When Weather Calls:An FSNE Experience

My latest rotation included working for two weeks with University of Maryland Extension, Food Supplement Nutrition Education (FSNE). It even reunited me with my internship partner Rory! FSNE is a nutrition education program designed to educate and help recipients of SNAP. FSNE sends nutrition educators to different sites across the state such as elementary schools and community centers to educate children and adults alike.

When working with schools and community centers during a snowy winter season, I learned to always remain flexible. During our two week rotation, several planned experiences were canceled due to inclement weather. Due to snow, ice, slush, and freezing rain, we were forced to switch gears and work from home. While working from home we were given assignments such as blog writing, creating themed Facebook posts, and website review of similar programs. I wrote a blog regarding added sugar in children’s diets and Facebook posts for the month of April; all of which will appear on the FSNE blog and Facebook page.

However, as the temperatures rose and the snow melted away, we were able to travel to different locations and join in on the fun! We traveled with different educators to sites in Frederick County, Gaithersburg, and Baltimore City. While in Frederick County we worked with fourth graders and adult mothers learning to speak and read English. In Gaithersburg we worked with first graders learning to think of seeds as suitcases for fruit; how cute! In Baltimore City we worked with both children and adults.

Whether working with children or adults, FSNE utilizes planned curricula developed specifically for nutrition education. Lesson plans cover topics anywhere from sustainability to eating more fruits and vegetables. We had the opportunity to both observe and co-teach lessons. Together Rory and I taught fourth graders about sustainability and living green with a tasting of green vegetables. We also co-taught a class of adults about eating the recommended amounts of fruits and vegetables.

FSNE is a quick two week rotation. But, like I stated in a previous blog, quick does not mean the experience is not as valuable as others. Instead, it means you have limited time to maximize your experience. As an intern, you must show initiative and say yes to the opportunities presented. Only then, will you be able to take full advantage of your experience.  

Working with children was fun and rewarding as was working with adults. I learned something different from each group.  I learned even more from the educators.   The two weeks I spent at FSNE was time well spent and a lesson well learned! 

DC Central Kitchen: Working With the Community.

            At this point in the internship, we are nearing the end.  It’s hard to believe how fast the weeks have gone!  As I look ahead to our exciting future, I can’t help but reminisce about my first few rotations. 

Let me take you back to one of our community rotations at DC Central Kitchen.  The staff works with individuals to provide healthy meals, future jobs, reducing hunger, and so much more!  I was so excited to take part in this initiative.  I had many eye-opening days that I will truly never forget.  I’m going to talk through some events we participated in; however, these are only a few provided by this wonderful facility. 

Healthy Corners

            Healthy Corners is a program that my partner and I were able to work directly with.  They focus on bringing affordable, healthy food products to convenient stores to help low-income communities and food deserts and/or swamps.  Essentially, they are selling smaller amounts of healthy food to the stores to increase accessibility. 

            My preceptor took us to a Healthy Corners event.  The event was providing free HIV and Hepatitis C testing, handing out goodie bags filled with healthy food items, and raising awareness.  I helped conduct surveys to participants, to gather and share related information on the program.  Many of the individuals were enthusiastic about providing their positive input on Healthy Corners!  We also shared the "Better for you Brownies" with participants.  They were a big hit!  I was able to strengthen my communication skills by jumping right in during the event.

Here we are helping our preceptor at a Healthy Corners community event.

Culinary Job Training

            The Culinary Job Training program provides students with a chance to become educated, and eventually work, in the food service environment.  My partner and I had the incredible chance to actually teach one of the classes.  Our class focused on whole grains and healthy shopping on a budget.  The class was filled with 8 extremely attentive students.  We provided them with the lesson content, quizzes, and answers to any questions they had.  I was so lucky to help empower the community members by providing useful nutrition content.

In this picture I am teaching a Culinary Job Training class.

Working in the office

            Our work at DC Central Kitchen included many hands on activities in the community.  However, some days we worked “behind the scenes” in the office.  My partner and I had so much fun creating activities to teach nutrition, including fat demonstrations in specific food products, Jeopardy games, and monthly newsletters.  We also worked on a PowerPoint focused on poverty and food deserts right here in Washington D.C.  This presentation was later presented to a class of college students to increase awareness. 

This was a fat demonstration to use in later educational classes.

Whether we were out in the field or behind a computer screen, DC Central Kitchen provided an irreplaceable opportunity.  During the UMD Dietetic Internship you will get your feet wet in so many areas of nutrition ranging from community settings, clinical, food service, and informatics.  My one piece of advice that carries through all rotations: Be open to any and all opportunities! 

It’s Not Just Clinical: The Technical Side of the Internship

It is hard to believe that just one year ago I had submitted my applications, checks were mailed, and interviews were being scheduled. I was initially intrigued by the University of Maryland College Park dietetic internship for its widely diverse rotations and “information technology” focus. I thought technology? Hmm… I like working on computers, learning the mechanism behind things worked, and knew technology was an integral part of the future.

Up until now my internship time has been filled with 12+ weeks of clinical experience and shorter rotations in between. I recently just finished my rotation at the Food and Nutrition Information Center (FNIC), working specifically with the SNAP-Ed Connection team and really learned how nutrition and technology go hand in hand.

I spent five weeks working with the SNAP-Ed team learning how to code, develop new pages for their website, perform resource reviews, attend conferences, and research materials for web pages. The SNAP-Ed Connection website is a great resource for state and local snap-ed providers, educators, and consumers. I learned html coding and was able to design nutrition information pages about food preparation and cooking for all ages. As a future registered dietitian, having webpage development skills and a nutrition background can be a great marketing tool. When I was first provided with the upcoming projects I would be working on, I would be lying if I say I wasn’t nervous. I didn’t know how to code or interpret Google analytics, but I do know how to listen and manage my time, which was key in being successful.

Using Google analytics, I was able to track site traffic and hits and depict the reasoning for certain spikes or falls in views. After uploading new materials, we are able to quantify data to make future decisions on the work site for better or worse. Although working on the technical side of things doesn’t involve patient interaction, I was able to see how my work truly made a difference when users emailed the team thanking them for new materials and describing the helpfulness to their classes even from behind the screen.

Producing a Meal for the Masses: A Grecian Island Getaway

            My time spent at Riderwood Village, a retirement community home in Calverton, Maryland, has gone quickly. Five weeks ago my internship partner Chandler Ray and I embarked upon this journey hoping to learn as much as possible about foodservice production in a kitchen restaurant. We have had many jobs while working here including working as kitchen staff members doing various tasks around the kitchen, serving on the buffet line in the Windsor Restaurant, and planning a theme meal that we hosted on Friday March 6^th. We have enjoyed meeting residents, staff members, and planning our meal!

Choosing the theme of the meal was the first crucial decision to be made in the production process.  Chandler and I both love the beach and the ocean so we immediately brainstormed places with beautiful beaches. In the end we chose to use the islands of Greece as our theme, entitling our meal “Grecian Island Getaway.”

The next step was to create a menu for the meal. This entailed researching the Grecian islands and their typical cuisine. After two days of research and planning we decided upon our menu:

Once the menu was chosen, theme meal planning went into overdrive. We produced flyers, handouts, and even a TV commercial to help market the meal to the residents of Riderwood. 

Recipes were converted to yield enough food for the 120 people we aimed to serve! Meals were analyzed for nutritional value and as a unique touch we provided the residents with a gluten-free menu; we did this to accommodate the requests of several residents who desire to reduce gluten in their diet. A grocery list was created, food was bought and ordered, and production schedules were created to help keep us on task throughout the final week before our meal.

The week before the meal we spent our time chopping vegetables (I smelled like an onion the entire week), butchering meat, planning, making, and buying our decorations, and prepping and cooking our dishes. Snow threatened the success of our efforts but communication and acceptance between Chandler and I played a key role in making the day run smoothly. We also couldn’t have done it without the help of our kitchen staff!

The day turned out great! Our goal was to serve 120 people and we ended up serving 130! The entire process of planning the meal required patience, flexibility, and hard work. I have newfound perspective on what it is like to work with the elderly population and what it is like to work as a kitchen restaurant employee.

Pictures below are from the theme meal!

A Day in the Life of a Clinical Dietitian (An Intern's Version)

Throughout the last five weeks I have had the opportunity to work with three RD's at Meritus Medical Center in Hagerstown, MD. There are five RD's at MMC, and each cover different units. Also, three of the dietitians work at outpatient facilities such the Wound Center, the Weight Loss Center, and the Cancer Center. These dietitians play many roles, which keeps every day interesting!

While interning I have noticed that the RD's follow a certain schedule, but since all patients have unique cases, there is always wiggle room!

A typical day at Meritus Medical Center goes something like this....

Investigative Work 

In the morning, the patient nutrition screening report is printed. This document informs the dietitian which patients to visit that day based off of certain criteria. 

Patients can be screened for:

• Low BMI
• Poor PO intake
• CVA
• Pressure Ulcers
• CHF
• Missing Data
• Bariatric Surgery
• And many more!

Once the dietitian sees what patients have screened on their floor, they print out their nutrition care record. This record contains the patient's diagnosis, height/weight, past medical history, and all recent lab values. Then the investigative work comes in. It is important to look through each patient's medical record to find any information that may be helpful to the dietitian when they do the assessments.

Meritus Medical Center in Hagerstown, MD

Rounds

Going to rounds is surprisingly fun! Rounds are when the doctor, pharmacist, care management team, social worker, RNs and RDs gather to talk about each patient on the floor and their future plan of care. It is also a great time for the intern (me) to learn about medications and disease states/conditions. I always keep a pen and paper handy to write down terms that I did not know before hand.

Visiting Patients

This is always the most rewarding part of my day (depending on the patient, of  course). I have talked to a variety of patients, both interested in talking to me and those who are not. When I go to visit patients I gain a better idea of how they are eating, if they need snacks or supplements, or if they are interested in any additional education pertinent to their condition. I have had some great conversations with patients who really do desire to learn more about nutrition. It's great to use all of the information I learned in MNT in college!

I was able to try a nectar thickened supplement, not that bad!

Document, document, document!!

Documenting may be the most critical part of the job. Without stating what you did and why in the medical record, you might as well have looked at Facebook all day! Filling out nutrition assessment notes allows other members of the health care team know what the RD's are doing to help patients with their nutritional needs. Learning the verbiage used in nutrition notes is probably the most difficult part  of documentation. There are so many abbreviations to learn, but with writing more notes everyday it is becoming a lot easier. 

Although a typical day at every hospital is very different, this is what I have taken away from interning at Meritus Medical Center. The key to being a clinical dietitian is flexibility! This week marks my half way point in clinical, and I am so excited to learn much more!

Me and the Registered Dietitians

Attention: Applicants!

During the last few weeks the current interns and I have been receiving multiple questions about the internship from current applicants. While the interns and I enjoy talking and communicating with the applicants, I thought it may help to answer the most common questions!

1.  What is the average time it takes you to drive to a rotation?
This really depends on what site you are rotating through. For  example, my clinical rotation was in D.C., which is where I live, therefore it was on  average a 10-15 minute drive. As for other sites that are closer to Baltimore this can take me anywhere from 45-50 minutes. This year, interns live in pretty spread out areas around Maryland and D.C. therefore some interns spend the night at other interns apartments who live closer to the rotation site!

      2. What is a typical class day like?
Class days can range from conferences to lectures to technology training's to homework review sessions or a mixture of all! If we are not attending a conference, our class days are typically held at the National Agricultural Library or Harbor Hospital. During the class days at the National Agricultural Library we typically spend part of the day learning about technology applications, databases or programs such as Weebly, Trello, and Prezi. We also work on upcoming technology projects such as podcasts, Weebly videos and Weebly milestones. During class days at Harbor Hospital we participate in lectures, which gives us a general review of clinical terminology and clinical care.

 3.  How many hours do you usually spend on assignments outside of the hours at the rotation sites?
This also depends on the specific rotation you are in. During my clinical rotation I found myself spending about 1-2 hours a night to complete the weekly homework. I did find if I competed a portion of the homework over the weekend I would only spend about 1 hour a night over weeknights. During the rotations that did not assign  specific homework, I still found I myself spending about 1 hour on internship projects, assignments or milestones to keep on track with  the internship's work load. 

 4. Where is the best location to live?
I am not sure there is a “best” location to live because finances, location and personal preferences may rank differently for everyone. I know last year interns recommended living in Silver Spring MD. or College Park MD. because these are pretty central locations to most of the rotations sites. This year a few interns, including me are living with family members, which may increase the distance to rotation sites, but decreases the total expense (not having to pay monthly rent). Therefore, I believe picking a location to live depends on the intern and how they feel they can manage their travel and expenses!

 5. Have you found the workload to be difficult to manage?
I have not found the workload to be difficult to manage. I do find that it is important to stay on track with the workload and to complete small amounts each night. I currently find it very helpful to make a list each week of objectives to complete and I try to stay on track with the list to ensure I do not fall behind with the completion of assignments and projects. Our director and preceptors are also always available for questions and are extremely punctual with responding therefore, I find it very easy to ask our director or preceptor’s questions that may arise!

      6. The website explains that interns must take technology classes, what are technology classes?
Technology classes are during class days and can range from learning about social media databases to learning about new technology applications to completing assignments and milestones. We have learned about social media databases, which allow us to market ourselves as RD’s such as Weebly, Twitter and Pintreset. During technology classes we have also learned how to create podcasts and videos for our Weebly account. Lastly, during technology classes we have learned about new applications that can be used for organization skills and presentation development!

7. What recommendations do you have during the internship?
I believe my number one recommendation during this internship is to be flexible! As I have been told, driving in Maryland is difficult due to traffic and weather conditions therefore it is always

a good idea to leave 20 minutes earlier than expected to account for any driving complications!