love yourself

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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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

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 :).

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!

An Email Address Means This Is Now a Real Blog, Right?

New contact information! If you have any questions related to nutrition/dietetics/soul searching/the Universe, any comments about the blog, constructive criticisms, or you’d like to be a contributor, you may continue to leave comments on posts, or shoot me an email at the blog’s new address: thenourishedsoulblog@gmail.com.

 

This is me attempting to compartmentalize my life’s never-ending tasks. I look forward to hearing from you all!

 

Also, if you haven’t already, please check out my Twitter and Facebook pages!

 

 

Why I Put Down the Wheat Thins

Alright, bloggees. I’m about to get real….

Today’s been a SHITTY day. I’m not even going to get into it. But I have a feeling it has a little something to do with this. Anyway… it’s been rough. And after getting home from my internship, I saw where my night was headed: a half-eaten box of Chili Cheese Wheat Thins and a tub of Greek-style hummus was calling my name. I was going to sit in front of my TV, watch The League (until I decided I wanted to watch something I could cry over), and consume that ENTIRE damn half-box/tub duo. I was in pretty deep. But I stopped. With about 10 crackers left in the bag (and a lot in my belly), I heard a voice: “You deserve better than this. ESPECIALLY on a day like today–when things just don’t feel quite right.” This voice was filled with love. She directed my attention out my big bedroom windows, and reminded me I had a few hours of daylight left (the best few hours, in fact, right before the sunset).

With much hesitation, I put the remainder of my “snack” down (YES, there were only 10 left, but it was time to STOP!), peeling my body off the chair, feeling double my actual weight (because of the depression–not so much the Wheat Thins ;-)). I changed into some comfy walking clothes, and headed out the door with my iPod in hand. I turned on one of my very favorite podcasts–The Mental Illness Happy Hour–and listened to the truthful, honest, and darkly comedic words of Stefanie Wilder-Taylor as Paul Gilmartin interviewed her about her struggles–from depression to an eating disorder to overcoming a drinking problem, all the way through the truth about motherhood and what true love is.

In the spirit of being honest–I do love this podcast, but I haven’t listened to it in quite some time. I think deep inside, even though I KNOW hearing others talk about their struggles always helps me get through my own, I’ve worried what listening will do to me. When I’m capable of it, I like to keep my negative thoughts folded neatly in a corner of my brain, where they can be left alone, and forgotten. But shouldn’t we all know by now–that never works.

To my surprise (not really), I felt comforted and warm while listening. I laughed and I cried, sending myself on a true roller coaster of emotions throughout this particularly long two-hour show (NOT complaining). There were parts of it that made me hurt, and parts that made me realize I was ok enough to be loved. But the thing that helped me most was realizing what Paul has been trying to show his listeners all along–I am NOT alone.

I am NOT alone.

We are NEVER alone.

No matter what you’re thinking, no matter what you feel, no matter what awful, terrible, embarrassing, disgusting or weird urge, desire, or thought you’re too ashamed to talk about–SOMEONE has thought it before, and more people than you ever believed possible WILL relate.

As a result of the combination I allowed for myself–a little exercise, some fresh air, and tuning into a podcast I worried would send me on a downward spiral–I changed the course of my entire night. I did not go back to those tasty little conniving, addicting Wheat Thins. I did not mope myself to tears. Actually, I came home with a smile on my face, my cheeks still pink and flushed from the cold ocean air that was rolling in after sunset. I cleaned my room and put away laundry which had been overwhelming me for weeks (if you don’t get it, ask someone with depression and/or anxiety–I’m 95% sure they can explain it to you). I even cleaned my kitchen, did the dishes, and cooked myself a wholesome dinner out of REAL food.


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I feel great. And I know tomorrow might be rough. And I know I HATE my depression, and still have a voice that loves to remind me that IT’S NOT FAIR. But the difference between me now and me 3 hours ago is that I now feel prepared to deal with it FOR NOW. I can tackle tonight. Tomorrow morning I’ll see what I can handle. I’ll get out of bed, and carry on to the best of my ability. And I’ll do the same thing the next day, and the day after that.

Commit to your own recovery–whatever that is for you. If you try, and you bring yourself toward the right path, there’s no way for you to fail. There’s no way you won’t come out 1 step further than you were when you started.

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Also, if you haven’t–check out the Mental Illness Happy Hour! Download it off iTunes or wherever you get your podcasts, or go to mentalpod.com. I am not lying when I say it has literally changed my life.

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Goodnight! Love yourself.

Because this is about honesty…

While I love to preach moderation, and share with all of you tips and tricks to maintain such a lifestyle, I think it’s also important to own each of my actions, INCLUDING the not-so-moderate.

 

So, for the sake of honesty, and giving support to any of you who struggle with maintaining balance, I would like to share with you all that yesterday was a rough day. I was experiencing some… “feminine problems,” with pain unlike any other I’ve experienced before. I am not embellishing. Yesterday, for the first time in years, I went day #1 of every girl’s favorite week with no meds. I now know that for me that is NOT a good idea. I love to avoid medication whenever possible… But I now believe that is something my body might need. Coupled with this pain, I was having some insane cravings for some seriously processed food items. I’m talkin’ good ol’ Ben & Jerry’s, Annie’s Pasta Shells, and a Justin’s peanuts and chocolate bar. Alright, so I kept it somewhat organic. But that is hardly moderate. Below, some evidence:

 

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(That’s right — the full fat version)

 

I just wanted to share this information with readers to say that living a moderate lifestyle is NOT fool-proof. But I should mention that today I feel great. I feel like I listened to a craving, squelched it (with some undeniable vigor!), and am now ready to move on and get back up on the horse of moderation. No restricting. No purging. No crazy recovery detox diet.

 

And that’s not to say we should indulge EVERY craving. But–you get it–LISTEN TO YOUR BODY! It has more to say than you may realize.

 

That is all! Please check back soon for a new video :).