New Year, New Rotation

This year, on the first week after winter break, I started my longest rotation: clinical! I got assigned Franklin Square Medical Center. I was somewhat apprehensive, because of the tales I've heard from past interns, but mostly I was excited for the new experience! On the first day, I was fully prepared and walked in bright and early with my lab coat, calculator, binder, notebook, pens, highlighters, and everything else I could think of to prepare myself. 

400 bed hospital

My preceptor was very welcoming. She helped me get a badge, introduced me to the other dietitians, and gave me a brief tour of the hospital. I was given my own computer station, since this will be an eight week rotation (followed by an additional two weeks of staff relief, working by myself!) We started out slowly, with me observing her as she met with patients and wrote notes about the consults. She asked me anatomy and medical nutrition therapy questions, so I'm very glad I had homework and class days for review! My first preceptor and all the dietitians are very knowledgeable, and were able to list facts for every disease state we encountered. I strive to reach that level of thorough knowledge, which I know will come with more years of experience.

Gradually, my duties are being expanded and my responsibility at the hospital is growing. One of the first things I saw was how they actually decide which patients to see. At this hospital, patients are seen if a nurse asks for a nutrition consult, if a doctor asks for a consult, if a patient has been in the hospital for more than 6 days, if a patient has been on a liquid diet for 3 days, or if we are following up on a past patient. Each day, I get a printout of the patients and use colored highlighters to screen who I need to see. So far, I've also learned how to read medical charts (paper and electronic), how to decipher lab values, how to read radiography notes, and how to present a patient's history. One of the most important skills that I'm developing during this rotation is the ability to read a large amount of information and pull out which pieces are relevant to the nutrition problem, diagnosis, and interventions. For my first few assessments, my preceptor came into the room with me to observe, and she occasionally interjected if I forgot something. I was surprised by just how quickly it felt natural, and soon after I started seeing patients by myself and writing the notes alone, then reviewing them with the preceptor to make any necessary edits before she signs off on them so I can add them to the official patient chart.

An example note that I wrote after seeing a patient (no private information on this page)

So far, I've shadowed a dietitian on the general floor, surgical floor, and oncology floor. Next week I'll begin cardiology and renal. I'm really enjoying each new assignment, and my binder of notes is growing quickly! To all future interns who are nervous about clinical, don't be! Prepare yourself in advance by brushing up on your MNT, and then be excited! It is a fantastic feeling to put all your education to use, meet patients, and have the ability to make decisions that actually affect and improve their outcomes.