The Life of a Dietetic Intern: Clinicals Week 3

Another week of clinicals in the books! Everyone said it would fly by and they were 100% right. I can’t believe Monday starts my fourth week of the internship. I’m really soaking in the experience but I won’t lie, I’m also excited that it’s going by so quickly!

Another week, another seventeen trips to Starbucks

On Monday, my fellow interns and I returned to The Atlanta Community Food Bank to learn how to give cooking demos. At the end, we got into groups and were given a mystery ingredient and scenario that we had to use to create our own cooking demos. Our group made chicken salad using our secret ingredient, apples.

Tuesday it was back to work at the hospital. This was honestly a big day for me because I had the opportunity to speak with a young woman struggling with some major health issues that were just starting to develop. I was able to practice some weight-neutral approaches to healthy eating for the first time in real life … I left my patient’s room after our talk feeling so sure that I am in the right place, and so grateful that I’ve found my purpose. I really love helping people in an individualized way, and everything just clicked for me today.

There is something that became glaringly obvious to me though that I want to be transparent about. I have never been overweight. I thought I was overweight in my early twenties, hence the eating disorders, but I never truly had to move through life in a larger body and experience the adversity that accompanies that. I left the room feeling like I had made an impact, but also wondering if I should have addressed the fact that I am a thin person talking about accepting your body as it is and that I can never truly know her struggle. It’s an area I’m excited to delve deeper into and learn as much as I can about.

Wednesday was a busy day full of learning – we had a lunch and learn at the hospital about enteral nutrition and fiber followed by a GADA (Greater Atlanta Dietetic Association) professional development meeting with some of my fellow interns that evening. We listened to a fascinating presentation on the potential benefits of using the ketogenic diet with oncology patients, a topic we’ve discussed on the podcast before. I know you’re rolling your eyes even at the mention of keto, but it’s a therapeutic diet y’all! Someday I’d love to really dig into the science and learn more about its potential.

Future RDs!

Thursday was when things really started to get crazy – I think I had 6 patients (the most I’ve ever had) and all the RDs were slammed. On top of the mounting list of consults, myself and another RD were scrambling to get our materials finished for malnutrition week (September 23-27, mark your calendars!). We made a deck of cards for the nurses with malnutrition trivia questions on them, along with a “Faces of Malnutrition” deck with case studies detailing different types of patients you might see with this condition in the hospital.

So much cutting out squares

Oh, and no big deal, but I did my first bolus feed calculation of the internship (and second ever shh) and got it right! When my preceptor asked me if I wanted to try it on my own I hesitated, but the other RDs cheered me on and gave me little hints to help me along the way.

Went with 5 cans, should have gone with 4 … ended up changing the order on Friday due to intolerance =P

I also got to have lots of interaction with other parts of the care team this week, like the care coordinator and RNs. The people on my floor are all so lovely and fun to work with. Oh, and of course a week in clinicals would not be complete without me getting stuck in an elevator … this is seriously on my (long) list of biggest fears, so at least I’m getting LOTS of exposure therapy?

Me hoping the elevator starts moving again and glad I have lots of snacks

And just like that, it was Friday again. It may have been even crazier than Thursday but what really warmed my heart was that two of my patients ask for my card because they wanted to work with me after they went home. Obviously I told them I was still an intern and can’t take patients on my own, but that just really made my day. It was a little sign that I’m at least doing something right and maybe even getting through to people!

I also had my first angry patient on Friday – y’all, I was actually excited about it because I got to test out my plan for dealing with situations like this. I let my patient yell at me and complain and didn’t interrupt him … and then when he was done, I told him I was sorry and that the whole situation sounded so frustrating. He yelled some more, I continued showing empathy, and then just as I hoped, he calmed down, apologized for his behavior, and let me talk to him about his diet. I know when I’m upset I just want someone to listen to me and not tell me that I’m wrong for feeling how I feel – this patient was no different. I know tough situations like this won’t always go as I plan, but it was nice to successfully navigate my way through a difficult patient interaction.

Oh and how could I forget, there was cake on Friday. Cake that we ate twice throughout the day, because dietitians love sweets just as much as everyone else 😉

Lessons Learned This Week:

  • You know more than you think you do – just try before you assume you don’t know what to do.
  • Be open to not being perfect. My mantra of this internship is “I’m learning”, and I am continually reminding myself that I won’t always know exactly what to say or how to act.
  • Be truly interested in each patient. When people feel that they matter to you, they tend to listen.
  • Eat. It can get really hectic in a clinical setting, but if you don’t pause to eat, you’ll make mistakes. Duh, right?

I also wanted to point out that I have a new article up on my main website all about vitamins! I tried to write this article for everyone – it’s easy to understand but gives a little bit of the deeper science too for you nerds. I like to use it as my own personal cheat sheet when I can’t remember what a certain vitamin does or how deficiencies manifest.

Until next week, friends!

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