Dietetic internship: inpatient dietetics rotation (so far)

Hi there!
(But actually Monday!)
Today I’m sharing an update on my dietetic internship as I am 8 weeks in (!!). This past week was my first week in outpatient. However, for the prior 7 weeks I was working through the first half of my inpatient rotation. There are many differences between inpatient & outpatient dietetics, but today I’m focusing on the inpatient side of things. Overall, I really enjoyed my experience and look forward to the second half. I learned SO much. Because every job becomes with its pros and cons, I figured I’d share a list of mine. Of course, I am NO expert, so take this information as a reflection on my personal experience.
-Everyday, I felt like I was learning something new. Patients are extremely complex. They often have multiple conditions that each have their own set of rules. It takes a lot of practice and experience to figure out how to prioritize conditions and nutritional problems, but spending time with the inpatient dietitians served me well in this regard.
-I put a lot of my medical nutrition therapy education into practice. Even though nothing is hardly ever by the book, I did get to apply a lot of the things that I learned into my assessments and evaluations. For me, there was less of a focus on counseling in school and more a focus of medical nutrition therapy, so I feel like my education was put to good practice.
-I saw several patients throughout the day. Working inpatients means things aren’t ever dull. It is fast-paced, as patients are continuously admitted into the hospital. Not all patients are at nutritional risk, but most patients need some degree of attention.
-The charting was fun. I know, I know. I probably will HATE charting in the near the future, but I actually really enjoyed writing out the notes for each patient.
-Results of an intervention can be seen soon after initiated.When patients come in malnourished, seeing the sudden changes with proper nutrition is quite amazing. With tube feeding and parental nutrition (nutrition through the veins) particiularly, lab work would show positive results by the next day a lot of the time.
-It’s easier to get in touch with other health clinicians for collaboration and consulting. Everyone is in the hospital for the most part, so a lot of the work is highly interdisciplinary.
-The interventions can seem so temporary. Because most patients are in the hospital for a short time, nutrition therapy sometimes felt like putting a patch on something that needed more attention. It’s always possible to consult an outpatient dietitian for follow-up, but it’s up to the patient to follow-up.
-A patient may be a captive audience, but not always an available audience. Patients see all kinds of health care professionals throughout the day, so they were often busy with someone else when I would go to their room. Hey, what’s another trip up four floors anyways?
-While I made many connections, I found that it’s hard to really get to know the patients. The fact of the matter is it’s better for them if I don’t have much time to get to know them, because it means they are out of their sooner.
-Nutrition is not usually a patient’s top priority while in the hospital. Patients in the hospital are typically dealing with an acute event. While they might could benefit from nutrition counseling at some point, it is likely not what they are worried about at the time.
-Time to give nutrition education didn’t always feel adequate. Patients who are soon-to-be discharged, recovering from surgery, or not feeling their best may not feel ready to receive education. Brief overviews are doable, but it’s nothing compared to a 30-60 minute nutrition appointment. I learned it’s important to do the best I could with limited time, but I know that’s an area I will need to work on.
Personally, I think the pros outweigh the cons. Nutrition therapy is an amazing science that is always growing and expanding. I love the continuous learning and new challenges that come with inpatient dietetics.
I need to do an update soon on the more personal side of going through the internship. In short, I feel pretty good, but do go through brief periods of feeling overwhelmed or less-than-adequate. I need to work on better sleep too!
Let me know if you have other questions!
Now you tell me,
What’s a pro and con of your current job/internship/student life?
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Good eats reel

Anyone else really feeling Friday today?

My sleep has been not-so-great this past week, so I am really looking forward to getting some rest. My church is throwing a Fall into Fun festival on Saturday, but that is all my plans so far. The festival should be a blast- games, tons of local vendors, music, and bounce-y houses. [If you’re located in the Columbia, SC area and want more details, let me know!]

Today’s post is compilation of eats that I had over my blogging break. My eating this past week has been quite dull thanks to being on an elimination diet, so reminiscing with past favorites before I started the elimination diet is doing me some good.  You may recognize most of these from my instagram, but now you have the full story to go with. All of these eats were deeee-licious.

These chicken pitas came from a major craving to get Greek food. When I reminded myself that I could easily put together a dish myself, when had an epic dinner of chicken pitas with feta, onions, lettuce, tomatoes, and homemade tzatziki sauce. 

You know what’s torture? We pass this giant chocolate dipped ice cream cone every time we go to the river front- which is several times a week! I’ve probably hinted at stopping for an ice cream cone 100 times, but we’ve always had our rowdy dog with us. When we finally had the opportunity to stop, I had 0 disappointments. I can’t wait to go back.

This black and bleu salad was a birthday gift from Newk’s Eatery. No, they didn’t personally ask me to stop by, but they rewarded me for being a part of their Round Table Club. Newk’s is one of my favorite restaurants thanks to their big salads, toasted baguette sandwiches, and AMAZING tomato basil soup. I was in the mood for red meat and stinky cheese (I <3 gorgonzola), so this salad was my freebie.

This dinner is called “Terry ate elsewhere”. Haha! For real though, I love making a simple omelet for myself when it’s just me. This guy had lots of dried herbs and gouda cheese. Another perk, Terry hates brussel sprouts, so I got have the other half of the batch to take with me to lunch the next day. 

This salad was the bomb. I would drive back up to Charlotte just to have it again. I had this salad at Vida when I was there for one of my girlfriend’s birthday. The ingredients included “grilled red chile chicken served on a bed of mixed greens with jalapeño bacon, queso fresco, black beans, tomatoes and red onion, topped with cilantro bleu cheese dressing.” Happy tears.

Acorn squash soup (recipe) + sunflower seed butter on toast. I got this jar of sunflower seed butter on sale and it was my first time trying one without added sugar. It’s got a really different taste in my opinion, but I love it in its own way. Perfect for more savory meals. PS I’ve been adding a ton of dried oregano to my meals lately after learning about it’s role in cancer prevention. 

Pumpkin cheesecake baked oatmeal (recipe) via Marina. Inspired by Cora, I made this for breakfast one day last week and loved it! Peanut butter was added during the last minute of baking, because why not add another favorite food to that wonderful line of ingredients?

Bagel! Life is better with bagels. I also posed that little pumpkin right there so it could make the picture. Happy fall, y’all.

Last but not least, this AMAZING breakfast-for-lunch I made after church one day. The pancakes were only mediocre (bad recipe), but the toppings for them made up for it. However, the eggs were insanely good. I added sauteed mushrooms and onions and then topped it with gorgonzola cheese. I was satisfied for hours!

Now you tell me-

What’s a super satisfying meal you’ve had recently?

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Getting more protein at breakfast

Good morning folks. Today we’re talking protein at breakfast.

At the beginning of my internship, I really struggled with finding a breakfast that would hold me over to lunch. Normally I have a chance to eat snack in the mornings, but there are no guarantees. Plus, getting hungry for a snack at 8 am isn’t exactly ideal. One day while skimming through a copy of Today’s Dietitian, I ran across an article about protein at breakfast. I’ve been focusing on getting protein at breakfast for a while now, but this particular article suggested 30 grams of protein at breakfast “to help control appetite, increase satiety, and manage weight.” 30 grams?! For someone who doesn’t eat meat or protein powder at breakfast, 30 grams is a challenge! Here’s the full article.

For the sake of not wanting to eat my arm at 10 am in the morning, I’ve started to focus more on protein at breakfast. With some contemplation, I decided the easiest addition for me was Greek yogurt. I’m not really into yogurt for breakfast (I want warm!), but I could use Greek yogurt to top my usual pancake or oatmeal.

With an abundance of apples from my trip to the apple orchards, I decided to make an apple oatmeal recipe. I used my crockpot to make multiple servings, so busy mornings wouldn’t get in the way of a protein-packed breakfast.

I used this recipe from Sugar Free Mom with a few tweaks. I left out the butter and added two whisked eggs.

With a 1/4 serving of the oatmeal recipe, 1 tbsp of peanut butter, and ~1/3 cup plain Greek yogurt, the total protein amount is about 25 grams protein. Not quite the 30 grams, but much than the 12 grams or so I would usually get.

I want to experiment with homemade turkey sausage for when I want a more savory breakfast too.

Other ideas for adding protein at breakfast: cow’s milk (12 g per cup), soy milk (8 g per cup), cottage cheese (13 g per 1/2 cup), eggs (7 g per egg), peanut flour (5 g per 1/4 cup), whole grain bagel (varies, some have up to 13 g), cheddar cheese (7 grams per 1/4 cup shredded), protein powder (varies among brands), Greek yogurt (~15 g per 6 oz), liquid egg whites (7 g per 1/4 cup), ground turkey (22 g per 4 oz cooked)

So you tell me-

How do add protein to your breakfast?

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