Receiving the Green and White Badge: What I've Learned During My Clinical Rotation
It’s such a fun and exciting time in life when you begin your dietetic internship. You’ve dreamt about this moment from the time you started logging those volunteer hours and crying through the endless organic chemistry lectures. You have this moment of gratitude and disbelief when Kati hands you your green and white name tag that reads “Dietetic Intern Cal Poly, San Luis Obispo.” That badge is the symbol of all the hard work you put into the DICAS application, the late nights of perfectly piecing together your community projects, and memorizing the needs of each individual age group. It’s an unbelievable feeling of humility and pride. Since most of you have yet to experience this life-changing event, I want to take a few moments of your time to share two valuable lessons I’ve learned so far during my first few months of the internship.
1. Patients are people, not case studies
I am currently in my clinical rotation at Marian Regional Medical Center. I love working with the interdisciplinary medical team. It is the most empowering experience that I have had the privilege of being a part of. Every morning I get to participate in rounds which is a small meeting with the doctors, nurses, physical therapists, respiratory therapists, social workers, and other members of the health care team. Each discipline works to contribute information about the patient to bring a wholeness to the treatment plan. As I started working with my patients I found myself mostly focused on getting things “right.” I was more concerned with making sure I was documenting information correctly in the charts, asking patients the right questions, and providing the “correct” interventions. In my undergraduate courses it was all about getting the right answer and pinpointing what the diagnosis was for your case study patient. I found myself now in the hospital setting with the same goal; to get the right answer.
After talking with one of my preceptors, I realized that my mindset was completely off. Yes, it is important for me to learn how to chart correctly, determine an accurate diagnosis, and provide appropriate interventions. But the main goal, the reason dietitians do what they do, is to be an addition to the healing process. You are often limited as a dietitian because food can only take you so far in the ICU. However, it is our job as nutrition professionals to care for our patients and help them in any additional way that we can. My new mindset is to gather the information, chart accurately, and then write down all of the ways I know to help this patient. That might be providing a supplement, advocating for tube feeding, providing diabetes education, or just simply lending a listening ear.
For example, I had a patient who was a malnutrition consult. This consult simply means that I need to verify that the patient is or is not at risk for malnutrition. I typically collect the information that I need and work to accurately diagnose moderate or severe malnutrition. This time, I listened to the patient’s needs and found that they were malnourished because they were eating really small meals. I then took my job a step further and provided handouts and additional education on increasing their calories and protein in those small meals. If this was a case study, I would have stopped at the diagnosis. I chose to do what I could to help this patient gain their weight back in a healthy manner. The people in hospitals are not just case studies, they are someone’s grandmother, brother, or child. I can’t encourage you future interns enough to humanize your patients and to always remember that your job is to help, even in your internship.
2. You aren’t just “the intern”
One of the most stressful parts of being in the clinical setting is having to communicate with the other health care team members. I have such a high respect for these disciplines and find myself getting nervous when I have to present information. I fear that my opinion won’t be valid because I’m just “the intern.” I recently expressed this perception to my preceptor and she quickly corrected me. She told me that I already have the knowledge and the understanding that I need. I have gone through a bachelor’s degree that has provided me the information that I need to be a capable nutrition professional. The doctors, nurses and other healthcare team members are confident in the interns and know that the internship is their chance to get the necessary experience needed to be a registered dietitian. My preceptor assured me that the biggest difference between an intern and a registered dietitian is experience. This has changed the way I approach other healthcare team members. I now come with humble confidence when I talk with patients and co-workers. I am aware that I might not yet have all of the experience to provide renal education as elegantly as my preceptors would, but I know that I DO have the necessary background knowledge to provide renal patients with all the information they need to successfully manage their disease through diet.
These two pieces of advice that I’ve shared have been the most influential lessons, thus far. They have changed the way I work in the clinical setting and have changed the way I see my role as an intern. The internship is 100% designed for you to learn, grow and hone your skills. I have grown both personally and professionally through the last few months. I am so incredibly thankful for the interns who I now call my friends, my amazing director, and the opportunity to contribute to the medical team. What an incredibly humbling time it is to be an intern and I am so excited for all of you to have this experience in whatever internship you find yourself in.
