Hi all! I hope there is still someone reading out there. I’m working hard to manage this whole work-life balance thing. I found a pocket of time to update you all on the internship. Because I’m a little behind, I’m giving you the condensed version of my notes from the past four weeks (!).
Even now, after having completed a week at the food bank, I’m not entirely certain how a dietitian’s skills might benefit a food bank. There used to be a dietitian that worked at the food bank where I interned, but she recently re-located to a different city. As a result, I didn’t really have a typical experience for this rotation. Nonetheless, it was worthwhile.
What I did: I did a lot of office work, but I also created a meal plan for a family of four using only the funds that would be allotted by SNAP. It was intended to be used for people who wish to participate in the annual SNAP Challenge. If any of you are interested in seeing the meal plan, let me know, and I’ll either post it or e-mail it to you.
My favorite aspect: I really enjoyed getting to visit a food pantry that received donations from the food bank. Getting to see how a food bank impacts the community is such a powerful thing–it makes me want to volunteer more in my community once I get a little more free time.
There is a clinic here in Birmingham devoted solely to people diagnosed with HIV, and it is one of the few places remaining that allows walk-in requests for HIV testing. I personally had never worked with this population before, and while I had learned about the disease in college and graduate school, there were definitely some holes in my knowledge about the course of the disease.
What I did: I performed bioelectrical impedance analysis on almost all patients to determine whether whether protein needs were being provided through diet. I also got to do several diet educations on my own for the whole weight spectrum–from morbidly obese to severely underweight.
My favorite aspect: I had a very trusting preceptor who let me do diet educations on my own fairly early in the rotation, and I really appreciated that. I enjoyed being able to have one-on-one contact with the patients to understand their life situations and specific nutritional problems. Being able to answer their questions made me realize that I know more than I think I do!
Throughout my education in nutrition, I’ve been told things like, “You’ll have to know how to do this in your clinical rotations,” or “Your preceptor will expect you to have memorized x, y, and z.” So as a result, I’ve kind of been nervous about my clinical rotations, for, oh, the past three years. As it turns out, it’s not that scary. I’ve completed two rotations thus far. The first was the “general” rotation in which the preceptor covered miscellaneous floors, from psychiatric to outpatient cardio rehab to ICU.
What I did: I did a lot of observing for this rotation, just because it’s a whole new world in the hospital setting. There are lots of specific protocols and charting procedures that I needed to watch the preceptor do a few times before attempting on my own. I was able to do a couple diet consults/educations, but just one completely on my own (on a low-fiber diet for diverticulitis).
My favorite aspect: I really enjoyed seeing the outpatients in cardio-pulmonary rehab during this rotation. It was a setting and subject matter that I was much more comfortable with, and the patients were more likely to be actively listening and asking questions.
Clinical: Trauma + Burns
This rotation was particularly nerve-wracking for me, as I’ve had so many people tell me how they got sick or fainted after seeing the condition that these patients are in. Yes, the patients mostly in ICU and in pretty rough shape, but the most uncomfortable situation I was in the whole week was just when the patient pooped while I was in the room. (FYI, not a big deal. The nurses will talk about patient stool with you all day long if you let them). I didn’t see any serious wounds or burns being dressed while I was in the ICU.
What I did: Unlike the previous rotation, there was not a whole lot of patient contact for the trauma + burns unit. Most of the patients are heavily sedated and intubated, which doesn’t exactly made them good candidates for chatting. So mostly what I did is review flow sheets to check ventilator settings, daily weights, Urinary Urea Nitrogen (a measure of protein losses), and calculate tubefeeding or total parenteral nutrition (TPN).
My favorite aspect: As weird as it may sound, I actually kind of like calculating tubefeeds and TPN. I think most dietitians like manipulating numbers to a certain extent, and you get to do a lot of that when you do these kinds of calculations. I enjoyed figuring out each patient’s “puzzle,” that is, what type of nutrition support is right for their situation and needs.
So that’s what I’ve been up to for the past four weeks. I have a few product reviews I’ve been putting off for a while, so hopefully I’ll get those posted soon (Van’s crackers are awesome, by the way). This week I’m headed to neurosurgery and neurology, so I’ll update on that experience when I can!
What have you been up to lately? I need an update on the blog world!
Filed under: Notes from the Intern