Sunday, April 27, 2014

Dietetic Interns at Maryland Day

As our time in the University of Maryland Dietetic Internship comes to a close we have been given a variety of opportunities to get out of the classroom and put our nutrition knowledge to use throughout the community. This Saturday we had the privilege to attend Maryland Day in order to promote a healthy lifestyle to not only University of Maryland students, but also to members from the community around UMD and all of Maryland! It was a beautiful day and we all had an wonderful time playing with the children and providing education at the same time!

            Interns were stationed at two separate booths with different nutrition related activities. At my station we promoted portion sizing with MyPlate. We provided our audience with a myriad of handouts and magnets they could take home and share with their entire family. We attracted a large audience with a variety of food models that demonstrated proper portion sizing. It was very fulfilling to meet families that were interested in improving their diet, and introduce them to MyPlate.

            We were then able to add some fun and a competitive spirit into our booth with a MyPlate inspired beanbag toss. Children and families were challenged to throw beanbags into different food groups on our boards. Everyone had a great time and were able to win an educational coloring book with an assortment of activities for all ages. This enabled our participants to take the knowledge they learned while playing with us home to share with the rest of their family and friends.

            I had an amazing day out in the community sharing what I love with all of the guests at Maryland Day! Becoming a dietitian has enabled me to learn a lot and have fun at the same time!    

Tuesday, April 22, 2014

Three Different Rotations and A Whole Lot of Experience

The past two months I have been rotating between three different rotations. Although these rotations were different in many ways they had one thing in common; a diverse population in need for nutrition care.  

During my pediatric rotation at Children’s National Medical Center, I worked in outpatient clinics counseling diabetic and obese children. While counseling young patients and their families I learned about the specific food preferences of Hispanic and African American culture, such as enjoying a simple, fat free dessert of mango coated in lemon juice.  Their unique preferences taught me the importance of tailoring specific nutrition messages.
After the two week rotation at Children’s’ National Medical Center, I started my long term care rotation at Charlestown Retirement Community run by Erickson Living Communities. It was ironic to me that exactly a week prior I was advising children to replace their fruit drinks with water, while at Charlestown I assisted residents in determining any type of hydration. From working with obese children and counseling them to lose weight, I was advising the older residents to eat frequent meals to prevent weight loss.
I then transitioned to a Davita Dialysis clinic where I again was met with a population with unique nutrition needs.  From liberating diets and encouraging fluid intake at Charlestown, I was counseling dialysis patient to limit their fluid intake. Most of my time was spent counseling patients about how to limit their potassium, sodium, and phosphorus intake.
Throughout the three different rotations in four weeks, the challenge of working with a diverse population taught me so much. I learned the nutrition needs, food preferences and cultural values and beliefs of patients in different age and ethnic groups. Moreover, I was able to practice how to tailor my nutrition messages to different audiences which has helped me become a more culturally competent future dietitian. 

Monday, April 14, 2014

Mental Stamina Required!

I didn’t have any experience in outpatient care before my internship began.
I hadn’t “been there.”
I hadn’t “done that.”

You might already know where this is heading... (that’s right) I recently spent a very educational week in outpatient care, as part of my rotation at Children’s National Medical Center. A week in outpatient pediatric obesity piggybacked a week of inpatient pediatric GI care.

During my week of inpatient care, I became well aware that MNT for infants and adolescents is nothing like MNT for adults. Also, parents, as part of the whole picture, mandate a different approach to patient care. Lastly, being the mother of 2 preteens added a unique level of sympathy and empathy to my reflection. 

Given what I learned during my first week, I felt prepared for outpatient pediatrics. I was  confident with my general nutrition and weight loss knowledge, yet I looked forward to tying it all together while improving my interview and counseling skills. I’ve become keenly aware of the mental stamina required in clinical nutrition; the outpatient setting added a couple twists.

Each appointment must be greeted with a fresh, sincere “Hello”; that’s a simple, basic, human courtesy and it’s what we do, as professionals. Most often we met with a parent/child pair. Sometimes both parents were present. Sometimes all the siblings were present. Regardless, for this intern, a sincere fresh “Hello” became an opportunity in the making after meeting with the first 3 or 4 parent/child pairs of the day. Throw into the mix a few hunger pangs and the opportunity for growth became exponential! Don’t get me wrong, I mastered the skill; but the first time this happened was eye opening. Talk about putting it all aside and giving more than you’ve got. That nails it on the head!

And, no matter what’s going on in the room, we have to stay on track and maintain a consistent train of thought. I was an observer when I first experienced the need for this skill, and for that I’m so grateful! I can’t highlight a particular experience because each was so unique; however, can I say with certainty my RD was absolutely amazing! I don’t know if I was outstanding when my opportunity to shine was presented, but, I know I was successful!

Saturday, April 12, 2014

Then & Now

By: Christina Kalafsky, UMD Dietetic Intern

This past Tuesday, the UMD interns attended the 2014 Spring Workshop hosted by Maryland Dietetics in Health Care Communities. I had previously attended their 2013 Fall Workshop back in October, and I can’t help but reflect on how far I have come since then.

Then: I was only a couple months into my internship and attending conferences was a new experience for me. Heck, wearing business professional attire was a new experience for me! I was basically the equivalent of a freshman. I was overwhelmed by all of the lectures throughout the day and furiously wrote down every single word each of the speakers said. All of the information was new and if I was going to be a good dietitian one day, I was going to need to know all of it. Our preceptor discouraged the interns from sitting together in order for us to network better. While I understood her intention, I was simply too intimidated to talk to any of the RDs. I mean, I was just an intern, what could I possibly say?

Now: This time I didn’t attend the conference as just an intern, I attended as an invited speaker. I, along with the rest of my internship class, was given the opportunity to present to over 94 registered dietitians and other health care providers about up-and-coming technology tools that can be used in the field of dietetics. The tables turned as the RDs were the ones furiously writing down notes instead of me! They came to me to ask questions and praise me for giving such a great presentation. During the other lectures, I didn’t have to jot every little word down. I understood a majority of the clinical concepts they discussed and could nod my head along with the other registered dietitians at my table. I met new people, networked and collected business cards. I even recognized faces from the fall conference. I went from a freshman to a senior all in a matter of months. I’m so proud of myself and amazed at the confidence and knowledge I have gained!

Tuesday, April 1, 2014

Clinical Experience at a Veterans Affair Medical Center

With less than 3 months until graduation from the UMD Dietetic Internship, it is hard to believe that I am 3 days shy of completing staff relief at my clinical site. For the past 10 weeks, I have been interning at the DC Veterans Affairs Medical Center (DCVAMC). My experience has been quite unique and different compared to my classmates, as I have gotten to experience both inpatient and outpatient.  At the DCVAMC, there are 16 Registered Dietitians; for my primary 8 weeks I was with a different dietitian each week. For my first month, I started with the outpatient RD’s who specialize in diabetes education and management, weight loss, cardiac rehab, and oncology. I began my second month working with the inpatient RD’s in the Medical Telemetry Wards and in the ICU/Critical Care Units. Prior to starting my clinical rotation, I was very nervous and slightly intimidated as I wasn’t exactly sure what to expect. All my worries and fears dissolved within a day as I quickly adapted to the fast paced environment and grew confidence within myself while interacting with patients and writing nutrition notes. The weekly homework assignments and weekend quizzes helped hone my knowledge, skills and application of different disease states and treatment so that I could better assess, diagnosis and create a nutrition intervention plan for a patient.
Fortunately, I was able to celebrate National Nutrition Month at the DCVAMC where every Wednesday, the Nutrition Department hosted a themed health fair in the atrium for the staff and general public. The health fair themes consisted of: Diabetes Management and Prevention, Weight Management, Bone Health, and a Heart Healthy Diet. I was able to participate in the Heart Healthy fair and educate the public on ways to lower their cholesterol and reduce their sodium intake, all while enjoying complimentary fruits and vegetables and handing out prizes to participants who answered game questions correctly.
During my time at my clinical site, I have been able to witness and experience firsthand different tasks a registered dietitian is responsible for—I even had to opportunity to watch a modified barium swallow and endoscopy! My rotation at the DCVAMC has been nothing less than rewarding as I feel I have strengthened my clinical skills all while being able to make a true and positive impact on the patients I have seen.

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