CLINICAL ROTATIONS
I began my ten-week clinical rotation at Frederick Memorial Hospital, in Frederick, Maryland, a little unsure of if I would enjoy clinical, but by the time I left I had discovered a sincere passion for educating and advocating for patients, collaborating with a team of talented dietitians, and working within the Nutrition Care Process framework. I was able to care for a dynamic and heterogeneous population of patients during my time here, providing hints and tricks to prevent weight loss or wasting in patients receiving treatment in the FMH cancer center, as well as dietary education to reduce malabsorption in patients recovering from recent GI surgeries on the Med/Surg floors. I was able to help manage growth and document development for premature babies in the NICU as well as calculate needs and help determine EN/TPN prescriptions for mechanically ventilated patients in the ICU. I was responsible for screening for malnutrition, assessing intake and needs, following up on consults, and providing nutrition interventions for hundreds of patients during my time at FMH. The last two weeks of my rotation were Staff Relief, and I was given two floors to completely manage on my own, during which time I saw approximately 12 patients each day. I also completed and presented a clinical case study about a patient I worked with during my time at Frederick Memorial Hospital. This rotation was a ten-week period of accelerated professional development and helped provide a stable clinical foundation that I will continue building on for the rest of my career as an RD.
University of Maryland Medical Center
02.19.19-03.01.19
I was lucky enough to have the opportunity to spend my two-week "clinical elective" rotation at the University of Maryland Medical Center in Baltimore, Maryland. During this time I spent one week with the trauma RD team, where I learned about the role of an RD in the critical care setting and practiced nutrition support for patients with traumatic brain injuries, spinal cord injuries, and severe multi-trauma after motor-vehicle accidents. I was also able to help provide nutrition interventions for patients with necrotizing fasciitis, on CRRT for renal failure, and ECMO for respiratory failure, while learning about the importance of using evidence-based recommendations for a population with very specific nutrition needs. This was a powerful educational experience and helped fuel my passion for critical care and nutrition support.
My second week at UMMC, I shadowed three outpatient pediatric RDs, with expertise in areas including gastrointestinal, genetic/metabolism, and cardiovascular. I was lucky enough to be able to attend and learn from the President's Clinic, a weekly outpatient clinic with an interdisciplinary team of pharmacy students, medical students, and social work students, with myself as the sole nutrition representative. During this clinic, we worked as a collaborative team to find interventions for complicated pediatric patients. I also got the opportunity to shadow UMMC's metabolic dietitian, observed counseling and interventions for patients with PKU, and learned about MSUD, PA, and LCHAD. Finally, I worked with UMMC's pediatric cardiovascular dietitian, which allowed me to learn more about the unique considerations when providing parenteral nutrition for a pediatric population with very special nutrition needs. This week was an excellent opportunity for me to get some valuable experience working with a pediatric population, and I learned a great amount about providing nutrition support for pediatric patients in this setting.
Children's National Medical Center
03.05.19-03.15.19
During my two-week pediatric rotation at Children's National Medical Center in Washington, D.C., I was able to get exposure to a wide variety of pediatric patients, while shadowing RDs specializing in areas including gastrointestinal, surgical, PICU, and bone marrow transplant. Throughout this time I was able to continue building my pediatric clinical knowledge, strengthen my understanding of current guidelines and recommendations, and even provide some nutrition education for hospital visitors during national nutrition month. I am extremely grateful to have gotten this exposure and I know the experiences I had at CNMC will set me up for long-term success as an RD.
TECHNOLOGY ROTATION
Technology Training Days
08.20.18-06.22.19
Work Samples: Personal Website, Not-So-Natural Podcast (and script), Blog Post #1, Renal App Article, CDS Document, UMD Infographic, and Tech Tools Presentation
In addition to our unique technology rotation, we participate in frequent technology class days as a part of the internships emphasis on Nutrition Informatics and Technology. We also create websites, podcasts, blogs, articles, CDS documents, infographics, manage the UMD DI Twitter and Facebook, and give technology-related presentations.
USDA: Food Nutrition Service
10.01.18-11.16.18
My seven-week technology rotation at the USDA: Food and Nutrition Service (FNS) in Arlington, Virginia, lined up perfectly with the 2018 Team Nutrition Training Grantee meeting, and I was given a large amount of responsibility for preparation in the lead-up to this event. I gathered and organized many of the materials and handouts for the grantee presentations, communicated professionally with all conference attendees in the weeks before the event, and exhibited incredible flexibility to make sure the meeting went smoothly. Finally, I compiled responses from evaluations of this meeting, analyzed the data, and created visualizations to show the results.
Fellow dietetic intern, Stephanie Jean, and I were responsible for familiarizing ourselves with the TNTG PartnerWeb (SharePoint) site, then presenting to the conference attendees about site navigation, contents, and uses. We utilized an interactive quiz app/game to test how much the attendees learned from our presentation. This lesson was a huge success, and many participants said it was the most fun they had all day.
Outside of this event, I evaluated CACFP graphic materials, provided support and assistance for a CACFP webinar with over 1,000 attendees, and met with FNS staff to learn more about their roles and responsibilities. I also drafted two months of tweets for the USDA Team Nutrition Twitter account, reviewed social media analytics for impressions, and utilized page-view software to determine which USDA FNS web pages were the most successful during the 2018 fiscal year.
COMMUNITY ROTATIONS
During our time at Manna Food Center, fellow University of Maryland Dietetic Intern Stephanie Jean and I shadowed Registered Dietitian Jenna Umbriac and learned about how she uses her dietetics experience and education in her role as the Director of Programs & Policy. Jenna explained to us that the purpose of this organization is to fight hunger, reduce food waste, and improve health outcomes. We’ve kept that purpose in mind while we created tools and guides for Manna volunteers, staff, and participants. We constructed new guides to help staff build food boxes for participants following a Kosher diet, as well as participants with diabetes who are following a vegetarian diet. We also made alterations to the vegetarian guides with instructions on how to make boxes fit a vegan diet. These guides will help expand the options for participants with specific dietary needs while saving staff and volunteer time constructing special boxes. We also designed and produced a Volunteer Produce ID Manual, which includes photos and names of many different varieties of fruit and vegetables, as well as information and recipes for Manna participants. This valuable resource will help volunteers identify unfamiliar produce, either by name or by image, and provide box recipients with tips for storage, preparation, and preservation, as well as recipes and nutrition facts. These tools will help reduce food waste and hunger, by providing participants with the knowledge and resources to incorporate the foods they receive into their diet, as well as improve health outcomes, by including items that fit with individual dietary needs. Manna Food Center keeps their community healthy, not hungry, and I’m proud to have been a part of it.
Prince George's County Office on Aging
09.11.18-09.14.18
During early September, I spent one week as a Dietetic Intern at the Prince George's County Office on Aging, with Registered Dietitian Cathy Stasny. Hurricane Florence derailed many of our original plans for that rotation, but I was still able to assist with a nutrition education presentation, participate in a home visit for a local senior receiving weekly frozen meals, and help out with a fish-fry for seniors at the Langley Park Senior Center in Hyattsville, MD. I was also able to get some experience using their database for tracking participant information and program impact, which helped me understand how the Office on Aging demonstrates their value for funding purposes. While this rotation was only one week, I know I was able to take advantage of every opportunity for learning and growth during that time.
During my two-week rotation at Maryland's Food Supplement Nutrition Education (FSNE), I had several opportunities to observe, assist, and lead nutrition education events, as well as create and edit nutrition education materials. We observed and provided assistance for nutrition education events at several elementary schools in Prince George’s County and Baltimore City, Maryland. We were also able to plan, prepare, and perform nutrition education sessions at an elementary school in Howard County, Maryland. I came into this experience feeling a little unsure of my skills in nutrition education, but thanks to the patience and guidance of some skilled educators, I made incredible growth in this area and am confident in my ability to communicate the importance of healthy eating to any audience.
During my time at FSNE, I also created friendly "nutrition nudges" for the FSNE Facebook page, wrote a blog for the FSNE website, and updated electronic resources for the FSNE educators to use during their lessons.
FOOD SERVICE MANAGEMENT
ROTATIONS
Holy Cross Hospital
03.19.19-04.26.19
During a six-week rotation at Holy Cross Hospital, in Silver Spring, Maryland, I gained a better understanding of what it takes to manage a food service operation. We completed several projects, including completion of a recipe analysis for the high-risk pregnancy menu, tabling several promotional events in the cafeteria, a waste audit, and temperature testing patient trays. We also planned, organized, and produced a theme meal, with responsibilities including creating marketing materials, choosing menu items, and serving our meal to the hospital staff. This rotation helped me build a solid foundation in food service management and I know I will be able to use this experience in the future.
Campus Dining, University of Maryland
04.30.19-05.17.19
Throughout a three-week rotation at the University of Maryland Campus Dining, I was able to create an enormous amount of blogs, articles, table tents, posters, and nutrition tips. We also created a presentation meal for the UMD staff members that had assisted us throughout our time in Campus Dining. This rotation was a valuable chance to practice creating informative and eye-catching educational materials and learning about how a university food service system functions.
