By Melissa Talley
Have you ever loved a job so much that it didn’t feel like work? Have you experienced constant desire to continue helping people because they, of all people, deserve the utmost care? That is how I felt for my entire 10 weeks of clinical at the Baltimore VA Medical Center. While we didn’t have the option to choose where we would spend our longest rotation, I was beyond lucky to have the VA be my clinical experience!
I packed my lunch the night before, picked out my outfit, and showed up an hour early in attempt to cancel out the nerves I was feeling on my first day of clinical. Fortunately my nerves dissipated quickly after I talked with my first patient that day. I felt a sense of relief as I knew this was where I belonged.
The first patient I saw was a challenge. He essentially had no nutritional problems, but per protocol required a nutrition assessment due to the length of his stay. I walked in trying to be as friendly as possible and introduced myself, “Hi, my name is Melissa and I am a dietetic intern. I’m here to talk with you about your nutrition.” So far so good I thought to myself, trying to calm my nerves. That was until the patient opened his mouth, “I don’t care who you are, all I want is a f** full-sized pizza.” I remembered “type two diabetes” from his medical history and noticed “carb-controlled” written in bold on the front of the menu that he was rudely waving at me.” I began asking him what he typically orders in an attempt to calm him down and start a dialogue.
After talking to the patient for a while and explaining the menu, we determined that by eliminating other carbs he was ordering during the same mealtime, he could receive a full pizza. I left the room knowing that he was now content, and also that I had the power to truly help people during their hospital stays. Although, some may not agree that my first encounter was ideal, I learned two very important things: how to react to unhappy patients and that I can work with patients to find ways to make both their health and happiness a priority.
As the weeks went on, I continued to have a variety of encounters with patients. Some were cheerful, talkative, and open to education, while others were hard to get through to or even denied nutrition education completely. However, regardless of the patient’s mood, mine would never change. A major difference at the VA compared to other medical centers is that one typically has more time to build relationships with patients, since their length of stays are normally longer. I came to appreciate this unique difference in a VA and enjoyed getting to know the veterans, which is a rare experience for the typical clinical dietitian. Whether it was checking up on Mr. J with dementia who always had a grin ear-to-ear, or Mr. C who complained about the coffee but always had something nice to say afterwards, or even Mr. W and his wife who were constantly requesting more strawberry Ensures, I woke up every morning looking forward to talking with patients.
While getting to know patients became my favorite part of inpatient, I was fortunate to experience more patient interaction with outpatient work here and there as well. These included oncology outpatient, the MOVE weight management classes, and healthy cooking classes. In these settings I was able to continue building relationships with veterans in a setting other than inpatient.
While I learned more than I could have imagined about disease states, chart writing, medications, and nutrition support during my clinical rotation, establishing relationships and developing rapport is something that will stick with me for my entire dietetic career. Working in the VA is a unique experience that I was grateful to have and the feeling of helping a veteran was indescribable. The pride I felt knowing I was helping them fight for change in their lives is the closest I could have come to repaying them for their fight to change ours.
