Happy Monday! I hope everybody had a great weekend. Friday, February 19th marked exactly one year since I became a registered dietitian. The last time that I was active on my blog, I was nutrition student and about one month away from starting my internship, or supervised practice. Today, I will talk in more detail about that. For this post to make sense, I'll have to tell you a bit more about my nutrition program and the process for becoming a registered dietitian.
The RD process:
To become an RD, you must do the following:
One of the perks of my nutrition program was that it included all of the core nutrition coursework, my masters classes, and my internship. For many dietitians-in-training, these three (or two, if you don't get your masters degree) components are separate. Having my internship included in my program saved me from the stress of having to find one on my own, since there is about a 50% match rate with dietetic internships. It also meant that my classes and internship overlapped and made me a very busy bee at times.
The Dietetic Internship is designed to make us apply our classroom knowledge to the real world. It exposes us to a variety of settings and teaches us how to be a dietitian once we pass our exam. With the exception a few of our rotations, we stayed at each location for four weeks at at time. There were required rotations (standards for ACEND or the Accreditation Council for Education in Nutrition and Dietetics), and then we had elective rotations where we could choose where we wanted to go.
During my third semester in February of 2014, while I was taking classes full-time, I started my 10-month internship. The rest of this post will discuss each of my rotations in more detail, starting with my community rotation. (I'm sorry there aren't more photos in here, but I did make chevron dividers!)
The RD process:
To become an RD, you must do the following:
- Obtain a bachelor's degree including a specific set of nutrition coursework that is set by the Academy of Nutrition and Dietetics.
- Complete the Dietetic Internship.
- Pass the RD Exam.
One of the perks of my nutrition program was that it included all of the core nutrition coursework, my masters classes, and my internship. For many dietitians-in-training, these three (or two, if you don't get your masters degree) components are separate. Having my internship included in my program saved me from the stress of having to find one on my own, since there is about a 50% match rate with dietetic internships. It also meant that my classes and internship overlapped and made me a very busy bee at times.
The Dietetic Internship is designed to make us apply our classroom knowledge to the real world. It exposes us to a variety of settings and teaches us how to be a dietitian once we pass our exam. With the exception a few of our rotations, we stayed at each location for four weeks at at time. There were required rotations (standards for ACEND or the Accreditation Council for Education in Nutrition and Dietetics), and then we had elective rotations where we could choose where we wanted to go.
During my third semester in February of 2014, while I was taking classes full-time, I started my 10-month internship. The rest of this post will discuss each of my rotations in more detail, starting with my community rotation. (I'm sorry there aren't more photos in here, but I did make chevron dividers!)
My community rotation was the first part of my internship. This portion of our internship went for 11 weeks, but we only went two times per week since we were taking our classes full-time. I was assigned to a homeless shelter in the East Garfield Park neighborhood. This organization that I interned for included two homeless shelters (one male; one female), a food pantry, a preschool, and many other services. I often helped in the food pantry as a personal shopper. Each shopper was paired with a volunteer who walked around with them, often held their food for them, and talked to them while they were shopping. We also kept track of their "points" while they were shopping (each person gets "points" depending on how many members there are in their family) and made sure they didn't go over their allotment. I, of course, encouraged shoppers to stock up on produce, especially since most of the produce was zero points! I also helped in the kitchen by prepping food and serving lunch to the men and taught a few classes. One of my favorite experiences was teaching the preschoolers about healthy snacks. I remember bringing humus for them. All in all, it was a very rewarding experience. I developed bonds with members of the community, especially since the majority of volunteers were from the neighborhood.The organization has flourished in the past couple of years, and I am so happy for them.
My second rotation, clinical, started about two weeks after I finished my classes. At this point, we started going to our rotation five days per week, eight hours per day. The only exception was holidays and attending class every other Monday for seminars. I was finished with all of my coursework except for one masters class, so I took my final class online for eight weeks. I was incredibly fortunate to score my clinical assignment about two blocks away from where I lived. Since our clinical rotation lasted 11 weeks, I was lucky to have a tiny commute.
Clinicals were, in a nutshell, awesome. This rotation was our nutrition classes in the flesh. I was assigned to an RD every day, who I followed around like a puppy dog for the first week. I observed them and started working while they observed me, and then, by the end, I was all on my own. I had my own floors and my own patients. I relied on my preceptors for guidance and to sign my notes, but besides that, I was essentially working as a dietitian. Now, in 2016, I am working in the same hospital and am teaching interns. It's pretty great.
I will probably write a post one day about what clinical dietitians do. In short, we screen for patients who need nutritional intervention (underweight, tube feeders, gastrointestinal cancer, etc), we collect information on them (weight, medical history, medications, etc), we assess them (visit them in their room, talk to doctors, talk to nurses), and then we make our plan (write the tube feeding recommendations, order supplements, discuss further interventions needed with doctors, etc). We also give bedside diet educations, and, in this hospital, we see outpatients. We are also involved with food service, which I'll discuss in my next section.
Clinicals were, in a nutshell, awesome. This rotation was our nutrition classes in the flesh. I was assigned to an RD every day, who I followed around like a puppy dog for the first week. I observed them and started working while they observed me, and then, by the end, I was all on my own. I had my own floors and my own patients. I relied on my preceptors for guidance and to sign my notes, but besides that, I was essentially working as a dietitian. Now, in 2016, I am working in the same hospital and am teaching interns. It's pretty great.
I will probably write a post one day about what clinical dietitians do. In short, we screen for patients who need nutritional intervention (underweight, tube feeders, gastrointestinal cancer, etc), we collect information on them (weight, medical history, medications, etc), we assess them (visit them in their room, talk to doctors, talk to nurses), and then we make our plan (write the tube feeding recommendations, order supplements, discuss further interventions needed with doctors, etc). We also give bedside diet educations, and, in this hospital, we see outpatients. We are also involved with food service, which I'll discuss in my next section.
To my delight, I was able to spend an additional four weeks at the same local hospital for my food service rotation. By this time, I was finished with all of my academic classes was able to focus 100% on my internship.
My food service rotation had the largest syllabus from my program, because there were so many assignments to do. I wrote papers on the department's budget, worked with my preceptor to develop a project on the plate/pellet rotation in the kitchen, did a cost analysis, performed inservices with the staff in the kitchen (talked to them about topics such as organization in the pantries, etc), did multiple test trays (took tray temperatures and tasted the food), created a bulletin board with food safety notices on it, developed a hypothetical patient menu for Labor Day, and made labels to organize the cooler. Each assignment required some kind of a paper to turn in to my program coordinators (as did each rotation, but again, this rotation had the highest paper yield by far). I grew very accustomed to using the laminator and label machine. On top of that, I made outstanding connections at this hospital. I'm very lucky that I'm working here almost two years later!
My food service rotation had the largest syllabus from my program, because there were so many assignments to do. I wrote papers on the department's budget, worked with my preceptor to develop a project on the plate/pellet rotation in the kitchen, did a cost analysis, performed inservices with the staff in the kitchen (talked to them about topics such as organization in the pantries, etc), did multiple test trays (took tray temperatures and tasted the food), created a bulletin board with food safety notices on it, developed a hypothetical patient menu for Labor Day, and made labels to organize the cooler. Each assignment required some kind of a paper to turn in to my program coordinators (as did each rotation, but again, this rotation had the highest paper yield by far). I grew very accustomed to using the laminator and label machine. On top of that, I made outstanding connections at this hospital. I'm very lucky that I'm working here almost two years later!
Towards the end of our school year, we gave our program coordinators a list of our interests and electives that we wanted to do. There are so many different career paths for dietitians, and the Dietetic Internship is a great way to experiment. I chose Public Relations. Others chose pediatrics, oncology, weight loss counseling, CPS (Chicago Public Schools), and community outreach, to name a few.
My PR internship took place in a fancy office in a downtown skyscraper where I worked in a sunny cubicle with unlimited access to cereal, soy milk, and coffee from an expensive machine. Every Friday afternoon, a woman wheeled a beer cart past my cubicle and told me to pick whatever brew I wanted. My preceptor kept me busy with assignments, mostly given to me via e-mail. Instead of walking to work, I stuffed my laptop into my over-sized purse every morning and crammed myself onto the crowded Red Line. I spent the whole day in my cubicle except when I was meeting with my preceptor, looking for cereal, or going to lunch. It was so different from my previous work environment that I didn't know what to do with myself for the first week (except write, of course).
While I liked the busy, upscale work environment, I left my final day knowing that I was unlikely to choose PR for my career. I love to write, of course, but I like to write what I believe. I would find it hard to support food brands that I don't actually like. My favorite part of the internship was weeks later when I went to FNCE (Food and Nutrition Conference and Expo) in Atlanta. My preceptor was very active with putting research together for a presentation there. She gave me assignments that were related to that, and I saw some of my ideas reflected in that presentation in Atlanta. I had a very good relationship with my preceptor, and it was her enthusiasm for PR that made me second-guess, even after I decided it wasn't right for me, whether I should pursue it. For those who enjoy writing and want to make very good money, this is a good way to specialize in dietetics. Could I consider doing something like this one day? Maybe. But for now, I want to work with patients and write what I want.
My PR internship took place in a fancy office in a downtown skyscraper where I worked in a sunny cubicle with unlimited access to cereal, soy milk, and coffee from an expensive machine. Every Friday afternoon, a woman wheeled a beer cart past my cubicle and told me to pick whatever brew I wanted. My preceptor kept me busy with assignments, mostly given to me via e-mail. Instead of walking to work, I stuffed my laptop into my over-sized purse every morning and crammed myself onto the crowded Red Line. I spent the whole day in my cubicle except when I was meeting with my preceptor, looking for cereal, or going to lunch. It was so different from my previous work environment that I didn't know what to do with myself for the first week (except write, of course).
While I liked the busy, upscale work environment, I left my final day knowing that I was unlikely to choose PR for my career. I love to write, of course, but I like to write what I believe. I would find it hard to support food brands that I don't actually like. My favorite part of the internship was weeks later when I went to FNCE (Food and Nutrition Conference and Expo) in Atlanta. My preceptor was very active with putting research together for a presentation there. She gave me assignments that were related to that, and I saw some of my ideas reflected in that presentation in Atlanta. I had a very good relationship with my preceptor, and it was her enthusiasm for PR that made me second-guess, even after I decided it wasn't right for me, whether I should pursue it. For those who enjoy writing and want to make very good money, this is a good way to specialize in dietetics. Could I consider doing something like this one day? Maybe. But for now, I want to work with patients and write what I want.
October came before I knew it, and I only had two rotations to go. My next rotation was an outpatient diabetes rotation, and it was also my favorite. I've never mentioned this before, but I've wanted to specialize in diabetes ever since I took biochemistry while talking my prerequisites. I was fascinated about how insulin works and the differences between the types of diabetes. I told my program coordinators that I was interested in this, and they rewarded me with an outstanding placement.
This practice was on the southwest side of the city and had a large Medicare/Medicaid population. We saw Type 1, Type 2, and gestational diabetes patients. My preceptor was also filling in at the bariatric (obesity) clinic once a week, so I got to help her with counseling and she let me teach a class for bariatric surgery patients. This was the first time in my life that I got to do counseling, and I fell in love with it. My preceptor was extremely helpful in critiquing me and prepared me so well for the outpatients that I see now. In addition to the counseling practice, I used a glucometer for a long weekend (a device that reads your blood glucose levels after you prick your finger), gave myself a saline insulin shot on the side of my abdominal area, and wore an insulin pump (filled with saline) for 24 hours. I learned an immense amount of information from these four weeks, and I can say with full confidence that I want to continue to learn about diabetes and specialize in it. Once I am an RD for two years and get enough hours working with diabetics, I'll be able to sit for another exam and become a Certified Diabetes Educator. I can't wait for that day to come!
This practice was on the southwest side of the city and had a large Medicare/Medicaid population. We saw Type 1, Type 2, and gestational diabetes patients. My preceptor was also filling in at the bariatric (obesity) clinic once a week, so I got to help her with counseling and she let me teach a class for bariatric surgery patients. This was the first time in my life that I got to do counseling, and I fell in love with it. My preceptor was extremely helpful in critiquing me and prepared me so well for the outpatients that I see now. In addition to the counseling practice, I used a glucometer for a long weekend (a device that reads your blood glucose levels after you prick your finger), gave myself a saline insulin shot on the side of my abdominal area, and wore an insulin pump (filled with saline) for 24 hours. I learned an immense amount of information from these four weeks, and I can say with full confidence that I want to continue to learn about diabetes and specialize in it. Once I am an RD for two years and get enough hours working with diabetics, I'll be able to sit for another exam and become a Certified Diabetes Educator. I can't wait for that day to come!
Our final rotation was six weeks, and we also got to choose where we wanted to go. This was our professional rotation. Examples of my friends' placements include clinical rotations with specific focus (e.g. renal), food service for schools, and working with media dietitians in Chicago. I was interested in corporate wellness, and I got lucky again with a great experience.
I was placed in a large hospital system with hundreds of employees who wanted to lose weight. Once a week, my preceptor and I met with the participants in person. We weighed them, gave them nutritional advice, and handed them recipes to try for the next week. Each participant was expected to hand in a food log and list how many times they ate out or ate processed food. I didn't get to help with those logs or recipes since they were already done by the time that I started, but I was able to help with the program for January 2015. We brainstormed weekly challenges (e.g. make bone broth, avoid added sugar for a week, etc). It was a fun, creative internship. When I wasn't weighing or counseling patients, I was working on the 2015 program, helping my preceptor with data entry, or doing e-mail counseling. My preceptor was very influential over the way I eat now. I no longer count my calories but try to eat real foods and avoid processed foods as much as I can. You'll see a lot of that reflected in my recipes!
I was placed in a large hospital system with hundreds of employees who wanted to lose weight. Once a week, my preceptor and I met with the participants in person. We weighed them, gave them nutritional advice, and handed them recipes to try for the next week. Each participant was expected to hand in a food log and list how many times they ate out or ate processed food. I didn't get to help with those logs or recipes since they were already done by the time that I started, but I was able to help with the program for January 2015. We brainstormed weekly challenges (e.g. make bone broth, avoid added sugar for a week, etc). It was a fun, creative internship. When I wasn't weighing or counseling patients, I was working on the 2015 program, helping my preceptor with data entry, or doing e-mail counseling. My preceptor was very influential over the way I eat now. I no longer count my calories but try to eat real foods and avoid processed foods as much as I can. You'll see a lot of that reflected in my recipes!
I remember working from home in my pajamas on the last day of my internship. At the end of the day, I sent my last assignment to my preceptor and completed the final paper of my internship to submit to my program coordinator. I was done, and it felt weird. My program met one final time as a class to fill out paperwork stating that we had finished our internship. About two weeks later, we received an email from the Commission on Dietetic Registration that gave us permission to register for the RD exam. But that is where I will end this post. The RD exam will be for another day. I'll conclude with this:
After our last day of filling out paperwork at class, one of our classmates threw a giant party. We ate, drank, and were merry. I'm still happy to call these girls my friends!
After our last day of filling out paperwork at class, one of our classmates threw a giant party. We ate, drank, and were merry. I'm still happy to call these girls my friends!
Thanks to Lexx for this wonderful photo collage!
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