Monday, September 12, 2011

My first rotation as a UMD Dietetic Intern

My first rotation was much anticipated; I could not tell if I was more excited or nervous to start clinical. However, once arriving it was a great feeling knowing that there are so many people support you and your efforts to succeed at a rotation site.

Day one was spent in the diet office, which really makes the whole food and nutrition segment of the hospital flow smoothly. They process all of the diet orders, nutrition consults, patient menus and any personal preferences or changes that need to be made within the hospital. Day two was where the fun really began. I got to put on my lab coat, attach my retractable name tag that gave me clearance to all of the floors and journey upstairs.

It was within the first hour that I realized that patients in real life are not what they were like in our case studies during our Clinical Nutrition or Medical Nutrition Therapy courses. I had a feeling that it was going to be this way, but I learned quickly that this was the reality of working in an acute care setting. I found that many of the patients did not have one chief complaint or just a few items in their past medical/surgical histories, they in fact had many more than you would imagine or like to see written down together.

In the last week and a half I have observed many nutrition consults and even completed some myself. I am excited to say that I am learning and re-learning old forgotten ideas and calculations much faster than I first thought I would (gold star for me) back on day two after being overwhelmed with all of the new information. I am very excited to continue my developing experience at the hospital and help patients recover better through nutritional interventions.


  1. Hi Erika,

    Sounds like you had a great and very interesting start to your rotation. I believe you about class vs. real world. I encountered similar issues recently during my last rotation. So what has been your most complex patient, case wise, so far? How did you prioritize their issues? Thanks, Joyce

  2. Hi Joyce,

    Wow, I've been thinking about the answer to this question for a few days now and you know there is no 'most complex' patient. Everyone has a variety of issues and PMHs that build on each other. All of which add to the case and the interventions that you are going to prescribe. As far as I have seen, everyone has HTN, DM II, bipolar disorder, and a few past surgeries under their belt. After this depending on what they are in for and that determines if we see them (unless we get a consult from RN or MD).
    Prioritizing issues comes down to what can you do for them at this moment to help them recover. I have dealt with a lot of severe weight loss, decreased appetite and decubitus ulcers. In those cases, doing what you can to get calories into their system and the necessary amounts tends to be the number one goal. Everyone is different and requires you to think out of the box.

    Hope this answers your question. At least partially :)

  3. Thanks. Your answer is very helpful and gives me good insight into what I will be facing when I start my clinical rotation in October.