I’m a Registered Dietitian!

Wow, the past few weeks have felt like quite the whirlwind! I finished up the last of my four weeks working as the pediatric ICU dietitian, graduated from my dietetic internship, studied hundreds of pages of dietetics information, made and learned oodles of flash cards, and took (and passed!) the Registered Dietitian Exam yesterday!!

I am officially Dana Goldberg, RDN!

(Not to mention, this is also my 100th blog post!)

With all of these milestones comes lots of self-reflection and things I want to share about my experiences, so first I thought I would use this post to share my thoughts 1-week post- dietetic internship.

I’ll start off by saying that these past 11 months have been some of the toughest months of my career as a student- both academically and mentally. Taking almost a full graduate degree course load and working 32 hours a week as an intern sometimes made me want to pull my hair out, but I am proud to say that I successfully made it out alive. There aren’t many things that I am ever really proud of myself for; it just isn’t my personality and I tend to be pretty hard on myself. Graduating high school didn’t faze me (I was livid and embarrassed when my mom tried to put a congratulatory sign on our lawn), graduating undergrad kind of seemed impressive (but everyone around me was also graduating college so I didn’t feel like it was that special), but I will confidently say that I am proud to have completed a dietetic internship and passed the RD exam. It feels like the hardest part – the uphill climb – is over and I can finally catch my breath.

I know I have shared this in a few previous posts, but I honestly didn’t love my time working at a hospital as a clinical dietitian. I didn’t feel like I really made any lasting impact on patients’ lives nor helped improve their long-term health. However, spending over 1,500 hours 27 different areas of the hospital, plus working with over 35 different dietitians, I learned so much about clinical nutrition that will set me up for success in any nutrition field that I end up going into. Although I dreaded walking into that hospital some days, I don’t think I would have wanted to do it any other way.

Finally, I can’t talk about my experience as a dietetic intern without mentioning my staff relief rotation. During the last four weeks of the internship, each intern got to choose an area of the hospital where she would act as the dietitian. We still had a dietitian to co-sign our charting documents, but we were basically on our own as if we were the sole dietitian covering that area. I chose to spend those four weeks in the pediatric intensive care unit (PICU), and it was my favorite four weeks on the entire internship. I chose the PICU because I found I enjoyed all of the enteral and parenteral nutrition (nutrition via tube feeds and IVs) calculations in the ICU setting. I also went into my internship wanting to work with kids – and especially enjoyed my pediatric rotations during the internship. The first week of staff relief was absolutely terrifying but by the end, I felt like I had the confidence to go out into the field and be a dietitian (which was very reassuring!). Also, I have to give a huge THANK YOU to the PICU dietitian and my staff relief preceptor Melanie for teaching me more than I thought I would ever know (and also making me laugh every day – even when I was working with kids who were critically ill).

Now, one week since the end of the internship, these are my main thoughts, but I’m sure as time goes by I will have more thoughts and reflections to share.

If you are a current RD2Be, dietetics student, or dietetic intern, be sure to stay tuned for my posts over the next few weeks because I’ll be sharing my dietetic internship and RD exam advice. Feel free to send me all your burning questions and I can answer them in my posts 🙂

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Career Confusion

Unfortunately, if your looking for helpful nutrition information, this isn’t the post for you. Instead, it is only an update on my unknown future career plans. But don’t worry, I’ll be dishing up some more advise in my future posts.

I am officially passed the halfway point of my Dietetic Internship! I am currently in my renal (kidney) rotation in a dialysis unit, which is fine…nothing special. I still have critical care, pediatrics, and oncology rotations this semester.

Recently, though, I have been struggling a bit. As I have said before in other posts, I haven’t really loved working in the hospital. I haven’t felt like I make any meaningful connections with patients and most of them don’t seem to care at all about what I am talking to them about, which I totally get – I don’t think that if I were sick in a hospital I would really care about how much salt was in my food or if I was getting enough protein.

I did enjoy my outpatient rotations much more than working in the hospital, but something still wasn’t clicking. I think I almost convinced myself I liked it because that it what I had always pictured myself doing. Do I still see myself doing some nutrition counseling? … Yes, it is definitely something that is still interesting to me, but I am not sure that I can picture myself doing it as a full-time job.

I am very happy I am learning my likes and dislikes now and not later, but you can see why I am confused now. I feel like the college sophomore that realized they didn’t like their major and is trying to figure out what to do. From the time I declared my nutrition major freshman year in undergrad I always saw myself being a Clinical Dietitian, and now I am realizing that is not really the path I want to go down.

Thankfully I have tons of supportive advisors and professors at school that are willing to help me figure out what I want to do. Maybe it is working in industry (for a cool, healthy food company), teaching at local colleges, traveling with an international health organization, working in media or social media, or doing a job that I don’t even know exists — I am exploring my options.

So for now, we will see where the next year takes me. In the mean time, if anyone has any nutrition career suggestions… my ears are open!

Whole Grains

Five weeks (holy cow-I can’t believe it has already been 5 weeks!) of my DI complete and I am finally getting into the swing of things. I have my daily routine down, feel a lot less overwhelmed, and still have time to explore Cleveland and spend a few hours at the grocery store ;).

The highlight of last week was working an outreach table at the outpatient pediatric clinic in the hospital. I spent the day educating patients about the importance of whole grains. I made a poster (which I don’t think I have done since high school), a handout, compiled some recipes, and played a whole grain game with some of the kids. Having quality conversations with some of the parents definitely made me feel like I was making a difference, but playing games with the kids continuously put a smile on my face throughout the day. And even better, not only did I have fun playing with them, they were also able to learn what whole grains were and be introduced to new food items to try! Win-Win!

Since I had the opportunity to teach so many people in the clinic about whole grains, I thought I would share the knowledge here.

Whole grainFirst off…What is a whole grain? You have probably heard of them, but do you really know what they are? A whole grain means that the product contains all three parts of the grain- the germ, endosperm, and bran. White or refined grains only contain the endosperm. The bran and germ are important because they have vitamins, minerals, fiber, and healthy fats, whereas the endosperm is made mostly of starch.

Whole grains have also been found to prevent stroke, heart disease, type 2 diabetes, obesity, and constipation. I don’t know about you, but I think those reasons alone are enough to want some whole grains in my everyday meals.

Ok, now that I hopefully have convinced you to eat some whole grains, you have to find them at the store. This can be the tricky part. Lots of packages slap phrases like “100% wheat” and “multi-grain” across the front to pull you in, but these phrases do not mean it is a whole grain. Here’s what you should look for:

  • Check the ingredient list on the box. If a food is a whole grain, the very first word on the ingredient list will be “whole” (ie. Whole wheat flour, whole grain oats, etc.).
  • Words like “brown rice” “bulgur” “quinoa”, “oats” and “wheat berries” listed first in the ingredients also always mean it is a whole grain.
  • Even if the front of the box says “5g of whole grain”, check the ingredients. While it might have some whole grain, if it is not the first ingredient, then the majority of the product is a refined grain.

There are lots of other whole grains including bulgur, millet, farro, barley, amaranth, buckwheat, and rye, which are great for adding to soups and salads or as a side dish. Those sound a little foreign? Try oatmeal or whole grain cereal (like Cheerios) for breakfast. Air-popped popcorn and whole grain crackers (like Wheat Thins) are perfect whole grain snacks. Even using whole grain bread on your lunch sandwich is a step in the right direction.

Making the switch to whole grains can be hard, but small steps can make it easier. A good rule of thumb is the make at least half of the grains you eat each day whole grains. You can also use this as an opportunity to try some new foods!

Here are some pictures from my outreach in the clinic!

Diet & Exercise, etc.

As promised, I have a Dietetic Internship update and some other goodies to share. These first two weeks have been dedicated to orientation at the hospital. I, along with the four other interns, have sat through lots of HR trainings, lectures about hospital policies, gone on more hospital tours than I can count, and even had a few homework assignments already. Aside from that boring stuff, we did have some sessions that were more interesting and applicable to dietetics, like an intro to the Nutrition Focused Physical Exam, a taste test of the various supplements the hospital can supply to patients, and we did some patient-clinician role playing to prepare for talking with patients.

IMG_9871In other very exciting news, I officially can check “run a half marathon” off my bucket list. At 9:58am this morning, I crossed the finish line of the Rock and Roll Half Marathon in Cleveland. Miles 10-12 were definitely a struggle and required a little walking, but I ran the first 10 and the last 1.3 without stopping. Considering my longest training run was 10 miles and I wasn’t planning on running the full 13.1 until October, I am pretty happy with how I did. I decided to run it two months early because I quickly realized, during week 1 at the hospital, fitting long runs into my busy schedule was not realistic.

Now, I am home, have eaten more food than I thought possible (Note: running 13.1 miles makes you very hungry!), and my legs are officially jello. Since getting up off the couch is not really an option right now, I thought I would also add something to this post that is maybe more relevant to you (as opposed to just leaving it as an update on my life).

Since I’m in the half marathon spirit, talking about workouts seems appropriate. While workouts and healthy eating are usually two peas in a pod, I have stayed away from writing about them too much because I have no background or credentials surrounding fitness or exercise. But, I do know a thing or two about the relationship between diet and exercise, which I can share that emphasize the importance of a quality diet:

  1. I’m pretty sure we have all heard that “You can’t outrun a bad diet” and “Abs are made in the kitchen”. While these phrases may seem silly, there is a little bit of truth to them. We, as a society often underestimate how much we eat and overestimate how much we burn during a workout (the cardio machines that give false calorie readings don’t help). So, it can be really hard to burn enough calories in a workout to compensate for the two extra cookies last night. Personally, those two extra cookies aren’t worth a whole ‘nother hour at the gym (see the graphic below)…I’ll stick to one cookie.

    food calories to workout convesion

    Calories in food equivalent to workouts (I think these workouts are a little but underestimated, but you get the point)

  2. Surprise! It isn’t all about the number on the scale. Maybe those extra hours in the gym are worth it to you (or you naturally have a fast metabolism) and you eat anything and everything you want. Just because you fall into a healthy weight category doesn’t make you immune to sodium increasing you blood pressure or saturated fat clogging your arteries.
  3. Diet and exercise are not one or the other. They are both important and you need to find a balance. Here are just a two examples… exercise can increase HDL (good cholesterol) which diet can’t do, and fruits and vegetables provide antioxidants that can reduce your risk of cancer and heart disease.
  4. A poor diet often leads to low energy, poor sleep, and negative mood meaning your workout (or any part of your daily life) probably won’t be that great or productive if your not eating well.

These are just a few examples of why a healthy, well-balanced diet are so important. Now, I’m not ragging on exercise (see #3), While the “diet pea” might fit very nicely in that pod with the “exercise pea”, sometimes they need to stand on their own and be recognized for their individual benefits. Trust me, after training for a half marathon, I get that after a good sweaty workout you feel like you deserve a giant chocolate bar and a bag of chips, but in reality, that isn’t going to work (not for losing weight or for overall health).

I hope this helps, eat more veggies, and stay sweaty!

Just because I am a nutrition student doesn’t mean I…

Wow, I am officially a senior in college! I just took my last final exam yesterday and now it is crazy to believe I only have one more year of undergrad. After spending the past three years learning all about the body and food, I have discovered that there are many misconceptions about (aspiring) dietitians. I thought I would share some with you that you might find surprising.

Just because I am a nutrition student doesn’t mean I…

  1. …Judge the foods you eat. Countless times I have been to restaurants with family and friends and they always feel obligated to give an excuse for why they ordered a burger and fries. I can’t tell you the number of time I have heard, “I have eaten very healthy all week” or “I’m starting to eat healthy on Monday”. This may be a shock, but you don’t need to qualify your dinner order, and I promise I am not judging you. I like burgers and fries just as much as you do; it is human nature to crave high calorie foods. We all have to make choices when it comes to what we eat, but without knowing your health or lifestyle goals, it is not possible or fair for me to judge your personal choices.
  1. …Don’t eat unhealthy food. Again, I crave chocolate chip cookies just as much as anyone else, and I eat more than just grilled chicken and vegetables. Just because I am interested in nutrition doesn’t mean I am not allowed to have pizza or dessert. You probably know just as well as I do that cookies are not so healthy. Fortunately, I have also learned about the importance of moderation and that cookie should be saved for special occasions.
  1. …Just help people lose weight. Yes, as a nutrition student, I am taught the importance of a healthy, balanced diet to promote healthy weight, but as a dietitian, that is only a small slice of the job. Majority of dietitians work in hospitals doing anything from creating diet plans to prevent cancer proliferation to determining energy needs of a premature baby with a feeding tube. People often forget that dietetics do so much more than just help people lose weight.

Study Abroad Update

I know I haven’t done the best job of keeping you up to date on my adventures, but that’s because I’ve been busy with all my adventures :). As my grandma says (hi Grandma!), this semester should have been called “Travel Abroad” instead of “Study Abroad”. While my actually classes may not have been difficult at all, there is no doubt that spending time in 21 cities in 10 different countries has taught me so much about cultures around the world. I have learned more European history than I ever learned in a classroom, and I have been able to learn about health and food from a completely new perspective. This experience has inspired me to write my senior thesis about the difference in food processing and manufacturing between the United States and European Union and how the different practices effect our health.

As I spend my last three days in Copenhagen saying goodbye to some amazing friends, having final family dinners with my host family, and spending my last few Danish Kroner in souvenir shops, I know that I will always look back on these four months as one of the best times of my life.

BUT! While the semester may be over, I still have another two weeks of traveling before heading back home. One final trip through Morocco and Spain before I’m back for a busy summer of volunteering, studying for the GRE, and trying to remember how to be an American again.