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What is Clinical Rotation Like?

From August through December 2015 I spent my days (which started at 5:12am every day) at a clinical facility visiting with patients in an acute care facility for 11 weeks, and then at an outpatient diabetes center for 2 weeks. At my inpatient facility I compiled a workflow list from the unit consensus sheets. There were on average 20-40 patients on one floor each day so I had to prioritize the patients I saw with the 'P' ranking system.

A patient identified by the RD as P1 was "high-risk"; P2 was "moderate-risk" and P3 was "low risk". From this key I followed patients throughout their hospitalization. I completed "Initial Assessments" on patients with a variety of medical and psychiatric conditions. I provided Nutrition Education to patients on Heart Failure MNT, Carbohydrate Counting, and some other conditions but those were the topics I educated patients on the most.

I learned by doing and I also learning by veiwing webinars with the staff during our lunch break. The A.S.P.E.N. Foundation hosted several webinars, free for members, that the RDs watched for CEUs. I watched purely for learning. Malnutrition was a major topic. The facility I interned at had a Malnutrition Assessment Form based on the criteria for identifying malnutrition. The dietitian's were very keen on updating their assessment forms. It was a major benefit for me to be able to intern at a facility who's Clincal Nutrition Manager was as up to date on the evidence based guidelines as she was prompt to implement them into the practice.

My facility was also in the process of implementing a bridle policy. I watched bedside Cor-trak placement, and with that saw the bridle placed. Seeing these advancement in patient care was a rewarding education experience. At the monthly Nutrition Support Committee meetings, the nutrition services team met to discuss these changes and others they were hoping to implement. These meetings included the dietitians, an MD and a PA, an also a Pharmacist. I was truly exposed to the interdisciplinary team at these meetings and others that were held during my time at the inpatient facility.

It was during this first rotation that I met a team highly qualified, young, determined dietitians. I was inspired to crave more than just the RD credential, and have identified a strong interest in becoming a CDE. This lead me to my second rotation at an outpatient center that focused on providing nutrition and diabetes therapy. I worked alongside RD/CDEs as well as RN/CDEs.

What experiences did I encounter? The most impactful experiences I encountered were those that helped me identify what I want out of my profession as a dietitian. And, also what I don't want. I want to work for an organization that encourages learning and allows me to practice as my own professional, provided I use evidence based guidelines. A company that allows times for learning would get the benefit of having a knowledgeable dietitian who is up to date with the research. Watching webinars, grand round presentations, and listening to my preceptors discuss their upcoming trip to A.S.P.E.N (funded by the facility) made me eager to find employment at a place that accommodates my passion for learning.

I do not want to sit all day at work, and for this reason I feel that having a job that keeps me on my feet is more suitable for me.

What did I learn? What have I gained? Overall I learned that there is no way to reach your dreams without having a clear vision of what you want and the skills you need to obtain to get there. Making the right network is also a major help in propelling your career. I have grown a sense of the type of dietitian I want to be and the type of private practice I hope to own someday. ​

What did I like about this practicum?

My favorite part about this practicum was the dynamic, wonderful, and selfless human beings I was able to work alongside each day. Each preceptor dedicated her time to foster a rich learning environment. They were always more than willing to lend a hand when needed, but felt enough trust in me to let me practice on my own. I am so grateful for that!

Problems & Solving:

Seldom did I run into an issue during my practicum. I only encountered 1 problem that may have impeded on my punctuality. However, I spared enough time on my commute that any *unforseen* circumstances that could arise would not make me too late for my rotation.

Strengths and Weaknesses:

Ahh, the ever popular strength and weakness question. You know, I really feel like my overall outlook on life helps me get through the day to day mundane work. I suppose my weakness is getting bored easily, but because I have the ability to conceptualize and see the bigger picture, this gets me through. I have a tendency to laugh things off because life is just too short to stress on little things.

What would I do different in the future?

If I could go back to the Monica on September 8, 2015 (day 1 of rotation) I would tell her to carry less materials, take more photos, and ask more questions. I lugged books I didn't need because I didn't trust that I knew my "stuff" when in fact I proved to be quite competent during my staff relief week. I have 0 photos of my experiences with my preceptors. Sure, the hospital setting isn't exactly a time for selfies, but there were several informal occasions that I could have photographed a memory with my mentors. I'm a visual learner and next rotation I hope to be more confident in my skills.

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