Clinical Rotations, Dietetic Internship, Nutrition, Tips for Success

Leaving Your Clinical Rotation on the Best Note Possible

There may or may not be a pun intended in the title here.

Last week marked the very last of my acute and ICU clinical rotations as a Dietetic Intern. I literally cannot believe it. The last post I made gave tips on how to shine your first week (after I had finished my own first week). And here we are, 7 weeks later, and I am officially done with acute and ICU clinical. I’ll still remain at Erie County Medical Center here in Buffalo, New York for my Clinical Nutrition Management starting tomorrow. This rotation is only 1 week, after which I move into my long term care rotation before Thanksgiving break.

I will start with an overview of my last few weeks. I was fortunate enough to be placed at a fairly large hospital. Because of this, I was able to see a wide rang of conditions from laryngeal cancer and Ornithine transcarbamylase deficiency to Megacystis-microcolon-intestinal hypoperistalsis syndrome and multiple traumas (among your common disease states like cardio vascular disease and COPD). Educating patients started off as the most intimidating part of the experience (especially with renal) and ended up being my favorite. Some patients don’t want to talk to you and don’t care about helping themselves, but those that do will melt your heart. The best part of my day was interacting with my patients.

Me last day of acute

Getting involved in the care of patients in the burn unit was also a favorite experience of mine. Typically those patients come in without any significant past medical history and are only there due to an accident that resulted in a burn. Burns are highly catabolic and require lots of energy and protein for healing, so it was always a pleasure to chat with patients in the burn unit about meeting their needs and the importance of getting enough protein.

My preceptors were great at showing me things in the Medical Intensive Care Unit and the Trauma Intensive Care Unit, as well as our Burn Trauma Unit. In these specialty areas of the hospital, the patients have a paper chart with pertinent information for RDs like I&Os, BMs, IV fluids like propofol, enteral feeds, and temperature and minute ventilation for those on a ventilator (which is common in the ICU).

There were a couple times where I forgot to write something down off the paper chart and would have to go back to the floor to get the info. In the acute setting, you can get basically everything you need from the Electronic Medical Record (EMR), so this was frustrating at times. You’re limited in the ICU due to the sedated condition of many patients. You can’t interview them and unless there is family present, there’s not much you can do to gather things like UBW and diet history. All of these things become second nature in time and you learn to live AKA chart, without it.

At first I was nervous and weary of being at a big hospital. I had 5 different preceptors with whom I didn’t know I would be placed with until the day of, I was sort of “thrown in” my first day (partially by choice, partially because i didn’t want to say no) and taking patients on my own, I had to chart/do my assessments in the library which was far away from my preceptor(s). But it all turned out just fine. It turned out better than fine in fact. Honestly, I can say I had an enriching clinical experience, and I have my preceptors to thank for a large part of that.

Cards close up Kaitlyn

When you leave any of your rotations sites, you should really take the time to thank your preceptors in some way. The easiest way is a “thank you” card. You can buy a pack of 10 cards from Target or Michael’s for less than $5. Or you can get crafty and hand make them!

I personally love to make cards. Birthdays, anniversaries, thank you notes, Christmas greetings — you name it — I’ve probably made someone a card for it. This seemed like the perfect opportunity to shine, once again. A farewell impression is just as important as the one you make on in your first week. Preceptors often have hundreds of students throughout their career as an RD — you have to stand out. You want them to remember you!

Cards inside with tableCards table inside Bonnie

Three Tips for Being Memorable

1. Get to know your preceptor(s) a little

Eventually you will get to a point where you can relax around each other a bit. Especially at the end of the day when you’re leaving on say like, a Friday. If you get invited to any events with he/she/them outside of your rotation, take advantage of that! I was able to attend two conferences that counted as Supervised Practice hours, and was able to socialize with my preceptors in a setting out side of the hospital. It was a very real-life, applicable experience. Not to mention it was fun! Be interested in your preceptors. They are people too. Ask them what they’re doing over the weekend, compliment them, etc. It’s the little things that count the most sometimes.

2. Say “yes” to everything and anything

You’re here to learn and absorb the most that you can in your time on site. For me it was 7 weeks, which felt like an eternity at the beginning, but flew by just them same. If they ask you to take more patients, say yes. If they ask you to attend an event with them on the weekend, say yes. Your efforts will not go unnoticed.

3. Say good morning and goodbye to everyone, everyday

Acknowledge everyone in the diet office. Say good morning when you arrive. Say bye to everyone when you leave. Bonus points for personalizing it and saying “bye, [insert first name here]! Have a great night/weekend/whatever!” Again, it’s these gestures that people remember because it makes them feel noticed, important and loved! People will always remember how you made them feel.

Cards ALL DONE

If you do all three of these things and leave everyone who mentored you with a personalized “thank you” card, I can pretty much guarantee you will be remembered. Personalizing the cards can be as simple as mentioning each persons unique characteristics and how they helped you/inspired you/guided you as well as drawing on any experiences you shared with them that stood out and made a lasting impression on you. Or you can go all out, 100% fancy pants and hand make each card. That will really knock em dead. People want to know they made a difference. It makes them feel good. And folks, that’s how you leave on the best note possible!

Xo,

Natalie, future RDN

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