My 6 Tidbits of Advice for Dietetic Interns

Last year, before I started my Dietetic Internship, a girl in the class above me reached out to provide some advice and answer any questions I had about the dietetic internship that I would be starting.

She told me, “You will learn more about what you don’t like, rather than what you do like during the internship”.

This didn’t faze me as earth shattering advice at the time, but let me tell you, when 5 months of clinical rotations had passed and I couldn’t name a single area I really enjoyed, nor could I ever envision myself being a clinical dietitian, that advice was life saving. I still had a few moments of panic (I knew I still wanted to be a dietitian, but suddenly I had no idea what I wanted to do as a dietitian), but knowing that it is okay to not enjoy parts (or whole chunks) of the internship was very reassuring. There are so many areas of dietetics that you may not be exposed to in your internship, so there is still so many other opportunities to find where you fit in. And don’t worry- I’m still trying to figure out what that niche is for me.

Anyways, since I received that invaluable piece of advice prior to starting my internship, and now having completed an internship myself, I thought I would share a few pieces of advice for any RD2Be’s out there.

  1. Going along with the advice I was given, I would tell people to find an internship with tons of different rotations/areas of experience – especially if you don’t really know what area you want to go into. I worked in more than 25 different clinical areas during my internship, and although a didn’t love any of them, there were definitely some I liked more than others and I discovered interests that I didn’t know I had. Even if you do have a specific area of interest, gaining experience in a number of different fields will make you a better dietitian all around.
  2. Practice what you preach as a dietitian. Dietetic internships can be extremely busy and stressful, especially if you are also completing as masters degree at the same time (like me). It can be easy to slack off, skip workouts, and order pizza for dinner, but as future RDN’s, we all know that those choices aren’t the best for our physical or mental health. Make sure you have plenty of fruits and veggies to snack on and especially get a solid 7-8 hours of sleep every night.
  3. Ask lots of questions! I was terrified starting my first rotation because I felt like I didn’t know enough. Guess what…you aren’t supposed to know everything – that is why you are there. I never had a preceptor who wasn’t willing to answer my oodles of questions – especially regarding areas of nutrition that I didn’t learn a lot about in undergrad.
  4. Similarly, take advantage of all the knowledge your preceptors have to offer. This goes for nutrition knowledge (again, ask questions!), but I also liked to pick their brains about life and career advice. They all landed a job as a clinical dietitian and most had other jobs and experiences prior to their current job, so they have lots of valuable information to offer about careers in dietetics.
  5. I know I probably don’t have to say this to a bunch of type A, aspiring dietitians, but say on top of your work and manage your time well. I guess this mainly goes for interns who are also getting their masters at the same time (like I did), but you definitely don’t want to fall behind and let the workload pile up. Start your assignments early, chip away at them every day, and you will definitely still have time to enjoy life!
  6. Finally, your internship is the greatest study tools and experience to prepare you to be a dietitian. I remember worrying during the first few weeks of my internship that I needed to start taking notes or studying for the RD exam (this was when I still had 11 months of internship ahead of me!). Now, having passed the RD exam, I can confidently say that there is nothing to worry about. Those 1,200+ hours spent working during your internship aren’t for nothing and prepare you very well to be a dietitian and pass your exam.
Advertisements

Cruising to the Finish Line

Happy April! I guess it has been quite a while since I wrote my last official update on my Dietetic Internship in December. It seems like every day goes by so slowly but suddenly I only have 4 weeks left of this semester of school and 15 weeks lefts of my Internship.

Since December I have had my bariatric rotation, renal (kidney) rotation in a dialysis unit, critical care rotations in the Medical, Surgical, Trauma, and Neuro Intensive Care Units, and now I am in my pediatric rotations. I definitely enjoyed critical care more than I thought I would and more than I enjoyed my general medical/surgical rotations earlier in the year. It was a lot less talking to patients (mostly because they were sedated and on a ventilator), and a lot more tube feeding and TPN (IV nutrition) calculations.

I originally started my Internship thinking I would want to work in pediatrics, but by the time I started peds I knew it probably wasn’t where I really wanted to end up. The past three weeks in my general pediatrics were definitely a nice change of pace getting to see kids, but it is also a whole new world. I feel like I am back at square one trying to learn all the different infant formulas. My next three weeks are in the Neonatal and Pediatric Intensive Care Units, which I think I am going to like a lot more than general pediatrics since I liked the adult ICUs.

Between all of my clinical rotations, we also had a ton of activities in March for National Nutrition Month. We had one full week dedicated to doing things in the community, including playing fruit and vegetable games with kids at a Head Start preschool, teaching a nutrition health class at a high school, participating in a high school health fair, and doing a food demo for hospital employees. Our biggest event was the National Nutrition Month Celebration Day in the atrium cafeteria at the hospital. Each intern, including myself, put together a big presentation board, an activity, and several handouts about a specific nutrition topic.img_1214.jpg My topic was plant-based diets (don’t worry, I’m not saying you should become a vegetarian or vegan). I discussed the importance of limiting meat consumption and encouraged more beans, vegetables, and whole grains. Not only are there lots of health benefits of plant based foods, you also get more variety of nutrients by switching things up. (I have included my plant based grocery list and plant based protein source handouts here, too!)

Plant Based Grocery List

Plant Based Protein Sources

From all of these community events I realized that I take for granted how much I know about nutrition. Because nutrition is the world I have been living in for the past 5 years, I sometimes forget what the average person knows. Some of the questions I got during the week really reminded me that people don’t know enough about nutrition and I have a lot of valuable knowledge to share.

I also had a big presentation for all of the hospital dietitians in March, which was probably the most nerve-racking experience ever. So, now that March/National Nutrition Month is over, I feel like I am just cruising to the finish line. I have a few big papers do before the end of April for school, one more big presentation at the hospital, and only three more major rotations until my Internship is over!

And for the final (and most exciting) update, I recently found out I won a scholarship for an educational international travel experience once I graduate in December! The location of my trip has not been confirmed, but I will keep you posted when I decide.

I guess I need to do these updates more often so they aren’t so long. Until next week, Happy Easter and Happy Passover from this RD2Be!

Med-Surg, Outpatient, and Change, Oh My!

Boy has this semester flown by! I am officially 1/3 of the way done with my Dietetic Internship and Monday is my last day of class for the semester. Last week marked the end of my general medical-surgical (med-surg) rotations in the hospital, which were a total of eight weeks: two weeks in cystic fibrosis and telemetry, two weeks in geriatrics and trauma step-down, two weeks in cardiac, and two weeks in bone marrow transplant. While I liked some rotations better than others, I honestly didn’t love any of them. Most of the time I was seeing patients due to unintentional weight loss and decreased appetite (both of which are major issues in the hospital). Unfortunately, the standard of practice for these patients is to recommend using high calorie/high protein supplements (which are filled with sugar) and encourage high calorie foods. I also didn’t feel like seeing a patient for 10 minutes, one or two times during their hospital stay really made an impact on their health. I wasn’t encouraging them to eat healthier or make better food choices in their daily life, I was just trying to manage symptoms and ensure they could be discharged as soon as possible. Besides all these dislikes, I did learn that I loved doing calculations for enteral and parenteral nutrition (feeding via a tube or IV) in patients that couldn’t eat food orally.

The past week I have been in my adult outpatient rotation, and I have absolutely loved it so far (which is very reassuring after not loving my previous eight weeks). My preceptors are amazing and I definitely see it as an area I am interested in working in in the future. You get to spend so much more time with the patients and it is exciting to see them learn and make progress with improving their diet. I have also learned a little bit about integrative and functional medicine, which also sparked my interest. It is a growing field and focuses on a mix of different eastern and western medicine techniques, plus uses food as a method of healing different types of diseases.

With all of my experiences this past week in outpatient, I thought I would share a few words of wisdom (per usual). It has been exciting to see all of these patients be so eager and motivated to make change (which is definitely different from the patients in the hospital). But, at the same time, change is difficult and it requires work. You can’t expect to just show up and meet with a dietitian and, poof, you start losing weight or controlling your diabetes. The same thing goes for reading my blog. While I love that people are reading my posts and I am able to share information, reading doesn’t translate to results. In fact, we only remember about 10% of the things we read. In order to make positive changes, you have to take the information you read and hear, and put it into action.

Since this post is getting a little lengthy, I’ll leave it at that for now, but I’ll share more about making changes in my next post!

Internship Update: Finally Time for Clinical

Last Friday marked a very exciting day…the last day of my food service rotations in my Internship. After 2 long weeks in the kitchen cutting fruit and making sandwiches, 1 week in the storeroom and purchasing, and 3 weeks working with a patient meal service manager, I am finally on to my clinical rotations!

As much as I don’t enjoy food service and could never see myself working in the field, I did have some valuable experiences. I learned just about everything there is to know about what patients can order, how patients order, where their food comes from, how it gets to them, and everything in between. As a dietitian, I can definitely see why it might be important to know what options the patients have while they are in the hospital.

Having my food service rotations first gives me good background knowledge on how the nutrition and dietary departments run, and I think I am well equipped to give patients meal recommendations based on their individual diet needs. I guess that I one perk of getting food service out of the way at the beginning (and I am glad I never have to put on another hair net again!).

Now, I have just finished day 2 of my clinical orientation. Day 1 was learning a lot about the electronic medical record and how the healthcare system works, but I am quickly getting the hang of it. My preceptor covers telemetry, general medicine, and adult cystic fibrosis floors so I have seen quite the variety of patients so far. I got to do my first note on my own today, and diagnosed a patient with moderate malnutrition. The patient’s doctor agreed with my diagnosis, which means the hospital gets reimbursed for my patient visit. I also feel very official (and old/not smart enough) wearing my white lab coat around 😉

That is pretty much all that is going on in the hospital. October is my busiest month with class work so I have been a busy beaver working on all my assignments every day after work. That unfortunately leaves me little time for any new recipes, but I have been enjoying a super simple (and of course, healthy) spaghetti squash bowl for dinner. I just mix spaghetti squash, steamed broccoli, peas, and chicken or ground turkey with some pasta sauce and wah lah… dinner is served.

Internship Status: Week 9/49