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!)
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.
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 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.
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!
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!
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!