Friday, June 4, 2010

The H1N1 Pandemic: A Shot at an Extraordinary Learning Opportunity

Interning with Public Health Services in the Capital District Health Authority, Nova Scotia during the H1N1 pandemic was a whirlwind experience. Public Health was my first rotation as an intern. I was privileged to witness both its health promotion and health protection roles during my community rotation. In the late summer, my preceptor alerted me that I would be starting my rotation with Public Health earlier than anticipated in hopes that I would miss an H1N1 pandemic that was forecasted to begin in January. This change did not go as planned as cases of H1N1 arrived earlier than predicted.

In the last week of October I could sense that the Public Health team was feeling the heat; it was ‘crunch time’ to prepare for mass immunization clinics as the vaccine had finally arrived. I was fortunate to experience two immunization clinics; once when the vaccine eligibility criteria was restricted to high risk groups and once when the vaccine was available to all. However, I was not involved with clinics every day as I had to complete other competencies unrelated to this unique experience.

While the nutritionists were at the clinics, I provided day care directors with verbal and written feedback on their menus, integrated dialogue from several meetings into notes, kept a journal, inputted an online survey, and worked on my research project. Because everyone was occupied with H1N1 related activities in the community, I was working in a ‘ghost town’ office complete with empty cubicles and lunches eaten in solitude. This contrasted my earlier experiences when I had had lunch with at least 10 others and would always hear someone typing at their computer. I began to feel a sense of isolation.

Before my internship, I anticipated that I would receive ample amounts of direction as an intern. My expectations became apparent during the pandemic as my contact with the team was limited. I was nervous that the work I was completing was not sufficient and I had few opportunities to ask for guidance. This unavoidable situation forced me to become more self-directed in my work. I knew I had to finish the projects and that it was time for me to trust my instincts and myself. This was the only way for me to accomplish the projects. Reflecting on this, I realized that I was afraid to believe in myself and that sometimes I have to be bold and take risks, even if it is uncomfortable. I had to trust my capacity and knowledge. I tended to forget that I am in a learning environment where I will make mistakes but will also celebrate successes. I realize that being pushed outside of my comfort zone in this supportive learning environment was integral to preparing me for the future as I continue to encounter experiences with unknown outcomes. My advice to future interns is to embrace learning opportunities and to engage in these experiences as much as possible - even if you feel thrown into the dangerous ‘deep end of the pool’ instead of what feels to be the ‘safe shallow end’.

In December when the immunization clinics came to an end, I was invited to participate in a closing discussion that involved Public Health employees who acted as clinic leaders. This discussion group of about 40 employees amazed me. I realized the honesty and mindfulness that this group of public health professionals possessed. I learned from the many stories told, and was touched and motivated by their enthusiasm and dedication. That evening I participated in a mass immunization clinic and confirmed my perceptions of this working group. I got to see the clinic staff (including volunteers, students, and public health employees) in action.

My participation in this experience was extraordinary! I believe that fate led me to Public Health during a time when I could experience first-hand health protection and health promotion, two of the core functions of Public Health. I did not learn about the functions of the health care system during times of crisis while at university. Owing to my immersion I feel better prepared for the possibility of involvement in a pandemic in my career.

I encourage future interns to seek rotation opportunities in public health, and suggest that internship programs provide and promote opportunities encouraging interns to experience community rotations in public health.

My sincere thanks to the staff members at Capital District Health Authority’s Public Health Services that made this an invaluable learning experience possible. A special thank you to my supportive preceptor, Rita MacAulay.


Melissa Koch, Dietetic Intern
Capital Health
Halifax, NS

Rita MacAulay
Keely Fraser

Public Health Nutritionists
Capital Health
Halifax, NS


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I really appreciated your story, especially the way you described how your experiences led you to take risks in ways you would not have predicted. You are an inspiration. Thank you for stepping out of your comfort zone; this is how our profession grows. It takes a supportive and trusting preceptor to enable such growth. Kudos to you both. I hope you can continue in this spirit.

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