a

clinical setting compared to working in a hospital, I see myself in more of a hospital setting. That

may change because I haven’t worked in a hospital setting yet, but I have always imagined that

being where I ended up. I like the clinic-setting because you can develop relationships with

patients that are coming in a lot, which is something I think I would apply towards patients that I

would be working with in a hospital setting. I think it is very beneficial to show patients you care

about them. I also really enjoyed the relationships everyone in the office had with each other. It
made it feel like a family, and I think maybe that could be a factor to change where I see myself

ending up in the future.

My next steps will be to research nursing schools I want to apply to and see what

qualifications I might still need to get in order to get in. I will also need to get my certified

nursing assistant qualification before I go to any nursing school. Once I get to nursing school I

will need to figure out what area I want to go into. I am thinking of the emergency room,

pediatrics, or perioperative. Things may change in the future, but I also think after some time as

an RN, I’ll go back to school so that I can be a nurse practitioner. I have learned a lot and

received a lot of experience at my field site that will be very helpful in the future and I can’t wait

to apply that knowledge.