Sunday, October 13, 2013

Confidence Through Preparation

                We've all heard it before: plan, practice, organize, make a list, etc. . . But were we ever told why?  Our high school and undergraduate careers involved little assignments that led to a final project or presentation, and our extra-curricular activities involved practices, drills and exercises to sharpen our skills for the upcoming performance. When it came time to write our final paper, we knew we could do it because we got As on all those little assignments; when it came time to throw a pass to a teammate as she streaked down the field toward the goal, we knew we could because we did it every day in practice. These assignments, drills and exercises gave us confidence through preparation.
              
             Throughout the clinical rotation of the dietetic internship, confidence through preparation is key. Reading a patient's past medical history, admitting diagnosis, current medications, and laboratory values are easy. Walking into a patient's room, asking them about their usual diet, social history, living situation, and self-management their current health is easy. It's tying all the information together to pinpoint a nutrition diagnosis with appropriate interventions that's difficult. However, this is where being prepared gives the confidence to do just that.
               
              Over the summer and throughout the clinical rotation, assignments have been given ranging from studying simple medical terms to identifying the appropriate nutrition therapy for gastroparesis. Assignments to determine the mechanisms, uses, and nutritional side effects of medications have been given , so when a patient is being treated with steroids, their high glucose levels are no surprise. These small assignments have prepared us interns to quickly answer our preceptors' questions, or to ask knowledgeable ones because we have adequate back ground information. The assignments have given us the ability to not only communicate in a medical setting, but to have confidence in our diagnoses and defend them when questioned. 
               Organizing reading notes, reviewing flashcards, practicing PES statements, and planning driving routes to assure a punctual arrival are only a few activities that assure confidence each day. Without confidence interns may be hesitant to speak with patients and their nurses, shy to inform the pharmacist of a TPN calculation, and scared to ask preceptors for help. To perform well at anything, confidence to do it is extremely important, and what better way to know you can do it than by preparing?  

Thursday, October 10, 2013

Dietetic Interns Enter the New World of Technology

There are many activities that present themselves while being an intern at the University of Maryland.  Some of these activities are optional -- and occur in the evening.  A recent open "techie meeting" -- "DC Tech Meetup" occurred on September 24, 2013 with a large agenda of presentations.  One UMCP dietetic intern attended focusing on those apps or software that might be of interest and useful either from a nutrition standpoint, or from a "let's get more efficient" standpoint.  Comments about two new tools included:
  • MediSafe -- Personal Medicine Management System.  The developer created it as a result of his father overdosing on his insulin.  The father couldn't remember when he had last taken his insulin dose and took too much.  How it works:  Fill your pillbox -- select your meds by name.  The color, shape and inscriptions of each medicine are recorded. A personalized reminder can then be created to send to take the medicine.  Starting in 2014, patients will be able to record medication doses via smartphone touchtone.  If you don't take the medicine, a personalized message will be sent to a designated family member, who can then remind the patient to take their medicine.  MediSafe has partnered with pharmaceutical companies and feeds user data to the pharmaceutical companies (ie.  frequency of missed doses, etc.)
  • Photo courtesy of MediSafe Project
    

  • Social Radar -- Provides social media information regarding people you know (directly or indirectly) located within a denoted geographical parameter around you.  This tool uses social media user's "check in" locations.  This tool can also provide navigation to specific people.  This could be useful at a professional or social gathering where you do not think you will know anyone.  


Sunday, October 6, 2013

Embracing Opportunities, Saying Goodbye to Fear

Everyone comes into the internship with different skills, experiences, and strengths.  Each intern also has areas in which they can improve.  As for me, I was excited for each rotation but was particularly nervous about clinical.  I’ve volunteered in a hospital before but never shadowed an RD—I mainly just listened to patients complain about the food during meal rounds.  I had a lot of concerns before my rotation at Harbor Hospital started: should I go over my notes and try to memorize everything I learned in MNT? What if I forget the different nutritional requirements for each disease state? What are the PPN/TPN equations again?

With all of these questions building up during my first two rotations, I felt pretty anxious driving to my first day last week.  My only homework assignment was to come up with a list of strengths and weaknesses for clinical.  My strengths seemed to focus on personality traits and work ethic while my weaknesses were…everything clinical.  While I was waiting for my preceptor to meet me in the visitor lobby at Harbor, I remembered something my friend told me years ago. She had told me that no matter how scared I am about something new, that I should always say “yes” to every opportunity that comes my way.  Even if I fail miserably, I’ll learn a great deal about myself and may be surprised at how much I like something that I initially feared.

Keeping her advice in mind, I went through my day with a much more positive outlook.  Okay, so maybe I don’t remember everything from undergrad but that’s why my preceptor wanted me to reflect on my strengths and weaknesses.  I could use my current skills and knowledge to improve on everything I was worried at the beginning: energy and protein requirements, nutritional needs, equations, bedside manner, etc. 

During my first week, I said “yes” to every opportunity to learn, even if I wasn't really sure what I was getting myself into.  I shadowed in ICU on my first day, learned how to screen using the malnutrition diagnoses criteria, and even began following up with patients on my own by the end of the week.  Even though a lot of terminology and abbreviations sound like a foreign language to me (especially during rounds with the medical interns), it allows me to set learning goals for myself during my time at Harbor. 


I am also very fortunate to work with an awesome team of dietitians who are not only aware that I have little to no clinical experience but are very enthusiastic to make the best out of my 8-10 weeks.  The first time I talked to a patient, I received great feedback on what went well and what I can work on to make the next encounter better.  I’ve asked more questions than I can count but it doesn’t seem to faze the RDs at all.  And embracing new opportunities for learning and growth is wonderful because it doesn’t give you the time to be afraid.  You’re so busy becoming a better RD that you forget to be nervous.  Even though I started clinical with butterflies in my stomach, I am already enjoying myself more than I imagined. I can’t wait for what my second week (and the rest of the rotation) has to offer.  

Where's My Salt?


Imagine you are a student at the University of Maryland eating lunch with friends at the South Campus Diner. Like usual, you reach for the salt, but this time you only grasp air. You look around and notice that all of the salt shakers have been moved to a different location. Wonder why they’re gone?

I had the pleasure of contributing to the University of Maryland Dining Service’s initiative to help students decrease salt intake. Developing posters and table tents were some of the creative projects I put together. I learned how to design eye-catching material that would hopefully spark students’ interests in staying healthy. I also created wellness walls for the employees, encouraging them to limit sodium and use different seasonings instead.

My partner, Becky, and I had the opportunity to survey the students and get their views on the new initiative. A majority of the students were very receptive and appreciated Maryland’s efforts to help them stay healthy.  This act is just one way that the Dining Services team shows their care for the students’ well being. Additionally, the team prepares a large amount of food from scratch and uses fresh produce.

It was a joy to work with the Dining Services team and learn how they put the students first. As a recent Maryland grad, I appreciate knowing I had people like them looking out for me.



Monday, September 30, 2013

Bushels of Fun

There are few things in life more satisfying for me than the smell of a hot apple pie coming out of the oven. Well may besides some hard cider oatmeal cookies or an apple bacon meatloaf. Or perhaps an herb-crusted turkey breast with apple cider gravy. Is your mouth watering yet? These were just a few of the dishes that Kevin and I whipped up for our Riderwood theme meal this past Friday. As part of our food service rotation, our main project was to plan and actually prepare a buffet meal for approximately 120 independent-living facility residents. With no food service experience except cooking at home, I looked at this task with widened and terrified eyes. But low and behold, it was the most fun I’ve ever had!


We went with an Apple Festival theme, with all of our main entrees having an apple-inspired twist, ranging from chopped apples, apple cider, and even Applejack Brandy.  Besides a five-gallon container of our spicy pumpkin soup spilling over the entire refrigerator, our event went off without a hitch and we received nothing but extremely positive and enthusiastic feedback from the residents. Some even asked if we could come back next year. Good luck to the other interns and their theme meals and stay tuned for new postings!




Friday, September 20, 2013

Welcome Class of 2013-2014



Please welcome our class of 2013-2014!   From left to right:  Vehik Nazaryan, Stacy Kim, Christina Kalafsky, Christine Spagn, Becky Gates, Leigh Tracy, Kevin Handsman, Erica Gavey, Annie Gallagher, and Lauren Wathen.  To learn more about our interns, visit Meet the current Class on our website.

Our interns have currently been in the program for about a month now and things have been going really well!  Please join me in welcoming them to the University of Maryland.  They will begin blogging about the internship journey very soon!  Stay tuned!

Sunday, July 14, 2013

The end is only the beginning


It has been three weeks since graduation.  While it may seem that graduation would signal an end, it only was the start of job searching and studying for the RD exam (yep, lots of time with Inman).

To celebrate our 10 month internship and recap all of our experiences and friendships made, I created this video for graduation.  Movie making is what NIRDs do... (Nutrition Informatics RD).


'


Happy Summer!

by: Melissa Grindle