Monday, December 16, 2013

Part of the Team

Time has flown by! So far I have had great experiences in all of my rotations. I especially enjoyed my time at the USDA’s Center for Nutrition Policy and Promotion (CNPP). I worked on many projects and felt like a valuable member of the team.

I developed educational and promotional materials for CNPP, such as Tweets, Facebook posts, and Tip of the Day posts. Seeing my working posted on the website, knowing it reaches thousands of individuals, is extremely exciting.

I also worked on a new Ten Tips– a great way for consumers to get quick tips on how to incorporate healthy eating and living into their daily routines. I relied on the Ten Tips long before I knew I would contribute to the series. I couldn’t wait to create a new one and add to the nutrition resource that I love! Everyone on our team was very appreciative for the work my partner, Becky, and I had done for them.

Prior to starting at CNPP, I wasn’t sure what to expect when working with the government. I was a little hesitant at first, but after just a day of working there, my anxieties were swept away. I found myself in a caring and exuberant work environment with people who love what they do and are excited to come to work. I was amazed how a small group of dedicated people could accomplish so much! Overall, I gained valuable experiences and skills that I will use throughout the remainder of my internship.  

Sunday, December 15, 2013

Empathy: An Important Trait of a Successful RD

Before I began my clinical rotation, I had this idea in my head that you couldn’t connect with patients in the hospital: either they’re too sick to talk to or they’re discharged before you have a chance to make an impact. I had never seen a dietitian in action in an in-patient setting before so I had no clue what to expect. But as someone who likes to form relationships and bond with people, I had assumed that being a clinical RD was not for me.

During my first week at Harbor Hospital, I quickly learned how wrong I was. Yes, sometimes the patient leaves before we have a chance to see them and yes, some people are not very receptive to what you have to say but for many patients and family members, speaking with a dietitian can make a huge difference. Some people have received mixed messages in the past or never received a diet education before—and they are really grateful that you stopped by.

I realized that knowing kcal/protein needs in different disease states, nutrition support calculations, and how to provide diet educations are not the only skills a clinical dietitian needs. They also need to have empathy, or the ability to understand the feelings of another person.  Here are some phrases I found myself saying over and over to patients, and it really helped them feel at ease:

“What are your concerns about making healthier choices after you leave?” It’s easy to blame the patient for their poor decisions or to become frustrated when you’ve seen someone several times in a month for the same admitting diagnosis. But we have no clue what that person has been through, and although nutrition is our top priority, it may not be theirs. Maybe the person can’t control their diabetes because they are homeless without consistent access to food, let alone healthy, carb-consistent meals. Maybe the person needs to deal with their alcohol or drug dependencies before their diet becomes a priority. It is crucial to learn more about the patient as a whole, and not just the signs and symptoms brought them in.

“Tell me more about it”. Or something along those lines. This can be difficult because you may have patients who aren’t very forthcoming. It may be their personality, it may be that they are overwhelmed with everything that’s happening to them, or it may be that they are afraid of being judged. Be patient—if no one has asked them food- and nutrition-related questions before, they will need some time to reflect. Tell them that you’re there to support them and to discuss their needs, not just to tell them what they should/shouldn’t eat.

“That reminds me of a time when…so I realize how frustrating that is”.  It’s totally okay to share your experiences with patients. Being relatable will put them at ease and hopefully encourage them to open up to you.  It may be helpful for them to hear that dietitians are human beings too—we struggle with weight loss, being short on time, limited budgets, enjoying junk foods, etc. just like everyone else.  But remember to maintain a professional relationship! Only share relevant stories and make sure you don’t reveal any private information.

“Would you like me to come back later?” For some people, the hospital setting is shocking and depressing. They have had a lot of time to come to terms with their health problems and what led them there. I’ve had some patients who cried during my visits—some wanted me to stay, some asked me to come back later. Let them be open with you if they want to share. Sometimes they will answer your questions so they can rest and not have you return. If they aren’t willing to talk to you, take a hint and leave.  

I’ll stop by later/tomorrow to see how you’re doing, if that’s okay with you”.  Each hospital will have follow-up protocols depending on the risk level of the patient.  But if your schedule allows it, you can try to visit patients that are having a particularly hard time or are not eating well more often. Or follow up with patients who received a diet education since they may need time to read over handouts and could come up with questions after you leave. People appreciate you checking in on them and enjoy seeing a familiar face.

Even though the time you have with a patient is limited, being empathetic can show that you care about their wellbeing, making a big difference during a difficult period in their life. My rotation at Harbor Hospital was very rewarding and taught me two important things: it’s definitely possible to bond with patients in an in-patient setting, and I would actually love to be a clinical RD!   

Tuesday, December 10, 2013

Oh, the possibilities!

Having an emphasis in nutrition informatics at UMD has its advantages. As interns we have the opportunity to rotate through a multitude of non-traditional sites. Through my undergrad, I was sheltered in the sense that the only positions I thought RDs had were in clinical, foodservice, or community nutrition. But there is a whole other world out there! Nutrition informatics is such a unique way to use your knowledge and brings about some exciting opportunities.
I’m currently at the Center for Nutrition Policy and Promotion (CNPP), an agency within the USDA. The phenomenal staff is comprised of nutritionists, nutrition scientists, dietitians, economists, and policy experts. The CNPP staff helps define and coordinate nutrition education policy within the USDA and translates nutrition research into information and materials for consumers, policymakers, and professionals in health, education, industry, and media. They are huge promoters of MyPlate and have an integral role in SuperTracker, a free online application to help Americans build a healthier diet, manage weight, and reduce risk of chronic diet-related disease. It’s amazing to see the time and energy that goes behind making the American population a healthier one and the impact dietitians can have in this process.

I’ve thoroughly enjoyed this rotation so far and look forward to my next three weeks there. Seeing this non-traditional side of dietetics has really sparked my interest of thinking outside the box. Internship programs are not only giving you hours and hands-on-experience, it’s enabling you to see first-hand your likes and dislikes. There are so many more possibilities for dietitians today than just the traditional clinical or foodservice arena. The profession is only expanding, so take the leap and find something unique – you never know what you’ll find!

Friday, November 29, 2013

Celebrating a Happy Thanksgiving with the Campus Dining Staff

As a dietetic intern with the University of Maryland I got the unique opportunity to celebrate Thanksgiving with the campus dining staff and student body. My last three days of this exciting rotation held three completely different experiences all themed after the upcoming holiday.

The festivities started as I acted as a food runner at the dessert table during the annual Thanksgiving meal served to the student body. My first task was artistic and fun, I was able to arrange the variety of pies and pastries in a visually appealing manner at the dessert table to entice the students over. As the night picked up I was in a constant flurry from the serving area to the kitchen fighting the crowds to keep the desserts stocked. It was a great experience to interact with the student body and the campus dining staff.

The next day we turned our efforts from food service towards employee wellness, as we compiled an educational wall to promote a healthy holiday to the campus dining staff. We provided many suggestions such as:
·      Controlling your portions by limiting yourself to 3 ounces of turkey and 1 cup of mashed potatoes.
·      Bake your turkey instead of fry.
·      Reduce the fat content of your meal by switching to yogurt in place of sour cream in mashed potatoes, or using oil instead of butter.
·      Exercise with your family by playing football at halftime, going on a walk, or taking a bike ride around the neighborhood.
The wellness wall turned out great check it out!

My final day at campus dining included a gourmet Thanksgiving meal where my rotation partner and I were transformed into chefs. Through the help of Chef George and many others at University of Maryland we produced a delicious meal consisting of a butternut squash salad, roasted sweet potatoes with caramelized red onions, green bean acorn squash carrot cheddar au gratin, stuffed turkey breast with red wine demi, and southern peach cobbler. As we enjoyed our fantastic food I was able to show off all the great work we had accomplished during our three weeks at campus dining.

This rotation was full of exciting opportunities and we were sad to see it go, but cannot wait to see what the rest of our internship has in store for us!

Monday, November 25, 2013

Finding Your Voice

The dietetics profession is very broad and diverse in types of jobs and clientele. Because everyone must eat to live, anyone can be a potential client. However, the same approach cannot be taken to communicate with all groups. A message that may resonate with one group may be irrelevant, confusing, or even offensive to another group. Finding the correct tone, voice, and message is essential to effective communication to a target population. During my first few months in the University of Maryland Dietetic Internship Program I have had the privilege of working for several different organizations that serve very different populations, and finding the correct message and voice to reach my target population has been an ever changing challenge.

At my first rotation, I worked at Riderwood assisted living community in the dining services department. One of my major assignments was to plan, advertise, and carry out a 120 person themed meal event for the residents. My target population was older adults who were retired and in the golden years. Much of this population was not very tech savvy, so more old- fashioned methods of communication were paramount to involving this group. Posters and flyers were essential to advertising, but great care had to be taken to make them have contrasting, easily readable colors and a large font size so that they could actually be read. Also, the seniors would become very engaged by just chatting with them, and would become much more interested if you took the time to interact- very different from my generation’s media centered interaction. 

My next stop was with the University of Maryland Campus Dining. During this rotation much of my time was spent developing educational posters, flyers, and table tents for both employees and students. Creating materials for the students tended to focus on how to improve the health of activities they typically engage, such as how to make football Sunday healthier, or how to eat healthy on a road trip. Materials for the workers had to be simpler, easily followed messages about increasing exercise and healthier eating that would be easily understood and affordable. Making materials for both groups taught me about how to realize who I am writing for, and what will strike a chord with each group.

Most recently, I have been working at the International Food Information Council (IFIC) whose mission is to effectively communicate science- based information about health, food safety, and nutrition for the public good. Because materials are developed for the consumer at large, creating a message that is easily understood and can be followed by large groups of people is a perpetual challenge. People are all different and a message developed for the largest common denominator consumer may not be applicable to many. Because IFIC is a company funded by its member companies it is important to never demonize any food, drink, or product. Positives much be emphasized at all times, so the message should always be what to do, not what someone should not be doing. It can be difficult as a nutrition professional to ignore personal opinions and thoughts when writing, but is imperative to being unbiased.
As shown above, my target audiences vary massively from week to week. At first it was a challenge to find my voice in order to send the message I want to be received, but with practice it is now one of the first things I begin to think about when I write. My takeaway from all this is to consider the needs, lifestyle, and desires of who you want to reach and find the common ground where communication can begin. If you can find your voice, your audience will listen.