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Sitting with Uncertainty (and other things I’ve felt while living unemployed…)

Hello beauties!

A happy mid-June to you all. I hope the weather is beautiful where you are. If not, get a load of this:

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I’m as shocked as you are. This is San Francisco, for Pete’s sake.

Well, last I checked in, I had just completed the final rotation in my dietetic internship. Uncertainties abound, but the newness of being free from supervised practice hours for the rest of my career was enough to keep at bay the flaming ball of anxiety that often inhabits my gut.

Prior to completing my internship, I firmly proclaimed that I required some down time, during which I could focus on studying for my RD board exam, and with money I had saved, I could get myself through a few more months unemployed. After passing the exam, I would carry on with my job hunt, warp speed – factor 10.

Well, to my utter shock, as soon as I had about 3 weeks left of my internship, I awoke from a haze to find I had been frantically perusing nutrition job websites, and noticed fingers that looked like mine typing away at cover letters and requests for references. What. Is. Happening?!

I wish I could say I caught myself in this old behavior, realized I wasn’t giving myself the unstructured time I so wanted and deserved, closed my laptop, and refocused my energy on passing my exam while enjoying life around me. Alas, this was not the case.

A number of weeks into practicing my daily routine of wake up, coffee, procrastinate, job hunt, “organizing” (shuffling things around until piles look manageable), listening to 1/4 of an Inman RD exam review track, and back to “organizing”, I had a nice little epiphany at which I so peacefully arrived by having it slapped upon my face.

Through networking and good fortune, I was put into contact with several people who were offering jobs that looked promising. After phone conversations and/or email correspondence, these opportunities looked like potential hires. They were jobs that I would be completely happy exploring, and I thought it would take away the anxiety I have felt relating to the dreaded day I run out of money. Well, time and time again, after informal interviews went as perfectly as they could have, I was told I would be a great candidate for the position, but right now they were looking for someone who had already passed their exam.

Alright – what’s the big idea, Universe? I was told early on in my plight into dietetics that many companies are ok with hiring prior to passing your exam, with the expectation that you pass within a certain amount of time from hire date. But that was proving wrong over and over again.

And then I remembered… Isn’t this exactly what I asked for? Didn’t I say I wanted and needed time to focus on this exam, and getting my life together post-internship? And didn’t I predict how I would struggle to just sit back and ALLOW this to happen?

Hm… Seems like the Universe just might have my best interest in mind here.

So currently where I sit is here:
Going against the voice in my head that tells me I’m not good enough because I get to live life on my own schedule these days, I have put the job hunt on hold. I am mostly focused on studying for this exam, and on appreciating what else I have going on, from a blossoming social life in a fantastic, still relatively new city, to community involvement and being of service to others. I have ACTUALLY done some legitimate organization which looks like this — a calendar where I can view things both weekly and monthly, noting sections of my exam review to go over each day to keep me on track to be as prepared as possible come test day. My exam is scheduled for July 23, which gives me over a month from right now to prep. I’m sure this time will fly by, so I’m avoiding the mind set that I have plenty of time and can get it done when I feel like it, which has often plagued me in the past; however there is enough time between now and the test for me to not be so susceptible to full-fledged conniption-style panic attacks if I only get through 5 pages instead of my intended 6 on any given Tuesday (if you don’t believe this to be a possibility, you were fortunate enough not to know me circa 2012).

For those fellow RDs to be who are curious about how I am studying and what materials I am using, I am going through Inman’s Review of Dietetics, and listening to the CDs where she reviews each domain and notes specific important details. That’s all I’ll say for now, and hopefully I can return in about a month to tell you that what I did actually WORKED, and share more at that time.

Until then, I will be sitting in some discomfort, and remembering to refrain from complaining about receiving the things I’ve always asked for.

Keep smilin, lovelies. Our futures are lookin damn bright.

<3,
Samantha

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Amy Poehler on Loving Your Body

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Photo borrowed from: inspiredbycharm.com

http://www.upworthy.com/yo-oprah-imma-let-you-finish-but-amy-poehler-has-the-best-body-image-advice-of-a?c=ufb2

I didn’t think I could admire this woman of comedy any more than I already did. But there she goes spreading wisdom, reminding me once again how to be kind to myself. All you beautiful beings who who tend to easily forget what perfectly imperfect beings you truly are (*guilty!*) will benefit from hearing this. Click the link and remember to be gentle.

Peace and Self-Love.
❤ Samantha

Vitamin D: The Sunshine Vitamin

As we say goodbye to the winter months, we welcome the spring time with open and bare arms. We get to say goodbye to sweaters, scarves, and 4pm sunsets, and hello to sun dresses and sun-kissed cheeks. So for this Nutrient Spotlight, I thought I might talk about a vitamin we get from the wonderful, amazing, nutritious rays of the SUN! Vitamin D is a fat soluble vitamin responsible for an array of crucial bodily functions — maintaining bone density may be the most talked about. The primary role vitamin D plays in bone density involves allowing absorption of Calcium.

So, where do we get Vitamin D?

Did you know that most of the Vitamin D that our bodies make comes from sunlight? Now, it doesn’t take a day of sunbathing on the beach to reap the benefits of the sun’s nutrient-saturated rays. All you need is about 5-10 minutes of direct, UNPROTECTED sunshine (that means no sunscreen, with some skin showing) per day to get enough exposure. So, if you can make that happen, you’re covered! After your allotted Vitamin D time, definitely throw on that sunscreen to protect yourself from irreparable skin damage, which can lead to visible changes and skin cancer.

Here’s the process, from sun through skin:body-vitaminD

If 5 minutes of sunshine per day is not possible for you, as is often the case in the summer months here in San Francisco, do not fear. There are other ways to meet your D-quota for the day!

What are good dietary sources of Vitamin D? How can we make sure to get enough when the sun doesn’t want to come out to play?

The good news for those of us who won’t be getting to soak up the sun during summer months, or for those dreading the winter’s gloomy return, is that there are alternative sources of Vitamin D. Food sources are limited, but do exist. They include fatty fish, mushrooms, and fortified milk; egg yolks provide a small amount as well. A number of other foods may also be fortified with Vitamin D, including cereals and milk substitutes like soy. Just be sure to read the labels on these items, and try to avoid adding highly processed foods into your diet in the pursuit of added nutrients — my opinion is that it’s not worth the trade off.

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 Keep it natural!

There has been some controversy over the use of UV (ultraviolet) lamps to increase vitamin D production. On one hand, the rays have been shown to increase the nutrient concentration in mushrooms, which produce Vitamin D the same way we do. Also, users of these devices have reported noticeable improvement in mood, and fewer symptoms of Seasonal Affective Disorder (SAD) during winter months. However, these lamps also come with risk of skin damage and cancer. It may be best to discuss the risks and benefits with your doc to determine if a UV lamp is right for you.

If you are still having trouble getting enough quality sun time, and feel your diet may be lacking, speak with your physician about getting a simple blood test to check for Vitamin D deficiency. Your MD may then recommend a Vitamin D supplement if you are deficient. I highly recommend checking your levels before starting a supplement, and always check with your physician before starting any kind of regimen to avoid dangerous interactions or toxicity (too much Vitamin D). Remember, supplementation will typically only provide benefit to those who are deficient in a nutrient. Otherwise, you might as well be swallowing capsulized cash.

 

What do you think?

What are some ways you clock some outdoor hours to make sure you get enough sun time? Do you take supplements, or use a UV light? Want to share your favorite recipe using Vitamin D rich foods?

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Now how are y’all going to enjoy this beautiful Friday at hand?

Weeks 13-21: Cardiology, ICU, Eating Disorders, Staff Relief

It seems we’re developing a motif here, as this post will continue to cram 5+ weeks of rotations into one abridged post. But, hey, so goes the life of the dietetic intern.

Week 13: Cardiology

Cardiology was my only 1 week rotation – and man, it went by SO FAST! I do feel like the length of the rotation was appropriate, however, given the patient population. During this rotation, most of the patients I saw were status post heart attacks, CABG procedures (stands for Coronary Artery Bypass Graft, and is pronounced like the vegetable – “cabbage”), or admitted with Congestive Heart Failure (often referred to as CHF). Working in a hospital as a clinical dietetic intern for 13 weeks prior to this, I had already been exposed to most of these conditions, and I don’t feel that having a very long cardiology rotation would have enhanced my experience dramatically. I basically gained more practice giving heart healthy diet and CHF educations, which I welcome more of! My one complaint for this rotation is that it was my only week working on a unit at a different campus than my other weeks, and it was a bit challenging to get used to the different buildings, and a new set of operations in such a short amount of time.

Because the heart healthy diet is the primary need on cardiology units, I’ve created a separate post to provide an overview of the guidelines. You can view the post HERE! The rotation really inspired me to spread the word about heart healthy diets, and catching signs of heart failure, because death related to heart disease is typically so preventable.

If you are in dietetics, I welcome your feedback. And if you are just interested in learning about the diet for your own benefit or that of a loved one, please leave a comment and let me know if you found the information helpful. Questions and comments are ALWAYS WELCOME!

And after Cardiology, it was on to Critical Care!

Weeks 14-15: Critical Care

This rotation was INTENSE, mostly consisting of recommending nutrition support options. The majority of the patients I saw were NPO, so taking in no nutrition by mouth. I had the opportunity the learn about the current nutrition support guidelines according to ASPEN and the Academy of Nutrition and Dietetics, and gained a clearer understanding of what makes each formula unique and appropriate for various individual conditions.

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Lot of calculations and lab values in Critical Care…

Not only was my critical care rotation interesting, but I also felt like a very strong component of every patient’s care team. I attended daily rounds on the ICU floor in which each critical patient was discussed, and the opinion of the dietitian was typically obtained, and highly regarded – usually my recs would be implemented immediately without hesitation! In previous clinical rotations, I recall experiencing frustration when having to recommend the same diet changes multiple times, seeing no orders placed. In the ICU, I felt capable of making a difference in the care of patients, and felt truly empowered as a proponent of good nutrition, particularly as I got to watch the transformation some patients took once appropriate nutrition recommendations were implemented.

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You fellow interns and RDs feel me??

Week 16-17: BREAK!

After Critical Care, I was lucky enough to have a 2 week long break. I spent a nice chunk of that time catching up on clinical readings and assignments, but I certainly got to have some fun as well…

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Went camping…

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…in Morro Bay, California…

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…with my best friends in the entire world (my SISTERS and parents)…

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…who walked all over town with me when I just had to have some Cioppino (it was SO worth it)…

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…We even got to have a little camera fun…

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…and got so many beautiful sunsets…

Then I got to welcome 2014 with my sister and brother from other mothers in Seattle, WA and Vancouver, BC:

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…where I got to see Captain Kirk’s Chair at the EMP Museum

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…climb atop this Space Needle…

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…with THESE two…

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…clean ourselves up for a New Years Eve celebration…

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…and I even found my name in LIGHTS!

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And of course, once returning to San Francisco (<3), had plenty of time left over for tasty coffee, a farmer’s market…

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 …and a little at-home yoga :).

And it’s a seriously good thing I got so much me time over these two weeks. I was definitely going to need it entering my eating disorders rotation…

Week 18-19: Clinical Elective – Eating Disorders

In a happy twist of fate, on my very first day of interning, my CNM offered my fellow intern and me 2 options for our clinical elective: eating disorders, or NICU. I immediately jumped at the opportunity to claim EDs – although I wish I could have experienced both areas of specialty, I’m sure no one is surprised by my choice.

My elective week brought up a whirlwind of emotion, both positive and negative. But the greatest thing I took from these two weeks was that I felt right at home. It was incredible to be reassured that ED treatment and recovery is the field I am meant to be in, because of my passion, my skills, and my own personal struggle. I feel blessed to have found this so early on in my career, and am so glad to see I still feel the way I did at the start of this journey.

Most of the week involved a lot of shadowing. Given the high specialization and touchy nature of this field, at the start of my rotation it was unclear whether I would have the opportunity to counsel one on one. However, after a few days of sitting in on sessions and observation of groups, in addition to spending time note writing and reviewing the past medical histories of the patients, I was able to conduct supervised one on one sessions with a number of people. This experience was anxiety-inducing, incredibly exciting, and limitlessly humbling. I was reminded of the love I have for this field, and was also reminded that I am quite good at it naturally! But I also saw how much I do have left to learn, and look forward to the career ahead of me.

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^This is what note taking looks like in an eating disorders rotation…

Weeks 20-21: Staff Relief – FINAL WEEKS IN CLINICAL!

Staff relief… What to say about staff relief. Well, I’m sure I grew from it, and I can say that. There were also a lot of tears coupled with self-doubt and feelings of inadequacy. Not to get all negative Nan on ya, but this experience is what it is, and I’m here to share it with you.

I must say, now that staff relief is behind me, I could not be more appreciative of those two weeks. I think it is so important to have them under your belt before entering the field as a clinical dietitian. But it was TOUGH!

For those of you who are unfamiliar with the term, staff relief is the rotation that usually comes at the end of your clinical rotations. During staff relief weeks, the intern is to act as dietitian, covering a unit on his or her own. It’s really the first taste you get of working independently as a clinical dietitian.

After discussing my staff relief rotation with my internship director, I learned that my experience was atypical. This may be one of the challenges of being in a distance program – my director is unaware of how things are going unless I share the information with her. During staff relief, most interns will cover 1 unit – ICU, Oncology, Med/Surg, etc (per my director, interns typically cover Med/Surg floors). During this rotation for me, things were organized a bit differently. The dietitians from each floor would assign me about 2 patients, totaling up to about 6-8 patients per day. I found that the most challenging part of this was having to switch mental gears from oncology to critical care to cardiac to CVAs so many times per day. I feel this brought down my level of efficiency, and made it challenging for me to do a quality job while also seeing the appropriate patient load each day. This impacted my confidence significantly, and I really had moments when I doubted whether I have what it takes to be successful in the field of clinical dietetics.

The good news is, once I spoke with my director (2 weeks AFTER completing this rotation), she assured me that my experience was not typical, and that seeing so many different types of patients each day in fact WAS quite challenging. I was so relieved to hear this, and felt I could reassure myself that staff relief did not indicate that I had made a catastrophic decision in choosing to become an RD.

Let it be a lesson to me – to give myself a BREAK, and not jump to thoughts of failure so immediately at the first sign of struggle.

So, that’s a wrap for my clinical rotations! I cannot believe that one of the biggest challenges in my path toward my RD is behind me. My next post will talk about my experiences working in long term care and community nutrition. Please check back for updates soon!

And all you DI hopefuls applying through DICAS right now, you are in my thoughts as programs sift through your applications. Next will be interviews for many of you! Remember: smile, stay calm, and be yourself – you’ll do great :).

Stay happy :).

2014: Year of the Trailblazer

2013 –

I can’t say you and I didn’t have our moments. You certainly didn’t make things easy on me. Over the last year, there have been some major peaks, coupled with significant valleys, each accompanied by imperatively important lessons to be learned.

This year I’ve seen what makes me tick, what makes me smile, what makes me giggle until I cry, and what makes me cry until there’s nothing left to do but laugh.

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I’ve learned that most of the time I’m bubbly, but it doesn’t mean I don’t also feel anger. And I’ve learned that I love Star Trek, and I’m totally ok with it.

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I’ve found that I love myself more when I’m sober than I thought I ever could. And I’ve learned that one should be ridiculously, laughably, wildly in love with his or her own life — and even more important, I’ve seen how within my control that is, and have had to remind myself multiple times that this control ironically often comes from accepting the things over which we have no control.

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2013 in summary – I moved to the city of my childhood dreams; landed jobs I never thought I was qualified for (and did just fine); matched to a dietetic internship, solidifying my plans to become a registered dietitian, and met clinical cases I thought I wasn’t capable of solving (sometimes excelled, sometimes looked utterly foolish, but after all I turned out ok); I cried a lot, laughed a little bit more, moved on from a wonderful relationship that had run its course, letting go of someone I loved deeply, learned to handle my emotions without alcohol to numb them, and determined who some of my real friends were whether I was ready for it or not.

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Oh, and finally got to try poutine (Canadian french fry dish with cheese curds and gravy goodness that has been on my bucket list for some time).

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(It was delicious, of course)

All in all, 2013, it’s been REAL. No other phrase seems quite as fitting. And to your successor, 2014, I say BRING. IT. ON. I’m ready, and can’t wait to dive in, blazing my own pathway from here to Happinesstown. I am open and ready to receive the bliss I deserve. Let’s do this!

A Quick Reminder for Self-Compassion

Sometimes it’s easy to forget that we all are human beings. And some days we need to have a little more self-compassion.

Just reminding us all to be gentle with ourselves, especially when we’re having a particularly rough day. Think of treating yourself with the same compassion you might show if a friend or child came to you with your same fears, anxieties, and stressors.

Now have a wonderful Wednesday!