Overview of Internship Research Mission

Exposure to drugs during pregnancy influences serious conditions and mortality among newborns, infants, and developing pediatrics patients. In utero drug exposure can cause the fetus to become vulnerable to teratogenic effects, death, inadequate growth, premature or fetal distress during labor depending on the substance abused. Following birth, the newborn may experience respiratory distress, low birth weight, and withdrawal symptoms (tremors/irritability, sleep problems, high pitched crying, tight muscle tone, hyperactive reflexes, seizures, poor feeding, vomiting, diarrhea, dehydration, sweating, unstable temperature, etc). While these immediate effects can determine the length of stay in the NICU, there is a significant potential for long term effects on physical, mental, behavioral development and ability to reach normative scoring and milestones. Since many studies have confirmed the negative impact among pediatric patients secondary to illicit substance use, it is extremely important to assess the outcomes of Intrauterine drug exposure and opioid maintenance during pregnancy. My research with Neonatologist Dr. Matory focuses on the observational study conducted between 2002 and 2009 of pregnant women receiving buprenorphine and methadone opioid maintenance therapy treatments at Wishard Memorial Hospital in Indianapolis, IN. This data followed the journey of 79 pregnant women all of whom received their prenatal care at the outpatient substance abuse clinic at Wishard Memorial Hospital. The principle of this data consisted of data regarding the newborns included the type of delivery, gestation, birthweight, maternal admission drug screen, newborn urine and meconium drug screens, Apgar testing scores at 1 and 5 minutes following birth, newborn length of stay and treatment for Neonatal Abstinence Syndrome. The children within this study are now between the ages of 8 and 15 and received follow up visits at Eskenazi Health. Our mission is to retrospectively observe the medical records of the long-term outcomes of those infants that unfortunately experienced in utero drug exposure to the most commonly prescribed opioid treatments, buprenorphine and methadone in order to evaluate developmental and behavioral outcomes, medical issues, resource utilization, and routine well visits in the first 3-5 years of the newborn's life. In prospect, the hypothesis follows the belief that women who received the opioid treatments of methadone and buprenorphine will illustrate increased numbers of health care provider and medical interventions and lower successful pediatric patient assessments compared to normative and acceptable scoring with aging.

Limitations Of Observational Study

Of the expected data consisting of 418 total moms delivered- 79 of those mothers received either methadone or buprenorphine opioid therapy treatment prior to delivery and some limitations imposed upon the research regarding continued participation of the families if multiple health clinics and physicians are involved. In order to ensure the results and completion of necessary testing and evaluations for follow up outpatient visits- it is essential that the patients begins and ends with the same identified provider who monitors the development of the child. Several of the infants within the newborn nursery and NICU were provided with discharge and follow up appointments with primary care physicians in the healthcare system (Eskenazi formerly known as Wishard). It is expected that a majority of the patients remained within the clinics for the first 1-5 years of the child's life. Review of follow up information could provide a foundation for emerging and ongoing developmental problems. Unfortunately to date it was confirmed that there was quite a bit of data is missing particularly the older the children become, supporting the prediction that they did not continue care through the represented health systems, that they did not receive annual physics, and that child notes are not as frequent as expected. We will continue to review charting for these patients and cross reference information with subspeciality and developmental clinics.

Journals That Represent Research Similar To Our Mission

Connections Between Classroom & Internship

The foundation of our research focuses on the idea that Neonatal Abstinence Syndrome proposes premature exposure to drugs which in consequence causes short and long term effects on infants health- physically, mentally, behaviorally. Since my major is Biology with pre-med track many off my classes relate to internship work in a way that supplies essential background information to understand the health risks imposed upon the baby. Throughout my college career I have enrolled in courses and become involved in activities that centralize science and medicine. Hand in hand, I am able to gain another perspective of how NAS works and possible ways to treat it in order to have a deeper understanding.

Meaningful Involvement

The first encounter I had with my supervisors was definitely intimidating because I found it difficult trying to balance professional communication yet also having the ability to be myself, since teamwork is the dreamwork as they say! After meeting them throughout the semester I am pleased to have been matched and accepted into an internship with such profound supervisors. I am able to express my concerns, questions, and ideas since they are always open and responsive, providing feedback when needed which allowed me to build a connection and a lasting impression that will make an impact for future career involvement. Throughout the site visit it strengthened my confidence as an intern when I was given validation that I was right on track and that my supervisor was satisfied with my work to recommend me for other possibilities down the line if I was interested! Having the opportunity to interact with my team whether it is via zoom, email, or in person has been extraordinary given the circumstances of covid- my supervisors have went above and beyond in order to give me an experience in areas I can grow in as a professional. My supervisors are supportive, display a helpful and respectful demeanor, and demonstrate compassion. They understand that even with my commitment and responsibility as an intern I am also a full-time student so while they hold high expectations they also always communicate so we as a team can effectively get the work done with quality along with meeting deadlines. I aspire to embody the professional behaviors and skills they acquire in order to be a successful and dependable professional myself one day.

Internship Reflections/ Favorite Experiences

While many people may reflect on the word "intern" as a person who just runs errands and grabs the coffee, it is so much more than that. As an intern I have become to realize that it is never to early in my career to gain experience and that there is never too much to learn from your supervisors- in fact, they become your role model and personally I embraced everything they threw my way in order to enhance my developmental goals and skills. Working in neonatology gave me newfound knowledge of skills, career paths, and research analysis. Throughout my time, there were multiple occasions I had to step out of my comfort zone in order to gain independence, believe in myself, and feel a sense of accomplishment through my work. In the past I never had much confidence in my communication in regards to speaking up and asking questions to my superiors. However, my supervisors have encouraged me to be a team player and involve me in tasks and projects along with providing constructive criticism and reassurance that my help is appreciated. My team has always been supportive from the beginning and forming professional connections with them has made journey that much better! Building a professional network has been an important aspect of this internship to me and I believe that I have made a lasting impression to be confident within. I have gained an understanding to always work hard no matter what I am doing even if the tasks are large, challenging, or never seem to be perfect which has taught me good work ethic to strive within the world of healthcare.