Sunday, May 1, 2016

The DCMAND Conference

Every state has an affiliate chapter under the Academy of Nutrition and Dietetics, and on Friday our internship class attended the annual conference put on by the DC Metro Academy of Nutrition and Dietetics, or DCMAND. As a resident of Washington DC, I was excited to see what my local chapter was all about! 

The conference was titled “Planning with a Purpose: Modern Strategies for a Better Food Future” and it focused on the entire food supply chain, food policy, customer patterns, federal oversight and technological advancements of both food production, access and consumption. 
Some of the highlights for me included:
  • Learning how local urban populations are growing and increasing the demand for locally sourced and produced food products – only with the help of technology used in food production can these demands be met.
  • Hearing about how a specific product (Chobani yogurt, in this case) can grow to be a national leader and still maintain locally oriented production with a strong commitment to sustainability, quality and nutrition.
  • Understanding how the FDA reviews prospective changes to the Nutrition Facts Panel. 
  • Seeing how science-focused communications are most effective when delivered with a bit of humor. 
  • Reviewing some of the methodology used to conduct NHANES, and learning how anyone can assess the treasure-troves of nutrition and eating behavior data the USDA collects on an ongoing basis, including the Healthy Eating Index. 
  • Understanding how public schools are measured according to the USDA’s healthy lunchroom standards – and seeing how few schools actually meet the relatively attainable standards.
  • Getting introduced to new apps that can help dietitians council their patients and clients towards personalized food and fitness goals. 
  • Learning more about how grocery store dietitians can coach shoppers towards making healthful purchases, and manage their specific nutritional needs. 
  • Being introduced to local DC companies that focus on local, healthful, affordable meals for lunch and dinner (check out Scratch DC and Tiny Grocery!). 
We were encouraged to tweet about the conference with using #DCMAND2016, take a look at some of the topics mentioned during the conference, here.

Meredith next to her award winning poster project!
In addition to attending the conference, our class and dietetic interns from National Institutes of Health and Howard University were invited to present posters and original abstracts. Our classmate Meredith Dillon won an award for outstanding original project! Congrats, Mere!

Attending the DCMAND meeting is a great way for our intern class to see how important it is to be connected to our local Academy affiliates. These groups provide great networking and discussions about potential job opportunities. We also were introduced to future opportunities for leadership roles. Involvement in local Academy affiliates can only help each of us grow in our careers as we become dietitians. 

Wednesday, April 13, 2016

More Than Just Food Service

I am currently doing my rotation at Riderwood retirement community for six weeks. My partner and I have been very busy here and learning so much (which I could say for all of the rotations, really!). The biggest thing that we do here is prepare a large theme meal that is served in one of the restaurants at the end of our rotation. There have been other intern blog posts about that project, so I am going to focus on the more behind-the-scenes projects that we also complete while here.

When people think of food service, the first thing that usually comes to mind is the actual cooking preparation in the kitchen and then serving meals.  However, there is much more that goes on, and this rotation has a large variety of projects for us so we can be very well-rounded in case we decide to pursue a food service type career in the future. We were able to look at the binders from years of past interns, which was a great source of inspiration and guidelines for our projects.

While here, we complete SWOT analyses.  These are a broad picture analysis of the Strengths, Weaknesses, Opportunities, and Threats in a situation so that managers can determine how to continue to improve the business both for profit and for customer satisfaction. I think this is a project where interns can really take initiative and produce a result that is truly helpful to the organization, so I was glad to do it. For one of our SWOT analyses, we looked at Windsor restaurant, one of the five restaurants on this campus.  We interviewed residents, employees, and managers for information as well as observed the restaurant in progress for a couple of days before typing up our report and submitting to our preceptor.  I am proud of what we created, especially since I think we identified some opportunities that they have not considered in the past.
Open source image from Wikipedia
Besides typed projects, we also learned a lot about staff management. Most days, we attended the pre-shift meetings for both the waitstaff and the chefs. We began by observing these meetings to see how the managers communicate and set expectations in order to

Monday, April 11, 2016

Elective: Vegetarian Resource Group

I had the pleasure of completing a rotation at the Vegetarian Resource Group (VRG) for the last two weeks. I had known about them in the past, from their newsletters and booths at conferences. They are a non-profit organization in Baltimore, MD that has the mission: "we are dedicated to educating the public on vegetarianism and the interrelated issues of health, nutrition, ecology, ethics, and world hunger." In such a short time, I was able to learn so much and I loved the experience. 

One project that VRG has been working on is promoting vegetarian meals at Our Daily Bread, a local hot meal program that serves breakfast and lunch to anybody in need of food. They have a high number of requests for vegetarian meals, but many of the donations are not vegetarian, so we are working to promote more vegetarian donations and recipes there. I got to talk to many people involved with the program to learn about its history and efforts to include vegetarian offerings. Brigette (the volunteer coordinator at VRG) and I went to Our Daily Bread to see it in action and see how popular the vegetarian meals were. We were again told that many people request vegetarian meals, but they usually get the same plate of salad, fruit, peanut butter and jelly or mac n' cheese, bread, and dessert. One food service director enthusiastically told us that they would love more vegetarian donations, so the next day I cooked three types of vegetarian casserole recipes that VRG has formulated to add to their donation recipe database. This was a great hands-on experience to be able to test out these new recipes and suggest changes to make them easier. When I delivered them the next day, I was told they would be used very soon! I wrote blog posts for VRG's website about the whole process in order to encourage others to do the same. It was great to feel like I had a direct impact on providing a variety of nutritious meals to less fortunate people who are requesting vegetarian meals.

I also helped a dietitian at VRG to do research for a webinar she is putting together. I was tasked with sorting through the various laws and government organizations to find any requirements or guidelines for meals served to senior citizens, so we could try to propose vegetarian menus that would meet those guidelines. I learned a lot during this process and hope it will also be able to make it easier for large federal facilities and nursing homes to provide great meals to vegetarians. One particular law does not currently allow tofu as a meat substitute in adult daycare facilities, but the bill to change it is being considered now, and I'll be rooting for it to pass!

In the VRG office, I was also able to help with some more day to day tasks. I helped sort through applications for scholarships and compose replies to the applicants. I researched vegetarian and vegan restaurants to write listings to add them to their international restaurant guide, which was a difficult task indeed: it's hard to look at so many delicious menus without being able to eat the food! But I didn't go too hungry, as there were many vegan food samples sent by companies to VRG, that I was able to try and write reviews about.

Overall, I really enjoyed being in this supportive environment that is dedicated to learning and supporting learning in others. The astounding number of books and resources in the office have given me a big “to read” list that I am excited to get started with. I am sad to be leaving so soon, but it won't be the last time I see them! I've signed up to help with the VRG benefit at a local vegetarian restaurant next month. Also, every year all 10 dietetic interns visit VRG for one day to educate them on how to work with vegetarian patients and clients in their careers, so I look forward to seeing them again on that day in May.

Maria Pittarelli

Thursday, March 31, 2016

Easter Bunny Says "Eat All Your Food Groups!" My Experience at the White House Easter Egg Roll 2016

On Monday, March 28th 2016, the First Family hosted the 138th annual White House Easter Egg Roll on the White House lawn.  Thanks to the UMD internship and my preceptors at the Center for Nutrition Policy and Promotion (CNPP), I got to attend! That's right, I got to go to the White part of my Dietetic Internship!!  Let me tell you, it was as cool as it sounds.

I first arrived at the White House around 11 AM and was immediately escorted behind a gate to make way for...the PRESIDENT OF THE UNITED STATES! I really did see him in person! He waved and smiled and I was headed off to the CNPP table.
Fountain on White House Lawn
So Close to the White House!

CNPP is a government agency that creates, updates, and oversees things such as the Dietary Guidelines for Americans, MyPlate, SuperTracker, the Healthy Eating Index, and more.  It is an amazing opportunity to have a rotation at an agency that is so central and involved in nutrition policy in the United States, so getting to help at their table was an amazing experience.

The CNPP table was set up with three activities for children and their families in attendance: a food group "trivia wheel" a photo booth, and an activity where kids could build a healthy meal with food models.  I had a blast teaching kids about the food groups and the importance of physical activity and the kids absolutely loved spinning the trivia wheel. We gave out prizes to children such as temporary MyPlate tattoos, stickers, pencils, and posters.

Me having some Photo Booth Fun!
CNPP education materials table

The CNPP table was also equipped with all kinds of educational materials to give out to any parents and teachers who were interested.  We had some MyPlate readers for young children learning to read, parent and teacher curriculums, and materials on how to help your child eat healthfully.  It was a great platform to spread the word about MyPlate and all of the resources that go along with it.

USDA's Team Nutrition shared a table with us and passed out many educational materials as well.  They also brought their mascot, the Power Panther, which was a hit with children, and with me too! I got a picture with him after my time at the table was over and I also got to walk around freely to explore the Easter Egg Roll as long as I wanted.  I got to see live music performances, a few famous athletes, and a few actors too!

The Power Panther, the White House, and me!

UMD's Dietetic Internship has so many diverse opportunities and you never know what you will get to do.  I am very thankful to both the internship as well as those at CNPP who were able to bring me to the White House this year; it was surely an experience I will never forget!

Wednesday, March 30, 2016

Organize Me: Clinical Edition

My acute care clinical rotation flew by and although it was tough, I grew to love every single minute of it at the Baltimore VA Hospital. With my preceptors, and staff helping me whenever I needed pertinent information about a patient, I found myself appreciating them for every single thing they did. I created relationships there and this was essential for my success. Another thing that made me successful was my reference sheets. These became tools for me to make me more efficient at what I did.

When I was in clinical, my mind was going a mile a minute. Clinical is tough and it never slows down but I gave myself peace. This was done by making my own reference sheets for medications, supplements, formulas, PES phrasing, and more. These were essential for my success at clinical and I think it is useful to have on hand. As a current intern giving a future intern advice, try and prepare a quick reference sheet before you go to your clinical rotation. It shows initiative to your preceptors and can be your saving grace if you get in a tough spot.
Things to consider having on a reference sheet:
  • Common medications (brand name, generic name, use)
  • Common supplements: Nestle, Hormel, Abbott (kcal/pro)
  • Types of Insulin Chart
  • BMI chart
  • % Significant weight loss over time
  • Common PES statement 
  • Energy requirements (kcal/kg, Penn State, Mifflin St. Jeor, etc...)
  • Adjusted weight for amputation
  • Fluid adjustments for dialysis
You may receive a form with your hospital's assessment standards on it but it may not be organized in a useful way for you. I love making tables so this is the route I took when organizing my resources. As long as you reorganize it, make it colorful, and bold so that you use it effectively then you'll do great.  Not every technique you try will be effective the first time you use it. I made a list of over 100 common medications alphabetized before I went to my clinical rotation. Once in my rotation however I found that it was difficult to read and it took forever to find medications on it. After a few days of struggling with it, I went back and condensed it down by category of medications. This helped immensely. Your clinical rotation is a learning process, you learn what works and what doesn't. 

Another thing I made for myself was nutrition assessment sheet. It included everything I needed for a nutrition note at my hospital. I printed it out everyday and used this to organize the information I needed so I only had to look at this while I typed my notes. My notes were much more cohesive when I used my assessment sheets. You can create and adjust it for your clinical rotation and you may find yourself not needing as much information as you go through your rotation.

Things to consider having on a nutrition assessment sheet:
  • Name
  • Height/Weight
  • Room #
  • Labs
  • Meds
  • Diagnoses/Medical Hx: 
  • Skin
  • Intake from kitchen data or RN
  • Subjective Pt. Appetite/Intake
  • Nausea/Vomiting/Chewing/Swallowing/Diarrhea/Constipation
  • Energy requirements 
These are just suggestions of tools to make in order to have clinical success. Once I utilized these tools, my clinical rotation went much smoothly and I saw myself working more efficiently. I hope that this helps future interns because it helped me. Try new things and be a success. 

Cassie Burr
UMD Dietetic Intern 2015-2016
Twitter: @cassie_burr

Friday, March 18, 2016

Gruezi! Welcome to Switzerland!

Why Switzerland?
People often think of Swiss army knives, ski resorts, and watches when it comes Switzerland. Instead we decided to draw attention to Switzerland's diverse cuisine. Switzerland is a landlocked country in Europe surrounded by France, Italy, Germany, and Austria. Over the years, those four countries have all contributed to create a special Swiss cuisine.

We came upon Switzerland for its hearty meat dishes, Swiss cheese, pretzels, and of course fondue! All components of our menu were recognizable by the residents of Riderwood but at the same time unique to the Swiss culture. When it came to desserts, Elizabeth was the expert as she worked in a Swiss Bakery in high school. 

The menu included four main entrees, four sides, a soup, a bread, and dessert. Below you can see our full menu.

Two weeks leading up to our meal we started testing recipes. We tested the pretzel rolls, Linzer cookies, and chocolate fondue. Testing the recipes beforehand allowed us to get the perfected product we wanted and made us more comfortable working in the kitchen. With all the Linzer cookies we baked during our testing, we used them to help market our meal by passing them out to residents outside of Windsor along with a reminder handout to attend our lunch. 

The week leading up the our meal we hung up posters throughout the different buildings of RIderwood and posted a menu in front of the restaurants. During dinner services we rotated through the different restaurants conducting table touches informing the residents of our meal. On the tables of Windsor restaurant we put out table tents. The front side of the table tent highlighted a city of Switzerland and the backside provided the when, where, and what about our meal. The rest of the week was spent in the kitchen prepping food. By Thursday we were in good shape and spent our last few hours (late) Thursday night decorating the dining room.

The day had come! 
The morning of I could say we were more excited than nervous but there was still a lot of work that needed to be done. The Windsor kitchen staff was extremely helpful and we truly could not have pulled it off without them. They took on our meal as one of their own and were more than willing to help any way they could.

As residents started arriving, we made ourselves available to greet our guests and thank them for coming. The servers took over from there allowing us to make rounds at the tables thanking them again, asking for any feedback, and reminding them to fill out our surveys.

The feedback we received from the residents after our theme meal was so rewarding and validated all our hard work for the past five weeks. However, we could not have done it without the help of both the management and kitchen teams from the Windsor. We’d like to thank everyone involved in making our theme meal a success!

Wednesday, March 16, 2016

Class Day in Annapolis: being a nutrition advocate

On March 2nd, 2016, UMD interns got the wonderful opportunity to spend the day in Annapolis. I’ve recently learned about the importance of becoming an advocate in the field of Dietetics.  I was never big on public policy until I attended Maryland Academy of Nutrition and Dietetics’(MAND) legislation day earlier in February, where I got the opportunity speak to delegates with interns from other dietetic internships and registered dietitians about our stance on nutrition related bills. Prior to meeting with delegates, guest speakers provided us with great advice on how to speak with our legislators. This made me confident, and ready to voice my opinion-- all in the name of nutrition!

This class day started with a history lesson and a tour in the historic rooms and chambers of Maryland State House! Next, we observed the Senate in session and the House of Delegates. As an intern class, we were announced in one of the sessions (we felt so special!). Then, we briefly met with Jim Brochin, who is the State Senator for Maryland’s 42nd Legislative District, Baltimore County. Although he was very busy that day, he still made an effort to meet with us, and shared with us his story of why he decided to run. Speaking to him made us realize how much he cares for Maryland and its citizens. 

Attending this class day in Annapolis refreshed my memory about the different roles that Maryland's Legislative, Judicial, and Executive branches play in enacting laws and enforcing them, as well as how a bill becomes a law. Being a nutrition advocate isn't so bad after all. When speaking to delegates, you have to know your stuff! The more you know what you are talking about, the less nervous you will feel. I look forward to becoming more involved in future legislation days, where my voice can make a difference! 

UMD, College Park dietetic interns and program director meet with Senator Brochin

The Agenda 

8:30 a.m. Meet- Joint Hearing Room, First Floor, Department of Legislative Services Building, 90 State Circle, Annapolis, Maryland

View Maryland General Assembly Video “The Legislative Process” 

9:00 a.m. Escort through the Tunnel to the Maryland State House
Tour Historic Rooms and Chambers of Maryland State House

10:00 a.m.  Escort to Reserved Seats in the Senate Gallery, Second Floor, State House

10:30 a.m. View Legislative Session from House of Delegates Gallery

11:00 a.m. Program Concludes in 221 James Senate Office Building

Meet with Senator Jim Brochin