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?

29 thoughts on “Dietetic internship: inpatient dietetics rotation (so far)

  1. Ooh this is really interesting. I’m currently studying my undergrad degree in Nutrition. I’m not sure where I’ll be going with it yet though.
    My current con is that I have to take this terrible genetics paper this semester which is killing me. My current pro is that I’m doing a food science paper which is awesome!
    Megan recently posted…What to do when you feel burnt-outMy Profile

  2. This is going to be such a good resource for anyone getting ready to go in to their internship rotations. And for the rest of us, still very interesting.
    I can see how different people would be drawn to different types of nutrition therapy. Some may really want a chance to develop longer term relationships with their patients, which it sounds like this doesn’t allow for. Yet some may prefer the quicker “in and out” busyness of a day. I know you are still in your early stages and need to continue to keep an open mind (which is great with these pro/con lists), but do you suspect you will want to work in a practice that allows for closer relationships/longer sessions?
    …. I would have also loved the charting. No shame.
    Cora recently posted…Week In Review: Take Care of Your Body and See Your FriendsMy Profile

  3. I can relate to this so much! I always felt the same way in inpatient- it was never the right teaching moment. Going into a patient’s room when they are acutely ill to give them nutrition education always made me feel a little uncomfortable because they had much bigger issues. You’ll definitely see that outpatient appointments allow you to really dig deep with people and nail down their particular problems. It really makes you feel like you can help. Also- I love charting! I love the organization, I love the notes, I love everything about it. No shame in my charting game!

  4. It’s so neat that you were able to get so many different experiences with different patients. I think the high turnover rate would be hard for me too, because I would want to develop friendships and relationships of trust with the patients. It’s neat that you are seeing the big picture and the pluses and minuses of the job, and I love that you came away with so much to be grateful for; charting doesn’t quite sound fun to me, but that’s neat that you loved it so much. 🙂
    Emily recently posted…Fudgy Coconut Chocolate Brownies with Matcha!My Profile

  5. so interesting to learn more about this!
    pro of my student life: being able to take cool psych courses, being involved in clubs that I am interested in
    cons: having to take dumb gen ed classes!
    Lyss recently posted…Link Love 10/21/16My Profile

  6. Having only ever been on the other side of this – and even then just briefly – this was really interesting to read. I can see how it can be frustrating to know you’re only ever getting this little time to work with the individual patients meaning a smaller chance to have a lasting impact on their health/lives.
    At the same time it’s great you still found enough pros to outweigh the downsides that came with inpatient rotation. I’m sure you did help a number of patient after all – every single one counts :).
    I’m already looking forward to hearing about your outpatient experiences come time!
    Miss Polkadot recently posted…Week in review: All over the place.My Profile

  7. I agree with everything you said here! Gonna be honest I already was getting annoyed with charting because my dietitian would let them pile up and give alot of them to me haha.
    I find the major con with working in a hospital is that if you specialize in GI let’s say, I feel as if after a while, the nutrition prescription can get repetitive. However, my internship was In a long term care centre and it was deeeefinitely not repetitive.
    Glad everything went well, can’t wait to hear about your next rotation!
    Stéphanie leduc recently posted…What I ate Wednesday: Are you a Marathon Runner, Sprinter or Procrastinator?My Profile

  8. The pro of student life is the freedom. I love being able to do anything I want after class, which normally ends at around 2:30. I also enjoy seeing my friends every day and going through some tough classes with them. I think the con would be the frustration from midterms, exams, and balancing life on top of everything else!
    cookiesnchem recently posted…Top 100 Awesome Things in Everyday LifeMy Profile

  9. Kate! Thanks so much for sharing your internship. I love reading about internship rotations. I am like you and I enjoy charting. I like to think that someone will come along and read my chart note, and I feel like it’s a work of art when you can be thorough yet succinct at the same time 🙂

    I can’t wait to hear what you think about outpatient since I believe you said that is the area you’d like to work in when you finish.

    I just started a new job in August. A pro would be that it is doing what I enjoy and a con would be just having to learn everything over again…. new EMR, new policies, new coworkers, etc. I’m learning that I’m a creature of habit.
    Sam @ Grapefruit & Granola recently posted…Weekend Recap: JDRF Hope Gala 2016My Profile

  10. I am SO glad you’re feeling like the pros outweigh the cons as that’s so awesome!

    Hmmm.. pros and cons for me right now…
    Pros? I’m really really busy with work (which is awesome as I do own my own business and thus work isn’t guaranteed)
    Cons? I have seriously minimal me time
    Con-pro? I’m managing to make it work and working out how to balance it all out so it’s not so bad! 😛
    Kristy from Southern In Law recently posted…Random Ramblings #12My Profile

  11. I’m so glad to hear that your internship is going well! I agree that the program was focused much more on MNT than counseling. I started my internship rotations in outpatient. I was nervous at first because I felt that I had minimal experience with counseling, but then I found that talking with patients for the 30-60 minute appointment felt very natural. These last couple of weeks have been spent in the oncology clinic, and I’ve really enjoyed being there. I also enjoy seeing how all the disciplines work together as a team and truly rely on each other in outpatient. Next week I start inpatient for general medicine!

    In a nutshell…
    Pro: outpatient experiences
    Con: workload! I’ve been changing rotations almost every week to two weeks, and it’s difficult to get ahead on work for other rotations/assignments.

    1. I am in the same boat with not being able to get ahead with much work thanks to frequent rotation changes. I am doing rotations in all the outpatient programs at my hospital and each RD has different expectations. It’s a lot to juggle!
      I start doing the long counseling sessions next week- I’m very excited!

  12. I love the schedule flexibility I have as a student but I don’t love doing “work” (homework) late at night or having scheduled meetings that start late at night, especially when I have early classes. Definitely know this is just a unique stage of life, though, so I’m enjoying it as much as possible 🙂

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