Internship recap: Week 2-4

Whooooooooooooooooooooooa.  That went fast.  I thought week 1 went fast.  I was wrong.  I'm pretty sure that all I did was blink and then two more weeks were over.

Waitaminute.  That means I only have two weeks left in my first foodservice rotation (I have 8 weeks total, but split between 2 preceptors).  Crap.  I have a lot to do in the next two weeks.  O___O.

Week 2 recap: 

Well this one went a bit fast because there was a holiday weekend thrown in there.  So we didn't actually start until Tuesday, which was spent with all of the interns doing foodservice on this rotation (4 of us) doing a day long orientation to nutrition services at the hospital.  We met the staff, learned about their roles, and toured around the foodservices area to see all of the facilities.  We followed the food from delivery to the hospital to the fridge/freezer to tempering to the belt line to the plates to the floors to the retherming units to the patients and back down to the basement for plates to be washed.  I finally met my preceptor on Wednesday, and found out about my projects for this rotation...

One of my projects is to review the job descriptions of the dietary aides.  These are the people who are responsible for reheating the food that comes up from the belt line, and delivering to patients (among many, many other things they do).  I'm not looking to see how well they're doing their job, or to make big changes to their jobs - I'm looking more at whether what they're doing makes sense, and whether things could be more efficient so that the staff aren't so overloaded with responsibility.  In order to figure out whether things are running well or not, I am shadowing the dietary aides.  All of the dietary aides.  Sometimes at 6:30 in the morning.  On weekends.  Seriously.  Let's just go ahead and put another pot of coffee on, shall we?

Other than shadowing everyone, I'm also working on other projects, including doing an in-service education session for staff about proper handling of equipment, developing a policy for maintenance of the meal carts, and a temperature audit of food from delivery to patient service.  On Friday I spent the day with a guy from a cart manufacturer company, who had these cool little temperature probe discs that we stuck into mashed potatoes and yogurt on a control tray, and recorded when the tray/food entered each part of service (on the belt line, waiting in the holding fridge, reheated, served to patient).  Of course patients didn't receive this food, but it was taken on the journey as if it were :)  At the end, the cart manufacturer guy pulled up a cool chart showing temperature fluctuations of the products throughout the service so that we could see 1. are things staying at a proper temperature while waiting to be portioned on the beltline, 2. how insulated are the carts, 3. how well are the retherm units actually reheating things, and 4. are things still hot when they get to patients.  It was pretty neat to babysit mashed potatoes for a day and see its temperature fluctuations!

Week 3 recap:
This week started my job shadowing.  I have now shadowed 6 staff in completely different shifts, and have 5 more left for next week.  Since the aides are unionized, I'm not allowed to actually help them do anything like fill coffee cups or help push the carts or anything, so I'm really just hovering over them and following them everywhere, taking notes and asking questions.  I'm not going to lie - it's a little boring to just watch someone do their job for 8 hours.  Especially when its essentially the same job that you saw yesterday and will see again tomorrow.  But the aides and their supervisors have been really helpful in answering all of my hundred thousand questions to help me with my projects.  I've now managed to figure out a number of recommendations for the aides job descriptions that will help make their jobs more fluid and make the job description on paper make sense with the job that's actually being done, and I've also finished about half of my cart maintenance policy :)
I also got to participate in a few cool meetings this week, including an interview to hire a new dietary aide.  Having now seen what the job entails in up-close detail, it was interesting to see the process all the way from the beginning, and to see how the hiring process works from the managerial side of things.  My preceptor and I also attended a clinical nutrition committee, where a group of dietitians from various concerned areas of the hospital come together to discuss changes to diets being given to patients based on ever-changing research.  In this meeting, most of the discussion centred around the anti-reflux diet and whether it was possible to reduce fat content to a low enough level to inhibit the reflux, but still leaving food palatable, giving patients their dietary needs daily, and provide enough variety.

Stay tuned for the next 2 week update, when I'll be wrapping up my first foodservice rotation!  

Writing your internship resume

In the next part of my "what's the deal with being an RD" series, let's chat about how to become an RD in Canada.

As I mentioned in the last post, the information discussed on this blog is relevant to the Canadian system, however may be different from how it works in other countries.  /disclaimer

To become an RD (Registered Dietitian) in Canada, there are three steps:

1. Complete an undergraduate degree from an accredited post-secondary institution.  The list of schools that meet Dietitians of Canada's requirements are shown here.  Note, other universities may have nutrition programs, but they are not accredited by Dietitians of Canada unless they are on that list.  For example, the University of Toronto has a nutrition sciences program that is not accredited; therefore, graduates of that program are ineligible to go on to step 2 of becoming an RD without going to an accredited school for more courses.
2. Complete an accredited one-year internship program through Dietitians of Canada, or an accredited graduate degree with integrated internship program.  Some universities combine steps 1 and 2 in an integrated program, where students complete both the undergraduate degree and internship program simultaneously.  These programs are highly competitive, and not all students in the integrated program will actually be accepted to the internship stream.
3. Your provincial regulatory body (e.g. professional college) assesses your academic and practicum experience to determine whether you are eligible to hold the title "RD".  In most provinces, you will now write the Canadian Dietetic Registration Exam (CDRE), a regulated examination that ensures that RDs possess the competencies needed to practice dietetics safely, ethically, and with an evidence-based backing.

Phew...

After seeing the requirements to becoming an RD, the next question that people tend to ask is:  "How do I get to step 2???".  Indeed, getting accepted into the undergraduate program is competitive, but the least of your worries.  The most intimidating and terrifying part of the process for most students is getting that coveted internship or grad school position!

 I'm no expert, but I can at least share some of my ideas of how I ended up with an internship.  By no means is this a guarantee that by doing these things that you will get a placement. /anotherdisclaimer. 

One thing that you need to have to get an internship is a great resume!  I've been getting a lot of emails and messages from former classmates who are applying to internship this year asking for advice about resume writing and what should/shouldn't be included, so I thought I'd share some of my ideas here!  Your resume should show a variety of experiences, demonstrate the many skills and abilities that you possess that will be valuable to the internship program, and show that you are dedicated to the process of being an RD.  Here are some of my thoughts of how to build up a strong resume:

1. Volunteer!  One of the best ways to figure out where you want to work in dietetics, or if you even want to work in dietetics, is to get some first hand experience!  Try to get a variety of experiences - clinical, community, and administrative or foodservice experience.  It can be tough to get paid work experience directly related to nutrition without having finished your degree yet, but volunteer work can be very rewarding and expose you to environments you wouldn't normally see.  In many hospitals, clinics and community centres, dietitians and other nutrition professionals take on volunteers for a variety of cool projects, but you can volunteer in other areas and still gain food and nutrition experience.  For example, I volunteered in a breastfeeding clinic for a year, where I wasn't working with dietitians but learned TONS from the lactation nurses and pediatricians running the clinic.  I saw and learned things there that I probably never would have learned otherwise. 
2. Work!  But wait, didn't I just say that it was tough to get work experience in nutrition?  Yep, I did.  But work experience of any kind is valuable, whether it deals directly with food and nutrition or not.  Even customer service and retail experience can be useful to build skills in problem solving, communication, organizational skills, and leadership.  I was fortunate enough to work in a couple of positions that dealt with food or nutrition in some way (e.g. Weight Watchers, worked briefly at a cooking school), but most of my other work experience was in retail, and health/fitness outside of food (teaching yoga).  You don't necessarily have to have a ton of food-related experience (though certainly you can't expect to walk into an internship without having ANY), but the experiences you do include on your resume should demonstrate transferable skills relevant to your future career as a dietitian.
3. Connect!  When I was a student at Ryerson, there were many student branches of professional organizations encouraging us to join.  At first I didn't think it was all that important - after all, I was far too busy with work/volunteering and keeping up with schoolwork and readings.  But I realized that connecting with these organizations was a great way to network with real world professionals, learn about career opportunities outside of just working in a hospital, gain experience and skills, and even have access to financial aid opportunities through scholarships and bursaries!  It helps to be part of a variety of organizations to see a variety of opinions and experiences.  I was a student member of Dietitians of Canada, the Canadian Association of Foodservice Professionals, the Canadian Obesity Network, and the Ontario Home Economists' Association, and participated in a number of events held by each of these organizations and job shadowing opportunities.  I know some students who even got job and volunteer opportunities out of their membership with these organizations.  I was also fortunate enough to have been given money :D!  Most of these student organizations have a professor as a mentor, so this can also be a great way to make your profs notice you and your ambition a bit more and earn yourself a great reference.
4. Be a leader!  In addition to just joining student organizations, it helps to take on a leadership role!  You don't necessarily need to become the president of your student association (in fact, the president of the student association I was most closely associated with didn't actually get an internship), but participation in the organization and helping out with events/volunteer opportunities when they come up can be really valuable.  I was an executive member of several organizations at Ryerson, including Meal Exchange (a food security advocacy organization), the CAFP, and the Nutrition Course Union - in these positions, I took a leadership role and organized many educational and social events for students.  However, I also took on a lot of student volunteers to help me do that, giving them the opportunity to get involved and take ownership too.
5. Learn!  Of course you're in school to learn anyway.  But while you're there, try to select courses that will broaden your horizons and be useful in the future!  Taking a variety of courses and showing that you are able to apply what you learned will be very helpful in setting you apart from other applicants, and show that you are truly passionate and dedicated to the practice of dietetics because you can apply your learning.  I got stuck in some of those liberal studies electives that will never be useful again (like the History of World War 1.  Yeah.  *yawn*), but also was able to take a few liberal studies/elective courses that were actually interesting and had the potential to help me in the future.  For example, I took an introductory psychology course, which helped me to understand some basic concepts in human behaviour and adapt my counselling skills.  Because I took that course, I was also able to take a more advanced psychology course in drug addiction.  I also took an elective course in food security in Canadian populations, and was fortunate enough to take an international community development course in New Orleans, giving me great perspective on the socioeconomic side of food and nutrition and a different perspective of how to approach counselling patients/clients dealing with food insecurity or economic hardship. If you took really special courses in your undergraduate program (like the New Orleans course, or a research course with poster presentations or something), you can include these in your internship resume.

There are other things you can do that will be helpful to beef up your resume, but I believe that those five are probably the most important.  The last thing I would add to the list as a "maybe 6" would be to get certified, i.e. make it easier for you to get the work and volunteer experience by showing initiative and getting a certification to get the position.  For example, get a food handler's certificate (often required to work in foodservice at hospitals) - some schools will run the program at a discounted rate, or it may be offered as a condition of employment if you are working in a foodservice operation.

And remember, you only have 2 pages that you can submit!  Keep it succinct, but explain your skill set thoroughly.  Try to keep your resume to experiences in the last 4-5 years (unless you had something that is extremely relevant from earlier years, otherwise, keep it recent).

The absolute most important thing about writing your resume for internship applications - REVIEW, REVIEW, REVIEW!  You'll end up reviewing and revising your resume about 3874328975647289732 times before you get ready to print and submit.  Have a friend, professor, or professional (like a dietitian you work/volunteer with) to help you review your resume and application package to make sure that it pops :)

If you're a dietetics student in Ontario looking for some info on internship applications, leave me a comment :)!  I'm happy to address questions in future blog posts!

Internship Week 1

Whoa.  What just happened?

A week has already passed by???

True story.  This week was orientation!  We spent most of the week touring the 3 sites where we'll be spending most of our time, visiting with dietitians in various clinics and inpatient units to get an idea of where we'll be working, and getting lost in the hospitals a lot.  We went over the internship program's expectations - what's expected of us and what we can expect from the program, our projects, and our preceptors.  We discussed patient centred care, the standards of care at the hospital and how to chart/what we're legally allowed to order by medical directive, and how to use electronic patient charting.

Maybe it was the fluorescent lighting.  Maybe it was the fact that it's been super overwhelming.  But I left the hospital on Monday with a cray migraine.

Yet here we are at the end of week 1, and it all went by so fast O__O!!!!

So far so good.  The other interns are awesome.  I couldn't have asked to have been put into a better group if I tried.  We've only known each other a week, and we've already bonded so much and are really looking forward to working together, learning together, and supporting each other through the next 11 months.  Despite how HUGE the hospitals are and how lost I've gotten this week, it's starting to become more intuitive and beginning to feel like home.  The staff, especially the dietitians we've met so far who will be mentoring us, have been incredibly supportive and showed how enthusiastic they are to have a fresh batch of interns.  I can't wait to get started!!!!!

We also (finally!) got our schedules this week, and I'm SO EXCITED that I got almost ALL of my top choices for clinical rotations!!!!  For the next 12 weeks I'm going to be in foodservice and industry rotations, followed by my clinical and public health rotations for the rest of the internship.  I'm working with a few other interns in foodservice, though I'm rotating by myself for the first 4 weeks before I meet back up with them.  Though I'm not too frightened of the foodservice rotation (since I have a business background and some experience in foodservice already), I'm anxious about working solo with my preceptor when the others are working in a team together!

For now, we've got a long weekend ahead (thank you, Canadian Thanksgiving :D) to do our readings and prepare for the first rotation.  And to, you know, breathe before starting up for real on Tuesday when we had back to work.

While I'd like to post an update here every week to keep y'all posted on how internship is going, I don't think that's very realistic.  Plus, with my foodservice rotation lasting a hundred years (well, 12 weeks, but it seems like FOREVER), it might not be too interesting to be like "I'm still here. The end!".  So, I'll post when I can - I'd guess every 2-3 weeks, depending on the rotation and what's going on.


Phew.  Here we go.

Veggie of the month

Since we're heading into October, it's only right that the veggie of the month this time around iiiissssss......

Pumpkin!

This globular orange gourd is best known for its decorative qualities at Halloween.  But, it's also a nutritional powerhouse!  There's a difference between the pumpkin that you find in the fleshy, little pumpkins and canned pumpkin versus that big jack-o-lantern pumpkin with more goo and seeds than flesh.  And of course, pumpkin pie isn't quite the same thing as cooked pumpkin!

Since when are jack-o-lanterns edible??

Pumpkins are related to other squash, like butternut, acorn and spaghetti squash.  Like its cousins, pumpkins have bright orange flesh, a core filled with pulp and seeds, and a thick orange or yellowish shell (sometimes pumpkins are white, but generally the kind found in grocery stores are orange).  Most parts of the pumpkin are edible, including the flesh, seeds, shell, and even leaves and flowers.

The kind of pumpkin that you get for jack-o-lanterns (big, hollow) aren't as exciting to eat since they don't have much flesh.  Smaller pumpkins will have more flesh than goo inside, and be more worth your while to roast or boil to eat.  However, the seeds that you scoop out from your jack-o-lantern pumpkin are definitely great to eat!  More on that later.

I like pumpkin pie.  But I hate vegetables.

Pumpkin pie is a fun treat on Thanksgiving, sure - but pumpkin on its own without the pie is also delicious and super nutritious!  Check out these stats from the Canadian Nutrient File!

For a 1/2 cup of cooked, mashed pumpkin (1 serving), you get:

• Just 44 calories!
• About 4 grams of fibre!  That's a whole lot of fibre for only a HALF CUP of a vegetable, and will help you to feel full longer, help to stabilize blood glucose levels, and may even help with weight loss.
• 17% of a man's Vitamin K needs, or 22% of a woman's needs.  This vitamin is important for blood coagulation and bone health.
• An amazing 140% of your Vitamin A needs!  Getting enough vitamin A is important for growth and development, maintaining a healthy immune system, and vision health.   
• A crapload (yes, CRAPLOAD!) of beta-carotene!  Beta-carotene is a precursor of Vitamin A, and an important antioxidant that may be helpful in treating some types of cancer.
• 22% of a man's iron needs, or 10% of a woman's needs.  For a veggie to provide that amount of iron in only half a cup is pretty impressive!
• about 6% of your potassium needs, an important electrolyte to maintain fluid balance in the body.  What?  Six percent doesn't sound like much?  Well, per half cup of pumpkin you get about 267mg of potassium - that's about the same as the same volume of bananas!

Wow!  And you thought that pumpkins were only good for pie.

I bought pumpkin seeds at Bulk Barn.  What's the deal with those?

Sweet!  Pumpkin seeds are also a great nutritional powerhouse!  You can find them in grocery stores or bulk stores (look for roasted unsalted seeds), or just roast them up yourself after scooping out the goo from your jack-o-lantern.  The little green kind that you often find in grocery stores/bulk stores are the kernals of the seeds, while the big white flat seeds are the whole seed.  Pumpkin seeds are a great source of zinc, needed for immune system functioning, cell division and growth, wound healing, and other bodily functions.  Zinc is also used in production of testosterone - which many women experience low levels of, contributing to low sex drive.  So ladies.  If you're looking to get your sexy on, toss some pumpkin seeds in your salad every once in a while ;)

I bought a pumpkin.   Now what....?

Hooray!  Let's get cooking! 

One of the easiest ways to use pumpkin's flesh is by roasting or boiling it, and mashing/pureeing.  The puree can then be used in a huge variety of ways.  Of course, if you can't find pumpkin in your grocery store/market, or just don't want to deal with the hassle of cooking a pumpkin just to mash it up anyway, you can get canned puree pumpkin in most grocery stores (sometimes found in the baking needs section rather than canned vegetables section).  Be careful to purchase pure puree pumpkin, not pumpkin pie filling.  They're often placed right next to each other and labelled similarly, so take your time picking a can.

I use pumpkin often in breakfast in the fall and winter.  I posted once before a recipe for ridiculously fluffy pumpkin pancakes.  I also often put in about 2-4Tbsp of pumpkin puree into my steel cut oatmeal, along with a sprinkle of brown sugar (not too much, maybe 1/2-1tsp), cinnamon and nutmeg (or if you have it, pumpkin pie spice).  Mmmmmmmmmmm.   Pumpkin puree can also be used in many dessert and baking recipes (like pie, cookies, loaves, muffins, etc etc etc...)

One of my all time favourite ways to use puree pumpkin, though, is CURRY!!!!!!!!!!!!  When pumpkin is added in curries, it takes on a sweeter flavour, helping to balance out the spiciness.  Try out this recipe for Pumpkin Shrimp Curry!

• 2 Tbsp olive oil or canola oil
• 1 cup diced onion
• 1 Tbsp each minced ginger and minced garlic
• 1/2-3/4 cups diced tomatoes (about 2-3 Roma tomatoes - they have more flesh than juice compared to the big hothouse kind of tomatoes!)
• 1 15oz can of puree pumpkin
• 2 cups low-sodium vegetable or chicken stock
• 1 cup coconut milk (** don't want leftover coconut milk?  Just use less stock and toss the whole can of coconut milk in.  Use 1 cup of stock to start, and if needed, add more later in cooking if the curry is too thick)
• 1 1/2tsp curry powder
• cayenne pepper to taste (about 1/8-1/4tsp)
• 1lb peeled, deveined shrimp
• 1 1/2tsp lime juice
• optional: 1 cup diced butternut squash.  No squash around?  Try 1 cup sweet potato, or just add some more diced tomato (about 1 1/2 cups total tomatoes).

Heat the oil in a large pan over medium heat, and sautee onion and ginger till soft and fragrant (about 5 minutes), then add garlic and mix another minute.  Add the tomatoes and pumpkin puree, stirring frequently till the pumpkin becomes a golden brown (about 8-10 minutes).

Add broth, coconut milk, curry powder and cayenne pepper, and simmer for about 20 minutes.  Add the squash (if using), shrimp and lime juice, and continue cooking till shrimp is cooked through and squash is tender.

Serve on steamed rice with a sprinkle of fresh chopped cilantro, if desired :)

But wait!  What about all those seeds from my jack-o-lantern!??!

When I was a kid, I loved doing the pumpkin carving and getting covered in the sloppy insides of the pumpkin.  But the best part of jack-o-lantern carving was getting to eat the aftermath by roasting the pumpkin seeds!!!

Get rid of any of the stringy goo that accompanies the seeds, and rinse your seeds to get residual slime off.  Toss your seeds in a bowl with about 1-2Tbsp of olive or canola oil (depends on how many seeds you get out).  You can toss it in the oven as is to just get roasted seeds, or try flavouring with:

• garlic salt (my favourite thing in the world as a kid)
• Sweet seeds: 1 tsp each cinnamon, ground ginger and cloves, and 1Tbsp brown sugar
• Spicy seeds: 1/2 tsp each garlic salt and chili powder (want an extra kick?  Sprinkle in some cayenne too!)  

Spread the seeds out in a single layer on a baking sheet lined with parchment paper (to prevent sticking and dealing with cleaning up later) and roast at 250 degrees for about an hour, till they are crispy and golden.  Stir them around every 10-15 minutes.  After removing from the oven, the seeds will become crunchier as they cool.  Let the seeds cool completely, and eat either whole or shelled.