life

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

Weeks 29 – 36: The FINAL 8 in School Nutrition Management

Well, it’s been a long road, but I can finally say with pride rivaled only by exhaustion that I have COMPLETED my dietetic internship!

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School nutrition management was my final rotation, and it was an experience unlike most of the others. Something I enjoyed was getting to work with a team of managers who worked in non-nutrition disciplines. For most of my 8 weeks, I spent time with our Food Service Director, a Manager in Training, our Associate Director, and worked closely with our head chef and catering manager as well. My rotation took place at San Francisco State University.  As I may have explained in previous posts, my internship was completed (love putting that in the PAST TENSE!) through Morrison Chartwells, a subset of Compass Group. Compass Group has a multitude of sectors, which provide food and nutrition services to establishments from hospitals, to schools, to business and industry settings. Morrison is the sector of Compass that serves healthcare establishments, which is where I did my clinical rotations. Chartwells is the sector that serves schools (and Chartwells Higher Ed, to further categorize, serves college campuses). My experience was unique in that I was working with Chartwells Higher Education, which works on college campuses – most other interns in my program were rotating in K-12 Chartwells accounts.

 

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Now that that’s out of the way….

 

My school nutrition rotation taught me a lot about management, and working with a team in which you are often the sole nutrition representative. I did have the opportunity to work with the Regional RD, Laura, who oversees Chartwells Higher Ed accounts. However, this was a long distance relationship, and  Laura did not have a scheduled trip out to SFSU during my time there. She was always available by phone and email, and was a large part of my learning experience in this rotation. Not having an RD present at the site on a daily basis taught me many times over to be proactive and independent.

Chartwells at SFSU incorporates a concept called Balanced Kitchen, which I was so excited to be a part of. Balanced Kitchen focuses on wellness on college campuses. At one point, I conducted an audit to ensure the dining center was meeting the wellness criteria for this concept – and our SF State champs did very well! I remember being a freshman in college, and staying well with healthy foods was such a challenge. It is great to see higher education moving in a direction that promotes the importance of a healthy lifestyle.

 

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Some of the criteria for Balanced Kitchen (aka Balanced U), and what the dining center strives to promote.

 

This was a project-centered rotation. In these 8 weeks, I think I completed upwards of 10 projects – and all of them took some serious time commitment! Some highlights:

 National Nutrition Month Activities:

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Me, beaming in the presence of my food models. Typical.

 

Nutrition Educations:

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Weird shadow on my face… But here I am giving a lesson on eating local and seasonally. My favorite educational tool right now is my local foods wheel. Ask me where you can find one!

 

Participation in Sustainability and Real Food Events:

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IMG_7790 A real local food-focused event!

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Put on a Farmer’s Market

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Enjoyed soo much delicious local produce.

 

Stress Reduction Fair:

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Focused on how to use good nutrition to keep stress in check! So much fun talking to students – and I met someone I’ve communicated with in the blog world! Amazing.

 

and Staff Trainings, and Food Service & Sanitation Audits (not pictured, because not that exciting – bein’ honest, folks).

 

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By the end of my rotation, I had made some strong connections with Compass employees at SF State, and I feel this rotation was the best opportunity to get to know some of the higher-ups who work for corporate! Getting to know some of the big wigs who manage entire regions was not only inspiring, but also allowed me to make an impression, shake some hands, and learn more about Compass as a whole.

 

As this blog is about honesty, I don’t want to leave out how much I struggled to get through this last rotation. With 8 weeks standing between me and RD eligibility, the to do list seemed forever impending. It’s not that the rotation was extremely challenging – I have been SO grateful to be done with clinical, and the stress level was NOT THE SAME here. But I did feel often paralyzed when I looked down at the list of projects to complete, and it even took me a few weeks to get started on some. But as of posting this, my assignments are COMPLETE, and I am awaiting the OK to sign up for my RD board exam (eeek!). This is a good reminder for me that it will all get done if I work toward it, but I have to remember to stay calm, get focused and organized, and just keep moving forward.

 

Well, folks, that wraps it up! Thank you to everyone who continued reading through my experience! I hope I was able to shed some light on the experience of dietetic internships for those of you embarking on this path. If you have questions, or just want to let me know how I’m doing (or how YOU are doing), please drop me a line below, or shoot an email over to thenourishedsoulblog@gmail.com.

 

This may be the end of my 1240+ supervised practice hours, but don’t you worry – there is still plenty of living, studying, and trying not to have panic attacks that I’ll be continuing to write about. Stay tuned, beautiful people! The best is yet to come over here.<3

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Lessons in Tree Pose

Lessons in Tree Pose

Something I learned in Tree Pose this week: if you take the time you need getting there, ya might stay longer. Applicable, no?

Speaking of taking our time, please expect a new post on how my dietetic internship ended up with my School Nutrition Management rotation, and take a peak into the uncertainty and excitement that comes with the life of an internship grad as I job hunt and study for my RD exam! Hope you lovely readers are having a beautiful day. Stay grounded ;-).

❤ Samantha

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 :).

Week 1: Orientation

Week 1 of my dietetic internship has officially been completed. This past week has been filled with too much information, not enough sleep, and some seriously tasty Southern BBQ (note: if ever in Atlanta, go to Bone Lick!). I also had the opportunity to meet and get to know my incredible fellow Morrison Chartwells interns. While there is some sadness about having to leave, and not getting to spend more time with new friends, I have no doubt that we will remain a strong support system for one another.

Here, an abridged recap of the week:

Day 0: My flight arrived into Atlanta from San Francisco at 9:00pm Monday night. Completely out of chronological whack, I remained awake late enough to meet my roommate for the upcoming week as she arrived around 1am (which felt like only 10pm). After some extended introductions, we turned in, both eager and terrified for what the week had to bring.

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Ready to go…

Day 1: The morning went leisurely, as we did not begin orientation until noon. Little did we know how much we would long for the liberty of having those morning hours back throughout the week. Our first day was… let’s face it… basic and boring. All logistics–things we all know, but need to hear again. Adjourning at 5pm, my roommate (who I already miss!) and I joined some of her local friends for a Braves game (they won! … don’t shun me, Dodger fam), and the BEST BBQ and jalapeño-bacon mac & cheese I have EVER had. My introduction to the Southern United States did not disappoint.

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Outfitted in Business Cas for Day #1

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Still surreal…

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Everything in moderation–including beer!!

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OH! And did I mention they put us up on the JUMBOTRON??? All we had to do was agree to air guitar when relief pitcher Kimbrel walked onto the field, as Welcome to the Jungle was played. Check out the video here! Embarrassing? Yes. Worth it? Totally.

Day 2: Wednesday captivated our interest just a bit more–and also managed to spike our cortisol levels significantly. Today we learned more about our School Nutrition Management rotation, of which I will personally not have the pleasure until mid-February. Chartwells is the sector of our overarching company (Compass Group) that oversees K-12 school accounts. Throughout the day we heard lectures from a number of accomplished (and YOUNG!) people in the field of dietetics who happen to be a major component of the Morrison Chartwells program. We were introduced to the inter-workings of the company, and taught who does what from Directors to Regional RDs to Resident Dietitians. We had the pleasure of being introduced to the Morrison CEO, followed by an introduction to the Cornell Plate Waste Study through the university’s B.E.N. (Behavioral Economics in Child Nutrition Programs) Center in which we will be participating. Cue 35 Type-A stress-induced heart attacks. As we learned about what would be involved in this study, and what our responsibilities would include, many of us began to panic at the sheer magnitude of information we would need to be collecting. The study basically focuses on how much food is being thrown out in schools across the country. After a solid hour-and-a-half or so of rapid-fire questions, and confusion-inducing answers, we were reassured that, as important as our contributions were, we were but a “data point” on the B.E.N. Center’s graphs, and an error did NOT in fact indicate epic failure. After learning as much more as we possibly could about our School Nutrition Management rotation, we headed back to the hotel to freshen up for a group dinner at Sage. We looked forward to some fun after such a rough day!

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Our yummy desserts… And the “Sage” in the olive oil above is written in Balsamic!

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Me, with the best roommate ever!

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Day 3: Thursday was the day I both looked forward to and had been dreading. It was the much anticipated CLINICAL NUTRITION DAY! Bright and early at 7:30am, we all met at the office, and began guzzling down mediocre coffee (sorry, Compass group–it is what it is). Each of us had worked LONG hours completing to the best of our abilities four clinical modules: General Medicine, Cardiovascular, Endocrine, and Renal. Although a thorough review was expected, we were greeted with a game of clinical nutrtion Jeopardy instead! Fortunately I am a total Jeopardy (and nutrition) NERD, and didn’t mind this at all. We concluded the day with FOUR HOURS of information from Abbott Labs, the company who provides many of the enteral nutrition (tube feeds) and supplements that are often used in clinical as well as non-clinical settings. Some of the products we learned about and/or had the opportunity to taste included Ensure (we tried Clear and Complete), Glucerna, Vital, and Pediasure.

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Above squiggly line: end of day. Below: new day. The difference between tired and awake.

We adjourned slightly early around 4:30pm, at which point most of us headed out to the vans that had been transporting us throughout the week. I stayed after for what I thought would be a few minutes to chat with the internship director, Karen. Unfortunately, a situation arose that could have been easily avoided with the implementation of the BUDDY SYSTEM, and I was left behind!

Karen politely offered to take me back to the hotel, and it turned out to be a great opportunity to get to know my director a bit more in the short time we had together.

That evening, four other interns and I decided to experience Atlanta the best we could during our limited stay; we hit the town with some friends of one of the interns, learning some more about the city’s delicious food and nightlife!

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A beautiful Southern evening.

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On our way!

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5 of us at a great taqueria–amazing fried pickles and jalapeños!

Knowing how much we might regret our decisions to be out late the night before our travels home, we gladly owned our choices, and arrived back to the hotel just in time for a solid 4 or so hours of sleep.

Day 4: Our FINAL DAY commenced around 6:30am, as we needed to pack our bags, check out, and make it to the office in casual Friday wear for some last-minute information by 8:00. After scarfing down my last complimentary breakfast (courtesy of Staybridge Suites), we crammed those of us remaining at the hotel into a van along with each of our sets of luggage, and enjoyed one last ride together.

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Still unclear on the reasoning for limes at the breakfast buffet, always next to the coffee… Insight, anyone?

We learned about our Long Term Care rotation, and had a nice long lecture on wellness coaching and motivational interviewing. We were able to close things up early around 1:30pm or so, at which point we all said our goodbyes and migrated to MARTA (Metropolitan Atlanta Rapid Transit Authority) to head toward the airport.

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On the way we got a solid last peak into the ways of the urban south, as we were graced with a man shouting the gospel at us on the train (rather inaccurately, per my friend who knows the Word pretty solidly). Fortunately, we were all rescued by this guy:

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We made it to the airport, and said last goodbyes as we boarded our respective flights, and I prepared for the long hours I would spend sitting in a seat in the sky.

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I like to make fun, but seriously SO GLAD I bought this…

After a long half day of travel, I finally made it back, safe and sound, to my very favorite place: home to San Francisco. I have wrestled with some regret over applying to a distance program, and feeling as if I may be missing out on the “real” dietetic intern experience. But after this week, learning what an incredible program I am lucky to be a part of, I could not be more excited to get to remain in the first place I have truly loved living, and have felt as if I fit. I love this city, and all of the diverse experiences it offers. Sorry, San Francisco–you’re stuck with me!

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And made it home just in time for the uncharacteristically beautiful weather! And also for a date night with my favorite guy on the planet :).

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Sandals? What??

Now, time to get myself re-situated, and ready to begin my clinical rotation at Alta Bates Summit Medical Center in Oakland TOMORROW!

Stay tuned for updates on what I am sure is to be an eventfully crazy week.

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Great group! Morrison Chartwells 2013-2014

P.S. My Instagram is @realfoodisthebest. Follow for more like this blog!

Coca Cola Life–Does the Green Label Say It All?

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Coca Cola has already released this version of its ever-popular cola beverage in Argentina, and it’s rumored to be hitting the U.S. soon. I am having trouble locating an ingredients list and straightforward nutrition info on Coca Cola Life, which immediately increases my suspicions. The marketing states that this version has fewer calories and sugar than the classic red can, due to a mixture of stevia (calorie-free sweetener) and sugar, rather than just straight HFCS.

I would love to get my hands on a little more information about the product, and I’m sure I’m not alone!

Thoughts on this stevia-sweetened treat from a company notorious for contributing to the worldwide obesity epidemic? Do I have any Argentinian readers who can shed some light on this new product?

Nice Melons!

…Thanks, they’re local.

 

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Just picked up a mini watermelon from my local produce market. Upon arriving home, I found this sticker on it:

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Melon Up! allows you to enter your fruit’s assigned serial number, and see where exactly your snack was grown, thereby being able to gauge how far it traveled to get to you.

And according to this map taken directly from the website, these services are available in a number of locations across the United States, Mexico, and Central America! Hooray!

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Thank you, Melon Up! for making eating local even more feasible.

Enjoy your weekend!