1/28/11

1 week down, 12 to go!!



I can't tell you overjoyed I am to be a clinical dietetic intern at St. Vincent's Hospital. I imagined that I would enjoy my acute care clinical rotation but this is beyond my dreams. Considering that I have never been admitted into a hospital for an illness, broken bone or condition, this is all a really exciting (and new) experience for me as a future RD.

Aside from interning, this was a planned recovery week from training. I had to change around a few workouts from my normal routine (due to time constraints of being a clinical intern) but other than that, I was able to get in at least an hour to 75 min of exercise every morning this week. The intensity in my training will increase during the next two week of build, but due to my internship, I will be cautious not to increase in training volume during the week. I only have so much time in the morning to train and I can not sacrifice sleep in the morning hours. Weekends will have an increase in both volume and intensity.
Despite waking up at 4:20am every morning this week (aside from recover day Monday), I have a lot of energy and feel very rested. My day is super long but I never feel depleted or drained. Interning and training could be exhausting but I am making it a priority to be asleep by 9:30pm every night (that means that I am in bed at 9pm) to give me a full 7 hours of sleep. I have not been waking up during the night so I have been waking up feeling super refreshed. Additionally, my diet is key to making sure I have enough energy during the day, as well as recovering as quickly as possible from workouts. I spend 30-60 min a day (from 6pm - 7pm) preparing dinner, as well as my breakfast and lunch for the next day. I typically make my next day lunch, from dinner and while I am preparing the dinner I will also get together several snacks/sides for the next day. I am not able to have a planned snack while interning so I make sure that my meals are as balanced as possible. I also make small snacks (that I keep in the dietary offices) for when we finish reading charts and seeing patients on the floor (ex. carrots, apples, cheese, walnuts). My meals are packed with fruits and veggies so that when it comes to dinner, I do not feel as if I have missed any food groups. Also, I always have a snack for the drive home (30 min), so that when I finish interning I am not feeling starved when I get home. This allows me to take Campy for a run before I start preparing dinner and so that I will want to take the time to make a healthy dinner after a long day of training and interning. Most importantly, by planning ahead and sticking to a schedule that is down to the minute, I feel as if this is routine that I can keep up for the next 13 weeks. I don't live my life on what I "once did" or what I'd "like to" do but rather what "I can do". This allows me to plan for the now and prepare for tomorrow.
A few days this week I sipped on protein powder and water between meals in my water bottle just because I was feeling a little hungry as I was adjusting to my new schedule. Thankfully, my blood sugar doesn't drop very quickly after my yogurt, cereal and fruit breakfast w/ wasa cracker and PB (oatmeal wasn't working for me so I had to change) but I make sure that I do not go longer than 4 hours without eating.

Monday was my first day at St. Vincent's and I was able to meet the kitchen staff and several of the dietary office managers. I also met a few of the dietitians but they were super busy (as always) so I wasn't able to talk long with anyone. I got my parking pass and INTERN badge so I guess I am official in the hospital. With my white lab coat, I fit in very nicely with all of the professional people in the hospital. The dietary manager took me on a tour and she took me to the maternity unit for our first stop. The hospital is super big and I have no idea how I am going to find my way around after my 9 weeks of interning. Since I finish with 4 weeks staff relief, I will be playing "Clinical RD" and will have the same responsibilities as the other dietitians but I just can't sign-off my name in the charts.

Tuesday was an orientation day....just what I needed. One of the RD's (I think there are 7-9 RD's that work at St. Vincent's) spent a few hours with me and 2 other interns (from UNF) discussing the forms and charts, as well as electronic charting, that are used at St. Vincent's. She also went over tube feeding calculations (enteral and parenteral) which was really helpful. After I left on Tues, I felt much more prepared for this part of the rotation.

Wed was a great day but an early one. I was at the hospital at 7am (not 8am, like a normal interning day) to spend the day with the dietary technician. We completed LOS (Length of Stay) forms which involved going to the rooms of patients who had been in hospital for 5 days. We needed to see if they triggered on the nutrition database for being at nutritional risk so we looked through the clipboards (outside each room) to find key information that we could checked off our sheets. We then imputed the information in the charts on the computer (St. Vincent's is 90% electronic charting, aside from physicians notes and orders). I seemed to pick up rather quickly with the information that was presented to me today but still wasn't able to find my way around the hospital all by myself. The dietary tech is super nice so overall, it was a really enjoyable day that went by really quickly. We covered almost every floor, from open heart surgery, infectious disease, ICU, cancer and a few others.

Thurs was my first real clinical day with a RD. The RD that I spent the day with was amazing! I am so excited cause I will be spending a few more days with her next week. I could tell that she had interns in the past because she was able to explain everything to me in a way that I could pick up things, very quickly. I still have a lot of learning to do but with two really challenging cases presented to us (a pt. with hyperemesis at x-weeks pregnancy w/ PPN feeding and another pt with severe abdominal bleeding, N/V, 0% po intake and possible x-cancer) I guess you could say I had a really exciting first day as a clinical dietitian.

Everyone at the hospital is super nice and professional. It is a great environment and I love coming HERE every day (Mon - Thurs)




As for the rest of my life...I DON'T HAVE ONE!!!
When I am not training, interning or preparing meals, I am studying. My life is studying but it is paying off in my weekly Fri/Sun quizzes. I try to stay ahead of my readings and studying so that means a little studying every evening. Karel is starting his racing season this weekend and I am bummed that I won't be with him at his first race. I will also miss the next race but plan to go to his race near my parents in Dade City/San Antonio (Karel loves this race weekend).


I can't believe this is the last part of my dietetic internship and I will be eligible to sit for the National Registered Dietitian exam on May 2nd. I don't plan on taking the exam until late June (so that I can study for at least 4-6 weeks).

I am looking forward to keeping you all updated with this exciting part of my dietetic internship!! Thanks for reading!