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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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Week 2/3: Outpatient Begins in an Endocrine Setting

Well, what a few weeks it’s been. I have learned a lot already–about outpatient counseling, carb counting, insulin, and even a bit about myself. Let’s start with my first week of rotations:

Monday: Orienting. Chaotic. Most of the day involved explanations, introductions to supervisors and systems, and a fair amount of confusion on everyone’s part. The day concluded with a brief meeting with the RN who supervises the Diabetes Center–where I would be completing my Endocrine/Diabetes rotation, and 1 week of outpatient.

Tuesday: 9 hour day. Got to meet my RD preceptor who I knew I’d get along with famously (I rarely meet an RD I don’t like…). I got to sit in on her 1:1 appointments, and observed a “Diabetes 101” 4 part class taught by the RD and another clinical team member. This class was the fourth of a four part series, and it was great to see the participants graduate at the end of the evening with confidence in their ability to own and manage their disease!

But finally sitting at home around 10pm, I found myself seriously questioning whether I have what it takes to get through this, and hoping for a better tomorrow.

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Hashtag Overwhelmed.

The day was challenging for a number of reasons, but a major hurdle I’m running into is the lack of understanding it seems people in other disciplines have as it relates to dietitians, dietetic interns, and our level of competency. Although I have an assignment which involves me teaching a nutrition education class (for which tonight would have been a PERFECT opportunity), the RN supervisor overseeing me stated she did not feel comfortable allowing me to teach, and that she felt I was there more for observation than participation/practice. I can’t blame her–she’s just not been told what a dietetic intern does, and that we are here to get hours in SUPERVISED PRACTICE. It has become frustrating on a number of levels, but I imagine it’s a taste of what some Registered Dietitians face on a daily basis. I do hope our reputation in the medical field is improving–we’ve worked hard to get here!

Wednesday: What an improvement! This day I got to have some actual patient interaction, and felt that I did relatively well. I worked with the Physician’s Assistant/Certified Diabetes Educator who does more of the medical side of diabetes education. I got to act as a true “RD-in-training” whenever her patients had a nutrition-related question. I felt needed, competent, and believed-in. My mood only started to decline once I realized how much work there was to do, and how in deep I really am.

Thursday: Similar to Tuesday, I got to mainly shadow the RD. I wasn’t able to jump in and do any 1:1 counseling on my own due to the supervisor’s wishes. But we found ways for the RD to assess my abilities, and I am meeting my competencies for the rotation.

Friday: For the final day of the week, I took a break from the Diabetes Center and reported to the main hospital across the street: Alta Bates Summit Medical Center – Ashby Campus in Berkeley. I met briefly first thing in the morning with the Food Service Director who greeted me with a bubbly sense of pride that I couldn’t have needed any more at that point. We discussed some basic logistics–what I needed to know to survive the day. She then sent me off to the diet office where I met the nutrition assistants. Throughout the day, I shadowed, asked questions, and saw the world of Alta Bates Med Center through their eyes. I got to meet the team of clinical dietitians at this campus, as well, who will be leading me through much of my clinical rotation.

The last part of my day went from 2pm-4pm, and gave me chills… LITERALLY! I observed and assisted in tray line, which lasts about 2 full hours, and actually takes place in a REFRIGERATOR. Temps in this room are very close to 40 degrees Fahrenheit. My hospital works on a cook-chill system: the food is prepared then frozen at a main kitchen, plated in tray line, and then sent off to wherever it will be served (if trays are going to a campus away from the main kitchen), and reheated immediately before serving. It’s a system I’ve learned about many times, but have never seen in live action.

Here is a flow chart that outlines the steps of the cook-chill system in comparison to a more common cook-serve system (Original link to diagram found here).

                                                                                                 Cook-Chill [Yellow] v

Production flow charts for school lunch boxes

^ Cook-Serve [Green]

So the tray line takes place in a cold environment so that there is no chance for food temps to reach the danger zone: 40-140 degrees–the window in which bacteria thrives. This tray line ends up providing meals for patients at the campus I’m primarily working at, in addition to the campus nearby which houses our psychiatric and residential eating disorder treatment programs–they produce HUNDREDS of trays! It was really something to witness… These hours served as a highly valuable learning experience. I’ve always found that when employees thoroughly understand the inter-workings of an entire SYSTEM, and not necessarily just the requirements of THEIR jobs, it allows all employees to perform their jobs at a higher level–even if all of the positions do not seem to cross paths directly.

After that week, I was beyond ready for a nice long weekend. Saturday I got to spend connecting to my Jewish heritage, as I participated in a Yom Kippur fast. Once we hit sundown, it was bagels and lox until our bellies stretched to capacity  (and beyond), and some of us even may have had to undo a top button…

Sunday was a bit more fun–got to attend a concert we had been looking forward to for months (The Slackers, for any ska fans out there), and spent the day in beautiful Santa Cruz.

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The instant serenity-inducing beaches of Santa Cruz — No filters needed here.

image (1) We rode that pirate ship ride that goes back and forth at the Boardwalk… It remains terrifying, in case you weren’t sure.

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The Slackers put on a seriously entertaining show, per usual.

The week began again far too quickly, but I jumped in with all the enthusiasm and vigor I could muster. My second week in Endocrine allowed me to hone some of the skills I was merely introduced to the week prior. Week 2 felt more hands on, as I felt more comfortable providing input during patient sessions, and knew which questions to ask both patients and practitioners. I also got to write my first very own chart note! I had the opportunity to attend another Tuesday night diabetes education class–this week was part 1 of 4, so it had a different feel to it. These participants were likely newly diagnosed, or just newly motivated. A lot of emotions filled the room that night–from excitement and enthusiasm, to denial, to fear, to confusion and unknowing. It was refreshing to realize I wasn’t alone in having those feelings ;-). By the end of the class, it was great to say goodbye while hearing the joy in the voices of some as they said “I’ll see you next week.”

Friday involved another diet office training. I got to meet a few more team members, and learned more about the management side as I shadowed the Patient Services Manager for the day.

The week wrapped up nicely, and I embarked upon the social weekend I had planned for myself! Met some great new people, and attended the last Movie in Dolores Park of the year before the weather turns cold (because it’s been just a blazingly hot summer here in San Francisco–oh wait, no it hasn’t).

I am now beginning week 4 of my internship: Patient Services and Clinical Nutrition Management. Check back at the end of this week to see how it shapes up!

In the meantime, be kind to yourself–I know I’ll be trying :).

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*Note: Most of my pictures within posts at this time are not necessarily going to be dietetics-related, as I am waiting on permission to use pictures I take at my rotation sites on my blog. So enjoy my personals! And check back–hopefully I can utilize the professional ones!

So Begins the Positive Plight of the Dietetic Intern

So Begins the Positive Plight of the Dietetic Intern

Back on the study train. Really excited to further my career and finally fulfill one dream of becoming a Registered Dietitian. Already feeling a tad overwhelmed, but as I keep the big picture in mind, I know this is worth it. And kind of fun, to be honest! So although my postings have not been as regular as I would like, I feel that now they may become even less so, as I attempt to figure out this dietetic internship:life balance. However I am sure my blog will end up being a great place to work out some of that! Looking forward to sharing my journey with you all :).

Some Mornings…

Some days just start out rough. The alarm goes off, and moving your body close enough to the alarm to hit snooze sounds like a form of ancient water torture. All morning, things are dropping, you stub your toe, and your hair isn’t doing a thing to cooperate with you. You’re in a daze, and when you get halfway through your travel mug full of home-brewed coffee, you realize it’s been leaking all over you since you started drinking. Some days are just this way. I usually call them Mondays. But there’s no reason this mediocre morning can’t turn into a fabulous, productive, positive day.

Time to breathe, center, and TURN THIS SHIT AROUND.

Happy Monday morning, blogosphere.

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This mug speaks the truth. But it’s not so effective at containing coffee within the intended coffee area. 😦

Monday’s Quick Tip

Today’s Quick Tip: TAKE THE STAIRS! It’s a great way to squeeze activity into your busy day, and will give you the boost you need to kick those Monday moody blues in the bee-hind.

Going up sound daunting? Try skipping the elevator on the way down. You’ll still work your muscles (especially if you go slowly), and at least you’re moving.

Enjoy this beautiful sunny day! (Sorry, cold-locale readers)

Did YOU do something active today?

Changes, Changes–Someone once told me they’re positive.

 

 

With all of my recent posts, I’ve been so EXCITED about sharing random new information with the blogosphere, that I did not realize… I neglected to explain WHAT THE HECK IS GOING ON, and why my clientele has suddenly made a shift from the elderly to the not-so-much. Well, allow me to explain…

 

Now, while this is a TRUE statement:Image

 

…I also LOVE preventative nutrition, and LOVE teaching others how to develop a POSITIVE relationship with FOOD. In some ridiculously fortunate curveball the Universe threw at me, it turned out that an eating disorder treatment program to whom I had sent my resume back in July/August decided to contact me (some time around Novemeber/December), looking to fill a part time position at their San Francisco location. I informed them that while I was so honored to hear from them, I had already accepted a full time position in Santa Rosa, Ca (about an hour north of SF). “It’s so interesting that you say that…” stated my soon-to-be supervisor… I am on the edge of my friend’s car seat at this point…. “We are opening a location in Santa Rosa in the next few months, and are looking for staff.” WHAT? YES. So, long story short (too late)… I began my second job in Santa Rosa (Saturdays and some evenings), doing EXACTLY what I had in mind when entering the field of nutrition.

 

Now… for about 3-4 weeks, having this job on the side of going to the Skilled Nursing Facility (SNF) M-F (and some weekends) invigorated me. I felt capable of dealing with every challenging aspect of my primary bread-winning job, even though it was not where my fervor for nutrition lie, and even though I felt rather limited in my ability to actually help my patients.

 

However, one day, out of SHEER frustration, after an extremely rough day at the SNF, I arrived home–likely in tears–powered up my dinosaur of a laptop, and logged on to a nutrition jobs website. There I saw the dream opening for most clinical-RD-hopefuls: “UCSF Nutrition Assistant/Diet Tech.” While I realized this was a LONG SHOT, I filled out an application. With the click of the “Submit” button, I felt a large amount of tension physically LEAVE my body. I figured that would be it, and maybe if I just sent out a few far-fetched applications every few weeks, I would be able to cope until eventually matching to a dietetic internship, and moving on.

 

Well, much to my surprise…. Not only was I contacted for an interview, but I actually got the job.

 

To conclude… I am now in my “week off” between the SNF and starting at UCSF (which has really been anything but… yet I am GRATEFUL for it). I begin with an orientation in SF on Monday, and am on the floor training on Tuesday. I am looking so forward to what these upcoming months have in store for me.

 

So, expect my posts to shift a bit, and if anyone out there needs a comrade in how to manage change, a COMMUTE, and still being sure to take good care of yourself, I’m your girl ;-).

 

I look forward to sharing the journey with you!

Hey! YOU!

Job opportunity available! You must have a B.S. in Nutrition and/or be a Registered Diet TECH. The job is in Sonoma County, Ca.

If you are interested, please leave a comment so I can contact you!