Monday, November 28, 2016

My Pledge to a Healthier Heart: the day my heart skipped a beat!

I will never forget the day my clinical preceptor selected me to teach the cardiac class to the open heart surgery patients. It was terrifying! That day I had the opportunity to witness  a real heart in action: OPEN HEART SURGERY! In my opinion, my day couldn’t have gotten any better. My excitement level was at an all-time high.
The surgery team was amazing and walked me through every single part of the procedure.The cardiovascular perfusionist even showed me how the heart-lung machine maintains the patient's physiological status during cardiac surgery. Witnessing a live aortic valve replacement plus a triple CABG (bypass) during cardiology homework week was “the full package” experience.

C:\Users\Sbodio\Desktop\IMG_5287.JPGAs I was describing the surgery to my clinical preceptor,  she said these words: “ I really appreciate your enthusiasm, so now, you will be in charge of teaching the mandatory cardiac class to the open heart surgery patients being discharged.” At that precise moment, I believe, my heart skipped a beat.
I would be lying if I didn’t say how nerve wracking it was to teach my first set of  patients. But what helped me the most was to remember the reason why I  wanted to become a registered dietitian: to make a difference in people's lives and to help them take charge of their health. As I was in front of those patients waiting for me to counseling them, I realized that all those years in college, studying Medical Nutrition Therapy, physiology and biochemistry were about to pay off. I had the opportunity to make them understand that by altering their dietary behaviors and lifestyle, they could increase the quality and the length of their life span.


To my surprise, after introducing myself to the patients, I was not nervous anymore. It was rather enjoyable, so enjoyable that after twenty minutes, a nurse had to come in the room to remind me that my time was coming to an end... twice. I even got to teach the patients some of my own recipes and to give them helpful tips on how to replace the salt shaker by using more fresh herbs to heighten the flavor of meals. Some of the points I covered at the cardiac diet class were:

  • How to read nutrition labels
  • To limit caffeine to 1 cup per day
  • To  limit sodium intake to 1500 mg/ day
  • To limit saturated fat and trans fat
Educating the patients about cardiac diet after their open heart surgery was one of the most rewarding moments of my clinical rotation. Seeing the heart functioning in a way I would have never imagined gave me a unique perspective of how our lifestyles and behaviors  impact our health. I will always carry the open heart surgery experience with me as I counsel my patients on my pledge to a healthier heart.

Sunday, November 27, 2016

Grub Shots: Behind the Scenes of a Food Photo Shoot

During my rotation at USDA’s Center for Nutrition Policy and Promotion (CNPP), I had the opportunity to assist with the One Ingredient, Five Different Ways blog and social media series. This mini-campaign promotes healthy recipes from the USDA’s What’s Cooking website. The focus of this series is to share five different recipes centering around a single ingredient to keep healthy eating interesting. Recipes were selected and prepared by  CNPP staff and interns. Five pictures with a pumpkin theme were needed, and I was asked to help set up the food and backgrounds for the photos.

Behind the scenes of the pumpkin photo shoot.

I got to be a Food Stylist for the day! Basically, I was in charge of making the food look pretty whether that meant meticulously placing apple slices on a plate next to a pancake, sprinkling cinnamon over pudding or making the backgrounds look inviting.  I ensured each prop leaf was placed in the perfect spot and that the napkins were wrinkled with precision. I learned a lot both from my work as a food stylist and from watching the other members of the team during the shoot. It took us longer than I thought it would to create those five photos, with a lot of care, creativity, and planning from the whole team. The result? Five beautiful photographs that are sure to get readers cooking.   

The three things that seemed most important for the photo shoot were the presentation of the food, the background, and the lighting. CNPP uses professional equipment such as soft box lights and reflectors. Soft box lights are used to imitate the soft, directional lighting that is produced by window light. The light goes through two pieces of material, which spreads out and produces a narrow beam of light. The reflector was used to control shadows and redirect the light given off by the soft boxes. Creating quality photos is important because the pictures inspire others to try these healthy recipes in their own homes.

Being a part of a food photo shoot was an activity that wasn’t even on my radar as a dietetic intern. It was interesting to see the different elements that go into social media. I know that creating images and posts that are aesthetically appealing are important to having an engaging social media presence, and now I have some real life experience doing it on a professional level. I really enjoyed this unique experience and have a newfound appreciation for all the pretty food pictures I see online.

Pumpkin muffins featured on CNPP’s One Ingredient, Five Different Ways: Pumpkin Month blog. (http://blogs.usda.gov/2016/10/20/fall-is-here-celebrate-with-pumpkin-5-different-ways/)

Wednesday, November 16, 2016

From (Terp) Farm to (Campus) Tables

As interns, much of our time is spent doing clinical or desk work, but sometimes we are able to get our hands dirty! Our sustainability rotation allowed us to do just that by spending a day at the Terp Farm with Farmer Guy. Not only did we get to contribute to the farm by preparing and seeding some plant beds, but we also learned about how much work goes into planting, growing, harvesting and selling the food the farm produces.

Currently in the midst of its third year of production, the Terp Farm works to bring the University of Maryland fresh, locally grown foods throughout the entire season. This does not come easy - winter weather conditions are not friendly for growing. So how exactly does Guy produce fresh salad greens, herbs and more when the weather is cold?

At our trip to the farm we learned that greenhouses, or green tunnels, are the solution! The Terp Farm has one small greenhouse, and three large greenhouse tunnels.

The small greenhouse protects the small seedlings that are in the early stages of growing. This greenhouse is currently nourishing cilantro, dill, onions, lavender, and rosemary. Once ready they will be moved into one of the large greenhouses tunnels.

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These large greenhouses tunnels create a warm environment for the plants to continue growing by trapping heat from the sun inside. It also protects the plants from outside elements such as rain, snow, frost and ice, allowing the plants to thrive. However, this also means that the greenhouses must be equipped with irrigation to ensure the plants get the water they need. During our trip to the Terp Farm we were able to see the salad greens, kale, tomatoes and rainbow swiss chard currently growing and even got to take some home for ourselves!

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Thanks to the greenhouses, we aren’t the only ones who get to taste this fresh produce through the winter.  These foods are harvested and delivered to UMD Dining Halls throughout the whole year and are included in dishes served by UMD Dining on a daily basis. UMD students are fortunate to get this local, farm fresh produce with nutritional integrity and delicious taste!

Tuesday, November 8, 2016

Finding Comfort in my Clinical Rotation

     
    
Tuesday, October 25th marked the first day that I strolled through the floors of Washington DC VA Medical Center as a dietetic intern. Out of all of the rotations of the internship, the clinical rotation was the one I feared the most for a few reasons:
  1. My MNT (medical nutrition therapy) class knowledge from college may not have survived in my long-term memory.
  2. The lengths of the homework assignments are comparable to the commute from DC during rush hour. 
  3. I have to take on the role of an actual dietitian during two weeks of "staff relief?!"
I decided that I had to come into the rotation with a calm, open mind because I knew I had a lot to learn. So far, a typical day consists of screening patient charts, assessing patients who need nutrition-related attention, and completing notes. Each day interning at the hospital has helped me develop my clinical judgment and writing skills. Applying information that I've learned in class towards real patients has helped me understand the role of a dietitian on a deeper level.

After just a week of being an anxious intern, I am quickly finding comfort at the hospital. When I say comfort, I don’t mean finding an empty bed to take a nap on; I mean realizing that people are there to help me learn. All of the dietitians I’ve worked with have guided me in the right direction. When I have questions to ask, they are there to answer. When they ask me questions, they are patient with my response.

Speaking of “patience,” the “patients” in the hospital have been a pleasure to meet. It is cool to know that dietitians have some power in improving a patient’s mood by simply asking them which snack they prefer. I’ve been warned, however, that some patients might express their strong disapproval of the hospital food. Each experience assessing a patient has helped me develop my communication skills and adapt to a hospital environment.

Yes, the first few days were intimidating. And yes, I got lost a few times. There is also a very long list of nutrition pertinent medications that I have yet to define. Although I am constantly being exposed to new things, I am ready and willing to learn more so I know I will be okay.


Friday, October 28, 2016

White House Tour


When given an opportunity to network, UMD’s dietetic interns jump at the chance.  The interns recently were able to connect with some previous interns during a tour at the White House. The tour was coordinated by Sasha Bard, a former UMD Dietetic Intern who currently serves as Associate Director of Policy for Michelle Obama’s Let’s Move program.



Current and past interns meet to tour the White House.


Although anyone can schedule their own self-guided tour of the White House, the intern’s tour came with a couple of benefits. We met members of Let’s Move who told us about their daily duties and what it’s like to work in the Office of the First Lady. We also met the White House Executive Chef and Pastry Chef. They described what it is like to cook for the first family and official visitors. The chefs shared some of the Obama’s favorite meals and other interesting facts about White House food.



White House chefs are explaining the intricacies of cooking for the first family.


After hearing from the speakers, it was time to go on the self-guided tour. The White House encourages visitors to take pictures and that is exactly what the interns did. From group pictures with statues of former Presidents to selfies outside the White House, the interns made sure to document their tour. Overall, the White House was an incredible experience and something that we are sure to remember. I am grateful we had this networking opportunity and I gained insight into these RDs’ valuable work.

2016-2017 Interns with bust of Abraham Lincoln.

Group selfie outside the White House!







Saturday, October 15, 2016

MD-DHCC Fall Workshop


On Wednesday, October 5th, we were given the opportunity to attend the Maryland Dietetics in Health Care Communities (MD-DHCC) Fall Workshop in Clarksville, MD. The emphasis of this meeting was Long Term Care, a specialty of many members of MD-DHCC.

As a first-time conference goer, I had two goals for this workshop: network and learn. Here's how I accomplished my goals:

1. Network with some of Maryland's finest Registered Dietitians 
I was excited to be in a building full of experienced RDs--people who not only share a common love for nutrition, but who have also been interns before and could provide words of wisdom to current interns. I can happily say that I was not disappointed! The RDs that I had the chance to speak with had nothing but encouraging messages for me and my upcoming career as an RD.

One of the messages that I particularly loved was: "Participate in everything you can during your internship. You may never have some of these opportunities again." I took this message to heart and the following day I made room in my busy schedule at my clinical site to see a Modified Barium Swallow Test!

I will also note that it was initially super overwhelming to be at my first conference. Thankfully, all of the interns were given jobs to perform during the day--like signing guests in, helping with parking, etc. Having a job made it easy for me to introduce myself as an intern and future RD.


2. Absorb information given during the workshop presentations
As I said before, the overarching theme of this workshop was long term care. There was a lot of incredible material presented, all contemporary and relevant to the field of nutrition in long term care. Some of the information I learned includes:
  • Nutrition Focused Physical Assessment (NFPA)
    NFPA is a valuable skill for dietitians and is becoming an essential part of the Nutrition Care Process. During this workshop, I learned how to look for and feel for signs of malnutrition, really using a literal hands-on approach to patient care. As you can see in the pictures below, we all had a chance to practice our NFPA skills with a peer. The interns in the pictures are checking their partners for wasting of the temporalis muscle.
Top: Intern Paula assessing intern Ysabel
Bottom: Intern Ben assessing intern Mike
  • Enteral and Parenteral Nutrition - Sure, I learned about the basics of tube feedings in my undergrad education, but this lecture told me how nutrition support really works for long term care facilities. Patients and/or patient families can have a say in what is being provided in a tube feeding. Many facilities are making blenderized feedings possible. That's right, tube feeding formula made from blended foods!
  • Pressure Injuries - Pressure injuries, formerly known as "bed sores" or "pressure ulcers," are a huge concern for long term care. I knew that adequate nutrition, especially protein, is needed to prevent and treat pressure injuries. This presentation taught me that Arginine intake up to 6-9 g/day is now also recommended for patients with higher staged ulcers whose nutritional needs for treatment may not be met through traditional measures.
Overall, I highly enjoyed my first conference experience. I exceeded my goals for networking and learning. I look forward to the next conference in Spring!

Tuesday, October 11, 2016

The Benefit of Tech Tools

As UMD Dietetic Interns, we have the opportunity to experience a lot of different dietetic settings, including community, foodservice, clinical, and technology. The technology rotations consist of completing blog posts, constructing infographics, or compiling and organizing data. The three programs below have been extremely helpful in developing my technology skills, and you may find them useful as well!
 
1] Google Drive
Google Drive allows you to easily create and store all kinds of "Google documents", including "slides" and "sheets" that mimic Microsoft PowerPoint and Microsoft Excel, respectively. These features are particularly helpful when my partner and I need to share documents like nutrition education flyers or research compilations. Google drive is very user-friendly, so it’s not too difficult to learn.
 
2] Piktochart
So far I have been to four rotations, and three of them have had me use some kind of simple graphic design platform to create informational handouts or pages for different audiences. While words are always useful in describing or teaching community members, clinical patients, or even the general public, pictures and colorful images are undoubtedly needed. Piktochart will allow you to create aesthetically pleasing graphics without much of a headache. Plus, it’s free!

3] Weebly
Weebly is simple for everyone to use. All UMD interns are required to create and update a professional online portfolio that will encapsulate all of our experiences, work samples, resume, and certifications throughout this internship. Since it’s interface is build-as-you-go, with a little patience and practice, you can easily become a pro.
From creating amazing infographics and detailed websites to organizing and sharing your documents, developing your technological skills will prove remarkably useful as you build your brand in the professional world. Even if you aren’t an expert right now, you can become one with a little practice! Soon you’ll be teaching your coworkers tech tips to simplify their jobs -- and yours.