HOLY CRAP!!!!!!!!!!!!!!!!
My bad for not posting again up until now, but things have been cray. I'm stupid busy at the hospital all day err day doing my staff relief and finishing up all the evaluations and projects that are due at the end of internship. Soon... soon.
Since my last blog about this rotation, things have improved substantially. I'm much more comfortable with renal nutrition and education, though I'm still learning new things every day. My preceptor and I came to a mutual understanding of each other - I understood what she expected of me, and she understood how to guide me. Internship isn't just about gaining clinical knowledge and skills, it's also about gaining interpersonal skills, learning your learning style, and participating fully in your own learning - being that I was the first intern that my preceptor has ever had, she taught me with a style that worked for her but most definitely did not work for me. We learned together what I needed, how to express it into words, and make changes so that we would be able to work well together and help me get the most out of the rotation.
The last few weeks I've been working all by myself as a legit RD doing my staff relief. My preceptor is away on vacation, leaving me in charge of all of her patients. This means that I'm running by myself - making decisions and recommendations for my patients' care, consulting with other professionals who see me as a professional rather than "just a student", getting paged for consults, and managing a full caseload of patients (I see somewhere between 7-15 people per day). I do have a "resource RD" available to me, basically an RD acting as my preceptor while she's away who I can ask questions or consult with things that I don't know what to do with. But other than that, it's all me. It's been pretty awesome to see what working as a real RD is like, and feeling fully responsible for my patients!
My next update will come after I've officially graduated from internship!!!! After next Friday, I will officially be done this chapter of my life. All of the school, the volunteering, the struggling, the sacrificing, the late nights and early mornings, the buckets of coffee, the smiles and the tears, the empty bank account, and the 10 month epic adventure in dietetic education all comes to an end on August 8th. After that day, I'll be eligible for registration with the College of Dietitians of Ontario, a day I've been longing for since the day I applied to Ryerson, way back when this blog first started four years ago.
Here goes...
Showing posts with label Internship recap. Show all posts
Showing posts with label Internship recap. Show all posts
Wednesday, July 30, 2014
Saturday, July 5, 2014
Internship Recap Week 37-39
It's my last rotation of internship!!!!!!!!!!!!!!!!! After this, I just have 3 weeks of clinical staff relief, also happening in the same area as this rotation. And that's all folks, we're heading towards the finish line!! This rotation is a bit longer (4 weeks + staff relief) and much more involved, so it's going to be broken up into a couple of blogs.
Here I am in end-stage renal disease management, providing nutrition care to patients receiving hemodialysis and peritoneal dialysis. With kidney failure, there's a lot to know: get lab values for electrolytes and protein metabolism markers (e.g. urea, albumin), interpret the labwork and prioritize patients based on who is at the most nutritional and/or medical risk, and create individualized nutrition care plans and education for each patient based on their labwork and current intake, modality of treatment (hemodialysis vs. peritoneal dialysis), and other issues like fluid restrictions, medication/nutrient interactions, concurrent disease management like diabetes and heart disease, financial constraints, amputations, etc, etc, etc...
This rotation has certainly been the most challenging yet. Being my last rotation, expectations are high. Preceptors expect that you've developed certain abilities and skills and can pull together a patient education plan with ease. Normally, this would be fine and good, but nutrition in dialysis is a whole different monster than anything I've dealt with before. I've had to understand specific lab values before (like in diabetes, we would gain and interpret fasting blood glucose, A1C, and serum lipids), but I've never before had to understand the finer details about why someone's potassium would be high (which can be very dangerous and cause heart attack) -- is it really just that they're eating too many bananas, or are they also on antihypertensive medication that's jacking up their potassium? Are they on a diuretic? What kind of K bath do they have in their dialysate? Are they diabetic - if so, are they hyperglycemic? Has their labwork been showing a trend up or down, is this high potassium unusual for them? If it really is dietary, do they need to be on a dietary potassium restriction? How many mg or mmol of potassium do they need to bring the potassium back down? Are they constipated - if so, what high fibre foods can they eat that are also low in potassium? Are they also on Warfarin? Watch that Vitamin K, and by the way, many foods with Vit K also have potassium. *sweating* Go ahead. Make a nutrition care plan and educate your patient in a way that they'll actually understand what's happening.
Within the first few days of the rotation, I knew I was in way over my head.
My preceptor was very tough on me. She would ask super challenging questions that I'd never encountered before and want me to think through the process to come up with a plan. Unfortunately for me, I struggled a lot with figuring things out, and my preceptor did not help my struggle or provide assistance when I was clearly not getting there, rather, left me with homework every night to research and deal with it. I became very frustrated and upset, because I could not for the life of me come up with appropriate answers to her questions. I felt dumb on a regular basis, because I felt completely incapable of answering things that it seemed to her to be easy enough questions for an intern in her 3rd day of a rotation. And then I remembered how I'm here for not just a 4-week rotation, but also expected to take over her job for 3 weeks as an independent practitioner.
And so, I had a complete meltdown.
It was epic, and awful, and ridiculous and humiliating. I managed to hold it till day 4 - I even succeeded in holding it while our practice leader and two senior level RDs were hanging out in our office chatting (kept my head down, didn't say a damn word for fear I would explode). Almost the minute they left, I burst into projectile tears. Preceptor admitted that she had been a bit harder on me over the previous couple of days in order to make it clear to me that I had a ways to go - I wasn't at the level she expected for my last rotation, I wasn't grasping the concepts and specifics of renal disease management, and I knew it. Our discussion only served to confirm everything I already knew, which really only upset me more. I cried in the office for an hour. I cried the whole subway ride home. I cried at home for another hour. I don't think I've felt that terrible about my performance, skills, or education in nutrition since, well, ever.
I took that weekend, which was the long weekend for Canada Day, and studied harder than I ever have before. I reviewed notes from university, read articles recommended for the internship (which I had kind of skimmed before, but decidded to buckle down into it), researched medications, nutrient/medication interactions, labwork interpretations. I practiced assessments, calculations, diet recalls with super specific detail needed for dialysis, and practiced education delivery for all kinds of different issues I might come across.
By the end of week 2 (now), I'm feeling more comfortable, but I'm not quite to the level of independence that I was in my last couple of rotations. Also, my preceptor has adjusted her teaching style drastically, and I no longer feel stupid all day long :) I'm feeling better about asking questions, knowing that there are some questions I'll just have to look up myself and take the initiative to figure it out or ask someone else before asking my preceptor. It's getting better, but I have to admit, I'm not feeling the awesomeness of "FINAL ROTATION!!!" like I thought I would at this point. Hopefully in the next couple of weeks, the comfort level will continue to increase and I'll feel a bit more competent.
Meanwhile, back to my neverending homework and studying.
Meanwhile, back to my neverending homework and studying.
Thursday, June 12, 2014
Internship recap: Weeks 30-35
So we realized that by the end of this rotation that erhmahgerd. We only have 8 WEEKS LEFT OF INTERNSHIP. Freaking. The eff. Out.
But, we'll get into the next steps in a bit. First, internship recap of the last 5 weeks at my community health centre (CHC) rotation!
I've been working at a CHC located about 2 blocks away from where I live, which has been just excellent because a) I can walk to work and have only used the subway maybe five or six times the whole rotation to get to offsite meetings, and b) this is my neighbourhood, and it's been super interesting to find out the demographics of people who live here and the food insecurity issues still present, even in a neighbourhood that appears generally to be quite affluent. CHCs have a reputation for being health centres only for the poor and marginalized, food insecure, recent immigrants, single parents, and people with other barriers to accessing health care at all. Certainly, that's how the CHC model began - to remove barriers preventing people from accessing health care and connect with communities to work on deeper underlying issues (such as housing, employment, food security). But, today's CHCs aren't places for only these marginalized and socially underserved groups - anyone can be served by a CHC. And, many have allied health professionals such as dietitians on staff, which you don't need a doctors' referral to see. However, CHCs do still focus on breaking down barriers and being accessible to people who would otherwise have limited access to health care, and provide many programs and services to clients for free.
One such program is the Kids Cooking Club, which I've been running for the last 5 weeks! I have a group of 8-12 year olds who come in once per week for 2 hours to learn basic cooking skills and basic nutrition. We have a focus on one food group each week (fruit/veg, grain, milk, meat/alternatives), and prepare 3 recipes focusing on those groups. The kids learn kitchen basics like handwashing and food safety, basic knife skills and food preparation (peeling, mashing, etc) and use the stove/oven to prepare meals that they can also make at home. We also strongly encourage the kids to try new foods - if they don't like it then that's fine, but we ask that they at least try once. After they eat their tasty treats, we have a nutrition lesson where I chat with the kids about the food group, how many servings per day they should aim for, what a serving size looks like, and how to make it fit into a day. My preceptor says that this year's group has been much less knowledgeable and more shocking than previous groups... their nutrition knowledge was near zero when they first started (most couldn't name all 4 food groups, for example), they were reluctant to try anything that wasn't meat and rice, their favourite healthy food on day one was blue KoolAid, and one 10 year old girl had never tried a tomato before in her entire life. Amazingly by week 4, we made a green salad (which I expected would end very badly with this group...), and they not only ate their portion, they lined up asking for more salad!!!!!!!!! SHOCK!!!!!!!!!!!!!!!!!!!!! We gave the kids a knowledge questionnaire before the sessions started, and again on the last day to see what they had learned - I was very pleased to see that all but one kid scored substantially higher on the quiz on the last day :) *proud*
Other than the cooking club, I also worked on a few smaller projects, gave a 2 hour presentation to mostly older adults about nutrition myths, and did a lot of networking with other health professionals and people working at other CHCs. I didn't get too much patient care experience here, but despite that I still feel like I learned tons. Being in this environment taught me the importance of considering a client/patient's needs from all sides - they aren't just having nutrition issues, and that nutrition issue may not be at the top of their priority list. I also got a lot of excellent experience working with different age groups - in particular, all this time I've been working with kids is going to come in really handy when I get to my first post-internship job at the CDA Camp in August!
Next up: one last research week/catch up on life, and then two more rotations: renal disease, and staff relief (also going to be in renal). And then? Well friends, then we're DONE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
But, we'll get into the next steps in a bit. First, internship recap of the last 5 weeks at my community health centre (CHC) rotation!
I've been working at a CHC located about 2 blocks away from where I live, which has been just excellent because a) I can walk to work and have only used the subway maybe five or six times the whole rotation to get to offsite meetings, and b) this is my neighbourhood, and it's been super interesting to find out the demographics of people who live here and the food insecurity issues still present, even in a neighbourhood that appears generally to be quite affluent. CHCs have a reputation for being health centres only for the poor and marginalized, food insecure, recent immigrants, single parents, and people with other barriers to accessing health care at all. Certainly, that's how the CHC model began - to remove barriers preventing people from accessing health care and connect with communities to work on deeper underlying issues (such as housing, employment, food security). But, today's CHCs aren't places for only these marginalized and socially underserved groups - anyone can be served by a CHC. And, many have allied health professionals such as dietitians on staff, which you don't need a doctors' referral to see. However, CHCs do still focus on breaking down barriers and being accessible to people who would otherwise have limited access to health care, and provide many programs and services to clients for free.
One such program is the Kids Cooking Club, which I've been running for the last 5 weeks! I have a group of 8-12 year olds who come in once per week for 2 hours to learn basic cooking skills and basic nutrition. We have a focus on one food group each week (fruit/veg, grain, milk, meat/alternatives), and prepare 3 recipes focusing on those groups. The kids learn kitchen basics like handwashing and food safety, basic knife skills and food preparation (peeling, mashing, etc) and use the stove/oven to prepare meals that they can also make at home. We also strongly encourage the kids to try new foods - if they don't like it then that's fine, but we ask that they at least try once. After they eat their tasty treats, we have a nutrition lesson where I chat with the kids about the food group, how many servings per day they should aim for, what a serving size looks like, and how to make it fit into a day. My preceptor says that this year's group has been much less knowledgeable and more shocking than previous groups... their nutrition knowledge was near zero when they first started (most couldn't name all 4 food groups, for example), they were reluctant to try anything that wasn't meat and rice, their favourite healthy food on day one was blue KoolAid, and one 10 year old girl had never tried a tomato before in her entire life. Amazingly by week 4, we made a green salad (which I expected would end very badly with this group...), and they not only ate their portion, they lined up asking for more salad!!!!!!!!! SHOCK!!!!!!!!!!!!!!!!!!!!! We gave the kids a knowledge questionnaire before the sessions started, and again on the last day to see what they had learned - I was very pleased to see that all but one kid scored substantially higher on the quiz on the last day :) *proud*
Other than the cooking club, I also worked on a few smaller projects, gave a 2 hour presentation to mostly older adults about nutrition myths, and did a lot of networking with other health professionals and people working at other CHCs. I didn't get too much patient care experience here, but despite that I still feel like I learned tons. Being in this environment taught me the importance of considering a client/patient's needs from all sides - they aren't just having nutrition issues, and that nutrition issue may not be at the top of their priority list. I also got a lot of excellent experience working with different age groups - in particular, all this time I've been working with kids is going to come in really handy when I get to my first post-internship job at the CDA Camp in August!
Next up: one last research week/catch up on life, and then two more rotations: renal disease, and staff relief (also going to be in renal). And then? Well friends, then we're DONE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Saturday, May 10, 2014
Internship recap: Week 27-29
Keep on going!
This rotation is at Princess Margaret Cancer Centre, and I couldn't be more excited about having this placement. This is the main reason I applied to my internship in the first place - a rotation in oncology from the largest cancer centre in the country, and one of the top rated in the world for treatment and research efforts. It's also the place where both my dad and my fiance's dad were treated for multiple myeloma, giving them another chance at living. I couldn't wait for the opportunity to be involved in this amazing place and give back to the hospital that has done so much for my family and thousands of others.
I'm working with head and neck cancers, including oral, sinus, pharyngeal (throat) and tongue cancers. Most patients are receiving radiation therapy, and some receive chemo and radiation in combination. The patients who I see are mostly those who are undergoing more intensive treatment: chemorads (combo therapy), or accelerated radiation treatments (instead of going once a day for 5 days/week, they go twice a day for one or more of those days), who are automatically scheduled to see a dietitian weekly to help manage the side effects of their treatment, and keep their weight as stable as possible. This often requires them to have a gastrostomy tube inserted so that they can receive nutrition supplement feeds, water/hydration, and take medications without using the throat. We also see patients on a regular radiation treatment schedule if they or their doctor request it. Usually these are the patients who had a history of alcohol abuse or severe weight loss prior to the treatment starting and are at greater risk of malnutrition and poor treatment outcomes.
It. Is. Awesome.
I was honestly a bit worried coming into the rotation that it might be kind of overwhelming, given my dad's current situation. But, it's been totally fine - it's a completely different type of cancer and very different kind of treatment. I'm doing fine emotionally with being here, but it is admittedly hard to be empathetic without feeling sorry for my patients. In particular, the ones with similar stories to my dad - middle aged men with young families, no history of smoking or alcoholism or much other medical history, who suddenly find themselves receiving radiation for throat cancer. Sometimes cancer just can't be explained, and it can be very sad. But, I know it's my job to make their journey just a little easier, and have one more person they can rely on to provide support, encouragement and hope.
By my second day, I was leading outpatient clinic visits with my preceptor in the room, and week 2 I was completely on my own. I led both the outpatient clinic and managed an inpatient load independently for the majority of my time here, with minimal help from my preceptor. Sure I made mistakes, but she gave me room to make them, learn from them, and correct them (mind you, the mistakes I made were never life threatening or anything, just maybe better advice or a better supplement regimen could have been chosen for the patient and could be corrected the next time they were in). In this rotation, I felt the most comfortable, confident, and competent that I have in any other rotation. Nurses referred to me as "the dietitian" and asked a couple of times if the regular girl (my preceptor) was on vacation or something. When I said I was her student, they looked aghast and said I was "legit" (their words :P). Patients told me they were grateful for the intervention of a dietitian to help them through the journey, and my last few were even a bit sad when I told them that I was leaving and they'd be followed up by someone else. It was truly rewarding to know that I was making a big difference in these people's lives, and I am so, SO grateful that I was able to have this experience in my internship.
Next up - 5 weeks in a community health centre! This rotation is super convenient - I live like 3 blocks away. I won't have to pay subway fare for over a MONTH! And when you're an unpaid intern, that's like, a super huge deal.
This rotation is at Princess Margaret Cancer Centre, and I couldn't be more excited about having this placement. This is the main reason I applied to my internship in the first place - a rotation in oncology from the largest cancer centre in the country, and one of the top rated in the world for treatment and research efforts. It's also the place where both my dad and my fiance's dad were treated for multiple myeloma, giving them another chance at living. I couldn't wait for the opportunity to be involved in this amazing place and give back to the hospital that has done so much for my family and thousands of others.
I'm working with head and neck cancers, including oral, sinus, pharyngeal (throat) and tongue cancers. Most patients are receiving radiation therapy, and some receive chemo and radiation in combination. The patients who I see are mostly those who are undergoing more intensive treatment: chemorads (combo therapy), or accelerated radiation treatments (instead of going once a day for 5 days/week, they go twice a day for one or more of those days), who are automatically scheduled to see a dietitian weekly to help manage the side effects of their treatment, and keep their weight as stable as possible. This often requires them to have a gastrostomy tube inserted so that they can receive nutrition supplement feeds, water/hydration, and take medications without using the throat. We also see patients on a regular radiation treatment schedule if they or their doctor request it. Usually these are the patients who had a history of alcohol abuse or severe weight loss prior to the treatment starting and are at greater risk of malnutrition and poor treatment outcomes.
It. Is. Awesome.
I was honestly a bit worried coming into the rotation that it might be kind of overwhelming, given my dad's current situation. But, it's been totally fine - it's a completely different type of cancer and very different kind of treatment. I'm doing fine emotionally with being here, but it is admittedly hard to be empathetic without feeling sorry for my patients. In particular, the ones with similar stories to my dad - middle aged men with young families, no history of smoking or alcoholism or much other medical history, who suddenly find themselves receiving radiation for throat cancer. Sometimes cancer just can't be explained, and it can be very sad. But, I know it's my job to make their journey just a little easier, and have one more person they can rely on to provide support, encouragement and hope.
By my second day, I was leading outpatient clinic visits with my preceptor in the room, and week 2 I was completely on my own. I led both the outpatient clinic and managed an inpatient load independently for the majority of my time here, with minimal help from my preceptor. Sure I made mistakes, but she gave me room to make them, learn from them, and correct them (mind you, the mistakes I made were never life threatening or anything, just maybe better advice or a better supplement regimen could have been chosen for the patient and could be corrected the next time they were in). In this rotation, I felt the most comfortable, confident, and competent that I have in any other rotation. Nurses referred to me as "the dietitian" and asked a couple of times if the regular girl (my preceptor) was on vacation or something. When I said I was her student, they looked aghast and said I was "legit" (their words :P). Patients told me they were grateful for the intervention of a dietitian to help them through the journey, and my last few were even a bit sad when I told them that I was leaving and they'd be followed up by someone else. It was truly rewarding to know that I was making a big difference in these people's lives, and I am so, SO grateful that I was able to have this experience in my internship.
Next up - 5 weeks in a community health centre! This rotation is super convenient - I live like 3 blocks away. I won't have to pay subway fare for over a MONTH! And when you're an unpaid intern, that's like, a super huge deal.
Friday, April 11, 2014
Internship Recap: Week 22-25
Diabetes education program!!!
I was super stoked to come into this rotation, because diabetes education is an area I'm really, really interested in working in professionally. And, this is my first outpatient rotation (where people are coming in to see us from home, rather than us barging in on their hospital room).
The centre I'm in is part of a family health team in downtown Toronto, and we provide education for diabetes management to people who have been diagnosed with Type 1, Type 2 or pre-diabetes. This includes people who are managing their diabetes through oral medications only, insulin, or through lifestyle modification alone (so no gestational diabetes, and no Type 1 using insulin pumps). Our clients come to the centre to meet with nurses and dietitians for assistance with managing their diabetes, including diet and lifestyle modifications, insulin adjustments, and recommendations to alter medications (which need approval from a doc). We also offer a huge number of classes to explain the condition to newly diagnosed people (different classes for each type), and to help them manage their condition (such as physical activity classes, label reading classes and supermarket tours).
The first week was really more an orientation to diabetes education, shadowing my preceptors (there are two dietitians working at this centre, so I kind of float between the two of them depending on whether their clients are comfortable having a student there), and starting to get more involved with client visits by taking diet histories. I also spent lots of time with the nurses to learn about using glucometers and reviewing the types of oral medications and insulins that our clients are taking. We need to be very familiar with these medications, as their effects will greatly influence how we provide care to clients! For example, if a client is on a medication that has a high risk of hypoglycemia, the recommendations I make for them will be very different than what I would offer to someone who has little risk of hypos. By the end of the week I was feeling pretty comfortable with the process and ready to start taking charge more in client meetings (considering that I had just come from a rotation where I was operating pretty much independently) -- but, I had so few clients to see!!! I told my preceptor that I'd like to start working more independently with the next clients we were expecting at the end of the week, and they agreed - but then the appointments all cancelled! D'oh... This is the unfortunate reality of outpatient clinics -- people have the choice as to whether they want to come see you or not. Even if they confirm their appointment, there's still no guarantee that they are actually going to show up!
By the end of week 2 I was taking charge much more often in appointments, and led part of a group education class (I taught people about the complications of unmanaged diabetes and some management strategies), and in the last week I was running pretty well independently again, though my preceptor was much more involved than the previous rotation. This was really more by my request than anything else, because I was still getting used to the outpatient environment where clients come up with very random out-of-the blue questions on a regular basis! For example, one client came in for their regular RD follow up, but actually wanted to talk about issues with IBS and her upcoming colonoscopy to investigate her for diverticulitis. Though I have some knowledge on these topics (particularly being a fellow IBS sufferer!), it was helpful to have my preceptor there to rely on for specific questions she had. I've also had several clients with psychiatric and emotional issues affecting how we conduct the appointment, which I've never really worked with before, so I was grateful for my preceptor's support!
It also struck me recently that OMG - THERE'S LESS THAN FOUR MONTHS LEFT!!!!!!!!! In four months, I will have my temporary licence and be able to legally practice with the letters "RD" behind my name!
Not only that, but I also got amazing news during this rotation: I HAVE MY FIRST POST-INTERNSHIP JOB LINED UP!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! AAAAAAAAAAAAHHHHHHHHHHHH!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Mind you it's very temporary, only a week long gig, but I will get PAID!!!!
I'll be working with a dietitian at a summer camp for the Canadian Diabetes Association with kids with Type 1 diabetes! The super cool part of this job (besides the paycheque) is that since I'll officially have my licence (even a temporary licence still counts), I can count all of the hours I work at the camp towards getting my Certified Diabetes Educator certificate, which you need 500 hours to qualify for. An overnight camp will let me rack up loads of hours in a pretty short period of time!
Oh yeah, and not only will I be able to be employed in four months, but I'm also getting MARRIED IN 8 MONTHS!!! It's sneaking up fast, but so far the panic hasn't set in yet: we have a date, a venue, a photographer, a DJ, and I got my dress already :D
By the end of week 2 I was taking charge much more often in appointments, and led part of a group education class (I taught people about the complications of unmanaged diabetes and some management strategies), and in the last week I was running pretty well independently again, though my preceptor was much more involved than the previous rotation. This was really more by my request than anything else, because I was still getting used to the outpatient environment where clients come up with very random out-of-the blue questions on a regular basis! For example, one client came in for their regular RD follow up, but actually wanted to talk about issues with IBS and her upcoming colonoscopy to investigate her for diverticulitis. Though I have some knowledge on these topics (particularly being a fellow IBS sufferer!), it was helpful to have my preceptor there to rely on for specific questions she had. I've also had several clients with psychiatric and emotional issues affecting how we conduct the appointment, which I've never really worked with before, so I was grateful for my preceptor's support!
It also struck me recently that OMG - THERE'S LESS THAN FOUR MONTHS LEFT!!!!!!!!! In four months, I will have my temporary licence and be able to legally practice with the letters "RD" behind my name!
Not only that, but I also got amazing news during this rotation: I HAVE MY FIRST POST-INTERNSHIP JOB LINED UP!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! AAAAAAAAAAAAHHHHHHHHHHHH!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Mind you it's very temporary, only a week long gig, but I will get PAID!!!!
I'll be working with a dietitian at a summer camp for the Canadian Diabetes Association with kids with Type 1 diabetes! The super cool part of this job (besides the paycheque) is that since I'll officially have my licence (even a temporary licence still counts), I can count all of the hours I work at the camp towards getting my Certified Diabetes Educator certificate, which you need 500 hours to qualify for. An overnight camp will let me rack up loads of hours in a pretty short period of time!
Oh yeah, and not only will I be able to be employed in four months, but I'm also getting MARRIED IN 8 MONTHS!!! It's sneaking up fast, but so far the panic hasn't set in yet: we have a date, a venue, a photographer, a DJ, and I got my dress already :D
Next week is a well-deserved vacation week (though I'll be spending most of it on finishing up my research, as our abstracts are due for submission in a couple of weeks too :/). After that, the rotation I've been waiting for since I first applied to this internship: ONCOLOGY!!!! Most of the reason I applied to this internship was to work at Princess Margaret Cancer Centre, one of the leading cancer centres in the world, and the place that gave my dad a second shot at life after his multiple myeloma diagnosis. I'm so excited to have the opportunity to contribute to this organization and give back in whatever way I can to help support other patients through their cancer journey.
Saturday, March 15, 2014
Internship recap: Week 18-21
We're HALFWAY DONE THE INTERNSHIP!!!!!!!!!!!!!!!!!!!!!!!!!!!!
The last three weeks I've been at a rehabilitation hospital working in the musculoskeletal rehab unit. This is a completely different world than the acute care setting I was working in with my last rotation - in rehab, patients are medically stable. No one is ill, no one is on IV fluids/medications, and the patients are fully conscious, participatory in their care, and very mobile. Most of the patients in the musculoskeletal rehab unit are there for rehab for hip fractures, hip replacements, and knee replacements, though we also have about 8 beds available for oncology patients needing rehab after cancer treatment (usually because they lost way too much weight and need to rebuild muscle mass). I also spent 2 days a week at a different site of this hospital in spinal cord injury rehabilitation, where most patients are paraplegic or quadriplegic. Most of these patients have spinal cord injuries from motor vehicle accidents, sports injuries, "stupid" injuries (like trying to jump off your roof for some reason), or have a condition that affects neuromuscular function such as multiple sclerosis.
The first week here was like orientation all over again. Though this hospital is part of the network that I'm interning with, it's the most recent acquisition and hasn't quite made a full transition yet to the practices and technologies available at the other sites. So, it took me the whole first week to figure out where to find things, how patient caseloads are managed, how chart notes are organized and written, and who to ask/where to find information. I had a lot of bad days. Days where I felt like I'd completely lost all the independence and competence that I thought I had from the last rotation, and felt super dumb because I didn't know how to do most things. My preceptor challenged me a lot - which is a good thing really, but I often felt dumb for not knowing the answer to questions that seemed like they should have been obvious. But I was determined to manage this rotation, and spent most of my "free time" in that first week doing readings and practicing doing assessments and chart notes to get more familiar with the process at this hospital compared to the last rotation.
By the second week, things were much smoother. I think my preceptor and I kind of figured each other out a bit more and learned how we worked best together, how I learn best and how she could help me get the most out of the rotation. By mid-week I had my own caseload and was visiting patients independently to complete assessments and do follow up work. My preceptor and I caught up once or twice a day so I could review what I'd done and make sure that my care plans were appropriate for the patient, and get her to order new diet orders or supplements I recommended (because as an intern, I can't sign for my own orders yet). I even attended a family meeting by myself with other team members to coordinate a patient's discharge planning. I gave the family information and offered education to help them achieve his nutritional goals (gaining/maintaining weight) while managing his other symptoms and comorbidities (low appetite, managing diabetes). By the end of the rotation, I felt much, much more competent and independent, felt comfortable to manage my caseload and develop a care plan/follow up with patients solo, and felt that my preceptor trusted my judgement and rationale for the care plan I had chosen.
This rotation also gave me my first case study! In this internship, we have two case studies to complete during the clinical portion of the program: one in the first half, one more complicated case in the second half. To qualify as a patient for these case studies, we need to have been the primary dietitian working with the patient, and have seen them from admission onward (to complete an assessment for the patient ourselves, rather than having them transferred from another dietitian's care plan). This patient was admitted early in my second week for rehabilitation following cancer treatment, where he'd unfortunately had a rough experience with severe mouth sores, nausea and vomiting, GI issues, and very large weight loss. I followed him pretty well completely independently from his admission through to discharge, created a care plan, followed up with him regularly, collaborated with other team members to get the "bigger picture" of his care, created a discharge plan for him, and provided diet education specific to his particular needs (of which he had many because of the cancer itself, side effects of the treatment, and other medical issues he had prior to hospitalization). I'll be delivering my case study presentation sometime later this month!
Next week I'm moving into yet another research week (read : a week to catch up on all the housework and errands I haven't had time to do in the last several months, catch up on reading for my next rotation, and - yeah, do research :/) I'm super excited for the rotation that follows the week after though: DIABETES!!! I'll be working in a diabetes education centre within a family health team, which is the kind of environment that I kind of see myself working in when I'm ready to work!
Updates to come :)!
The last three weeks I've been at a rehabilitation hospital working in the musculoskeletal rehab unit. This is a completely different world than the acute care setting I was working in with my last rotation - in rehab, patients are medically stable. No one is ill, no one is on IV fluids/medications, and the patients are fully conscious, participatory in their care, and very mobile. Most of the patients in the musculoskeletal rehab unit are there for rehab for hip fractures, hip replacements, and knee replacements, though we also have about 8 beds available for oncology patients needing rehab after cancer treatment (usually because they lost way too much weight and need to rebuild muscle mass). I also spent 2 days a week at a different site of this hospital in spinal cord injury rehabilitation, where most patients are paraplegic or quadriplegic. Most of these patients have spinal cord injuries from motor vehicle accidents, sports injuries, "stupid" injuries (like trying to jump off your roof for some reason), or have a condition that affects neuromuscular function such as multiple sclerosis.
The first week here was like orientation all over again. Though this hospital is part of the network that I'm interning with, it's the most recent acquisition and hasn't quite made a full transition yet to the practices and technologies available at the other sites. So, it took me the whole first week to figure out where to find things, how patient caseloads are managed, how chart notes are organized and written, and who to ask/where to find information. I had a lot of bad days. Days where I felt like I'd completely lost all the independence and competence that I thought I had from the last rotation, and felt super dumb because I didn't know how to do most things. My preceptor challenged me a lot - which is a good thing really, but I often felt dumb for not knowing the answer to questions that seemed like they should have been obvious. But I was determined to manage this rotation, and spent most of my "free time" in that first week doing readings and practicing doing assessments and chart notes to get more familiar with the process at this hospital compared to the last rotation.
By the second week, things were much smoother. I think my preceptor and I kind of figured each other out a bit more and learned how we worked best together, how I learn best and how she could help me get the most out of the rotation. By mid-week I had my own caseload and was visiting patients independently to complete assessments and do follow up work. My preceptor and I caught up once or twice a day so I could review what I'd done and make sure that my care plans were appropriate for the patient, and get her to order new diet orders or supplements I recommended (because as an intern, I can't sign for my own orders yet). I even attended a family meeting by myself with other team members to coordinate a patient's discharge planning. I gave the family information and offered education to help them achieve his nutritional goals (gaining/maintaining weight) while managing his other symptoms and comorbidities (low appetite, managing diabetes). By the end of the rotation, I felt much, much more competent and independent, felt comfortable to manage my caseload and develop a care plan/follow up with patients solo, and felt that my preceptor trusted my judgement and rationale for the care plan I had chosen.
This rotation also gave me my first case study! In this internship, we have two case studies to complete during the clinical portion of the program: one in the first half, one more complicated case in the second half. To qualify as a patient for these case studies, we need to have been the primary dietitian working with the patient, and have seen them from admission onward (to complete an assessment for the patient ourselves, rather than having them transferred from another dietitian's care plan). This patient was admitted early in my second week for rehabilitation following cancer treatment, where he'd unfortunately had a rough experience with severe mouth sores, nausea and vomiting, GI issues, and very large weight loss. I followed him pretty well completely independently from his admission through to discharge, created a care plan, followed up with him regularly, collaborated with other team members to get the "bigger picture" of his care, created a discharge plan for him, and provided diet education specific to his particular needs (of which he had many because of the cancer itself, side effects of the treatment, and other medical issues he had prior to hospitalization). I'll be delivering my case study presentation sometime later this month!
Next week I'm moving into yet another research week (read : a week to catch up on all the housework and errands I haven't had time to do in the last several months, catch up on reading for my next rotation, and - yeah, do research :/) I'm super excited for the rotation that follows the week after though: DIABETES!!! I'll be working in a diabetes education centre within a family health team, which is the kind of environment that I kind of see myself working in when I'm ready to work!
Updates to come :)!
Tuesday, February 25, 2014
Internship Recap: Week 15-17
It's clinical time!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
I know I'm way too excited about this. And I know it's probably going to wear out eventually. But for now, let's all just rejoice in the fact that clinical rotations have started and are making me happier than a basketfull of puppies. And I would just looooove a basketfull of puppies.
My first clinical rotation was General Internal Medicine, in which I was with a dietitian who works primarily in the stroke and neurovascular wards/clinics. She also does some work on medical floors, so we saw some stuff outside of stroke as well. I did this rotation with a fellow intern who had also just come out of the foodservice rotation, so it was the first clinical rotation for both of us. Because our primary focus on this unit was stroke and neurovascular disorders, we dealt a lot with dysphagia (swallowing difficulties), enteral feeding (tube feeding when swallowing isn't working), and many, many cognitive challenges with our patients including speech difficulties and language barriers (both because of the stroke and the patients' ability to understand us/respond appropriately, as well as language barriers because the area we are in is primarily Portuguese and Italian). It's been super interesting. Like, ridiculously so. Every day is different, every patient's situation and plan is unique, and every nutrition support plan you make for a patient can change on a dime.
I.
LOVE.
It.
!!!
So since I didn't blog throughout the rotation, I'll give a general overview of the last 3 weeks...
First week of clinical was "orientation week", which really means that we had a half day or so orientation to the unit and common things to watch for before being tossed into it! Within the first 3 hours of the first day, we had already participated in neurovascular medicine rounds, and had a family meeting with a patient who was to be discharged back home with support from several community health services. The next day we were reviewing charts for medications affecting nutritional status and calculating enteral nutrition feeds for a patient who was scheduled to receive a G-tube (a feeding tube that is surgically implanted into the stomach, rather than the kind that goes up the nose and down the throat). By Thursday we were charting our own assessment and follow up notes, and calling for consults with other disciplines. It's all been very fast, and the first day or two was very overwhelming, but the pieces are starting to come together and make more sense. The more we get immersed, the more we're learning and becoming better able to work independently.
The really cool thing about general medicine, and particularly stroke/neurovascular medicine, is that several disciplines are involved in just about everything the patient does. Almost every patient (depending on their situation and how they were affected by their stroke) has a doctor, a physiotherapist, an occupational therapist, a speech language pathologist (SLP), a dietitian, a social worker, and maybe others who follow their case. Everyone meets every morning to discuss every case in the unit to keep each other updated on patient conditions, and collaborate to determine if other disciplines should get involved to better care for the patient. This also gives us interns a great opportunity to learn from these other disciplines, who also have their own students and are usually more than happy to have an extra couple tag along to observe their work. We've watched a few swallowing and language assessments from SLPs including two barium video fluoroscopies (where the patient drinks/eats something with barium in it, and their swallowing is x-rayed so that the SLPs can watch the video back and see whether the person is swallowing correctly).
Over the last 3 weeks, I've seen a lot of progression and growth - both my own, and my patients. It's been really cool to see stroke patients progress in their treatment and eventually get to go home. In the first week we met a man who was a retired physician and had had a stroke. He was receiving feeds through nasogastric tube (the up-the-nose down-the-throat kind) and wasn't making much sense when he talked. His language skills had been greatly affected - speech slurred, having difficulty finding the right words to use. When he could speak coherently, his cognitive ability seemed to be pretty impaired. This week he was eating pureed and thickened foods (a BIG deal to graduate from feeding tube to swallowing your own food!) and was talking clearly, and able to respond to questions coherently. He told us about his practice as a physician, and was able to participate in his care. Amazing. In my own growth, I've gone from having absolutely no confidence to speak to patients independently and being unsure of everything, to easily walking into patient's rooms and projecting confidence, empathy, and able to provide education to patients without my preceptor even being in the room with me. I'm also doing my own chart notes directly in the patient records, and just needed my preceptor's sign off (because we're students and can't legally sign off our own charts or write orders).
I'm now heading into clinical rotation #2 in musculoskeletal rehab, dealing with spinal cord injuries and disorders affecting muscular or neurological function (like Parkinsons, cerebral palsy and MS). Update to come!
I know I'm way too excited about this. And I know it's probably going to wear out eventually. But for now, let's all just rejoice in the fact that clinical rotations have started and are making me happier than a basketfull of puppies. And I would just looooove a basketfull of puppies.
My first clinical rotation was General Internal Medicine, in which I was with a dietitian who works primarily in the stroke and neurovascular wards/clinics. She also does some work on medical floors, so we saw some stuff outside of stroke as well. I did this rotation with a fellow intern who had also just come out of the foodservice rotation, so it was the first clinical rotation for both of us. Because our primary focus on this unit was stroke and neurovascular disorders, we dealt a lot with dysphagia (swallowing difficulties), enteral feeding (tube feeding when swallowing isn't working), and many, many cognitive challenges with our patients including speech difficulties and language barriers (both because of the stroke and the patients' ability to understand us/respond appropriately, as well as language barriers because the area we are in is primarily Portuguese and Italian). It's been super interesting. Like, ridiculously so. Every day is different, every patient's situation and plan is unique, and every nutrition support plan you make for a patient can change on a dime.
I.
LOVE.
It.
!!!
So since I didn't blog throughout the rotation, I'll give a general overview of the last 3 weeks...
First week of clinical was "orientation week", which really means that we had a half day or so orientation to the unit and common things to watch for before being tossed into it! Within the first 3 hours of the first day, we had already participated in neurovascular medicine rounds, and had a family meeting with a patient who was to be discharged back home with support from several community health services. The next day we were reviewing charts for medications affecting nutritional status and calculating enteral nutrition feeds for a patient who was scheduled to receive a G-tube (a feeding tube that is surgically implanted into the stomach, rather than the kind that goes up the nose and down the throat). By Thursday we were charting our own assessment and follow up notes, and calling for consults with other disciplines. It's all been very fast, and the first day or two was very overwhelming, but the pieces are starting to come together and make more sense. The more we get immersed, the more we're learning and becoming better able to work independently.
The really cool thing about general medicine, and particularly stroke/neurovascular medicine, is that several disciplines are involved in just about everything the patient does. Almost every patient (depending on their situation and how they were affected by their stroke) has a doctor, a physiotherapist, an occupational therapist, a speech language pathologist (SLP), a dietitian, a social worker, and maybe others who follow their case. Everyone meets every morning to discuss every case in the unit to keep each other updated on patient conditions, and collaborate to determine if other disciplines should get involved to better care for the patient. This also gives us interns a great opportunity to learn from these other disciplines, who also have their own students and are usually more than happy to have an extra couple tag along to observe their work. We've watched a few swallowing and language assessments from SLPs including two barium video fluoroscopies (where the patient drinks/eats something with barium in it, and their swallowing is x-rayed so that the SLPs can watch the video back and see whether the person is swallowing correctly).
Over the last 3 weeks, I've seen a lot of progression and growth - both my own, and my patients. It's been really cool to see stroke patients progress in their treatment and eventually get to go home. In the first week we met a man who was a retired physician and had had a stroke. He was receiving feeds through nasogastric tube (the up-the-nose down-the-throat kind) and wasn't making much sense when he talked. His language skills had been greatly affected - speech slurred, having difficulty finding the right words to use. When he could speak coherently, his cognitive ability seemed to be pretty impaired. This week he was eating pureed and thickened foods (a BIG deal to graduate from feeding tube to swallowing your own food!) and was talking clearly, and able to respond to questions coherently. He told us about his practice as a physician, and was able to participate in his care. Amazing. In my own growth, I've gone from having absolutely no confidence to speak to patients independently and being unsure of everything, to easily walking into patient's rooms and projecting confidence, empathy, and able to provide education to patients without my preceptor even being in the room with me. I'm also doing my own chart notes directly in the patient records, and just needed my preceptor's sign off (because we're students and can't legally sign off our own charts or write orders).
I'm now heading into clinical rotation #2 in musculoskeletal rehab, dealing with spinal cord injuries and disorders affecting muscular or neurological function (like Parkinsons, cerebral palsy and MS). Update to come!
Wednesday, January 29, 2014
Internship Recap: Week 11-14
Holidays have come to an end, but its time for me to start a shiny new rotation!!! This time I'm in my external management rotation (so, still kind of foodservice related :( But it's only 4 weeks, and then it's all clinical for as far as the eye can see!!!)
I'm now at a large food corporation (hmm... not sure if I'm permitted to say which one...) that produces several kinds of convenience foods, such as breakfast cereals, snack bars, pastry products, and others. There are only a few dietitians who work here full-time, but a few others who are here on contract/temporary positions as well. The contract/temp dietitians are working mostly with the regulatory department, which determines what kinds of claims Health Canada will allow companies to make on their packaging, and whether our products meet those requirements. The full-time people work mostly with the health and nutrition department, where they advocate to the R&D and marketing teams to develop and promote the manufacture of products that will promote health, based both on nutrition evidence and an understanding of the marketplace. The company's products become more reputable, because a regulated health professional is somewhere behind it. The dietitians also network with other health professionals (including other dietitians, pharmacists, nurses, etc) to promote the health qualities of the products and encourage them to recommend certain products to their clients/patients when appropriate. This networking also helps the company to gauge how they are perceived by health professionals (e.g. do other dietitians think that we've "sold out" and are only here to make money? Do they understand the role of advocacy in the company to influence what kinds of products are made?)
My project for this month is to do a competitive analysis of the "grain snacks" category (things like granola bars, marshmallow/rice squares, and protein bars). I'm working with three other interns to figure out where our company stands against the major and smaller competitive brands in grocery stores. The marketing people gave us a huge list of all of the "snack" products out there that was pulled from some database, and now we interns have the task of gathering in-depth data on each of them. We've been hunting around grocery stores to find the nutritional info, ingredients lists, what kinds of health claims are being made (such as "this product contains soluble fibre, which helps to lower cholesterol"), if they are peanut free/gluten free/organic/other specialty things, etc. We will then take all that data and create a massive report comparing where our company's products stack up nutritionally against the others - e.g. are we way higher in sodium than others? This information can be used by the marketing and R&D people to figure out market trends, and potentially contribute to development of new products or reformulations of existing products to meet those trends.
For me this project isn't all that exciting, simply because I've done this a thousand times before. Having already completed a business and marketing degree, and worked in sales, marketing and communications for several years before transitioning to a career in nutrition, I've done competitive analyses countless times before. I can do a SWOT analysis with my hands tied behind my back. But, because of my background and understanding of business processes, I've somehow been elected the leader of this project because the other interns are straight-up nutrition and science people who have never fathomed anything like this before. Using an Excel spreadsheet for data analysis is a completely new experience for some. So, it's not all bad - even though I don't anticipate that I'm going to be learning much about marketing or food industry above what I already know, at least I will have a great opportunity for leadership skills development through this.
I've also figured out that working in industry is absolutely not the job for me. Nothing against the dietitians who choose this area, really, but it's just not for me. I've experienced the business world before and knew then that it wasn't the place for me. I wanted to become a dietitian because I wanted to work with patients in a healthcare environment, not in a cubicle working on marketing projects for food products or on R&D for new convenience products. Other interns have had an awesome experience at their industry placements, so I absolutely wouldn't call this a waste of time or discourage people from taking the experience - some people who thought they would never enjoy industry ended up loving it!
We're wrapping up here this week, and soon the day I've been waiting for all this time will come ---- CLINICAL ROTATIONS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1 *SQUEAL!*
I'm now at a large food corporation (hmm... not sure if I'm permitted to say which one...) that produces several kinds of convenience foods, such as breakfast cereals, snack bars, pastry products, and others. There are only a few dietitians who work here full-time, but a few others who are here on contract/temporary positions as well. The contract/temp dietitians are working mostly with the regulatory department, which determines what kinds of claims Health Canada will allow companies to make on their packaging, and whether our products meet those requirements. The full-time people work mostly with the health and nutrition department, where they advocate to the R&D and marketing teams to develop and promote the manufacture of products that will promote health, based both on nutrition evidence and an understanding of the marketplace. The company's products become more reputable, because a regulated health professional is somewhere behind it. The dietitians also network with other health professionals (including other dietitians, pharmacists, nurses, etc) to promote the health qualities of the products and encourage them to recommend certain products to their clients/patients when appropriate. This networking also helps the company to gauge how they are perceived by health professionals (e.g. do other dietitians think that we've "sold out" and are only here to make money? Do they understand the role of advocacy in the company to influence what kinds of products are made?)
My project for this month is to do a competitive analysis of the "grain snacks" category (things like granola bars, marshmallow/rice squares, and protein bars). I'm working with three other interns to figure out where our company stands against the major and smaller competitive brands in grocery stores. The marketing people gave us a huge list of all of the "snack" products out there that was pulled from some database, and now we interns have the task of gathering in-depth data on each of them. We've been hunting around grocery stores to find the nutritional info, ingredients lists, what kinds of health claims are being made (such as "this product contains soluble fibre, which helps to lower cholesterol"), if they are peanut free/gluten free/organic/other specialty things, etc. We will then take all that data and create a massive report comparing where our company's products stack up nutritionally against the others - e.g. are we way higher in sodium than others? This information can be used by the marketing and R&D people to figure out market trends, and potentially contribute to development of new products or reformulations of existing products to meet those trends.
For me this project isn't all that exciting, simply because I've done this a thousand times before. Having already completed a business and marketing degree, and worked in sales, marketing and communications for several years before transitioning to a career in nutrition, I've done competitive analyses countless times before. I can do a SWOT analysis with my hands tied behind my back. But, because of my background and understanding of business processes, I've somehow been elected the leader of this project because the other interns are straight-up nutrition and science people who have never fathomed anything like this before. Using an Excel spreadsheet for data analysis is a completely new experience for some. So, it's not all bad - even though I don't anticipate that I'm going to be learning much about marketing or food industry above what I already know, at least I will have a great opportunity for leadership skills development through this.
I've also figured out that working in industry is absolutely not the job for me. Nothing against the dietitians who choose this area, really, but it's just not for me. I've experienced the business world before and knew then that it wasn't the place for me. I wanted to become a dietitian because I wanted to work with patients in a healthcare environment, not in a cubicle working on marketing projects for food products or on R&D for new convenience products. Other interns have had an awesome experience at their industry placements, so I absolutely wouldn't call this a waste of time or discourage people from taking the experience - some people who thought they would never enjoy industry ended up loving it!
We're wrapping up here this week, and soon the day I've been waiting for all this time will come ---- CLINICAL ROTATIONS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1 *SQUEAL!*
Monday, December 16, 2013
Internship Recap: Week 8-10
Wheeeeeeeeeeee!!!!!!!!!!!!! Foodservice rotation is DONE :D!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Honestly, it's not that it was really all that bad. I even learned stuff. But after 8 straight weeks, I'm ready for a change of scenery. And, of course, a 2 week vacation :D
Week 8
Coming back after a week of breaking away from foodservice for research, I was ready to get crackin'. Well. It seems that I cracked too hard. I finished all of my projects by Wednesday... and I still had a week and a half to go :/ Oops. The inventory thing? Done. The puree taste panel? Finished that last week. Salad project? Completed it by Friday, just had to finish up the final write up and hand 'er over early in week 9. I also did a bunch of presentations to explain the results of a recent patient satisfaction survey to anyone involved in foodservice (dietary aides, supervisors, belt line assembly staff) at all of our sites. There are 6 of them. Some of them had me traveling over an hour away. But whatever - also done :)
With nothing much to do but sit on my hands, I asked my preceptor for something - anything - to keep me from going crazy. After looking at the competencies that I hadn't yet had much practice in, sadly, there still wasn't much that she could give me that would give me those experiences. But she did give me some work to do that should take me at least a couple of days. It's something similar to the cart maintenance policy that I did in my last half of the foodservice rotation, so I guess I'll be a rockstar at developing occupational health and safety policies by the end of this... This time, I developed an occupational health and safety audit checklist, so that supervisors can inspect each area of the kitchen and prep area for hazards, and address things before they become big problems and pose a safety risk for employees. The hospital does a similar audit annually, but this way they can do it within the foodservice department on a more regular basis to prevent these hazards in the first place.
Best part of the week - we had another education session on Friday with an RD who works in the diabetes clinic, who taught us about nutrition treatment and medication therapies for type 2 diabetes. Most of this is stuff that we learned in university, but she got a bit deeper into how to counsel a patient in an outpatient setting and gave us case studies to work through. It was awesome :D I was already pretty interested in working in diabetes education (not sure if it would be in an outpatient clinic, or as part of another role like Family Health Team, renal/endocrine clinics, etc), but this just solidified how much I enjoy working in this area. It got me all excited to go to my diabetes placement - until I remembered that I won't actually be there until March. :(
Week 9
LAST WEEEEEEKKKKK!!!!! All projects were done and handed in to my preceptor by Tuesday morning except for the health and safety checklist, which was finished on Thursday. Friday morning, I handed everything in, said one last goodbye, and was OUTTA THERE!
Similar to last week, we had another diabetes education session on Friday, and also participated in a lunch and learn earlier in the week with a physician who presented her findings from a recent study about the prevalence of malnutrition in Canadian hospitals. *squee* Clinical just makes me so happy :)
Week 10
Currently starting it, and it is yet another research week. But, it turned out that this research week came at an extremely convenient time for me... See, I'm supposed to be researching about stroke and hypercholesterolemia and all that, but it was replaced with researching about something else.....
He proposed!
Chances are that I won't get back to the blog over the next few weeks due to holidays, general busyness and, well, wedding planning (WHAAAT?!?!?!). So - happy holidays and happy new year to you all! I'll be back in January with a brand spanking new rotation (!!!!!!!!!!!) and maybe even some exciting wedding updates!
Saturday, November 30, 2013
Internship Recap: Week 5-7
Already 3/4 through my foodservice rotation!!!!!
Week 5
This week I started the second half of my foodservice rotation, moving over to another hospital and a new preceptor. This hospital's focus is on rehabilitation (from musculoskeletal injuries, cardiac rehab, stroke and brain injuries, and others), and their patients tend to stay in hospital for a lot longer than they would in an acute care facility (like where I was before). In most hospitals, patients stay for an average of 4-7 days or so - here, patients may be there for 2-4 months, sometimes longer, sometimes for years. As a result, the foodservice needs for this facility are very different than what I saw in my last rotation!
This time around, my projects don't involve any shadowing (yay!!!), but do involve a lot of work from a cubicle. So, once again, if nothing else, I'm definitely learning that I made the right choice in escaping the business world because working in a cubicle is really, really, not for me! My projects this time around include figuring out the costing of producing some of our salads in-house instead of outsourcing (the rest of the hospital network outsources and gets boxed pre-made salads, but since our patients are here for a very long time, we'd like to give more variety wherever possible), and running a tasting panel of some new puree entrees for our special neuro rehab patients (again, trying to give more variety). I'm also working with another intern on updating the inventory system at the hospital. This facility was recently taken over by the hospital network and, thus, will be taking on the same ordering and inventory systems. Again because the foods served here are different than the other hospitals because its such a different population, the current inventory system just isn't making sense with the system they need to move to. So, its up to us interns to make it work. Somehow. Basically we're trying to match up what is being pulled for the belt line with what is actually needed for the trays. Somehow this wasn't done before, at least not very well. Goodie.
Meanwhile, as I was getting these projects started, I was also finalizing the projects from my last rotation. I had a meeting with the foodservice supervisors to review my recommendations for the dietary aide job descriptions and present my draft re-writes. For the most part it went well, but the supervisors challenged me on a few things (sometimes with valid reasons, sometimes due to a fear of change, sometimes the fear of change was actually a valid reason...). I was able to handle the conversation so that it didn't escalate too far out of control, and we had a productive session in the end :) My preceptor told me later that I handled the challenging people/situations extremely well, and had done a great job overall. So, yay!
Week 6
With a week under my belt, I was able to get pretty far with my projects and actually finish a few things already. I held my tasting panel on Thursday with the puree items - which were surprisingly more tasty than you'd think (and definitely more tasty than they looked...), and am already done the data entry, analysis, and report. I've also gotten the pricing of salads that we're currently buying, the pricing of raw materials, staff hours needed to make them, extra materials and equipment, etc etc etc... -- just have to put the pieces together to figure out which is the better deal for us. I also had a visit from one of the suppliers, who wanted to give me samples of diced cucumber. Um, I know what a diced cucumber is, thank you - but I will take your free vegetables anyway :D The inventory stuff remains a mystery, but I've done what I can for at least one week of our 3-week menu cycle...
Other neat things this week: I attended an education session with a group of dietitians who had recently attended a conference. Apparently when people go to conferences related to practice, they almost always present a conference debriefing to share what they learned with their colleagues. Some of us interns went over (it was off-site) to hear about the diabetes and vascular disease conference, and I'm so glad we did. It was awesome! Maybe it was only super exciting for me because I haven't heard anything about clinical nutrition in months, but it was great :) Some of the sessions focused on counselling skills and psychology, others dealt with new medications and therapies, and others reviewed population health studies and strategies from international presenters. I took lots of notes and asked lots of questions, and I feel like I took a lot out of the session. I'll definitely keep my eyes open for more of these conference debriefing sessions!
Week 7
This week was actually a research week instead of a work week! We're starting to do our literature review and critical analysis for our major research project. So, unless there were meetings to attend, I didn''t actually have to go to the hospital - in fact, I only had to go in once. On research weeks, I can be in my pajamas with tea and still technically be at work :D hooray! But because I'm terribly easily distracted at home, I packed up my stuff and wandered around between the various coffee shops in my neighbourhood instead. Somehow I'm more productive when outside of the house (and well-caffeinated :P). Our research project is basically doing a gigantic literature review to see what the evidence is for dietary recommendations in certain populations/in prevention or treatment of certain conditions. My topic is investigating the evidence for recommending a reduced saturated fat intake for stroke prevention. From what I've found so far, there's lots of evidence surrounding reduced saturated fat intake/greater mono- and polyunsaturated fat intake for cardiovascular disease prevention in general, but not a lot that deals specifically with stroke prevention. The research I have found so far has been pretty interesting so far.
For the next couple of weeks, I'm back to my foodservice rotation and FINISHING IT!!!!!!!!!!! Then, one more research week, and VACAY :D!!!!! Erhmahgerd!!!
Week 5
This week I started the second half of my foodservice rotation, moving over to another hospital and a new preceptor. This hospital's focus is on rehabilitation (from musculoskeletal injuries, cardiac rehab, stroke and brain injuries, and others), and their patients tend to stay in hospital for a lot longer than they would in an acute care facility (like where I was before). In most hospitals, patients stay for an average of 4-7 days or so - here, patients may be there for 2-4 months, sometimes longer, sometimes for years. As a result, the foodservice needs for this facility are very different than what I saw in my last rotation!
This time around, my projects don't involve any shadowing (yay!!!), but do involve a lot of work from a cubicle. So, once again, if nothing else, I'm definitely learning that I made the right choice in escaping the business world because working in a cubicle is really, really, not for me! My projects this time around include figuring out the costing of producing some of our salads in-house instead of outsourcing (the rest of the hospital network outsources and gets boxed pre-made salads, but since our patients are here for a very long time, we'd like to give more variety wherever possible), and running a tasting panel of some new puree entrees for our special neuro rehab patients (again, trying to give more variety). I'm also working with another intern on updating the inventory system at the hospital. This facility was recently taken over by the hospital network and, thus, will be taking on the same ordering and inventory systems. Again because the foods served here are different than the other hospitals because its such a different population, the current inventory system just isn't making sense with the system they need to move to. So, its up to us interns to make it work. Somehow. Basically we're trying to match up what is being pulled for the belt line with what is actually needed for the trays. Somehow this wasn't done before, at least not very well. Goodie.
Meanwhile, as I was getting these projects started, I was also finalizing the projects from my last rotation. I had a meeting with the foodservice supervisors to review my recommendations for the dietary aide job descriptions and present my draft re-writes. For the most part it went well, but the supervisors challenged me on a few things (sometimes with valid reasons, sometimes due to a fear of change, sometimes the fear of change was actually a valid reason...). I was able to handle the conversation so that it didn't escalate too far out of control, and we had a productive session in the end :) My preceptor told me later that I handled the challenging people/situations extremely well, and had done a great job overall. So, yay!
Week 6
With a week under my belt, I was able to get pretty far with my projects and actually finish a few things already. I held my tasting panel on Thursday with the puree items - which were surprisingly more tasty than you'd think (and definitely more tasty than they looked...), and am already done the data entry, analysis, and report. I've also gotten the pricing of salads that we're currently buying, the pricing of raw materials, staff hours needed to make them, extra materials and equipment, etc etc etc... -- just have to put the pieces together to figure out which is the better deal for us. I also had a visit from one of the suppliers, who wanted to give me samples of diced cucumber. Um, I know what a diced cucumber is, thank you - but I will take your free vegetables anyway :D The inventory stuff remains a mystery, but I've done what I can for at least one week of our 3-week menu cycle...
Other neat things this week: I attended an education session with a group of dietitians who had recently attended a conference. Apparently when people go to conferences related to practice, they almost always present a conference debriefing to share what they learned with their colleagues. Some of us interns went over (it was off-site) to hear about the diabetes and vascular disease conference, and I'm so glad we did. It was awesome! Maybe it was only super exciting for me because I haven't heard anything about clinical nutrition in months, but it was great :) Some of the sessions focused on counselling skills and psychology, others dealt with new medications and therapies, and others reviewed population health studies and strategies from international presenters. I took lots of notes and asked lots of questions, and I feel like I took a lot out of the session. I'll definitely keep my eyes open for more of these conference debriefing sessions!
Week 7
This week was actually a research week instead of a work week! We're starting to do our literature review and critical analysis for our major research project. So, unless there were meetings to attend, I didn''t actually have to go to the hospital - in fact, I only had to go in once. On research weeks, I can be in my pajamas with tea and still technically be at work :D hooray! But because I'm terribly easily distracted at home, I packed up my stuff and wandered around between the various coffee shops in my neighbourhood instead. Somehow I'm more productive when outside of the house (and well-caffeinated :P). Our research project is basically doing a gigantic literature review to see what the evidence is for dietary recommendations in certain populations/in prevention or treatment of certain conditions. My topic is investigating the evidence for recommending a reduced saturated fat intake for stroke prevention. From what I've found so far, there's lots of evidence surrounding reduced saturated fat intake/greater mono- and polyunsaturated fat intake for cardiovascular disease prevention in general, but not a lot that deals specifically with stroke prevention. The research I have found so far has been pretty interesting so far.
For the next couple of weeks, I'm back to my foodservice rotation and FINISHING IT!!!!!!!!!!! Then, one more research week, and VACAY :D!!!!! Erhmahgerd!!!
Sunday, November 10, 2013
Internship recap: Week 3-4
Hey guess what?? My first foodservice rotation is officially DONE!
Week 3: This week I was, again, mostly shadowing the dietary aides. I managed to get out of doing all 5 remaining shifts because I went into the hospital last weekend to do one, which turned out to be not that much different than what happens during the week. Plus, my preceptor has been pretty adamant about making sure that I actually have a life outside of the hospital, and has been encouraging me strongly to take a day (or more) off since I've been working lots of overtime and that extra weekend day. So - day off :D! I spent the morning catching up on all the housework I've been neglecting over the last few weeks. I also managed to get in a Friday afternoon off to make up for all that overtime. Long weekend, yay!
Having some time off also gave me the opportunity to do some reflective writing, something that is highly encouraged for interns for a few reasons. One - it helps you to remember things, and to look back later and remember what you learned. This becomes useful when you have to do evaluations (which seems to be constant). Two - it helps you to really understand what you experienced. Though I'm currently in my foodservice rotation, I've learned lots about patient-centred care through my experience following the dietary aides around, and come to understand the importance of excellent communication and understanding between disciplines. Three - it helps to encourage self-directed learning. Similar to reason two, reflective writing is helpful to show what you've learned, but what you have left to learn or expand on as well. I've learned about interprofessional communication from the dietary aide's perspective, but have yet to see the same issues from the other side of the desk and gain a better understanding of how communication lines can be opened, and hopefully impart some of my wisdom from the foodservice perspective on the clinical end :)
Week 4: LAST WEEK!!!!!!!!! My preceptor was away on Thursday and Friday out of town, so I actually had to get almost everything pretty well DONE by Wednesday. Ummmmm, impossible? Yes. Sadly this meant that I couldn't get everything quite done on time for my last day in this rotation, since the last bits of my projects would need my preceptor's approval before they rolled out. But, one of the neat things about having 8 weeks of internal foodservice management split between two preceptors is that there is flexibility. For the next week, I'll be kind of split between my previous preceptor and new one, finishing off the last of my current projects and getting started with something new. The only thing I really have left to do of my current projects is follow up with staff - I've done my job descriptions and changes, and finished my maintenance policy. All I need to do now is present it to the supervisors and staff, get their feedback and make final changes. Presto chango, projects complete!
So, final thoughts on the first internal foodservice management rotation:
I'm still not convinced that I want to become a foodservice dietitian; I have a business background and understand management pretty well, but I'm interested in being involved in patient care. However, I did find that I could still find a way to be involved in patient care through these projects, despite being in a cubicle. I was pretty surprised about that, and it made me more excited to complete these projects to the best of my ability. I'm intrigued and excited about what will happen in my next management rotation, as I'm going to a hospital that is in a period of transition with their foodservice operations, and I'm sure that I will find lots of opportunities to be involved in improving patient care and satisfaction during the next 4 weeks.
Week 3: This week I was, again, mostly shadowing the dietary aides. I managed to get out of doing all 5 remaining shifts because I went into the hospital last weekend to do one, which turned out to be not that much different than what happens during the week. Plus, my preceptor has been pretty adamant about making sure that I actually have a life outside of the hospital, and has been encouraging me strongly to take a day (or more) off since I've been working lots of overtime and that extra weekend day. So - day off :D! I spent the morning catching up on all the housework I've been neglecting over the last few weeks. I also managed to get in a Friday afternoon off to make up for all that overtime. Long weekend, yay!
Having some time off also gave me the opportunity to do some reflective writing, something that is highly encouraged for interns for a few reasons. One - it helps you to remember things, and to look back later and remember what you learned. This becomes useful when you have to do evaluations (which seems to be constant). Two - it helps you to really understand what you experienced. Though I'm currently in my foodservice rotation, I've learned lots about patient-centred care through my experience following the dietary aides around, and come to understand the importance of excellent communication and understanding between disciplines. Three - it helps to encourage self-directed learning. Similar to reason two, reflective writing is helpful to show what you've learned, but what you have left to learn or expand on as well. I've learned about interprofessional communication from the dietary aide's perspective, but have yet to see the same issues from the other side of the desk and gain a better understanding of how communication lines can be opened, and hopefully impart some of my wisdom from the foodservice perspective on the clinical end :)
Week 4: LAST WEEK!!!!!!!!! My preceptor was away on Thursday and Friday out of town, so I actually had to get almost everything pretty well DONE by Wednesday. Ummmmm, impossible? Yes. Sadly this meant that I couldn't get everything quite done on time for my last day in this rotation, since the last bits of my projects would need my preceptor's approval before they rolled out. But, one of the neat things about having 8 weeks of internal foodservice management split between two preceptors is that there is flexibility. For the next week, I'll be kind of split between my previous preceptor and new one, finishing off the last of my current projects and getting started with something new. The only thing I really have left to do of my current projects is follow up with staff - I've done my job descriptions and changes, and finished my maintenance policy. All I need to do now is present it to the supervisors and staff, get their feedback and make final changes. Presto chango, projects complete!
So, final thoughts on the first internal foodservice management rotation:
- Though I wasn't entirely convinced that I would be learning things by shadowing the dietary aides for the majority of my rotation, I ended up learning tons. I saw the care that aides put into their meal delivery and interaction with patients, and I saw the frustrations that prevent them from doing their job to their greatest potential. I learned that even something as simple as delivering a meal tray can be an opportunity to deliver patient-centred care, and can make a huge difference in the patients' experience in hospital. And, something as seemingly simple as delivering a meal tray provides an opportunity for interdisciplinary communication and teamwork to give patients the best care possible.
- While learning from the aides and the delivery portion of foodservice, I also saw the managerial side. I came to understand management's role in foodservice, from production all the way to dishwashing after service. Similarly to learning from the aides, I learned from managers about the challenges that they face in making changes to improve patient foodservice - things that I never would have thought of as challenges before, but become a huge issue when you understand the impact that a small change would have on the employees, patients, and food itself throughout service.
- I used this understanding to create the new job descriptions for dietary aides and my maintenance policy. Going into the project, I thought "Well duh, just write XYZ and you're done. Problem solved. Why didn't anyone do this before?". But as I got into the project and started asking questions, I found out why it wasn't done before - things were a lot more complicated than I had expected! In writing the job descriptions and maintenance policy, I had to use this new knowledge to create documents that would be fair to all of the nutrition employees - from the basement to the management - and ensure that patients receive the best possible foodservice delivery (i.e. food is delivered on time, a the right temperature, is acceptable for their dietary needs/preferences, and allows aides the time they need to deliver patient-centred care in every delivery they do).
I'm still not convinced that I want to become a foodservice dietitian; I have a business background and understand management pretty well, but I'm interested in being involved in patient care. However, I did find that I could still find a way to be involved in patient care through these projects, despite being in a cubicle. I was pretty surprised about that, and it made me more excited to complete these projects to the best of my ability. I'm intrigued and excited about what will happen in my next management rotation, as I'm going to a hospital that is in a period of transition with their foodservice operations, and I'm sure that I will find lots of opportunities to be involved in improving patient care and satisfaction during the next 4 weeks.
Sunday, October 27, 2013
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 myhundred 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!
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
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!
Saturday, October 12, 2013
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.
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.
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