Thursday, October 24, 2013

An Internship that Offers Variety

What drew me to the University of Maryland Dietetic Internship was the emphasis of information technology. I grew up in a computer literate family, which might have been considered geeky at the time, but it was definitely helpful in giving me a competitive edge.  After orientation, I was excited to learn that my first two rotations would be in information management, technology and social media. I spent five weeks at the Food and Nutrition Information Center (FNIC) under the WIC Works Team. My previous background experience working as a nutritionist for the WIC Program definitely helped me during my rotation as I was required to brainstorm ideas for the USDA’s National Breastfeeding Campaign, Loving Support. Loving Support is a website that offers educational materials and resources to the public about breastfeeding (what to expect, benefits of breastfeeding, support and resources for mothers, etc…). I developed a detailed outline about new topics I thought would be beneficial to include in the new website that will be under construction in early next year. 
Another project that I worked on and enjoyed thoroughly was using Google Analytics. Google Analytics is a free service offered by Google that tracks and measures web statistics for websites. Some of the many statistics include: web traffic, bounce rate (how quickly someone leaves a website), page views per visit, demographics and which device was used to access the website (desktop, mobile or tablet). I really enjoyed this project as I found it fascinating that this resource was available. Aside from the fact that it is free of charge, I was able to incorporate it into my own Weebly e-portfolio. I created a spread sheet and made correlating graphs and charts depicting specific statistics from the current fiscal year, which ended on October 1, 2013, to be included in the WIC Works Annual Report.
My second rotation was working at the International Food Information Center (IFIC) in Washington D.C. I spent three weeks at IFIC and attended several full-day committee meetings regarding topics such as sodium, food ingredients and protein.  At IFIC, I wrote a total of 5 blogs (one of which is featured on the Food Insight website) with topics ranging from Dietary Fats to Global Hand Washing Day. Other assignments included outlining top media headlines from the month of September that had credible information about functional foods, as well as evaluating a tweet made by Food Insight’s Twitter account (IFIC’s twitter account). I measured the performance of a particular tweet based off how many retweets were made and considered how many people potentially read the tweet. 
This week I started my community rotation at Food and Friends. Food and Friends helps individuals with AIDS, cancer and other life challenging illnesses by providing freshly prepared meals and nutrition services. On Tuesday, with a group of volunteers, I helped prepare 500 groceries-to-go bags that included fresh produce, canned goods and frozen protein options to individuals that receive the services from Food and Friends. Last night, I helped with a cooking and nutrition class and taught about incorporating a balanced breakfast, food budgeting, meal planning, and making healthy choices while dining out. 
I cannot believe that it has only been 2 months since the internship started. I have already learned so many different and valuable aspects of the profession from my first few rotations. I am very impressed with my experience and exposure thus far, and look forward to what the future rotations hold!

Sunday, October 13, 2013

Confidence Through Preparation

                We've all heard it before: plan, practice, organize, make a list, etc. . . But were we ever told why?  Our high school and undergraduate careers involved little assignments that led to a final project or presentation, and our extra-curricular activities involved practices, drills and exercises to sharpen our skills for the upcoming performance. When it came time to write our final paper, we knew we could do it because we got As on all those little assignments; when it came time to throw a pass to a teammate as she streaked down the field toward the goal, we knew we could because we did it every day in practice. These assignments, drills and exercises gave us confidence through preparation.
             Throughout the clinical rotation of the dietetic internship, confidence through preparation is key. Reading a patient's past medical history, admitting diagnosis, current medications, and laboratory values are easy. Walking into a patient's room, asking them about their usual diet, social history, living situation, and self-management their current health is easy. It's tying all the information together to pinpoint a nutrition diagnosis with appropriate interventions that's difficult. However, this is where being prepared gives the confidence to do just that.
              Over the summer and throughout the clinical rotation, assignments have been given ranging from studying simple medical terms to identifying the appropriate nutrition therapy for gastroparesis. Assignments to determine the mechanisms, uses, and nutritional side effects of medications have been given , so when a patient is being treated with steroids, their high glucose levels are no surprise. These small assignments have prepared us interns to quickly answer our preceptors' questions, or to ask knowledgeable ones because we have adequate back ground information. The assignments have given us the ability to not only communicate in a medical setting, but to have confidence in our diagnoses and defend them when questioned. 
               Organizing reading notes, reviewing flashcards, practicing PES statements, and planning driving routes to assure a punctual arrival are only a few activities that assure confidence each day. Without confidence interns may be hesitant to speak with patients and their nurses, shy to inform the pharmacist of a TPN calculation, and scared to ask preceptors for help. To perform well at anything, confidence to do it is extremely important, and what better way to know you can do it than by preparing?  

Thursday, October 10, 2013

Dietetic Interns Enter the New World of Technology

There are many activities that present themselves while being an intern at the University of Maryland.  Some of these activities are optional -- and occur in the evening.  A recent open "techie meeting" -- "DC Tech Meetup" occurred on September 24, 2013 with a large agenda of presentations.  One UMCP dietetic intern attended focusing on those apps or software that might be of interest and useful either from a nutrition standpoint, or from a "let's get more efficient" standpoint.  Comments about two new tools included:
  • MediSafe -- Personal Medicine Management System.  The developer created it as a result of his father overdosing on his insulin.  The father couldn't remember when he had last taken his insulin dose and took too much.  How it works:  Fill your pillbox -- select your meds by name.  The color, shape and inscriptions of each medicine are recorded. A personalized reminder can then be created to send to take the medicine.  Starting in 2014, patients will be able to record medication doses via smartphone touchtone.  If you don't take the medicine, a personalized message will be sent to a designated family member, who can then remind the patient to take their medicine.  MediSafe has partnered with pharmaceutical companies and feeds user data to the pharmaceutical companies (ie.  frequency of missed doses, etc.)
  • Photo courtesy of MediSafe Project

  • Social Radar -- Provides social media information regarding people you know (directly or indirectly) located within a denoted geographical parameter around you.  This tool uses social media user's "check in" locations.  This tool can also provide navigation to specific people.  This could be useful at a professional or social gathering where you do not think you will know anyone.  

Sunday, October 6, 2013

Embracing Opportunities, Saying Goodbye to Fear

Everyone comes into the internship with different skills, experiences, and strengths.  Each intern also has areas in which they can improve.  As for me, I was excited for each rotation but was particularly nervous about clinical.  I’ve volunteered in a hospital before but never shadowed an RD—I mainly just listened to patients complain about the food during meal rounds.  I had a lot of concerns before my rotation at Harbor Hospital started: should I go over my notes and try to memorize everything I learned in MNT? What if I forget the different nutritional requirements for each disease state? What are the PPN/TPN equations again?

With all of these questions building up during my first two rotations, I felt pretty anxious driving to my first day last week.  My only homework assignment was to come up with a list of strengths and weaknesses for clinical.  My strengths seemed to focus on personality traits and work ethic while my weaknesses were…everything clinical.  While I was waiting for my preceptor to meet me in the visitor lobby at Harbor, I remembered something my friend told me years ago. She had told me that no matter how scared I am about something new, that I should always say “yes” to every opportunity that comes my way.  Even if I fail miserably, I’ll learn a great deal about myself and may be surprised at how much I like something that I initially feared.

Keeping her advice in mind, I went through my day with a much more positive outlook.  Okay, so maybe I don’t remember everything from undergrad but that’s why my preceptor wanted me to reflect on my strengths and weaknesses.  I could use my current skills and knowledge to improve on everything I was worried at the beginning: energy and protein requirements, nutritional needs, equations, bedside manner, etc. 

During my first week, I said “yes” to every opportunity to learn, even if I wasn't really sure what I was getting myself into.  I shadowed in ICU on my first day, learned how to screen using the malnutrition diagnoses criteria, and even began following up with patients on my own by the end of the week.  Even though a lot of terminology and abbreviations sound like a foreign language to me (especially during rounds with the medical interns), it allows me to set learning goals for myself during my time at Harbor. 

I am also very fortunate to work with an awesome team of dietitians who are not only aware that I have little to no clinical experience but are very enthusiastic to make the best out of my 8-10 weeks.  The first time I talked to a patient, I received great feedback on what went well and what I can work on to make the next encounter better.  I’ve asked more questions than I can count but it doesn’t seem to faze the RDs at all.  And embracing new opportunities for learning and growth is wonderful because it doesn’t give you the time to be afraid.  You’re so busy becoming a better RD that you forget to be nervous.  Even though I started clinical with butterflies in my stomach, I am already enjoying myself more than I imagined. I can’t wait for what my second week (and the rest of the rotation) has to offer.  

Where's My Salt?

Imagine you are a student at the University of Maryland eating lunch with friends at the South Campus Diner. Like usual, you reach for the salt, but this time you only grasp air. You look around and notice that all of the salt shakers have been moved to a different location. Wonder why they’re gone?

I had the pleasure of contributing to the University of Maryland Dining Service’s initiative to help students decrease salt intake. Developing posters and table tents were some of the creative projects I put together. I learned how to design eye-catching material that would hopefully spark students’ interests in staying healthy. I also created wellness walls for the employees, encouraging them to limit sodium and use different seasonings instead.

My partner, Becky, and I had the opportunity to survey the students and get their views on the new initiative. A majority of the students were very receptive and appreciated Maryland’s efforts to help them stay healthy.  This act is just one way that the Dining Services team shows their care for the students’ well being. Additionally, the team prepares a large amount of food from scratch and uses fresh produce.

It was a joy to work with the Dining Services team and learn how they put the students first. As a recent Maryland grad, I appreciate knowing I had people like them looking out for me.