My Clinical Experience in a Rehabilitation Hospital

I recently finished my second clinical rotation at MedStar National Rehabilitation Network (NRH) in Washington, D.C. MedStar NRH provides inpatient and outpatient services to patients with disabling illness or injury, such as stroke recovery, spinal cord injury and brain injury. One of the things I enjoyed most was about working at NRH was the strong focus on diet education. I had the opportunity to provide both individual and group nutrition- education sessions to patients on a variety of topics, such as weight management and diabetes.

I was so excited to teach my first lesson to a group of patients on the basis of MyPlate, healthy cooking techniques, and a heart healthy diet. Keeping it simple is key to nutrition education, especially since these patients have varying levels of cognitive, neurological, and behavioral function. To make the lesson more interactive and fun, I brought in MyPlate paper plates, provided handouts on each topic, and used colorful posters. The patients were so involved and interactive throughout the lesson; it was such a rewarding experience!

I also enjoyed participating in the Wellness Cooking Demo featuring January’s super food of the month: citrus. The event featured five delicious and healthy recipes using citrus as the base ingredient and incorporating other foods such a salmon and Brussels sprouts with fennel. The registered dietitians and I handed out samples and recipes to patients, staff members and visitors in the cafeteria. Although some were hesitant to try the recipes, many others were pleasantly surprised by how yummy everything tasted!

During my two-week rotation at NRH I learned so much about the integral role nutrition plays in the rehabilitation process. I thoroughly enjoyed the time I spent at NRH and have developed so many new skills working with an amazing team of registered dietitians!

Theme Meal Troubleshooting

Almost all dietetic internships require the interns to complete a theme meal. At the University of Maryland dietetic internship, the theme meal takes place at a retirement home. The foodservice rotation requires the daunting task of the interns to create a theme meal for 200 people.

The requirements of the meal included:

• Soup
• Salad
• Two Vegetable Side Dishes
• Two Starch Side Dishes
• Beef Entrée
• Chicken Entrée
• Fish Entrée
• Vegetarian Entrée
• Two Desserts
• Beverage

The week leading into the theme meal was spent entirely in the kitchen. Prior to that we researched our theme, tested recipes, made flyers, talked to residents to promote the event and even filmed a commercial. Considering we are organized individuals who like to have everything planned out, we created a schedule for the week outlining the steps to complete each recipe. Even with all the planning and preparation the weeks leading up to the event, there were challenges we could not prepare for.

Time Management

One of our biggest challenges was not accurately determining how long each task would take. For example, writing we need to chop onions for the soup doesn’t seem like a task that would take a lot of time until we started. The recipe called for 50 onions, which we thought would take 30 minutes with two people chopping. Two hours later – with tears rolling down our faces – we had sliced 50 onions for the soup. From that point forward, we knew each task would take much longer then originally planned.

Andie cooking the onions in the soup kettle.

Food Ordering

Another challenge faced was the correct amount of food we requested on the grocery list was not ordered. We needed sweetened condensed milk to make the toffee bars, and it was not ordered. We started making the recipe before gathering all the ingredients, so we discovered we didn’t have the milk until all the other ingredients were already mixed together. Luckily, another kitchen on the campus had enough cans to finish making the dessert.

I am making the toffee cookie bars.

Temperature Check

The morning of the theme meal was very stressful. My partner and I needed the help of two chefs to get every menu item ready in time for the event. Even with their help, we faced problems. We discovered our brisket was raw when we went to carve it and it had to go back in the oven. We had just enough time to cook it and have it carved for the meal. Now, we know to ask someone to double check the temperature of the meat before assuming it is done just by cooking it in the recommended amount of time.

Knowing these simple precautions in advance could have saved us time and stress during the preparation of our theme meal. Even with facing challenges every step of the way, our theme meal was a success.  We had about 100 guests and minimal food waste.

School Dayz

As with most recent graduates, as you put away your cap and gown, you probably thought school days were a thing of the past. Right? Wrong! As with any dietetic internship, school days are here again. The life of a dietetic intern includes a variety of learning experiences to enhance the rotation experience including class days. Once a week, typically on Monday, the dietetic interns meet for class. Class days can include anything from MNT related lectures to conferences. They can also include field trips and joint class days with other internship programs. Whichever the venue or the topic, you are guaranteed to learn and have a great time. Below are just a few of our most recent class day adventures.

University of Maryland Joint Class Day: Nutrition, Communication, and Information Management

Joint Class days are always fun especially when you are the host! On January 12^th, the University of Maryland Dietetic Internship Program hosted a joint class day. The over-arching theme, like our emphasis, focused on nutrition, communication, and information management. Presenters shared information on new and upcoming Apps in nutrition and dietetics, reaching a new generation of foodies through technology, and life as a super market dietitian just to name a few. As inters hosting a class day, we all participated in helping the day run smooth. I was able to introduce different speakers while others helped with registration and facilitated other activities.  We were also given the chance to network with registered dietitians and other interns while visiting different vendor/information tables.

Me, Rayna, and Rory at UMD Joint Class Day

Children’s National Medical Center Pediatric Symposium

The Pediatric Symposium was hosted by Children’s National Medical Center in Washington, D.C on January 5^th.  The symposium included multiple speakers lecturing on a variety of topics. Presentations were given on pediatric nutrition assessment, formula and enteral nutrition, inborn errors of metabolism, cystic fibrosis, and much more. The symposium allowed interns to take an in-depth look at how to appropriately assess, evaluate, and care for critically ill infants and children.

Always time for selfies! Chandler, me, Rory, and Andie!

Technology Class Days at the National Agricultural Library

Technology class days are by far the most fun yet the most simple in regards to class days. Many of our class days are spent on the 14^th floor on the National Agricultural Library (NAL) in College Park, MD- what a great view!  During class days at NAL we cover tons of information regarding technology and nutrition information management in a variety of ways. We've learned how to effectively maintain information databases through useful applications; the importance of reaching audiences through social media; and, how to build our own website.  Having html basics is a great tool to have in your back pocket in the age of technology; having your own website to showcase your hard work is even better!

Me and the gang at Hopkins Bayview Joint Class Day

Halfway through the internship program I find myself extremely thankful for class days! Whether I am learning about MNT or learning how to reach audiences through Twitter, I count them as days to learn more about what I truly love-nutrition!   

A Day in The Life of a UMD Dietetic Intern: Outside Rotations

UMD’s dietetic internship is filled with a variety of experiences.  Throughout the rotations, each intern is able to try out different areas of nutrition, whether it’s in a hospital, a school, the government, and the list goes on.  However, our practice goes beyond our rotations.  We are offered many outside opportunities, along with class days filled with conferences and workshops.  As with many things in life, it’s important to take as many chances that come your way.  Our director is sure to include us in many great events!  Here are some I took part in. 

Mission of Mercy Health Fair

I attended the Mission of Mercy Health fair with some of Food Supplemental Nutrition Education (FSNE)’s amazing staff!  The health fair was a free dental clinic.  I was so impressed with the procedures being completed right before my eyes.  I was introduced to a piece of equipment known as the “smoothie bike”.  We encouraged participants to pedal away to power the blender attached to the bike!  The blender was filled with a delicious cantaloupe and watermelon smoothie.  I of course, had to give this bike a shot!  I also helped hand out healthy s’mores with non-fat vanilla yogurt, graham crackers, and slices of strawberries!  People asked me nutrition related questions about healthy breakfast ideas, healthy shopping on a budget, or getting kids involved in the kitchen.  I’m so glad I was part of this amazing fair! 

Maryland Dietetics in Health Care Communities Fall Workshop

Phyllis, our director, allows the interns to actually get hands on involved in many of the conferences.  At this event I was lucky enough to introduce Pam Cureton who was speaking to us about Gluten Free Diets.  Following Pam, we learned about managing diabetes with the elderly, prebiotics and probiotics, public policy, and so much more!  Each lecture was filled with educational information.  Many of these events are great for networking with extremely established individuals in the field.  We even got to taste new gluten-free products!

Moveable Feast: Food Day

My partner and I decided to join Moveable Feast’s celebration of Food Day back in October and we are happy we did!  This was a really special event, which again provided a great place to speak with others in the field and network.  We met Registered Dietitians who worked at Moveable Feast, as well as other interns from various internship spots.  It was great to hear their experiences.  The event had incredible chefs who participated in a healthy cook-off.  They had to use cabbage, eggs, raisins, apples, sweet potatoes, and could add items ranging from garlic powder to crushed tomatoes.  I was so impressed with the dishes they created!     

Food Supplement Nutrition Education Annual State Conference

On a class day, the 10 interns met in Annapolis to participate in the fall conference for FSNE.  The day was filled with great presentations talking about how to be a better communicator and develop teamwork skills.  We did really fun icebreakers, which had us all laughing and getting comfortable with each other.  One icebreaker even landed me some new Okra seeds to plant!  Since I already had my rotation at FSNE and worked with the wonderful staff and educators, it was really nice to see them again and catch up. 

All in all, throughout my internship, I am continuously learning that each day and each event presents so many learning opportunities.  I am so excited to continue taking advantage of everything that comes our way!