Dietetic Internship: Week 6

Ughhhh okay. If you’re keeping close count on my internship update posts, you’ll realize I skipped week 5. Maybe I’ll come back to it to briefly review it at the end of this week’s update, but nothing too crazy happened. We had a week long orientation class, in which we essentially reviewed things we were uncertain on. We also attended a local foods training session that focused on integrating local foods and nutrition education in schools around the area. It was actually super interesting, and will definitely be of use — especially living in the area that we do. Anyway, that really is about it. The real fun started at the beginning of this week…..

Monday, August 24, 2015: DAY ONE OF CLINICAL ROTATIONS. It finally arrived. And, I made it out alive and unscathed! I am completing my 15 weeks of clinical rotations at a smaller hospital just outside of Asheville, working both inpatient and outpatient, as well as inpatient rehab. It sounds like I’ll also be getting a good feel for cardiac rehab, as well as some diabetes education. Today was more of a “get accustomed to everything” type of day, observing how assessments and patient encounters are done, coordinating with the other attending staff, and growing more comfortable with the hospital guidelines. At the end of the day, I left with a list of diseases, medical terminology, and lab values to either refresh or familiarize myself with to ensure I won’t make such a fool of myself as the weeks go on 😉 My preceptor is great and seems like she will be a world of help as the rotation continues, so that’s always nice too. I ended my day at 4:30, then headed to Wicked Weed for a celebratory beer with a couple other interns to hear how their first days went as well. I was WORN out by 7 PM, which is so sad to admit. Then again, I have been out of the real world work schedule for 2 and a half months…my body can definitely tell. I mean yeah, I did start my day before the sun rose with a 4:45 AM wake up call and workout (just as I did every other morning earlier this year), but I just think my body clock has to adjust to my new schedule. Worked on researching and looking up some terms and such before calling it a night at 10:30ish….

Tuesday, August 25, 2015: Waking up was easier this morning (#score), so I squeezed in a quick run before getting ready and heading off. I have a 30 minute commute, so I try to leave around 7:15….I like to be a little early, oops. Today was a lot like Monday — observing the RD during rounds, patient interviews and assessments, charting in the medical records, etc… Hopefully all things I will feel more comfortable with soon, and will eventually be able to do on my own after a sign off by the RD (aka my preceptor, used interchangeably 😉 ). I got to observe an outpatient diabetes education appointment, which I enjoyed. I completed a practicum with the RD and CDE (Certified Diabetes Educator) at the hospital in Athens last year, so combining the knowledge and experience gained then with the education I got in class has helped improve my understanding of diabetes on a deeper level. However, there is still a lot I need to learn. I left again with a list of items to research, review, and familiarize myself with.

Wednesday, August 26, 2015: Today went a little differently than the last two days. Instead of doing our usual inpatient rounds in the morning, we had two cardiac rehab education classes! The heath and wellness center of the hospital holds a 12 week program that offers education, monitored exercise, and fitness counseling for individuals that are recovering for a heart attack, heart surgery, or COPD. The RD typically does the nutrition education class, which is held at two times every Wednesday morning. This week the lesson was on label reading, and we also had a food demo to start off! The clients were really interactive and interested in the presentation, which always helps. Wednesdays are also when my preceptor has a care plan meeting with the rest of the interdisciplinary team in inpatient rehab to review how each patient is progressing, and if any new problems or concerns need to be addressed. We followed up with the remainder of the patients for the rest of day as usual. I’m still observing, but it was fun! I’m starting to get a better feel for the charting process and computer system, making sure every part of the Nutrition Care Process has been addressed and charted. After I got home, I changed and headed out to a local brewery (one of the 1000s) for their weekly run club — it was my second week! This week, they also had a 15 minute ab class after the run. Came back home after some socializing to shower and review some things from work before hitting the hay around 10.

Thursday, August 27, 2015: The same ol’ grind today, making rounds with the hospitalist and team, visiting new patients and following up with old ones, in both acute care, ICU and rehab. 

Friday, August 28, 2015: Again, more of the same. With it being my first week, I’m still getting used to my surroundings and the system of how my preceptor works, so I apologize for this week not being too exciting sounding! I anticipated being able to do more this week, but I’ve got 14 more weeks for that to happen 😉 I did get to follow up with a patient in inpatient rehab and discuss a heart healthy diet handout upon discharge, so that was exciting! Small steps, small steps. I rolled out a little later today, and got home to relax a bit before heading out to the Asheville Tourists baseball game with a couple other interns! Despite being in the program with 11 other interns, we are all in different hospitals across the area, so we don’t actually see each other that often, unless it’s after work or on the weekends. We anticipated going to see a reggae band at a wine bar after the game, but we arrived to a crowd standing outside of the bar..it was too crowded, that it was one in, one out. The band sounded really good, so we hung outside for a bit before heading off to another bar for a bit before calling it a night….at 10:30. 

So, I successfully made it through the first week of my clinical rotations — never thought I’d be able to say that! While I definitely have some things I need to brush up on, I felt pretty comfortable for my first week. My preceptor is understanding and open to questions, and wasn’t in my shoes too long ago. I’m the first intern that she has precepted, so in a way we are both learning how to navigate together. I anticipate things to go even smoother in the coming weeks. 

Next week is going to be a bit different than usual. My preceptor will be on vacation next week, so instead of the hospital, I will be working and shadowing with RDs at the weight management center of a local hospital, which I think will be really interesting. I’m placed in a relatively smaller hospital, so I’m hopeful that I will be able to gain some experience in other specialized areas to get a better, bigger picture during my clinical rotations.