Well, here we are, the very first day of my rotations as a dietetic intern, and in clinicals to boot. I woke up Tuesday morning (Monday was labor day so we had the day off) feeling all the feels. I was a tiny bit nervous, but mostly excited and actually feeling pretty confident! I’ve worked in a clinical environment before (with animals instead of people but, same idea right?) so I was excited to get back into it.
I drove up to the hospital and found the employee parking garage (the largest one I think I’ve ever seen), drove around for five minutes and finally found a place to park. I then realized I had NO idea where I was or how to get to the employee entrance. I called my preceptor and she kindly came and found me and brought me inside, reassuring me that this happened to everyone.
Once we found our way to food and nutrition services, I was walked through an orientation for the hospital and then we went on a tour and got my badge. I officially have no idea where to get anywhere in that building and I don’t know if I ever will, but it’s an impressive facility! Everyone was very nice and luckily I’d met many of the dietitians during my visit the previous week.
After the tour I was given a display project to do – cue my spiral into anxiety. I was feeling like a deer in headlights after getting lost, orientation, the tour, and meeting everyone, and now I was supposed to be creative? I’ll be honest, I kind of started to panic. I kept repeating over and over in my brain “WHY ARE YOU DOING THIS THIS WAS A HUGE MISTAKE GO HOME GO HOME GO HOME!!!!!!!!!!!!!!!!!” … and I share this because I want you to know that if you have the same thoughts, you aren’t alone. I muscled through the project (they needed it done that day so we could display it the next morning – ah!) and then like a gift from heaven, a freaking therapy dog pranced into the office.
This little pupper felt like a reward from the universe for not grabbing my bag and running out of that hospital as fast I could. We snuggled and got kissies, and he seriously sucked the negativity and fear right out of me. After that I felt so much more at ease and then just like that, it was time to go home (at 3pm! Woohoo!).
I drove through Dunkin Donuts on the way home and treated myself to a coffee and a pumpkin muffin. Once at home, I finished up some work on the handouts that go along with the presentation I did, diffused some calming essential oils, talked on the phone for an hour with my lab partner for life and fellow intern Jenn, and pet my cats. Self care, y’all! It was a whirlwind of a day, but I was excited to start seeing patients the next morning.
Wednesday was my first day waking up super early – I promptly discovered I’d try to have to get to sleep before midnight in the future. Once I got to the hospital and found a parking spot, I was actually able to find my own way to food and nutrition services and only got lost twice! I thought it would take me at least a week to be able to do this.
Once I got settled I made my way to the cafeteria to put up my Nutrition Corner display. The RDs were all so nice and gave me compliments on how it looked, which was definitely a confidence boost I was needing that morning. My preceptor had some stuff of her own to do after that so I spent some time working on my next module. After that we walked through how to use the electronic medical record software (it’s confusing, but like everything else I know I’ll get used to it) and then it was time for my first ever rounds!
Now, these rounds were not on the floor I’m going to be covering – they were in the ICU (or “the unit). Even though I’m not doing intensive care right now, I opted to tag along with my preceptor just to get an idea of how rounds go. To be honest I felt like I had been transported into an episode of Scrubs, only I had zero idea what anyone was talking about. My preceptor kept reminding me not to get to overwhelmed with this stuff because it wasn’t my current focus.
After almost two hours of rounds, we had lunch and then began going over the patient I was going to see that day. My FIRST EVER PATIENT. I was super nervous to go up to see her and my preceptor offered to let me shadow her, but I knew this was the time to push myself so I decided to take the lead. Once we got into the room, we quickly realized the patient was (very) elderly and (very) not in the mood for anyone’s BS. I asked her how she was doing and she opened her eyes, said “NOT GOOD”, and turned away. I was not prepared for this response and just turned to my preceptor with a “help me!” face. She graciously took the lead and got some information from the patient’s son who was also in the room visiting.
After filling out my patient’s chart, we took yet another tour of the hospital and I felt 1% more confident in my ability to find different floors. I feel like my brain was just in survival mode all day and I was having trouble thinking critically. I pride myself on being able to think on my feet, so this was kind of a blow to my ego. Lessons learned today – give some sort of answer even if I don’t know what to say. It’s better to try and be wrong than to say silent!
I was feeling much more confident by Thursday, thank goodness! It felt like I was starting to get my bearings a little bit and I felt much more comfortable. I started the day by going over the patients I would be in charge of – I read through their charts and calculated needs. Then for the patient I would be interviewing, I wrote down some questions I thought would be good to ask – any nausea or vomiting? How has your appetite been today? What about before you got here? Honestly a lot of these questions were already answered in the chart, but sometimes it’s good to ask again anyway.
Then I finally got to do rounds for the main floor I’ll be seeing patents on in acute care. I was so relieved to find out that I understood almost everything they were saying, as opposed to understanding almost NOTHING during rounds in critical care on Wednesday. Two patients ended up asking to see the RD during rounds, so we added them to our list to talk to that afternoon.
Next was lunch, but first I took a bathroom break to meditate for 30 seconds (and also pee, duh). I wasn’t feeling overwhelmed or anxious, but it’s good to practice self care even when you’re feeling good so that you STAY feeling good.
After lunch I read up on the charts for the two patients who had requested to see us before trucking back upstairs with my preceptor to talk to the patients. I was feeling way, way more confident than yesterday – I had a plan for what questions I would ask, plus I had some great educational materials printed out for a woman who wanted to talk to us about her GI issues. I only got to talk to that one woman (the other patients were busy or already discharged), but she was super eager to learn and it went great! I honestly wasn’t nervous at all – it helped that I had already met her in rounds and that she truly wanted to see us.
Afterwards my preceptor gave me some input as far as what I can improve on (mostly just remembering to introduce myself and identify the patient when I walk in, even if I’ve seen her before) and then I finished my records. Since I was feeling more comfortable and my brain was out of survival mode, I made sure to ask my preceptor if she had any additional input or suggestions for me from that day and thanked her for taking the time to help me. Then, I went home!
I’m really surprised and so grateful at how quickly I’m getting used to this rotation, especially considering the sheer panic I experienced on my first day. I’m going to try to remember this for my future rotations, so hopefully my next several “first days” will be more bearable!
Friday was another big day because I went to rounds by myself. This felt like a huge step and apparently it was – just jumping in and trying things is the theme of this rotation for me so far! My preceptor was on the same floor most of the time charting, but I went into the rooms by myself with the rest of the care team and made notes as appropriate. I also made friends with the Care Coordinator on my floor while we waited for rounds to start – striking up conversations with strangers is not in my comfort zone whatsoever, but she was super nice and was new to the hospital too!
After lunch I typed up my records and reviewed some stuff with my preceptor before we headed outside to have our weekly check-in. We went over my goals and expectations for this rotation and discussed my strengths and weaknesses of the week. It was really nice to have this check-in and I’d highly recommend asking to do these with your preceptor if they don’t already. It’s great to find out how you’re doing and express any questions or concerns you’re having.
If you had told me on Tuesday that I would be feeling this confident by the end of the week, I would have laughed in your face. But it’s true! I think focusing on self-care every single day, even at work, was huge for me. Also having check-ins with my fellow interns and friends from undergrad helped me feel like I’m not alone (because I’m not!).
Lessons from this week
- When asked for your opinion or input, say something. Even if you think it might be wrong, it’s better to offer some input than just shrugging your shoulders
- Stretch yourself. My preceptor is great and always gives me options – watch her shadow or take the lead, go to rounds together or by myself … I always try to take the scarier option because the internship is all about learning and growing. Not to say do something before you have any clue what to do, but push yourself when you feel it’s appropriate.
- Everything is temporary – including discomfort, fear, feeling out of place, not knowing what to do, and being totally lost.
- Take care of yourself!
Until next week!