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| Running off to inpatient! |
A dietetic internship is usually composed of three major
rotations: clinical nutrition, public health and community nutrition, and food
service. Here I briefly describe the rotation, what to expect, and some of my experiences.
1. 1. Public Health/Community Nutrition Rotation: the
aim of public health is to provide access to healthcare typically to people who
may not be able to afford or would have difficulty affording it. Public health also focuses on prevention and
overall wellness, and nutrition is a great tool for both of these. Some dietetic
internships may even focus their program on public health or community
nutrition. I’m sure rotations vary, but
I have found that most interns do theirs at WIC or Head Start.
-What to expect: Interning at WIC, you will
learn a lot about counseling, education, maternal and child nutrition including weight
gain during pregnancy, prenatal nutrition, coping with side effects of
pregnancy, preventing pre-term birth, breast feeding, child nutrition and
eating habits, proper growth for children using growth charts, promoting
activity and exercise with children, promoting decreased screen time for
children. I learned SO MUCH about
nutrition and pregnancy, child nutrition, and the WIC program itself. I was pretty hands on doing height and weight
measurements, counseling with my preceptor observing, and running group
classes. I did struggle with the slow
pace of work since my facility had primarily Spanish speaking clients. I’m not
too familiar with what would be done at Head Start but I think it would be more
education and child based. If you’d like
to learn more about the WIC organization, refer to a previous post I wrote: WIC post
2. 2. Clinical rotation: a clinical rotation can be
broken into several categories and although programs vary, most will want you
to spend time in a mix of them. People
probably think of an inpatient (hospital) rotation as clinical nutrition,
however there are also rotations in the outpatient, pediatric, and long term
care worlds. Most programs will also require you spend time as full time staff
relief meaning you work as a dietitian would, you are still considered an
intern, but it would be expected that you are able to see as many patients as
an RD-don’t stress, this is usually at the end when you are much more
experienced! So let’s break it down!
- Inpatient: this is done at a hospital and in my experience, I was able to work in all units (surgical, medical, telemetry, ICU, CCU, postpartum, even a gero-psych ward). Definitely didn’t start in ICU or CCU, I built up to that! I could do another post about what to expect from different units in terms of medical nutrition therapy. You do a lot of screening, seeing patients, educating patients, writing notes, calculating tube feeds, calculating PPN/TPN (at my hospital the pharmacy was in charge of parenteral feeding; we would recalculate their formula to give energy, fat, protein, fluid, etc. to make sure it met the patients’ needs), ordering supplements; basically making sure patients are meeting their nutritional needs. In my experience, I had a lot of independence and saw patients basically as an RD would and had my preceptor sign my notes at the end of the day. If you’ve never worked in a hospital before, prepare for a fast paced and sometime smelly environment J However, you get to wear a white coat which makes you feel super legit!
- Outpatient: this could be done at a diabetes center, renal/dialysis center, or some sort of eating disorder clinic. In my experience at a diabetes center, it is primarily counseling and group classes. Slower paced that inpatient, but great because RD’s can build relationships with patients since they come back for multiple appointments.
- Long-term care: this could be done at a skilled nursing facility, hospice facility, and possibly home health. I haven’t done this one yet-will have to report back! I am doing mine at a skilled nursing facility.
- Pediatric: usually done at a children’s hospital or a general hospital that has a pediatric unit. Unfortunately I was not able to find a peds rotation L
3. Food
Service rotation: I have not started this one yet, but will report back when I do!
It can be done at a hospital, school, or maybe a long term care facility. I am doing mine at a school which
incorporates child nutrition and school lunch/breakfast programs
My rotations themselves varied from 2 weeks to 13 weeks. Here’s what mine looked like:
Public Health/Community: 4 weeks
Clinical: 6 weeks inpatient, 2 weeks full time staff relief
(done at inpatient), 3 weeks outpatient, 2 weeks long term care (13 weeks
total)
Food Service: 13 weeks
So you can see, my internship is 30 weeks long plus 1 week
of orientation. Note that your required
hours do not take into consideration driving or doing assignments for your
program. Although I had time to work on
assignments in community and outpatient,
there was zero time in inpatient-it is that fast paced!
