My Dietetic Internship Recap

I originally planned to start blogging before my internship started in July 2015 so that I could keep friends and family up-to-date with all of my experiences. But graduation, summer jobs, prepping for the start of the internship, and trying to maintain my sanity got in the way...so the best I can do for you is a recap!

When I was looking into which internships to apply to, I loved reading other interns' experiences! It helped me get a feel for what I should expect and how I should prepare for each rotation. Even though all dietetic interns have similar requirements, it seems like everyone has a unique experience depending on who we work with, where are our sites are, and what type of program we are in.

I completed a distance dietetic internship - the less traditional option. Most internships require you to relocate to their site or headquarters and complete your rotations there. I want to offer my two cents on what I distance internship is like. And for anyone who was curious about what I was doing during the months that I non-stop used the hashtag #rd2be, here is what I did:

Rotation #1 - Community Nutrition

From the end of July to the first week in September, I did my 200 hours of community nutrition! What was unique (and challenging) about this is that I split up my hours between two different sites. On M/W/F I interned at Cape Cod WIC, and spent my Tuesdays, Thursdays, and some Saturdays doing various activities with the dietitians from Cape Cod Cooperative Extension. The reason I split it is because CCCE had me doing some nutrition programs on Tuesdays and Thursdays but didn't have any work for me on the other days. Because I did not choose the part-time option of the internship, I had to complete 35-40 hours per week of supervised practice hours in order to finish the internship on time. WIC kindly agreed to take me on the extra days! I was also still living on the Cape and working at my summer job a few nights a week. It was overwhelming at times to keep up with projects, deadlines, and sleep - and also manage two different sites at once - but well worth it! This was my favorite rotation because I love this type of work, working with kids, and providing nutrition education and promotion.

Cape Cod WIC

WIC was a great experience for me because I finally got to utilize my Portuguese skills in a nutrition setting. Incase you didn't know already, there is a large Brazilian population on the Cape and a lot of new Brazilian moms use WIC. I love WIC and wish it's services on nutrition education for children, breast feeding promotion, etc were available to all new moms.

At WIC I would observe appointments between the moms and their babies or mom-to-be's, and was able to provide my own counseling after that. I also worked on some educational material and boards in the office on promoting breast feeding and its benefits, and also focused on healthy back-to-school snacks and recipes for kids. During my time there, I learned TONS about breast-feeding, formula, and infant/child nutrition needs, which I was interested in since I did not do a pediatrics rotation. For the record, this ended up helping a ton on my RD exam as I had lots of infant and pediatric nutrition-related questions. WIC was also the first place where I was able to practice my one-on-one counseling skills which was helpful for the rest of my internship.

Cape Cod Cooperative Extension

Community work is typically all over the place - which is why I love it so much! Through CCCE, I was all over Cape Cod doing various work for them for those 6 weeks. My "main" project was assisting with and then teaching a children nutrition education series at two different Cape Cod Child Development sites. These classes were about two hours long total (I would usually do two sets and split the kids up by age group) and we would focus on one fruit or vegetable, how it is grown, and then we would do a taste test! Then, I would make a recipe with said produce and have the kids try it. Depending on the group size, they would often help me which made them even more excited to try the food. 

I also did various cooking demos and nutrition education at places like the national guard base, a veteran's center, open houses at various elementary schools, and farmer's markets. I also attended a meeting at the Greater Boston Food Bank where we received some teaching resources. I used some of those to teach a nutrition facts label reading class to teen moms and provided tips on easy, healthy, and affordable recipes.

Rotation #2 - Food Service

If there is an area of nutrition that I dread the most, it is food service. But the beauty of a distance internship is that we have full control over where we complete our rotations, so long as they meet the requirements. 

When I took my Food Policy course senior year, I became really interested in school nutrition and the new regulations that Michelle Obama helped put in place as part of her Let's Move campaign. I also couldn't handle the fact that pizza was technically considered a vegetable on the lunch menu and needed to find out more about why this was a thing. Luckily, one of my former coworkers, Allison, was now the Food Service Director of Foxborough Public Schools and agreed to take me on as an intern! 

Allison is a healthy foodie like myself and it definitely reflects in her job, which is why food service ended up being fun and exciting! Since she started her role, a fresh salad bar was implemented in every school - elementary to high school - and a smoothie lunch option was also created. She was also in the process of growing greens in two separate towe I spent my time working with the cafeteria staff at the different schools learning the basics of food service like kitchen and food safety, sanitation, storage, ordering, etc. 

And do you remember those french toast sticks we always got at lunch? One of my main projects was to make a healthier version of this popular lunch from scratch and sample it with the kids. I did this with a group of 4th graders and they loved it! I also helped sample some other smoothie options to encourage the kids to try new foods - the pumpkin pie smoothie was definitely a hit.

Rotation #3 - Long-term Care

Long-term care was another area I wasn't too excited about, but ended up really enjoying it. I spent a few weeks at EPOCH Senior Healthcare on the Cape. During my clinical volunteer work while in college, I saw patients on my own but never was able to talk to them for too long. Working at the nursing home made me realize how enjoyable it is to be able to sit down with a patient and make sure they are comfortable, eating, satisfied with the food, and just provide some company for them during tough times. A lot of the nutrition work in nursing homes is monitoring for weight loss and malnutrition and making sure that the residents are consuming an adequate amount of food. Similar to acute-care work, long-term care dietitians work closely with the food service director and chefs to make sure everything is running smoothly and the food and consistency is appropriate for the residents.

Because my internship focus was in worksite wellness, I also did a small presentation for the staff at EPOCH on how to pack a healthy lunch or dinner to bring to work! I provided some ideas and resources on how to shop smart, stretch meals, and how to create a balanced and filling meal that is nutrient-dense. The feedback showed me that it was very appreciated :)

Rotation #4: Clinical

Clinical was another rotation I had to split between two sites. The thing about a distance internship is that you have to find your own preceptors, while traditional internships have affiliated sites where they place their students. So when I started to reach out to hospitals in the area, I ran into a lot of trouble because most said "no" to me right away, because they already had interns and no time for me. I totally understand, but after a while it became extremely discouraging. It ended up working out, and also challenged me to be more persistent, which I see as a plus. Read more about my "Benefits of a Distance DI" to learn more.

I ended up splitting my 400 required clinical hours between The Miriam Hospital in Providence and Kindred Hospital in Stoughton, MA. Two very different locations that both provided a great education and experience.

The Miriam Hospital is an acute-care facility, so I did not spend too much time with any critical care patients. Most of my time was spent focused on cardiac, diabetic, renal, and elderly patients with malnutrition. I also spent one week working with the bariatric department - where the dietitians counsel patients who are interested in undergoing weight loss surgery.

Kindred Hospital was a completely different setting. It is an acute long-term care facility, so basically the care that goes between an ICU and a nursing home. The average length of stay at this hospital was 28 days, while at Miriam it is 4 days. And because Kindred is a tiny hospital, I quickly became comfortable with the patients and got to know them and their families very well during my 6 weeks there. At this rotation, I learned a ton about nutrition support and critical care, and also got to participate in patient and family meetings and discuss my role in providing nutrition-related care to the patient. 

Rotation #5: Elective Rotation

The Elective rotation is when you have a "free week" to work in whatever setting you like. This could be an extension of an already-established rotation, or you can branch off an focus in an area you have a general interest in. I reached out to Kate Scarlata, owner of For a Digestive Peace of Mind, LLC because I was interested in private practice. Owning my own practice is a long-term goal of mine and I wanted to get a head start in experiencing it. During my week with Kate, I observed various of her appointments - both in-person and virtually. Because her practices's focus is on digestive health and the low-FODMAP diet, I spent a lot of doing taking notes and reading research articles based on what she was communicating to her clients. I was also exposed to a lot of the tests she requires her clients to take to determine their exact problem - as well as how she takes notes on their symptoms, communicates with their physicians, and her counseling methods. 

Rotation #6: Worksite Wellness

Wellness Workdays is the one and only internship dedicated to worksite wellness. Aside from hosting a dietetic internship, Wellness Workdays is a company based out of Hingham, MA (just south of Boston if you're not from around here!). A lot of the work is standard office work. During my time at WW, us interns would spend a lot of time creating power point presentations and educational material for upcoming programs run by Wellness Workdays. Companies around the area, such as Rockland Trust, Cape Cod Lumber, Brown University, and many more hire Wellness Workdays to conduct a wellness program at their sites. These can range anywhere from Get Fit challenges, to weight loss, smoking cessation, and mindfulness challenges. Occasionally we were able to go off-site and observe some of these presentations! In addition to this work, we contributed to their social media platforms and newsletter. One of our main projects was also to design a wellness program for a potential client based on their data - age, % overweight/obese, activity levels, and interests. It was fun to wrap up the internship in such a creative way!

And that completed the end of my internship! Actually, Wellness Workdays holds an annual worksite wellness conference in April, and we were required to attend that too. One of the downsides of a distance internship is that you aren't always with your fellow interns - we were all over the country! So orientation and July, and this conference, were the only two times we were all together. But given how much we all supported each other during the internship process, it felt like we'd all known each other forever. **Corny**