By: Sina D’Amico
It’s funny how when you start college you are surrounded by new people and places, and over four years you become comfortable; then, post-graduation you once again must begin the same process. As my internship got underway, I found that this unfamiliarity also applied to the learning environment. I had just spent four years in college sitting in a classroom learning what I could theoretically say and do in various situations. This mentality is also applied to your learning environment. The four years of college are spent sitting in a classroom learning all of the “what if” situations that could arise in the field without ever actually experiencing those in person. As a student studying dietetics in college, the core classes focused on implementing medical nutrition therapy in a clinical setting (aka a hospital). Much of my undergraduate curriculum focused on various disease states and how adequate nutrition could be the determining factor in the management or recovery of the specific disease. I was prepared to spend the majority of my dietetic internship immersed in the world of clinical dietetics. The internship is all about getting hands-on experience; taking the theoretical knowledge learned in school and applying it to real, live patients. However, for how uncomfortable I would be in a hospital and talking to patients. I didn’t want anything to hinder my learning experience.
As I walked into my first day of orientation, which just happened to be at a hospital, I was excited about the next 10 months of rotations. I was oblivious to the fact that I could have to start my rotations in a hospital. Although I had not received my actual schedule yet, I was confident and ready to learn more about the different roles of a dietitian. Then it happened: I looked at my rotation schedule and I was set to start in clinical the following week. My calm, cool and collected demeanor immediately switched to feeling anxious and panicking in a matter of seconds. Luckily, that day of orientation just so happened to be at the same hospital where I would be for my clinical rotations – St. Agnes Hospital in Baltimore, MD. Because of this, I was able to meet the dietitians that day, which eased my nerves. Each of the three dietitians assured me that there was nothing to worry about because they were there to answer all of my questions – that did NOT stop me from worrying for the entire next week.
Fast forward one week to my first day of clinical, to say that I was sweating with nerves would have been an understatement. I began shadowing my first preceptor in the Intensive Care Unit (ICU). The critical condition of the patients did not help; my fear of making a mistake added to that uncomfortable feeling. I continued that day observing her interactions with patients and interdisciplinary team members, trying to obtain as much information as possible. I left that day unsure about how the following 12 weeks would play out. My mind was moving at 1,000 miles a minute and was filled with endless questions regarding my ability and, ultimately, my career choice. What would the following 12 weeks hold? Would this anxious feeling ever disappear? How would I be able to talk to patients about their diets when they had much bigger medical problems to worry about?
The days went on and I found myself being unable to shake the anxious feeling that was looming overhead. Then it happened: it was time for my first solo interview with a patient. I had watched my preceptor do this exact thing countless times and knew exactly what I wanted to ask to obtain the information I needed. I started off strong, but then lost my train of thought halfway through and started to panic. Thankfully my preceptor was in the room and jumped in while I collected my thoughts. After we exited the room, my preceptor assured me that I would get more comfortable as I got more experience conducting patient interviews. But would I really?
My rotation went on and I continued interviewing patients. Some got better while others remained uncomfortable and awkward. The dietitians kept up their encouraging words stating that feeling comfortable and confident comes with practice and experience, everything that I was there to learn. This feeling was extremely discouraging for me. I had experience speaking with clients and patients so I was unsure why I was struggling with it in this setting. The more I thought about it, I began to realize I had never spoken to anyone in a hospital setting before. My experience was with speaking to athletes right before or after practices who were always smiling and did not have to worry about anything besides performing their best. I had never been in an environment where patients were being bombarded by countless doctors and nurses and also having a dietitian questioning their eating habits. And in many cases, their nutrition was the last thing these patients were worried about. The more I let myself think about how uncomfortable I felt in these situations, the worse my patient interviews would go. I decided that changing my mentality around the situation might actually change the situation itself.
When it came time for my final weeks with my last preceptor, she talked about how she often got nervous during patient interviews with the dietitians looming over her shoulder in the rooms. Because of this, she wanted me to go into the room alone while she waited outside. I took a deep breath and instantly felt my nerves wash away as I walked into the patient’s room alone. I conducted my interview, still having a couple of hiccups, but not feeling nearly as uncomfortable as I felt in the previous weeks. My preceptor asked how that went as soon and I walked back into the hallway. “A lot better than all of the other ones,” I was happy to report.
We kept this up for the remainder of our time together and I finally started to notice a difference in my confidence in patient rooms. Instead of thinking about how I couldn’t mess up because the dietitian was standing right behind me, I started focusing on my conversation and making it more personal to each individual. Instead of feeling nervous walking into a room, I was confident and ready to tackle the questions I had prepared to ask. I had come a long way from the first day when I could not have imagined ever feeling comfortable enough to conduct an interview alone.
I wouldn’t take it as far as to say that I was completely comfortable with interviewing patients in a clinical setting. However, I was confident in myself and my ability to hold a conversation and share appropriate information. The location of the conversation is not as important as its content. Whether it be in an outpatient office, on a soccer field, or in a hospital room, the premise behind each conversation is similar. You want to learn about your patient or client and relate to them so they will open up to you. So that’s what I did. I learned to get comfortable with being uncomfortable, and it worked.
Now, here I am, finished with my clinical rotation. I survived my staff relief without any problems. I know that I am capable of adapting and getting the job done. These last 12 weeks have been a rollercoaster of emotions but have taught me many valuable lessons about my own ability and the confidence I have in myself. It’s completely normal to feel uncomfortable in a situation, and that feeling might not quickly go away. When this happens in the future, I will lean into it, grow and develop and get comfortable with being uncomfortable. Sometimes that just might be the only answer.