My Short Experience with A Long-Term Care RDN
My preceptor, Tamara Philpot, MS, RDN, drives over an hour to work each day from the Vandenberg Air Force base to serve the elderly patient population at Valle Verde, a retirement community in Santa Barbara. Tamara completed her internship and received her Masters of Science in Nutrition with The Sage Colleges in Albany, New York. Prior to her internship, she took a year off to work at a WIC center in Georgia where she was a nutrition manager. When Tamara learned she would be moving from Georgia to North Dakota with her husband for his job, she found jobs at Trinity Hospital and at CHI St. Alexius Health. Tamara was happy to escape the -70 degree weather (yes!) of North Dakota for the Central Coast of California when she decided to take the job at Valle Verde.
Tamara is the only dietitian for the Valle Verde community, which means she is responsible for both the clinical and food service management aspects of dietetics. Tamara is adamant that she is much more clinically-minded and never pictured herself taking a role in food service. I’m convinced that she knows everything there is to know about the inpatient setting - oh, and she knows every medication out there. She attributes this to picking up a pharmacy tech job during her senior year of undergrad. Take notes, nutrition majors of all ages!
Tamara enjoys the fast-paced life that inpatient has to offer - specifically in high risk patients where enteral and parenteral nutrition are necessary. She says that she never pictured herself working in long-term care, but that she wanted to expand her horizons and learn from the experience. This will help Tamara stand out and let others know that she is willing and unafraid to try new things.
Clinically, at Valle Verde, Tamara has an average of 3 new admits each day and charts multiple notes per patient. At a census of 60, this is no easy task. Charting for this population is highly regulated and requires notes to be completed at multiple points throughout the patient / resident stay. In regards to food service management, Tamara helps plan menu operations for 3 locations, educates on food safety and sanitation, and manages food service staff. Despite how busy she is throughout the day, Tamara has been such an amazing preceptor. She has a wealth of knowledge in the field and is so happy to share that knowledge with her interns.
From 7 am to 3:30 pm, Tamara is explaining everything she does and why it is necessary and important. As an intern, it’s not only important to observe, but also to understand why things run the way they do. She would have me perform an action and explain why I am doing it. For example, I was calculating tube feeding needs for a patient one morning. When I was finished, Tamara asked how and why I arrived at my numbers. I explained and she agreed. Then, when we went to talk to the patient’s nurse, she and I explained how and why I arrived at these numbers. Tamara made a point to show me that we, as dietetics professionals, need to know that our work is valuable and that we are the experts in nutrition. We should be confident in our reasoning and should relay our findings to other members of the medical team. This testing of my knowledge was not in an effort to put me on the spot. I attribute a lot of my development to her making me verbalize the “why.”
Tamara taught me a lot throughout my rotation and I thought I’d share some of her advice:
• Never stop asking questions and searching for the “why”
and “how”
• Collaborate with nurses and doctors for patient care
• Don’t be afraid of interdisciplinary relations and be sure
to speak up about those things within your scope of
practice
• Prioritize your daily tasks in order to maximize the use of
your time
• Never work for free
• Treat patients and their families how you would want
your family to be treated while suffering
Not only has Tamara been an incredible preceptor, but I have had exceptional experiences with each of my 9 preceptors so far. This is the quality of education that the Cal Poly DI has to offer and I encourage those applying to dietetic internships to look more into the quality of preceptor/intern relations. Your preceptors can determine the quality of education you receive and will also be your network for your future as a Registered Dietitian.