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My dietetic internship come to a close today. I have to say that it is bittersweet to be finished. All of the other interns that I have come to enjoy seeing on a weekly basis will cease after today. However, we are all going in different paths and I have seven new colleagues that I know I will keep in touch with. I have had many wonderful experiences throughout this year but I must admit that I am glad that working for free is now complete and I can begin to make money!!! One last time as a group, below is a picture of the eight interns of the 2007-2008 University of Maryland Dietetic Internship!

Interns at graduation

June 23-25 -- Outpatient Diabetes Union Memorial
My last week as a dietetic intern!! I can't believe my 10.5 months has flown by! During my last week, I spent three days at the Outpatient Diabetes Clinic at Union Memorial Hospital. This gave me a chance to see what it was like to be a dietitian in the outpatient setting. I realized during this week that as a dietitian in this setting, you cannot get discouraged about the amount of no-shows that occur during the course of a week. When the patients do come in to see the dietitian, it can be very rewarding because you are able to see the progress that these patients are making and experience the thrill of knowing you are making a difference. If the patients do not return for their additional visits, it can sometimes be frustrating to try and figure out why they do not feel it is necessary to return. This week taught me that patience and diligence is a definite necessity doing outpatient but I feel it could be very rewarding at the same time.

June 16-20 -- Montgomery Co. Aging
Montgomery Co. Aging is located in Rockville, Maryland. During the week at Aging, Jinee and I were able to see first-hand several of the programs that are encompassed within Aging. This program is a result of the Older Americans Act that helps to fund programs that assist in feeding individuals over the age of 60. Programs included within this act are congregrate and home delivered meals. We had the opportunity to go to one of the sites that provided Meals on Wheels and then went out with several of the drivers to deliver these meals. We also spent time at one of the Senior Citizens Centers and provided a lesson on Food Safety During Disasters. This lesson was very appropriate as the entire county was having issues with water due to a water main break. For most of the week, the county was having to boil their water and many of the facilities were unable to serve meals due to the problem. Learning to be very flexible and roll with the punches was the theme for the week!

June 9-13 -- Elective Rotation (NAL)
For my elective rotation, I chose to return to the National Agricultural Library to work with the Web and Reference Team. I really enjoyed working at NAL during my very first rotation as a dietetic intern and thought I would return to learn more about the work on this team. In the short time that I spent there, I was able to complete several different projects for this team. First, the team was looking to update the Organic Page on the website. This is a collection of resources available that consumers can use to learn more about organic foods. In addition, I researched obesity and interventions and outcomes for a patron. I also added more resources to the Online Learning and Conferences and Events pages. While working with the Web and Reference Team this week, I had the opportunity to learn more about the NAL Tool which is how the library adds resources to their online pages. I found that this team has a variety of projects that they work on and I thoroughly enjoyed the time that I spent there!

June 3-4 -- Baltimore VA Medical Center
My second week at the Baltimore VA was a little different than my first week. On Tuesday, I worked with one of the part-time dietitians to see several of her patients. While reading my notes, she was able to give me some theory behind some of the lab values that I should be looking at and the purpose behind looking at these labs. I learned that you can tell a lot about a patients' nutrition status by the lab values. On Wednesdays, there is a Weight Management class that is taught at the VA. I had the opportunity to assist with the teaching of the class and found it very enjoyable. The patients that were there seemed very interested and committed to making some positive changes. I found that doing a weight management is difficult to only see the patients one time and try and provide all the information that you want to say in just an hour. In the hospital it can sometimes be frustrating to educate patients on healthy eating when they do not seem motivated to make any changes. I found that providing these individuals with visual reinforcement gives them better understanding of the topics that I went over. With only 3 weeks to go in the internship, things are definitely winding down, or should I say getting very hectic to get things completed by graduation day!

May 27- 30 -- Baltimore VA Medical Center
After being away from Clincial for over a month, I return to complete my second hospital rotation. My second hospital is located in downtown Baltimore at the VA Medical Center. This facility is a bit different than when I was at Union, as this hospital has electronic charting. All charting that is done at this hospital is through the computer, which I found was much different than what I was used to. Learning where to look in the computerized chart and knowing where to begin when looking at the chart took some getting used to. I did find it helpful though to know that all encounters with the patient is at my fingetips and I can see if the patient has previously been to the hospital and if they have been seen by the dietitian before. I can also review notes to see if a patient has previously missed appointments with the dietitian or a nutrition class. The clinical aspect of this rotation is much the same as I experienced at Union, but I found that having my notes being computerized allows me to prepare my thoughts a little differently. The computerized charting system has a basic template that I fill in rather than writing an "original" note; however, I do write about the encounter with the patient and place that at the end of the note. For me, it would take a litte getting used to have electronic charting, but I think it would be very helpful once I learned the system.

May 19-21 -- Renal
My Renal Nutrition rotation was at Bon Secours in downtown Baltimore. Bon Secours is an outpatient dialysis facility attached to the hospital where dialysis patients come three times a week. There are two dietitians that I worked with while at Bon Secours that gave me a better perspective on how dialysis works and the role of the dietitian in the dialysis clinic. At Bon Secours, the dietitians have the ability to manage anemia and bone disease and adjust medications such as Procrit (for RBC production) and Hectorol (for Vitamin D) based on lab values. I found the work that the dietitians performed while I was there very interesting and something I think I really might enjoy as a career. I had the opportunity to talk to one the dialysis patients that had been coming there for 28 years. He was very open and honest and told us that he did not follow any specific diet, but knew the things he needed to watch. He told us one of the most important things to remember is that we are treating individuals and not as a group. What might work for one of the dialysis patients may not work for another and that we need to make sure that we tailor whatever we are doing to the individual. Additionally, we need to be realistic and never tell someone they can NEVER have certain foods because it just makes the individual want that food even more. Being in dialysis is all about compromise and trying to tailor treatment goals to the individual patient. I learned more about how the actual dialysis machine works and the importance of good compliance of dialysis visits. I found the three days to be very exciting and enjoyed seeing the dialysis clinic!

May 12-16 -- Nursing Home/Long Term Care
My nursing home/long term care rotation was at HCR-Manor Care in Rockville, MD. This is a 150 bed facility that had residents that live there permanently as well as residents that were there for rehabilitation purposes. The long term care setting is very interesting as one as the opportunity to get to know most of the residents that are there and able to monitor acute changes in this population much more quickly in other settings. While at Manor Care this week, I sat in on morning "rounds" which discussed events in the past 24 hours to give all members of the healthcare team an idea of changes that have occurred. I also spent time on the Alzheimer's unit observing these residents. I felt that it was important for me to spend time in this area to better understand how this population is affected by Alzheimer's in order to better comprehend their nutritional needs. I truly enjoy working with population because they provide such knowledge and wisdom as well as tell so many interesting stories of their past. Being at the nursing home this week brought back many memories for me from my childhood when I would spend my Saturdays at the nursing home with my great grandmother. I learned a lot this week about the role of the dietitian in the long term care setting and how to manage these residents nutritionally. What an enjoyable week to be around these residents and them be so welcoming to me!

May 5-9 -- School Lunch
School lunch in the Montgomery County Public Schools (MCPS) is very different from what I remember when I was going ot school in Kentucky (of course that was also several years ago). In MCPS, the food for the elementary schools is prepared at a Central Production Facility (CPF) and then transported to the schools to be reheated and served the following day. The CPF prepares 139,000 meals to go to the elementary schools per day. The secondary schools (middle and high schools) prepared most of their foods in their facililty for serving to the students. I had the opportunity to tour a couple of the schools to better understand the school meals and what is served to the students. While visiting the MCPS food service office, I met with several of the dietitians to discuss their role in the school lunch program. In addition to being a supervisor over several of the schools, each dietitian oversees another program such as the breakfast program, childcare programs, and senior citizens program to name a few. I was able to better grasp the role of the dietitian in the school foodservice and the many programs that encompass the school lunch program. I found the school lunch program very interesting and would like to explore this area further!

April 28 - May 2 -- Food and Friends
AVON WalkFood and Friends taught me much more than I expected. Although they originally began as a means ofproviding food to HIV/AIDS patients, they have extended their services to breast cancer patients through a grant with AVON. I had the opportunity of meeting one of their new clients this past week that was younger than I was and had just found out she had breast cancer. Without her diligence, the cancer would have never been detected and she would not be undergoing treatment. This lady had a partial mascetomy on April 4th and then had a child on April 15th. During the time I spoke to her, it became very apparent to me that the services of Food and Friends would definitely help her make it through these difficult times. Never had I ever been so proud to be participating in such an organization! Also during my week I had the opportunity to see the work of many volunteers helping to prepare and package 10,000 cookies and lunch for the participants of the AVON walk that was held in Washington D.C. over the weekend. Since having a family member currently undergoing treatment for breast cancer, I have decided that next year I want to be one of those participants at the AVON walk showing my support of breast cancer research and all women that have been affected by breast cancer. To learn more about the AVON walk, click here: http://walk.avonfoundation.org/site/PageServer?pagename=walk_homepage

April 21-25 -- Food and Friends
Food and Friends is a non-profit organization that seeks to provide food to HIV/AIDS, cancer and other life threatening illnesses to ease the burdern of cooking meals. Food and Friends provides meals delivered to the home daily, groceries delivered once a week, or a meals plus option where several frozen meals as well as groceries are delivered. The dietitians I am working with collaborate with the kitchen staff to develop 6 week cycle menus for the clients, input recipes into nutrition software to determine the nutrient content, and provide nutrition counseling to the clients. I had the wonderful opportunity to accompany one of the dietitians on a first day delivery where we brought their first meal to the home and then provided them with information about Food and Friends and lastly performed a nutrition assessment on the patient to determine their nutritional risk level. I met a delightful breast cancer patient that will be receiving meals three days per week. She was very grateful for the services that she would be receiving and it would hopefully take a little stress off of her family members having to be there to prepare her meals. I had the opportunity to help in the kitchen and bag groceries that would be taken to families as well. Being able to provide food to these individuals is a great feeling because you feel you are able to make a difference in these clients. By providing food to these clients ensures that they are getting well-balanced meals while they are undergoing medical treatment.

April 14-18 -- Children's National Medical Center
My second week at Children's was spent learning about Renal. Before beginning the renal portion of the rotation, I was very nervous about working with population. In my opinion, renal patients are one of the most complicated to manage nutritionally, yet nutrition is one of the most important aspects of managing this population. With a renal patient, one must take into consideration foods that contain potassium and phosphorus, but also manage the amount of sodium and fluid that they take in throughout the course of a day and ensure that they are eating enough protein to keep lab values such as albumin and nPCR within normal limits. Since I had a family member on dialysis for about 15 years, I know that managing patients on renal issues can be somewhat difficult but to restrict a child or adolescent in these areas can be even more challenging. With my fears in check, I began this week almost scared to talk to these patients; however, I was soon made very comfortable and realize these patients have dealt with this the majority of their lives and have a large amount of support to help them adhere to these strict nutrition parameters. I learned that a lot of these patients have been living with these conditions for the majority of their lives and that they just need some encouragement and a little "push" sometimes when trying to get lab values back within normal limits. These patients know what they need to do in order to maintain their health and well-being and for the most part adhere to what they should do. I found it very easy to attach yourself to these patients because you see them at least once a week and possibly as much as three times a week while they are in for their dialysis treatments. Just talking to these patients casually as I walked through the dialysis clinic I found that they were very knowledgable about what they were going through and very eager to tell me their story. Through the time that I spent with these patients this week, I have a new found respect for Renal Dietitians and realize that they play a very important role in the management of the dialysis patients. This is definitely an avenue I will explore further in the near future!

April 7 - April 11th -- Children's National Medical Center
I began my pediatric rotation at Children's Hospital in Washington D.C. this week. I spend two weeks here learning the pediatric aspect of clinical dietetics. My first week I was in the general ouptatient clinic where msot of the patients seen here are either overweight or considered failure to thrive. Two very different realms of the spectrum but very interesting population. I never realized how exciting it could be to work with motivated parents and children that were so eager to make changes. During this week I found a case study patient to present to the dietitians next week. While presenting this case study, I will also present an article that is related to my case study topic. I am going a different route with the article and will be discussing motivational interviewing which has been very to be very effective in the adolescent and child population. Motivational intervewing is a concept used to provide positive feedback and place responsibility on the individual to make changes. This method seeks to overcome the barriers that keep the individual from achieving their goals. I found this week to be very interesting and thorougly enjoyed the outpatient clinic. On Friday, I had the opportunity to attend the state MDA meeting in Rockville, MD were I was able to present my master's project through a poster presentation to the Maryland Dietitians.

March 31 - April 4th -- Union Memorial Hospital
My second week of staff relief, and my last week at Union Memorial Hospital. Wow, time has flown! I have really had the opportunity to test out my clinical skills this week while being in staff relief and I feel as though I did pretty well!! I have gained a great deal of confidence being the "decision maker" on the two floors that I covered and I felt that I handled the floors very well on my own. I learned several things during my second week of staff relief that I will definitely take with me. First, I learned that everyone doesn't feel that nutrition is extremely important in the overall outcome of patients. As the dietitian, we can only make recommendations and it is the ultimate responsibility of the physician to make final decisions of aggressive nutrition support for a patient. Secondly, I learned that I do well under stress. During my staff relief, I did the Cardiac Discharge Class as well as went to 4 East round everyday which took up approximately 1&1/2 hours of my day. I really had to manage my time and try to see as many patients during the morning that I could so that I could free up time to do those classes. I learned a lot doing discharge class and found that I actually enjoyed it! Lastly, I survived my clinical rotation!!! My last day was a bit rough having 18 patients to see and several issues with my patients at the beginning of the day, but I did survive! I learned a lot from Union and will take my knowledge as I finish my internship. The most important thing that I learned: I can do clinical. I was very scared beginning my rotation due to the amount of time that had lapsed since my clinical nutrition classes, but I successfully completed my clinical rotation and have confidence that I could work in a hospital in the future!

March 24-28 -- Union Memorial Hospital
My first week of staff relief went off much better than I really expected. I was a little concerned about being by myself and having to make the decisions on patients on my own rather than having someone right there for me to ask questions. Granted, if I had questions I could always page another dietitian and they would gladly help me, but essentially this would be like my first week of working as a dietitian. This week has taught me to have more confidence in talking to patients and to look at the whole picture. I have learned to involve the whole healthcare team in a patients' care and understand that no matter how hard I try, some patients just do not listen! A patient I visited several times this week refused to eat despite having several pressure ulcers and recoving from an amputation. Nutrition was essential in this patient getting better, but he told me he just wasn't going to eat. I have learned that I can only do so much and the remainder falls on the patient to get better. I have one week left at Union Memorial for staff relief before I move on, but I have come to really enjoy my clinical rotation and feel that I could work in a hospital once I am finished with my internship!


March 17-21 -- Union Memorial Hospital
This was my last week of working directly with a dietitian in the hospital before I begin staff relief. I followed patients in the ICU and pediatrics units this week. I am feeling more comfortable in working in the ICU and knowing how to handle the patients on this floor. I have learned that just becuase these patients are in the ICU doesn't mean that they are at nutritional risk and need immediate nutrition support. These patients often come into the hospitl well-nourished and only need nutrition support if they are not easily weaned from the ventilator or have been without nutrition for longer than 3 days. I find this unit to be very fascinating because these patients should be monitored closely for any changes that occur in the blink of an eye. A patient that I saw at the end of the week is a patient I had seen numerous times on another floor and has continued to not eat for the last three weeks. She is now intubated and at risk for refeeding syndrome due to her nutritional status over the course of her hospital stay. Refeeding syndrome is an interesting concept within nutrition support. Refeeding syndrome occurs when the patient has been malnourished for a period of time and are fed high levels of carbohydrate and cause their phosphate, potassium and magnesium levels to drop considerably. Refeeding is monitored in every patient and most formulas are started at lower rates for a patient so that their risk for refeeding is decreased. This next week I will begin staff relief in which I will cover two floors, 4 East and 9 East, on my own and have registered dietitian sign my notes. I am very excited about the fact that I will be working on my own and have to make decisions on my own, which will help me to learn a lot more and give me the opportunity to think critically to make my own decisions on how to treat these patient nutritionally. I am also a little scared in the fact that I feel like I have a lot yet to learn but know these next two weeks will be a great learning experience for me to be placed on my own and make executive decisions!

March 10-14 -- Union Memorial Hospital
My last two weeks at UMH as the intern will be spent in the intensive care and pediatrics. Two very specialized fields with very different methods of treating these patients. Most of the patients in the ICU are on ventilators and unable to communicate to let their needs be known. These patients are typically open heart surgery patients that were not abel to be weaned off of the ventilator as quickly as others or may have come in with other medical conditions. Within the ICU unit, many recommendations that I make are based on tube feeding, which I found to be very exciting to write! I enjoy calculating patients' needs for a tube feeding and try to determine which tube feeding would be most appropriate for the patient based on other medical conditions as well. I visit the pediatrics portion of the hospital on a consult-only basis. The nurses send a consult down if the patient is in the 80% or above for height and weight according to the growth chart or if the patient is very underweight. These patients are exciting to talk to because they are very honest with me and tell me just what they like to eat or things they really do not like. It amazes me the parents sitting by the children and the "cringe" that occurs when the children tell me they really like ice cream, hamburgers, and not really like fruits and vegetables. Getting the children excited now about eating fruits and vegetables hopefully will carry them throughout their life!

March 3-7 -- Union Memorial Hospital
I continued working with Erica this week as well as covering additional floors as other dietitans were away this week. I have had the opportunity to write more tube feeding orders this week and I am becoming more comfortable in determining the needs of the patient and then deciding which tube feeding to use. Erica has allowed me to see patients this week somewhat on my own to give me a feel of how I would do if I was by myself. I think that has helped me to develop my critical thinking skills during this time and realize that at some point I will be the one making these decisions on my own. I know I still have a ways to go in working on my educations that I provide to the patients, but I have learned that I will need to come up with my own way of doing them and tailoring them to each individual that I see. I continue to work harder on these and hopefully I will be more confident once I complete my hospital rotations. This week we also had the opportunity to go to the Maryland State Capital and sit in on a Senate session as well as House hearings in the afternoon. While at the Capital, we met with Senator Jim Brochin and talked to him about his current position in the Senate and some of the legislation that they are currently working on. I found that it very interesting to be there and really felt part of the whole legislative process. I better understand now that topics that I am interested in should be portrayed to the legislators so that when votes arise, they will better be able to vote based on what their constituents want.

February 25-29 -- Union Memorial Hospital
I began working with Erica Reinhardt this week on the floors that she covers. This week turned into a great learning week and I was able to observe a lot of interesting procedures. I began by going to see a Modified Barium Swallow (MBS) that the Speech and Language Pathologists (SLP) perform to determine if the patient is on an appropriate consistency diet. With the barium, the SLP and the radiologist can tell if this person is having difficulty with food going down. Next, I was able to check residuals on a tube feeding patient with the help of one of the ICU nurses. I had heard many times about checking residuals, but did not fully grasp the concept until I was able to see it for myself. Erica and I followed the surgery team around for a couple of hours during the week learning about plan of care for some of the patients that we were also following. I also chose my second case study patient, someone with acute pancreatitis that was experiencing extreme pain when he ate. Stay tuned for further information on this patient. I will probably present my case study the following week.

February 18-22 -- Union Memorial Hospital
My second week working on the Cardiac and Oncology'General Surgery floor was very interesting. I began teaching the nutrition portion of the Cardiac Rehab class this week and reviewing specific guidelines these individuals needed to follow when they went home. I also saw patients just after Open Heart Surgery and was able to write a few tube feeding orders for patients that were not recovering as quickly as expected. Several patients that I saw this week were having trouble coming off of the ventilator so I learned how to write the tube feeding orders as well as writing a few TPN orders for a couple of patients. On the Oncology/General Surgery floor, I saw a wide variety of patients with great nutrition needs. I had a couple of patients with pancreatitis that were being treated with TPN and learned the importance of looking at labs for these patients to ensure that they were getting adequate nutrients that they needed. This has been an interesting week because I have seen not only patients that have just hat Open Heart Surgery, but a wide variety of illnesses that placed these patients at nutritional risk. I look forward to learning more from the dietitians I am working with and learning about various other disease states and how to manage them nutritionally.

February 11-15 -- Union Memorial Hospital
This week I began working with a different dietitian, Catherine, at Union. I spend two weeks with each of the dietitians there to see different techniques and ways of evaluating patients. It has been a nice change because this week I began working on the cardiac and oncology floors. I have a different set of patients to see and very different disease states to encounter. I observed the Cardiac discharge class this week and will begin teaching that class next week. I also helped to calculate tube feedings and TPN this week while on these floors. I am still working on perfecting those skills, but have a much better concept of how to provide appropriate nutrition to these patients. I find these floors to be very interesting but challenging becuase of the various disease states that I have dealt with and the many nutrition issues I need to consider with these patients. I presented my first mini case study on Friday and will be placing a copy of this on the clinical page for review.

February 4-8 -- Union Memorial Hospital
This week has gone much better and I feel more comfortable being in a clinical setting. I had the opportunity to begin seeing patients this week and by the end of the week I was taking the initiative to find the charts and just go in to speak to the patients to determine what nutrition interventions need to taken, if any. I also began work on my first mini case study regarding a lady that came in on my 2nd day at the hospital. We had been following her pretty closely and I decided to use her as my case study that I will present this week. This is my last week with Hilary and I begin working with Catherine next week on the Cardiac and Oncology floors. I continue to learn a great deal about various disease states and how to approach patients and speak to them in a kind manner. I found that the patients that I have spoken to become comfortable with me very quickly and know that I am there to help them rather than to just tell them the things they need to change.

January 28 - February 1 -- Union Memorial Hospital
My first week of clinical! This portion of the internship is something I think everyone is a little anxious about starting. It can be a little difficult trying to put everything that you learned in class into practice. I was no different going into my clinical rotation due to not having any MNT classes in the last two years while doing my masters; however, I soon was able to pick up a lot of the information that I had forgotten. I began working with Hilary on the Geriatric and CEU floors at Union. Hilary has been very patient with me this week and I have learned a great deal about looking at lab values for patients to determine their hydration status as well as what might be an underlying cause of their hospital visit. I was able to actually go into several rooms by the end of the week to talk to patients about various things from why they have lost weight recently to how we could accomodate some of their food preferences while they are in the hospital. I am learning a great deal on how to handle patients in the hospital and good bedside manner. My week turned out much better than I had anticipated and I look forward to the coming weeks and what all I might be able to learn!

January 21- 25 -- Riderwood Village
My last week at Riderwood...My how time has flown by! This week was spent completing the large binder that we are to turn in to describe our theme meal. Essentially everything that we did for our theme meal goes into this binder that Riderwood keeps for other interns to look back on. In addition to some of the materials that we have already produced to market our meal, we also put costing, the layout of the dining area and our decorations, recipes, and pictures into the binder. It has been a great deal of work this week trying to get everything there, but what an accomplishment to have everything done! There is also an intern summary that allows us to refect back on our theme meal and tell what we truly thought of the entire project. I am going to miss all of the wonderful residents at Village Square and the many smiling faces I have come to expect to see on a daily basis. I have really enjoyed the time that I have spent at Riderwood and hope that I have made as much of an impact on these individuals as they have me.

January 14-18 -- Riderwood Village
Our theme meal was on Thursday!! We had a lot of fun this week getting our food and decorations ready for Thursday. We had prepared a production schedule for what needed to be done each day and everything the day of our theme meal. We were able to pretty well stick to what needed to be done; although, it took us about twice as long to do everything as we expected. Nevertheless, we had an excellent day on Thursday and feel that it was a huge success. The residents seemed to really enjoy the food and telling us stories from where they grew up and the foods that they remembered from their past. We really enjoyed doing this meal for the residents and I hope that we were able to bring back memories from their childhood. Check out the photo gallery for pictures!!!

Food DisplayJinee and Laryessa During Theme Meal

January 7 - 11 -- Riderwood Village
One week and counting until our theme meal! We shopped for decorations this week and began our final preparations for how we wanted the room to look. Our decision to do a Southern theme was very easy but coming up with decorations for the room were a little harder than expected. We just weren't sure how we wanted to portray the "south". You will have to revisit the website to find out how we decided to decorate the room (I can't tell that now...it would ruin the surprise!). We also did our FSNE presentation at Johnston Square on exercising and physical activity. Our residents seemed to really enjoy our presentation and the food that we prepared for them. Pictures of that event to come!!!

January 2 - 4 -- Riderwood Village
With our theme meal just two weeks away, there was a lot of work to get done this week. We looked for decorations already at Riderwood to see what we might be able to use and what might fit our theme. We also had to make our grocery list, production scheudle and talk to the other chefs to see if they would be willing to help us. During the week we also worked in the kitchen with the chefs and other employees on two evening meals preparing and expediting the food. I learned three valuable things this week: how to properly cut a pepper, slice oranges for garnish, and always wear a cutting glove when using a knife!

December 21 - January 1 -- Christmas Break

December 17 - 20 -- Riderwood Village
I didn't realize how much I would truly enjoy being in a long-term care facility. I spent much of my second week at Renaissance Gardens which is part of Riderwood Village except it houses skilled nursing and assisted living. During the mornings, I helped to prepare foods for the convenience stores and get things together to send to the floors for lunch. I was able to observe on the floors how the food was given to the residents, which is very different than what I have seen in other nursing homes. The residents are brought into the cafeteria, sat in their respective seats and the cook fills the plates and they are served...HOT food. The residents are getting foods based on a regular, mechanical soft (which means ground foods) or pureed diet. Their diet is based on whether the resident is able to chew and swallow the foods without choking. In the afternoon, we helped to prepare foods for the evening meal and then went to the rehab floors. These residents are much more mobile and need less assistance than the other cafeterias. It was so enjoyable to go around and speak to the residents. They were such a delight and made me feel so comfortable while I was there. Jinee and I are "recognized" now by the residents in Village Square as the "INTERNS" and those smiling girls! How great it is to have such support for what we are doing at Riderwood.

December 10 -14 -- Riderwood Village
A change of pace this week as I head to Riderwood Village. Riderwood is a retirement facility located in Silver Spring, Maryland and where I will spend the next 6 weeks doing food service. While there, we will have a theme meal which Jinee and I have decided to do "A Taste of the South". Since Jinee is from Georgia and I am from Kentucky, it was the logical choice for our meal. During our first week at Riderwood, we have already gotten our advertisements ready to put up and our menu set. We are in the process of extending recipes and getting everything together for our big day. We spent two days at Windsor and I learned how to fry massive amounts of beef and cut a million potatoes! The people there are so nice and very willing to show us anything that we ask to see. We look forward to the rest of our time there and our big meal.

December 3 - 7 - University of Maryland College Dining
My last week at College Dining and I can't believe it is going by so fast. I worked a great deal on the wellness presentation and our book that we were putting together in order to present on Friday. There was a lot we had to do to get prepared. Jinee and I worked on our project most of the week while trying to get back to the kitchen to spend time with the employees as much as time allowed. During the week we were to do a survey of the students from the University of Maryland on styrofoam versus glass usage. We presented our findings to the Assistant Director and gave a suggestion which she was very impressed with and hopefully will be implemented next semester. On Friday, we presented our project to the food service staff and they were very impressed with the changes that we made, the cover of our book, and the overall presentation. We also got snow this week. Our first snow of the year and it was beautiful. It makes it feel like Christmas already!!

November 26-30 - University of Maryland College Dining
This week Jinee and I really began to build on the previous two groups information for the wellness program. We placed information on the wellness wall for the first time this week to see how the employees would react to the information. We got very positive feedback from the employees and they seemed to appreciate all of the information that we provided them. We worked the production room one morning where they prepare all of the salads, sandwiches, and fruit for the satellite operations on campus. It was VERY COLD there, but we had a good time. We also helped to prepare breakfast one morning and I was told I made "perfect" pancakes. Jinee and I have become very close to the employees and have quickly gained a great deal of respect from them. I have realized that my fears of food service were definitely not justified and I have a whole new respect for the food service profession. This is definitely an area that I may pursue further.

November 12-16 -- University of Maryland College Dining
This week I began my food service management portion of my internship. We began food service management at college dining and I must admit I like it much more than I thought I would. We began the week by observing in the kitchen, serving breakfast, and looking at various storage rooms and refrigerator/freezers. I had the opportunity to be part of the Thanksgiving meal on South Campus which was a lot of fun and the food was excellent. The employees at college dining take great care in preparing the foods for the students and the food is much better than what I remember in my earlier college years eating with friends. I attended a web seminar about Food Sustainability and learned about the ways in which the University of Maryland is trying to conserve energy and resources.

November 5 - November 9 -- International Food Information Council (IFIC)
I have had the opportunity to do a wide range of activites this week at IFIC. I began the week off at the American Public Health Conference (APhA) in Washington D.C. IFIC had a booth and I was allowed to go and exhibit with them. What a great experience to talk to a lot of people that come by the booth and wanted to chat about nutrition. On Wednesday, Thursday and Friday Jinee and I helped to compile the binders for the annual board meeting to be held the following week. The board meeting is a chance for representatives from the companies that help to fund IFIC come together to hear about the year in review and what they plan on doing in the future. We also participated in a couple of roundtable discussions while we were there regarding MySpace and Facebook pages that were going to be created on Food Safety and Ag Biotechnology.

October 29 - November 2 -- International Food Information Council (IFIC)
The International Food Information Council (IFIC) is located in Washington D.C. and this is where I spent my week. This organization provides nutrition and food safety information to the public. During the week, I updated the Cancer, Diets and Fat page of the website in response to the new Cancer Review being released. I also checked the websites of their funders to see if IFIC was listed on the respective websites. I provided an Excel spreadsheet for internal use. On Friday, we had Joint Class Day focusing on CAM Therapies and Public Policy.

October 22-26 -- Food Stamp Nutrition Education
This week was a bit different for me. I was in Kentucky for the first three days for the funeral of my grandmother. Many mixed emotions abound during this time; however, I knew I there was also rotations waiting for me when I got back. I arrived back on Wednesday morning where I was originally off due to volunteering for the following Saturday. I had time to rest and get ready for the next two days. Thursday was spent researching events to be placed on the Eat Smart, Be Fit Maryland website. I placed the events that I found on the website for later use. On Friday, we went to Baltimore Highlands to do a nutrition education lesson with the 4th grade students. We helped them to prepare 3 different nutritious snacks and then write down sensory words that would describe the foods that they tasted. This exercise was used in conjunction with a writing assignment the students would be doing later on. What a great time I had with the students and seeing their eyes light up when they had tried something new for the first time!


October 19th -- Johns Hopkins Bayview Joint Class Day
The Joint Class day focused on Eating Disorders as well as gastric bypass. There were some very interesting speakers and I learned a great deal about two vastly different eating conditions that I may be faced with during the course of my career. Knowing how to handle each population will be an invaluable resource. Today was a little bittersweet for me. Later on that day, I lost my grandmother. Being so close to her, it was difficult sitting there and listening but knowing the condition that she was in. I miss her so much and think of her everyday, and know she was so proud to know that I was in a great place and almost finished with school forever. Thank you, Mama, for always being there and believing in me!!!

October 16-18 -- National Agricultural Library
This is our last 3 days at NAL. My how time flies!! I can't believe we have been here 6 weeks already. This week we did reference. I had the morning shift on Tuesday and Wednesday and the afternoon shift on Thursday. I was very busy answering questions this week. There was a wide variety of questions that came in, and a couple that just couldn't seem to believe some of the information that I gave them. I am amazed at the public and the things that they will come up with to ask! On Thursday, we gave our final presentation to the FNIC staff. We really enjoyed our time here and hate to go. If you are interested, you can see the presentation that Jinee and I did on the link below. This week we were at IFIC on Monday and Bayview on Friday. Very interesting class days. Lots of information in a very short amount of time.

NAL Presentation


October 9-October 12 -- National Agricultural Library
This has been a short week again due to the Columbus Day holiday and having Monday off for going to the ADA conference. Nevertheless, it has been a busy and yet exciting week. Jinee and I continued working on the Childhood Obesity resource list gathering education materials and additional contacts. On Thursday, we had the opportunity to go to D.C. to the ERS RIDGE (Research Innovation and Development Grants in Economics) Conference. This conference showcases the research that is currently being done in food assistance. We had a great time and were impressed to see some of the work that was being done. My masters focused on EFNEP and Food Stamp Participants and the literature review that I presented featured some of the speakers and mentors that were at the conference. Its very exciting to know the research that is going on with Food Assistance programs and hopefully in the near future we will be able to bridge the gaps that have been found in reaching this population. Lastly, we completed our training on reference and I had my first actual shift on Friday afternoon. Soon I will have some of the questions that I encountered for those to see. I am amazed at what the general population can come up with to send in for me to answer!!!

October 3 - October 5 -- National Agricultural Library
This was an exciting, but short week! Due to the ADA conference, we were only at NAL for three days. On Wednesday, Jinee and I continued working on the childhood obesity resource list. We reviewed the articles that we have found already to determine which sub-section they would fall into, then decided what areas we needed to look further into. On Thursday, we had the opportunity to take a tour to all of the Agricultural Research Service facilities within Beltsville. We saw honey bees, interesting products made of corn, toured the farms and saw the buildings that housed the nutrient laboratory and Human Nutrition studies. It was interesting to hear about all the research going on in the area.


September 29 - October 2 -- National Agricultural LibraryADA Poster Presentation
This weekend the interns had the opportunity to travel to Philadelphia for ADA FNCE where 12,000 dietitians met to listen to various speakers on new and emerging topics in nutrition, see new products on the market, and network with fellow dietitians. It was incredible to be in the midst of so many people in the same profession! While there, I had the opportunity to present a poster on my special project about food behaviors of EFNEP participants. What an experience to be chosen to present at a national conference. If you would like to see my poster, click on the link below!


September 25-28 -- National Agricultural Library
I have done a variety of things this week at NAL. I was able to review materials to be placed into the WIC Works Resource Center database. I found some very interesting materials that I never knew existed!! We put together materials that will be given away at the exhibitor booth at FNCE and then began compiling a resource list for educators and researchs on childhood obesity. It is amazing to me the information and research that has been done on childhood obesity just in the last couple of years. Finally, we were able to attend a couple of parties at NAL. The end of the year picnic was held on Wednesday and we had a great time. Nice to have a little break in the day and meet new people. Off to Philadelphia this weekend!

September 17-21 --National Agricultural Library
This week was my first full week of the internship. I worked with the web reference team two days this week learning how to answer questions that come into the FNIC inbox. Whenever going to the NAL website, one can send in burning questions that they may have about food and nutrition. I learned a great deal about how to respond appropriately to questions that come in. I also began reviewing materials that may be placed into the WIC database. NAL has some great resources for the public to use and are most usually readily available if someone wants to use them for presentation purposes. Lastly, I had the opportunity to help put together a binder that will be displayed at ADA FNCE in Philadelphia next week. A variety of things were experienced this week!!!

September 10-14 -- National Agricultural Library
This week was my first actual week of supervised practice. My first rotation is at the National Agricultural Library (NAL) working with WicWorks, which is a resource program for individuals that work with WIC participants. This week I have updated two different portions of the website, whole grains and infant feeding. I get to use the knowledge that I have learned from the training classes the last 1& 1/2 weeks and update the website. I think I expected to have to do a lot of technical work which I was a little worried about because I do not have a lot of technical experience. I have really enjoyed working on the websites so far, and it has been great to find out more about the WIC program.




Last updated:
June 7, 2008