Long Term Care

I am doing my Long term care rotation at the same location I did institutional food service at the Long Island State Veteran's Home. I actually really enjoy this rotation and have learned more than any other rotations. I have only been there for 4 days and I am already writing assessments/notes on my own. It also helps that all the dietitians there are VERY helpful and nice. I love working with them... which i believe is important when i find a job. Long term care is nice because you can get to know the residents and follow their prognosis as opposed to a hospital where the turnover rate is much faster. Although clinical has not been my top choice (besides outpatient) I am enjoying long term care. Perhaps because I am actually applying what i have learned in the past few years to my work.

Institutional Food Service

Institutional Food Service is food service at a hospital or nursing home. I already did School food service but they are pretty different. At institutional, all the residents are served 3 times a day. In order to make 1000 meals a day, there are many staffs and tray line. During my rotation, I watched some of the staffs/cooks prepare meals, watched tray line, participated in tray line, and supervised tray line. I watched them make pureed foods and had to taste them as well. I did CQI(continuous quality improvemtn) of tray accuracy and presentation. Personally I dont like food service and i did not particularly enjoy this rotation either. However, I am now during long term care clinical at the same location so it is nice to have the background of the kitchen so I understand how the food is prepared and handled for the residents.
For the module I had to plan a 1 week cycle menu for breakfast/lunch/dinner, make a standardized recipe, create a production sheet (for a meal), and make an order sheet for one meal, and choose a kitchen equipment to purchase. Although I did not enjoy this rotation, i think the experience will help me somewhat for the RD exam.

elective: Eating Disorder

I did my elective back home in san diego. i got to be at an eating disorder clinic called mandometer. this was very interesting since i had never seen eating disorder patients before. I didnt really get to sit in on nutrition counseling because of condientiality issues. but i was able to observe the patients, who are at the clinic all day every day. I attended "lectures" where the rd or md talked about nutrition, eating disorders, etc. i was able to hear first hand what these patients experience. Although this is not exactly my area of interest, i got a lot out of it. This is a lot of psychology, so i think it is beneficial as an rd to understand what these patients go through. I didnt really get to sit in on nutrition counseling because of condientiality issues. but i was able to observe the patients, who are at the clinic all day every day. I attended "lectures" where the rd or md talked about nutrition, eating disorders, etc. i was able to hear first hand what these patients experience. Although this is not exactly my area of interest, i got a lot out of it. This is a lot of psychology, so i think it is beneficial as an rd to understand what these patients go through.

WIC

WIC is WOMEN, INFANTS, and CHILDREN. It's where low income mothers can get food vouchers, nutrition information, etc for themselves, and children.
I was here for 2 weeks. I sat in on "certs" meaning the rd spoke with the mothers and assessed their nutrition status and giving out checks. So i didnt actually get to DO anything. The rotation is nice to see for maybe 2 days max. 8 days is ridiculously long. It helps if you know spanish too.

Outpatient continues

I am almost done with outpatient! Actually this rotation has been by far the best. I have learned a great deal by listening to counseling sessions and actually counseling by myself as well. I also went to an ALS center and got to see ALS/PLS patients and saw the nutrition counseling side of that as well. I sat in on doctor visits for 2 days with a holistic doctor, so I got to see different patients with various diseases and also a different counseling style. Yesterday I sat in on a weight loss program run by the preceptors. I think it would have been interesting if i were there from the beginning of the program and see how people respond. I think I would want to do some outpatient but maybe not as a full time job...
Next post will be WIC!

Food service and community comments =)

I have some comments from an intern from a different internship:

1. Not all school foodservice directors get summers off! I know at Sacramento City Unified they are very busy during the summer with Summer Feeding and preparing for the next year. My guess is the bigger the school district, the busier during the summer.

2. Not all community rotations are awful! I am really enjoying mine in the field of corporate wellness. I give a lot of nutrition presentations to business professionals at their workplace.

Nutrition Counseling-Outpatient Rotation

This week I am doing out-patient...which i love so far!
Tuesday I sat in on nutrition counseling with an RD who is also Certified Diabetes Educator. She had a type 1 diabetic patient. I just listened to the counseling session, which lasted for 1.5 hours. I really enjoyed it. At night I went to her diabetes education session. there was a podiatrist who talked about the effects of diabetes on your feet and then the RD spoke about how to manage your diabetes. There is a useful guide from the American Diabetes Association on exchange lists.
The next day i went to sit in on nutrition counseling with another preceptor who counseled a recently diagnosed type 2 diabetic. I was able to see different counseling techniques. There were lots of no-shows and cancellations on both days so i only got to see one patient each day.
And TODAY i just "educated" (counseled) a patient on my own! it was a little scary but it was kind of fun. I used handouts provided by my preceptor, very helpful. the patient was knowledgeable about nutrition and health conscious so i didnt have too much to say...but it went okay. I was able to make some recommendations- both nutritional and exercise.
I finally feel like im in the dietetic internship!