The Do’s and Don’ts of Working From Home: A Dietetic Intern’s Perspective

By: Hannah Lundeen

A year ago, when I envisioned my life as a dietetic intern, I was not expecting to spend much of my time in my house. However, as we all are experiencing, times have changed in ways that nobody could have predicted. With the unfamiliarity of the current COVID-19 pandemic, society has been forced to adapt to a new way of living. Having spent the first two rotations of my internship working from home, I have adjusted and found techniques in order to work as effectively as possible.  

Within the first few weeks of working from home, I determined that it would be important to set up my workspace. I learned some good, practical things from a webinar on staying organized given by a University of Maryland faculty member. I knew implementing some of these new tactics would be crucial in order to be the most productive and efficient dietetic intern possible. For instance, with a few simple modifications I was able to maximize my workspace to make working from home a more comfortable experience. To begin, I elevated my laptop using five textbooks. This helped to maintain posture and kept my computer screen within eye level. Additionally, I purchased a keyboard, mousepad, and mouse, all of which made working from a desk easier.

During my second rotation, I came to understand the importance of sticking to a schedule. For this seven week rotation, I had to sign onto my email by 7:30 AM, and I usually finished work and signed off around 5:30 PM. Having never worked a 9-5 style job before, there were several habits I cultivated early in this rotation that helped me work long hours from home. For example, I learned that sticking to a morning routine was extremely important. When looking to create a new habit, integrating it with something you enjoy can help with adherence. For example, I had to wake up around 6:30 in the morning in order to be ready by 7:30. I mentally connected the act of drinking coffee, which is something I deeply enjoy, with waking up. As such, combining my morning routine with an activity that I look forward to made it easier to uphold. 

Additionally, I came to understand how important maintaining good sleep hygiene is. This, perhaps, is even more necessary when working from home. Sleep hygiene is the practice of creating an environment that helps to foster healthy sleeping habits. Though it doesn’t have to, working from home can hinder one’s sleep hygiene if adequate precautions are not taken. I had to learn this the hard way. Within the first three or four weeks of working from home, I had my desk setup in my bedroom. Not surprisingly, I began to develop insomnia and I think that having my desk situated so close to my bed definitely played a major role. Following the onset of these symptoms, I took steps to improve my sleep hygiene. Most notably, I moved my desk from my bedroom to the basement of my house. This change made an immense difference in my ability to get a restful night’s sleep. As such, I now understand that even if one works from home, there are spaces that should remain work-free.

Upon advice from another University of Maryland faculty member, I learned that getting in regular movement or stretching throughout the workday is very important. During our class days that take place once a week, we generally get up and take a break every 45 minutes. However, on rotation days, it can be easy to fall into the habit of not taking breaks and continue working for long stretches of time. Being able to compare how my body felt at the end of class days versus the end of rotation days was reason enough to implement walking breaks every hour in a half. Now I look forward to walking breaks not only to give my eyes a rest but to see the beautiful fall weather as well.

 In conclusion, the COVID-19 pandemic has drastically changed many aspects of day to day living. Although this may not be what I had anticipated pre-pandemic, I have learned tactics along the way that have made working from home a more productive and pleasant experience. The skills gained during this time can be carried with me throughout my career as a future dietitian — no matter where the setting may be.

A Sustainable Approach to Nourishing Our Bodies and Communities

By Jennifer Rivera

Have you ever wondered where the food on your plate came from or how it got there? My community rotation at Farm to School, an organization that connects local produce to students and their families, taught me so much about where food comes from, the benefits of eating seasonally, and how to eat locally. Farm to School promotes consuming food in a way that supports our health and our communities. During this rotation, I learned not only why it is beneficial to eat seasonally and locally, but also about many ways to make positive changes. I will share with you some online tools that help locate seasonal and local produce, and I’ll share some of my firsthand experiences rotating with an organization that supports this idea.

The Catoctin Mountain Orchard – I had the opportunity to visit during my Farm to School rotation.

There are many benefits to eating seasonally and locally. Seasonal produce, which is sold shortly after it has been harvested, is typically fresher and more delicious. When produce needs to travel great distances, it must be picked before it ripens so that it can survive the journey, but local produce is picked when it is ripe and ready to be harvested. This means local produce tends to be fresher due to shorter storage and transport times. Eating by the season also helps provide a variety of nutrients to our bodies throughout the year. Off-season produce found year-round is still tasty and nutritious, but it’s great to include local and seasonal produce when possible.

While choosing seasonal and local foods is beneficial to our diets, it also supports the communities that we live in. Buying foods that are sourced within our community supports local farmers who compete with large chain grocery stores. This is especially important to note as we navigate through the COVID-19 pandemic. During my time at Farm to School,  I was able to listen in on a conversation regarding the challenges local farmers are facing during this time. Eating locally not only helps your local farmers but also may support other jobs in your community. In addition to buying produce locally, you can check out restaurants in your area that use locally sourced foods.

Knowing where your food is coming from is an added benefit of choosing to consume food this way. During my Farm to School rotation, I had the opportunity to visit Catoctin Mountain Farm in Thurmont, Maryland. Here I was able to see for myself how different fruits and vegetables are grown. I spoke to the farmers about their growing practices and learned how much time and effort goes into the growing process, from start to finish.

Kale growing at the Catoctin Mountain Farm in Thurmont, Maryland.

Choosing to eat local, in-season foods is not only good for your stomach but good for your wallet too. Produce that is in season costs less. Be sure to check that out next time you are shopping for groceries! 

Now that we have explored some benefits of eating this way, learning what is in-season around you is a wonderful way to start. The Seasonal Food Guide is a great online tool that will show you what is in season in your state for any month you choose. Shopping at farmers markets is fun and a great way to support the farmers in your community. Along with doing a simple Google search, the National Farmers Market Directory is an online tool that will show you where the nearest farmers markets are located.

The Catoctin Mountain Orchard selling fruits that are currently in season.

Other tips on eating this way include looking for local labels when you are shopping at the grocery store or planning ahead by preserving what is in season, using creative methods like canning or freezing. 

Interning at Farm to School gave me the opportunity to learn more about this topic. It also encouraged me to eat a variety of food with the intention of caring for the environment and community. Starting slowly and making little changes here and there on how we choose to eat can make a big difference. 

 

Interprofessional Teamwork Amid a Global Pandemic

What is the most important skill to have during a global pandemic? Teamwork. We all must come together to reach a common goal, and that is exactly what we did during my interprofessional education (IPE).

What is IPE

IPE trains students from different health professions to work together in order to best help the patient. It allows students to gain a better understanding of each other’s work while also fine-tuning our collaboration and communication skills.

Traditionally, IPE occurs in a clinical setting with all students, professionals, and the patient together in the same room. However, to best follow social distancing guidelines and keep everyone as safe as possible, IPE was turned into a telehealth experience. Not only was I getting experience working alongside other disciplines, I was also getting my first encounter with telehealth. Talk about a robust experience!

IPE as a Telehealth Experience

IPE in itself presents learning experiences and challenges, and adding a telehealth component on top of an already intimidating experience made me exceptionally nervous for my first day. I continued to think about all of the things that could go wrong, such as a spotty connection, people talking over one another, and the logistics of creating a collaborative plan with others without actually being withthem in person. Nevertheless, I moved forward with confidence and completed my IPE experience. Here is how it went:

I first completed an online training with professionals and other students. We went over a tool called a flowsheet which helped us organize our thoughts and hone in on the main problems our patient was experiencing. We also talked in small groups in order to better understand each other’s unique discipline. This helped shape our collaboration efforts. Next, I started seeing patients.

Just before each patient arrived, we prepared by discussing any relevant medical history, lab values and other information. We also created a plan for who would talk first, second, third and fourth. My group decided that our order would be as follows: nurse practitioner student, pharmacy student, dietetics student, then the social work student. We used an interpreter for each patient which presented its own unique barriers, such as words getting lost in translation and remembering to be very succinct, clear and concise when I asked a question.  After hearing the patients’ concerns and their answers to our questions, we were then able to discuss opinions from each discipline’s unique lens. Then, as a team we created an intervention for this patient. We were able to help this patient without ever actually meetingin person – something I never thought I would do prior to this pandemic.

I really understood the benefit of working in a multidisciplinary team when we were discussing possible recommendations for a patient with uncontrolled type 2 diabetes and depression. The team member from social work explained the side effects from certain antidepressant medications. I wasn’t familiar with this and it was good for me to be aware. Conversely, I was able to explain the importance of spreading carbohydrates out throughout the day to help manage type 2 diabetes to the team. Together we were able to share our knowledge and craft a solid plan.

The unique aspects of this experience taught me how important collaboration is. It also gave me more confidence to work in a clinical setting and it showed me how important technology is when faced with unprecedented times such as a global pandemic. You truly never know when you will use certain skills, and we could not have been successful without understanding how to utilize technology and telehealth to create behavior change. I thoroughly enjoyed this experience and I feel comfortable working with an interpreter, collaborating an interdisciplinary team, counseling clients and patients, and using telehealth. With great challenges come unique and amazing breakthroughs, and I can say that at the very least, this pandemic has taught us all that teamwork truly does do wonders.

Digging into the Internship

By Anna Ziegler

Wow, was I excited to hear that I would be working outside all day for my second rotation! I was ready to be out in the fresh, fall air and finding out what sustainable farming was all about. Growing up in the city, I had no experience with farming and had no idea what to expect but was eager to find out. 

During this rotation of the internship, I worked at the Terp Farm in Upper Marlboro and the UMD Campus Pantry. At Terp Farm, Guy and Nicole led my internship partner, Myranda, and me through the process of harvesting sweet potatoes and a variety of peppers. Right away we learned that a lot of hard work goes into efficient harvesting. Even with muddy hands and an aching back, I decided the effort was worth it. This was the first year Terp Farm grew sweet potatoes. Guy said we were his guinea pigs since we were the first interns helping him harvest them. On the first day we harvested 10 buckets full of sweet potatoes and even found one that was the size of my head! 

The peppers we harvested included jalapenos, banana peppers, chileno peppers and poblano peppers. I learned how to tell when each type of pepper was ready to be picked. There was a rhythm of twisting the crops off the vines and cutting off the vines, which I found therapeutic. While Nicole, Myranda, and I harvested, we discussed how important mental health is and how gardening and mindfulness go hand in hand. Gardening can help us disconnect from our daily stressors, focus on the task at hand and reconnect us to nature. 

Terp Farm is a sustainable farming operation, which means it is able to produce crops without compromising the ability of future generations to meet its needs. It is on two acres of land and offers four-season vegetable production that usually is provided to the campus dining halls, catering, Green tidings mobile dining food truck, and donated to food-insecure members of the campus and community. Due to the circumstances with covid-19, all of the crops are now being donated to the UMD campus pantry. During this rotation, I was able to volunteer twice at the campus pantry and it was amazing to see the crops I helped harvest be given out to students and staff members. The Campus Pantry works hard to eliminate food hardships at the UMD College Park campus by providing a variety of good quality and nutritious food. While volunteering there, I helped unpack donations, organized the fresh produce, screened for quality, sorted items, and restocked items when low. The Campus Pantry has a goal of creating a hunger free campus and, with the amount of effort I saw them put in, they are on the road to success. 

Overall, I am so grateful I was able to gain a better understanding of how food is grown and learn about sustainable farming. I had no idea how much work, planning, and patience it took to maintain a farm. Terp Farm puts many efforts towards sustainable farming and strives to protect the health of the environment.  As a future dietitian, I think it is important to have hands-on experience in order to educate the community about local food systems. I left Terp Farm with a lot of mud in my boots but even more knowledge. 

An Unexpected Foodservice Experience

By Hannah Etman and Rachel Eldering

Six months ago, the thought of interning virtually with a detention center never crossed our minds. Being a dietetic intern at a detention center comes with its own set of questions. What roles do dietitians perform in corrections? How will we be able to help? In school, we studied many aspects of dietetics, such as working at hospitals or food banks, but our profession covers so many different areas of life. Without any prior knowledge of the special needs of inmates and the unique challenges of a detention foodservice operation, we were excited to learn all we could about corrections dietetics. Our 3-week rotation took place remotely with Frederick County Adult Detention Center (FCADC). Working from home presented a unique challenge but, ultimately, we found many exciting and surprising takeaways from the experience. 

Foodservice in a corrections facility differs from other foodservice organizations in unique ways. When knives are in use, they must be secured by a “leash” to the leg of a table that is bolted to the floor so they cannot be removed. The kitchen utensils are inventoried three times a day and must be signed out every time they are in use. If a utensil goes missing the center is locked down until the utensil is found. 

FCADC has made precautionary changes because of covid-19, many of which have been in the foodservice department. There is now less staff working in the kitchen to facilitate social distancing. Due to having fewer employees in the kitchen, many meals have moved from scratch-cooking to pre-prepared foods. This can be more expensive, however, it is necessary to keep everyone safe. 

FCADC is a provider for Frederick County’s Meals on Wheels Program. The meals are prepared by two inmates with the help of dietary officers, then other inmates help them tray up the meals. They are able to serve 13 different routes and two meals daily to each client. 

Like many foodservice organizations, FCADC provides special meal options. There are medical diets, such as cardiac, prenatal, and GERD available to inmates that have medical documentation. Additionally, inmates with allergies must have them medically documented in order to receive an allergy diet. The facility also accommodates vegan, vegetarian, and religious diets, and does not serve pork for any meal. Food preferences are not accommodated due to complications that may arise from having differing meals.

Seeing the varying benefits that our projects would bring to FCADC was an exciting and rewarding part of our experience. Initially, we were tasked with creating two infographics, which we entitled The Benefits of Exercise and A Guide to Staying Hydrated. For our first assignment, we created two infographics, entitled “The Benefits of Exercise” and “A Guide to Staying Hydrated.” These were created to be displayed to the inmates through the facility’s television system and had to be designed concisely, only containing information that would be of use to the inmates. A challenge was figuring out exactly what information we had to work with—for example, we discussed foods with high water content for the hydration infographic but ultimately could only list foods served by the facility. 

Two assignments with similar objectives and obstacles were the 3-day emergency menu and the 7-day bagged lunch menu. Both required creating diverse menus out of shelf-stable products for easy service. For the emergency menu, we first planned the meals, then found the total servings of food necessary, and lastly found the required quantities of each product to be purchased. Having an emergency plan is necessary to any foodservice facility, as emergencies do happen and preparation is key. The bagged lunch menu included brainstorming different lunches for inmates to take when they leave the facility for work release or court, meaning the products had to be shelf-stable. There were other requirements to be met for each meal. For example, we could not include peanut butter and jelly sandwiches, each meal was to be around 900 calories, and the meal had to be safe without refrigeration for about 4 hours. These assignments emphasized the use of creativity in menu planning as well as the importance of temperature control and shelf-stability in foods. 

Another project we were tasked with was completing the bread order for the entire facility. These orders are received twice weekly, on Monday and Thursday, and cover all of the bread items on the menu. We were provided the necessary menus and worked to figure out exactly how much of each type of bread would be required based on the projected number of servings. We had to ensure the order covered the meals for inmates, officers, and Meals on Wheels. The quantities for the officer’s meals could be tricky because the number of officers eating changed daily. We learned that it was better to slightly over-purchase rather than not have enough to feed everyone.  

Interning at a correctional facility is something neither of us would have expected prior to the internship, but we are thankful that we were given this opportunity. Having a supportive and attentive preceptor helped make this rotation as exciting and unique for us as possible—she provided great information and stories that will stick with us. We will certainly use the knowledge we gained throughout our internship, as well as into our careers.