-by: Samantha Adas

It was a Saturday morning in August when I opened an email requesting further personal information needed by the hospital where I was to begin my clinical rotation. I immediately thought “What? That can’t be right!” We weren’t supposed to find out about our rotation assignments until the first day of orientation! Yet here I was, the week before my orientation began, with an email indicating that I was starting the internship with my clinical rotation.

It had been over a year since I sat in a Medical Nutrition Therapy class. What did I know? Everyone says clinical is the hardest and most intensive rotation. I remember being genuinely worried.  But before I knew it, orientation week was over and I was walking into my first day of clinical carrying a much too large lab coat in one arm and an outstretched arm to shake the hand of my first preceptor at Holy Cross Hospital.

While I am sometimes still just as nervous as the first day, with each week I have found myself becoming more confident. I’m learning and practicing all at the same time, with the opportunity to apply my new knowledge daily. There isn’t one day where I am not learning or experiencing something new. Calculations that once took up my whole night are becoming easier each day. The support I have had from my preceptors is nothing like the horror stories I have heard previous to my internship. My preceptors push and challenge me, but also are my best resource when I do need help. And they have allowed me to see that it is okay to ask for help! Even dietitians on the team bounce ideas and questions off of each other all of the time.

Prior to my rotation, I was under the false impression that clinical meant next to no patient interaction. The truth is that some patients are not too interested in their nutrition, as they are focusing on a new diagnosis or a medication plan. However, during my rotation at Holy Cross, I have had many great experiences, as well as memorable conversations, with patients.

For instance, I specifically remember an education consult patient I had one day. After an initial assessment I asked him if he followed any particular diet at home and if he’d like to learn more about nutrition and blood pressure. It turned out that this patient and his wife had been wanting to see a dietitian and had so many questions regarding overall nutrition. I was able to affirm lifestyle changes they were already implementing, such as cooking plant based meals, but also taught them hidden sources of sodium and tips to flavor food in different ways.  Leaving this patient’s room I felt that I had helped motivate him to make small changes in his future dietary behaviors. It is these interactions that excite me most and remind me why I chose to pursue dietetics.

One aspect I wasn’t expecting is the amount of exposure to the medical field I have been given. During my rotation I have had the chance to learn about conditions and procedures I’ve never even heard of; for instance, I have witnessed barium swallow studies in infants and even followed around the wound and ostomy nurses. These nurses showed me that they incorporate zinc to promote healing by placing a specific tape produced with zinc and oxide over wound dressings. I didn’t realize how integrated all medical professionals are in practice. As a future dietitian, I now realize how vital this background experience is so that I am well informed. 

As much as I hate to admit it, I went into clinical thinking that I never actually wanted to pursue a clinical career. I even specifically applied to internships with as little clinical as possible because I was so sure it wasn’t what I wanted as a dietitian. I am still unsure where I will end up, this is my very first rotation after all, but I have gained a love and appreciation for this work. I am able to interact with patients each day and experience the excitement and uncertainties that come with working in a clinical setting. It is crazy to me that I will soon begin my clinical staff relief. My clinical rotation, the one I dreaded most and grew to love, will be over. These past eight weeks have flown by, and I am sure the last two will be no different.

-by Isabella Dang

Planning and executing a theme meal from start to finish was a big challenge. Thankfully, with the support of the Holy Cross Hospital, Silver Spring, Food and Nutrition Services (FANS) staff and working alongside my partner, Jackie, the challenge was met with hard work and excitement over pierogies.

Let’s dive right in!

Start

The first step in planning a theme meal is to create an alluring theme and set a date. After talking with the executive and sous chefs, we decided to debut our lunch on Thursday, September 27th. Jackie and I bounced ideas back and forth as we were considering what is “going on” around that time of the month. Here is what we came up with, as well as some things we needed to consider:

Theme Ideas

• Fall Fest/ Harvest→ autumn inspired vegetables: squash, carrots, root vegetables, hardy vegetables, apples etc.
• Oktoberfest→ German-inspired/European- inspired cuisines: pierogies, bratwurst, cabbage, etc.

Considerations

• Acceptability of the food… will customers be attracted to food that is typically not served in the cafe?
• Jackie and I had a personal goal of wanting the entrees to be more plant-based.
• We heard many customers like white rice.
• We heard a good number of customers are vegetarian.
• We wanted to make sure the entrees looked attractive; therefore, we considered the color and presentation of the dishes.
• The executive chef was going to be out of town on the day of our theme meal, so we needed to have everything prepared at least two days before and be in constant communication with the sous chef.

With all of this in mind, Jackie and I tackled pinning down a theme. To be honest, we liked both of our theme ideas. The attractive colors from the fall produce in a harvest theme, as well as the excitement of introducing pierogies and bratwurst to the cafe, made it a hard decision. So Jackie and I decided to combine both themes together to generate: OKTOBER HARVEST.

In the second step, my partner and I developed the menu. After an afternoon brainstorming session, we came up with two entrees and three sides:

1. Sauteed Bratwurst and Cabbage
2. Chickpea Butternut Squash Curry
3. Basmati Rice
4. Pierogies
5. Roasted Carrots, Red Potatoes, Parsnips, and Brussel Sprouts

The executive and sous chefs liked our menu idea! After reviewing some recipes from the internet and tweaking the portions and ingredients, we had our final menu. The sous chef commented that the recipes were straight-forward and the dishes would definitely bring something new to the fall menu rotation. After finalizing the menu and starting on some marketing material, everyone in the office referred to our “Oktober Harvest” as the “big day.”

The third step was all about ordering products. We worked with the executive chef, sous chef, and retail manager. Jackie and I looked over their shoulders as they ordered the products and compared prices. We all talked through how the produce would be pre-cut to reduce labor on the kitchen staff and we went back on forth on how the pierogies would be prepared. Boiled? Fried? Pan-fried? In any case, the kitchen was too busy to do any pierogies testing days before, so we settled on testing the best pierogies-cooking method on the “big day.”

In our fourth step, we created a marketing campaign and the presentation of our serving station. Jackie and I spent hours working on Canva, a design tool, creating our menu, flyers, education material, and recipe hand-outs. We designed our signage with uniform color schemes, fonts, and graphics. After countless drafts and reviewing our material with the retail manager, we had our final products. Our preceptor, the general manager, and one of the RDs were kind enough to advertise our “big day” by sending out e-mails and posting our flyers on the hospital floors.

Finish

Jackie and I arrived in the kitchen at 7 AM for our “big day.” We cut the parsnips, portioned out the ingredient for the curry, adjusted the curry consistency by adding some cornstarch and finished off the morning by testing pierogies. We decided frying the pierogies would be the best approach for service. The decorations were out, signage was up and the food was cooked… it was time to debut!

Jackie and I proudly served meals during lunchtime, between 11:30 AM to 2 PM, and overall, it was a success! We received multiple compliments from customers in person and through e-mail. One customer actually came back for more curry. According to the sales numbers, the retail manager said our event was a hit and customers really like pierogies. Parts of our menu will be featured on their permanent fall menu rotation. I’m not going to lie; being on our feet, hovering over the steam tables, and talking to customers was pretty tiring. And Jackie and I cannot thank the FANS staff enough for the training they gave us and all of their hard work. The successful Oktober Harvest theme meal would not have been possible without all the support and help we received, from all the managers, cooks, cashiers, servers etc. I learned that when you work with a dedicated team, almost any challenge can be tackled together!

 

 

 

-by Adam Sachs

My time as a dietetic intern is coming to a close. It has been almost a whole year since starting this program and my fellow interns and I will soon be starting our careers. Now that I have completed all my rotations and competencies, it is really interesting to look back and take note of all the accomplishments and experiences I have had throughout the year. Thinking back to some of the questions the other interns and I had at the start of the program, I’d like to give some first hand answers that pertain to my experience.

FAQ

Q1: Would I get the opportunity to listen to current research and studies being published in field?

A: Yes! On a very regular basis, the interns would attend class days, conferences, and other special events throughout Maryland. We often were able to listen to lectures about new research and prominent studies in the field of dietetics. Some of the conferences that stick out in my mind were the Johns Hopkins Bayview class day and the DC Metropolitan Academy of Nutrition and Dietetics (DCMAND) annual meeting. The Johns Hopkins class day contained lectures on eating disorder treatment and rehabilitation, dietary management of obesity, and surgical management of obesity. The DCMAND meeting had professionals from all around the DC/Maryland area. The conference had some great lectures on the current state of probiotic research, as well as a new study on protein synthesis related to consumption of dietary protein in conjunction with exercise.

 

Q2:  What event during the internship would really stand out to me?

A: In late April, during my foodservice rotation, my partner Julia and I hosted a Hawaiian luau for the Veterans living at the Loch Raven VA. We designed the menu and cooked all the items to be served to about 40 of the current residents of the long-term care facility. The staff at the VA really put their best foot forward to help us and the veterans seemed to be having a great time. We were busy most of the day, so we did not get a chance to speak to many of them, but later that week, we went around to conduct surveys about the event. There was an overwhelmingly positive reaction towards our event, and it was so amazing to see many of the veterans faces light up when talking about how much they enjoyed our theme meal.

 

Q3: What are some of the ways the internship will prepare me to find a job in the field?

A: One of the best things about this internship is how much exposure I gained in the Maryland area. The UMD internship is not a site-based internship, so we completed rotations all around the state of Maryland, as well as the DC metro area. Every rotation was an opportunity to form a connection with a new preceptor in a variety of dietetic settings. Going from a clinical rotation to a foodservice rotation, then to a technology rotation really allowed me to experience unique perspectives at each location. I found it very helpful to learn from a variety of preceptors at different sites, especially because I was not sure which aspect of dietetics I would like to focus on when I began the internship.

Q4: What will the technology rotations be like and how will they assist me in dietetics?

A: Technology rotations are a unique aspect of this internship. Technology and social media are becoming more integrated in our daily lives as well as the field of dietetics. Our technology rotations really allowed me to see how dietitians can use tech skills to help patients and/or clients. It was great to gain experience creating online nutrition resources, conducting online webinars, and identifying reliable information on the internet. I was able to practice some of these skills during my rotation at the International Food Information Council. One of their main focuses was to create and distribute scientifically backed nutrition information to the general public, which was  especially important given all of the inaccurate information available online. One of the blog segments I worked on examined current fad diets such as the “alkaline diet” and the “Tom Brady diet,” in order to bring to light any unsupported claims or scientifically inaccurate information they contained. During my rotation at Wellness Corporate Solutions, I gained experience with another communications tool; I helped develop a webinar which was designed to allow busy individuals to receive some nutrition and diet education from the comfort of their homes, or during breaks at work.

 

Q5: What will be the most important thing I will learn?

A: One constant concept I encountered in my rotations is that people usually have more going on than just their nutritional status. Dietitians are meant to figure out how a person’s diet is affecting their health and how it can be changed to make a positive impact, but everyone has their own unique set of circumstances that affect how they eat. Not only that, but people are also much more complex than a textbook case of diabetes or heart disease. They may have more than one disease, or their diet may be heavily influenced by their cultural, social, or economical status. Throughout the year, I presented three case studies on real patients I had worked with in my rotations. One of the hardest things to initially wrap my head around was seeing the big picture in a patient’s situation. Looking past just their medical history and delving deeper into what factors of their specific life contribute to their nutritional status. After trying to collect as much relevant information as possible, I could then start to see how to help the patient in a way that will work for them.

Hopefully some of these Q & A’s give you a little more insight into my year as a dietetic intern and have been able to convey a portion of the experience I have had throughout this program. It is hard to believe that I will be graduating about a week from now, but I am looking forward to the next phase of my life in the field of dietetics. I want to thank the internship staff, my fellow interns, and my many preceptors for all the support and guidance they have given me throughout this year!

By: Melissa Talley

Have you ever felt intimidated by reading an abstract? Imagine how it would feel if you were assigned to write one! “I never wrote an abstract before, how am I supposed to do this right?” I thought to myself. As a born perfectionist, I wanted to do everything not only correctly, but flawlessly. When our director mentioned we would be presenting these abstracts at multiple conferences, that made me that much more eager to have an amazing product to share with my peers and judges.  And while writing an abstract, creating a trifold board, and presenting it at various conferences was hard work, the experience was priceless and is something I will carry on with me throughout my career.

Between the months of April and May, my classmates and I were fortunate to display, present, and discuss our abstracts at three different conferences, the MDDHCC (Maryland Dietetics in Health Care Communities) conference,  DC MAND (Maryland Academy of Nutrition and Dietetics), and the University of Maryland Department Poster Day. Through these events, I was able to thoroughly explain my abstract posters and learn how to do so in a timely manner to interested attendees and judges.

After completing this year with abundant experience in abstracts, here are a few things I learned along the way of my abstract developing journey:

Lists

Deciding on a topic was one of the hardest things for me to do. I jotted down a list of possible abstract topics and spent some time reflecting on what would make a great topic. I chose to write about The Fall Harvest Festival because I thought that the combination of local foods and helping college students eat healthier was an interesting topic and it presented a nutritional challenge. Once I selected the topic, I was excited to begin writing.

Drafts, Drafts, Drafts

I wrote numerous drafts to tailor my writing into a polished abstract. Writing drafts not only helped me with grammar, sentence structure, and spelling, but it was a great way to get my ideas out when I was just starting. Abstract writing is different than other forms of writing because you have a limited number of words and have to be concise.  I had to remind myself: I can always cut things out later!

Quality Printing/Paper

Once my abstract was finalized, I started on the poster. A good quality printer and paper makes all the difference, so I gathered my pictures and “large-font” abstracts in one place and headed over to my local university printer. This was important because I wanted to draw my audience in with a visually appealing poster. Having several graphics helped convey a lot of information in a way that people can absorb well. I selected my colors because they were fall-themed since my topics was about the Fall Harvest Festival.

Practice!

Before my first conference, I reviewed my project again and prepared what I would say when someone wanted to talk to me about my abstract. I jotted down a few key notes on a notecard and memorize main points to bring up. Practice makes perfect!

With writing abstracts comes writing skills, strategic thinking, and condensing. The overall experience helped me build those skills along with fostering creativity with making my poster and public speaking skills while presenting. With all of this hard work, I am grateful that I received the training and experience in abstract writing and presentation to carry with me into the professional world after my dietetic internship!