First Winter, First Clinical

ft: “Let it Go” by Idina Menzel

by: Isabella Dang

As much as I want to be smooth like Elsa and say, “The cold never bothered me anyway,” I can’t. This Californian (yes, me) is not so used to “real” cold.

Since coming back from the holidays, there have been some changes.  I am now a proud owner of a waterproof winter coat and an extendable ice scraper. But the biggest change was the transition into my CLINICAL rotations. (bum, bum, bum) As of today, it will be day 9 of clinical and I’m enjoying every part of it.

I didn’t think I would enjoy clinical this much.

Some of the lessons I have learned so far in this rotation are playing in my mind like the 2014’s Academy Award Winner for Best Original Song, “Let it Go.”

“The snow glows white on the mountain tonight” (Day 1)

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College Park got 9″ of snow the night before my first day of clinicals!

As my car is warming up, my muscle memory is kicking in as I scrape off the ice on my car windows. It’s my first day of clinical and it would be a nightmare if I was late. After an hour commute, I drive up to the quaint Carroll Hospital which sits on a hill at the edge of Westminster, MD. Carroll is “home” for the next 4-weeks.

On my first day, I got my badge, went through a mini-orientation and visited patients with a dietitian. After rounds, check-ups, face-to-face consults, it was time to vigorously take notes on how to chart in Carroll’s electronic medical record (EMR). Thousands of questions later, it was time to go home.

The day flew by!

My mind feels stretched as a lot was deposited into it. After my first taste of clinical, I drove home with an eagerness to drive up the next day.

“Well, now they know” (Day 4)

I forgot a lot of my undergrad Medical Nutrition Therapy.  When the Registered Dietitians (RD) would “quiz” me, I would communicate panicked looks because of my inability to answer some questions. The RDs would chuckle and say, “It’s okay if you don’t know, you’re here to learn.”

And boy, did I learn!

I learned the most powerful answer to give is “I don’t know.” Honesty goes a long way, and as I embraced a growth mindset, I was learning and applying lessons faster than expected. I took notes on everything: terms I wasn’t familiar with, unpronounceable medications, nutrition interventions and names of the nurses who I will interact with. Every bit counts!

 

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This is the pocket notebook I use to jot down notes

Early on, my preceptor taught me how propofol (an anesthetic) affects an RD’s tube feeding calculations. Fun fact, propofol is a lipid solution that adds 1.1kcal/ml. I quickly jotted down this fact and did further research that night. The next day, during critical care rounds, one of the doctors mentioned how a patient is on propofol. He then looked over at me and asked if I knew what propofol was and how it affects tube feeding rates. Luckily I knew the answer to that question! By the end of the first week, I was writing in the electronic medical record and having my notes checked off by the RDs. It’s a great feeling to have your first note critiqued, corrected and signed off

 

 

“Let it go, let it go” (Day 5)

My preceptor:  “I want you to take the lead on this patient.”

Me: (internal panic) “Okay.”

My preceptor: “Great, let’s go!”

I felt awkward knocking on the patient’s door and soon discovered my interviewing skills were rough. After meeting the patient, my preceptor gave me feedback. I communicated having a lot of nerves going in and she assured me they go away the more you do it. I took in her advice and understood how I have to continue to practice, prepare and ultimately get out of my comfort zone.  Let it go!!!!

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I “made it” on to the RD agenda board.

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On my way to see a patient 🙂

 

 

 

 

 

 

 

 

 

Time to see what I can do… test the limits and break through (Day 6)

According to my mini- case study assignment, I need to be the primary dietitian for the case I will present. I will perform an initial assessment, create chart notes and diet instructions, and, if possible do subsequent assessments. “As I initially read the assignment, I worried that it would be an impossible task. But I had to go back to GROWTH MINDSET. Let’s see what I can do. Thankfully, I was able to find a patient who fit my case study criteria.

Applying the “let it go” mentality, I knocked on the patient’s door and walked in prepared and less nervous. I had a great conversation with her, and she is looking forward to seeing me again! I’m excited to monitor and evaluate her progress.

The cold never bothered me anyway (Day 7)

As of writing this blog, it’s been a full 7 days of snow and clinical. Overall, I’ve had a positive experience, but I know not every day will be positive. That’s just reality.

But as long as I’m learning something (or a dozen things) each day, it’s a good day.

I must say, my clinical rotations have sparked something in me that I can’t fully identify yet. Clinical is fun! And as I’m getting more used to it, I’m getting more used to the cold.

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