By: Frances Miller
The clinical rotation in the dietetic internship is a great foundation for all dietitians no matter what path they take after the internship. Prior to my clinical rotation, I did not necessarily see myself as a clinical dietitian. By keeping an open mind, I was able to build a good foundation of clinical knowledge that I can use in a variety of positions. By the end of this rotation I found that I enjoyed clinical more than I was expecting, particularly my time in the intensive care unit (ICU).
During my first few weeks I felt I was overloaded with information. During this time I was learning the electronic health record system, brushing up on medical terminology and medications I had not previously seen, and, of course, reviewing clinical information I had learned in undergrad. Overall I found that by taking time at the end of the day to review new or complex information, I successfully absorbed the information that was thrown at me throughout the day. I also spent time reviewing prior to rotations in units with a specific focus such as the ICU, renal, pediatrics, etc. This allowed me to feel prepared and confident in my ability to perform calculations and take on more difficult patients on my own.
Being prepared also meant having the right tools for the job. One of my sites required me to bring my personal computer. It was not required at every site, but I found it helpful to have on hand. This also allowed me to work on projects and homework in the mornings before my official workday started. Since traffic can be unpredictable, I found myself arriving early to my rotation on a daily basis. I used this time preparing my brain. By this I mean I checked my email and worked on clinical homework or projects. This warmup time made it easier for me to feel ready to tackle more difficult information early in the workday. Additionally, I always had buffer time to ensure I was never late to my rotation.
From my personal experience the majority of my preceptors used their phone’s calculator rather than carrying a separate one; however, I still think it is a good idea to bring a calculator. If my phone dies or I have a preceptor who prefers calculators, I will already be prepared. I mainly used this calculator in my two weeks in the ICU. On my first day during rounds, I calculated around seven tube feeding calculations, all of which were calculated correctly. This is something that I did not feel comfortable doing prior to the start of my rotation. I gained confidence by asking questions throughout, spending time reviewing, and being able to complete these calculations on my own!
The thing I struggled most with before starting was determining how I could best organize my papers. I was given several helpful handouts and readings that I wanted to keep on hand. I also had an additional notebook that I used to take notes of things I wanted to refer back to when the day was over. I ended up choosing to bring both a notebook and a binder. I used a few page protectors for handouts that I referred to daily; for others, I used a hole punch and filed them in my binder. I used my notebook to take notes of things I wanted to ask my preceptor or research at home. I learned to make a copy of important documents that I wanted to refer back to after my rotation; this way if they got damaged or worn down I would still have a copy to refer back to.
An additional item that is by no means a necessity, but I used frequently, is my blue light glasses. Clinical dietitians spend a good chunk of the day looking at computer screens. My glasses kept my eyes from tiring out, and also helped me get good sleep even if I was working on clinical homework.
The internship is for learning; the expectation is not that interns will be perfectly clinically competent right away. Preceptors expect interns to make mistakes and learn from them during their rotations. I came to this rotation prepared to ask questions and research what I didn’t know. I learned that being open minded and asking questions even if I felt as though I should have known the answer, showed my preceptors that I was engaged and wanted to improve.