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!