2013

       One of my biggest pet peeves is celebrating holidays (or any occasion, for that matter) without remembering the background meaning. So, on Christmas, I reflect on Christ’s birth. On the 4^th of July, you’ll probably find that I’ve read the Declaration of Independence recently. I doubt I’m unique in this, but, I do like to be a conscientious celebrator.

       So, today, I’ve taken time to reflect on the past year. I’ve noticed several friends’ posts regarding all that has happened over the past year and have been reminded that a lot happens in a year. A year ago, I was hopeful, but not very confident, that I would still be in Iowa City. I would never have guessed that I would now be employed as an RD at UIHC or teaching classes at UI this academic year. In 2013, I celebrated my second graduation in two years, passed my RD (thankfully, after 5 years of work!), continued grad school as a second year MPH student, moved into my own apartment, purchased my first car (sad to see the Alero go, but, I do like my little Honda Fit), have taken on more responsibilities at church, moved into the 21^st century with my first smart phone, and probably many other things that have slipped my memory. I’ve been challenged, in both good and perhaps not so good ways. I’ve strengthened existing friendships and gained many new friends, for which I am incredibly grateful. A few things that I’ve learned or been even more convinced of their importance this past year:

1. Never underestimate the importance of smiling at someone. Truly, I think it is among the easiest, comforting, and meaningful things that we can do as humans.

2. Take time for people and invest in them. Worth it every time.

3. The more you learn, the more you realize you have absolutely no clue.

4. Reflexivity is incredibly important. Interesting that it took my qualitative research methods course for me to realize how beneficial (and disturbing at times, to be honest) it can be to reflect on things.

5. New situations are only difficult and challenging if you believe them to be. Fake it ‘til you make it if nothing else.

6. Being a teacher is ten times harder than anyone thinks, whether actually teaching classes, leading children in learning music, or helping interns learn to become competent, confident RDs. The content is the easy part, it’s finding how to enable others to learn that is the tricky part.

7. Pretty much everything my parents taught me I have found to be true and I’m thankful every day to have had such God-fearing, devoted parents. I am ever amazed that they’ve pulled off raising 2 grown kids that are at least somewhat normal with 3 more still at home. Parenting isn’t for the faint of heart, that’s for sure.

8. People are often interested in your friendship, even if it seems that they are not. Worst case scenario, someone takes you to just be nice and polite. No harm done.

9. Connecting to a church is probably among the most important things you can do.

10. Life is perpetually in transition. Maybe it’s because I’m 23, but, I’ve decided that it is much better to simply accept this as the norm rather than fighting it.

11. Almost everything I’ve learned in public health revolves around treating people fairly with integrity, humility, and compassion. Where have I heard that before…

12. There is no point in complaining about things you cannot change. Deal with it, do the best you can, and move forward.

13. I like people. A lot. Anyone. I love nothing more than playing with a squirrely almost two year old, chatting it up with one of my adorable “older adult” patients, or interacting with students.

I know that 2013 has been a year filled with joys, sorrows, triumphs, and disappointments for virtually everyone. I hope you all have a splendid 2014. I’m excited to see what God has in store. 

The journey continues

In one paragraph, I shall attempt to catch you all up on my life since my last post - apologies for that being so long ago. You've been forewarned that this will probably be one long paragraph: 

Over the past 4 months, I have completed and graduated from my dietetic internship, successfully passed the registration examination for dietitians (aka, I'm an RD!), become a licensed dietitian, started work as a PRN relief dietitian at UIHC, took two online grad courses over the summer (while working full-time...it was busy), moved, purchased my first car, and just today completed my fourth week as a 2nd year MPH student and grad assistant at Iowa. On the extracurricular side, I've continued to be involved in my church in varying capacities, been able to babysit some pretty adorable children, run a few races, tried my hand at painting canvases for my wall (which actually turned out half-ways decent), went camping. I probably left something out somewhere, but this description will suffice. 

Throughout this incredibly busy, challenging, and oftentimes stressful time of life, God has remained to be ever-present and faithful. He's given me supportive friends and family to keep me sane, communities in which I am able to minister and serve, I get to live one more year in a city that I love, and my knee is finally better and I can run as much as I want! While the above paragraph may lead you to believe that I have it all together, by no means allow yourself to think that for a moment. I struggle with life issues just like any other human, I still don't know what I want to do with my life following graduation in August, and my courses and jobs have been challenging me in unforeseen ways. Not so much due to the content (grad school for me is not near as intensive as that of the didactic learning of undergrad), but more because of the issues, ideas, and thoughts with which I continually wrestle and regarding which I try to develop educated opinions. Let me explain. 

In public health we are, obviously, concerned about the health of individuals, families, and communities. So, basically everyone. Furthermore, we quickly learn that, when public health is doing its job correctly, no one knows we exist. So, I'm earning my masters degree in a basically unseen/unknown area that often not appreciated and does not receive enough funding to complete desired activities. Additionally, my heart breaks most days for the stories told by researchers who have worked with the Native American population, other ethnic minorities, health disparities, abuse (physical and otherwise), and many other scenarios. Furthermore, my brain starts to become challenged in regards to human rights (what things do or should we consider a basic human right?), the government's role in the nation's health (when can we intervene appropriately when individual responsibility is not failing?), how to effectively help others, do these efforts really make a difference, why has the human race done such a terrible job of caring for the health of themselves and the planet, and many more ethical dilemmas. All this aside from the fact of me trying to figure out how a dietitian fits into this public health arena. 

And then there's the issue of me still being unsure what I really want to do for my life's work. I have continued to really enjoy teaching (I'm teaching two sections of one course on my own, grading for another course), I like academics (yay school!), but I also like the clinical aspect of my RD job, too. About the only thing I've concretely decided is that I really like pediatric work of any variety. I have recurrent thoughts of completing a BSN, or going to medical school, or PA school, or earning my doctorate. I sometimes wonder why I became a dietitian in the first place and question whether this is really where I'm meant to be. So, once again, I'm not 100% sure of what I'm currently doing and I am in the place of not knowing where the next year will take me. It's becoming a trend. ; ) Honestly, this has been causing me some unrest, although this is subsiding now. I want to serve people in the best capacity I can while using my gifts. SO, what does that look like? And, who decides this? Me? Maybe my unrest has been due to an issue of control: Perhaps, unwittingly, I think I should be the one to determine where I am "best" serving and using my gifts, rather than my Creator who truly is the one calling the shots. Going back to the trusty Westminster, my primary purpose is to glorify God and to enjoy Him forever. Outside of that, I just need to trust God and remember that other life decisions and career paths will be evident at the necessary time - and not before. Micah 6:8 sums it up pretty well: 

He has told you, O man, what is good; and what does the Lord require of you but to do justice, and to love kindness, and to walk humbly with your God? (ESV)

So, friends, be just, be kind, and walk humbly. The rest will come. 

Nearing the finish

            Enjoying my first evening off in…let’s just say quite awhile, I realized that this blog needs some updating. Two months is perhaps pushing it just a bit. Not surprising to any of you, I’m sure, my life as a dietetic intern has continued to be busy. But, the big news is, we graduate next Friday, meaning that we only have 6 more days of actual rotations! I’m excited, obviously, but also have been feeling a little down. No matter how many times it happens (which I have learned is, essentially, all the time), change is hard. And moving on to a more normalized adult life, while exciting in many aspects, means that I have to come to grips with the fact that I will soon and very soon be a licensed professional working independently.  I know that I am competent, generally confident, and able to perform my job. It’s just weird to know that I am so close to being at the finish line of five-and-counting years of difficult and ever-challenging work. Good thing I’m prolonging the whole full-time job aspect of this thing for another year. ;) Yay for grad school-which, sidenote, begins again for me in 1 ½ weeks!  

                In regards to an update on rotations, I’ve now completed community nutrition and, within the food service management realm, retail and patient services. Community nutrition was four weeks primarily of observation, which I didn’t mind due to the fact that we were exposed to so many different aspects of dietetics. We spent time in long-term care, working with the Blue Zones Project in Muscatine, IA, taught a health fair for 5-6^th graders, taught a nutrition lesson to 3-4^th graders, visited a school food service operation, Johnson County WIC, and other things that I’m unable to remember at this time. All in all, it was a good experience. We did have extra free time, which was nice, as it gave me an opportunity to finalize grad school details.

                Both retail and patient services were great as a way to gain more exposure to still other areas of dietetics. They also served as a good reminder of the importance of knowing your employees and being a manager whom they both trust and respect. While in retail, I spent time developing materials on composting awareness, as UIHC began a composting program about two months ago for food waste and other compostable materials (including our new  compostable to-go containers, cups, etc.) We also standardized a few new recipes for possible inclusion in the summer menus of the various cafeterias. Patient services consisted primarily of observation, but it was good to see the entire process of the patient menu (which is a la carte/room service style at UIHC), formula preparation and delivery, and sanitation, in addition to the actual managerial aspects of the various areas.

                One thing I’m realizing, in all of these experiences, is that I am still unsure of what I really want to do, which is frustrating to an individual who wants to serve in a way that fills the biggest need possible while using my talents. I enjoy each area of dietetics and honestly could see myself working as a clinical dietitian, a food service manager, a professor, or a community-based R.D. I am ever-reminded of my love for people, of all ages, ethnicities, shapes, sizes, and sorts. I know that I am passionate about investing in their lives and serving the needs of others. At the same time, I am very much academically minded, organized, and in many ways fit the mold of the stereotypical dietitian. Obviously, this makes deciding on a career path a little difficult. Also, there is often a nagging fear in the back of my mind that I’m not doing enough to serve others, or that I don’t know where I best fit. Try as I might to assure myself that I’m where I’m meant to be and that there are many avenues to achieve this end, I must admit that these thoughts still occur. But, I’ve decided to rest in the fact that God must have made me this way for a reason, that this reason will become evident at the right time (and not before), and, meanwhile, my job is to follow His lead.

                So, as I enter into the end of the last phase of my internship, I plan to enjoy these moments as much as possible, with as little worrying as possible. Currently, I am working on special projects with managerial staff. Along with two other interns, our present project is developing and revamping website content for various departmental webpages. All these things that you don’t realize have to actually be done by someone….until you’re the one doing them. J On the non-work side, I just got back from my first trip to the Iowa City Farmer’s Market, which was fun. Definitely will be going back again later in the growing season. Also, I’m doing a color run this weekend with a few other interns, for which I am super excited! Hopefully all that dye will come off before graduation…..

                I wish you all a great and lovely day, my friends! No matter if you’re feeling depressed, unsure, happy, sad, or otherwise, rejoice in the fact that we have a Father who loves us. A lot. And has a plan for us. And made us for the sole purpose of glorifying Him and enjoying Him forever. I don’t know about you, but being reminded of that fact always makes my current situation seem ever so much better.

Anticipation and provision, forever and always

      April 1^st isn’t exactly a big day to most people. I mean, there’s the April Fool’s Day component, but otherwise, it’s just another day. [Sidenote: April Fool’s Day has always annoyed me. Why purposely lie to or trick people? I guess it’s just not my style]. Back on topic now, April 1^st is a pretty big day for me. One year ago today, I found out whether or not I would be able to become a registered dietitian. Prior to that day, I had no idea what I was doing after graduation, where I would be living, when I would be moving (if I was accepted into a program), who I would be living with, which program I would (hopefully!) be attending…. You get the picture. The best of senior year stress rolled into one day.

     This story has a happy ending, however. April 1^st, 2012 was match day, a phenomenon unknown to anyone who is not a dietetics major or somehow connected to one.  Once I was able to eventually log in to the online matching site for D&D Digital (the system through which applicants and dietetic internships rank each other), I was able to find that I matched to the dietetic internship at UIHC, my top pick!

      Now for a brief history on why exactly all this was so important. First, it is required that a supervised practice internship (typically about one year in duration) be completed after obtainment of a bachelor’s degree in dietetics or other approved area  in order to be eligible to sit for the registration examination for dietitians. You can only match to one program (hence the matching website), even if you apply to more than one program. You rank your programs, the programs rank you, and as the applicant you hope that they align somewhere.  Oh, and, every applicants logs in to the matching site at the same time to find out if they matched or not. Add in the fact that, last year, 53% of applicants did not receive a spot (it’s a long-standing problem that there are not enough dietetic internships for the number of new grads each year), it’s a stressful day at best. So, the odds are decently good that you may not be able to become a dietitian after putting in 4+ years of work. There are options, of course, including reapplying, but this is obviously not ideal.

      So, I mention all this because, for me, today is a celebration of God’s faithfulness. He gave me opportunities to not only attend the college I wanted to and study the area that interested me the most, but also allowed me to have jobs, volunteer opportunities, an academic mindset, leadership roles, research, etc., that helped make me a stronger applicant for internship positions. He providentially provided for me to come to Iowa City, a place that I never would have dreamed of coming to prior to two years ago. In fact, I wasn’t initially interested in the program here and planned to stay in the Chicago area. I was actually pretty stubborn about it and only looked closer at Iowa out of respect for my mother. Funny how things change. As it stands now, I’m in the midst of a program I love with people that I like, I’ve been able to experience and learn more than I ever imagined, made new friends, become a part of a great church, continue to work at Hy-Vee….the list could go on for a really long time. All this became a reality starting one year ago. And for this, I am grateful to the One who made it possible. I’m also thankful for the four dear friends/roommates who put up with the anxious and distracted Martha of one year ago, who truly shared in my pain. They probably deserve a medal for their support. J

     And now, one year later, I must admit that I was in a very similar place of not-knowing-what-I’m-doing-next until last Thursday. You think you’ll know what you’re doing sooner when you get older, but I’m adjusting to the fact that this is not the case. (I give all you wiser souls permission to laugh at the young adult mindset present before you). Irregardless , I found out last week that I was officially accepted into the master of public health program (MPH) at Iowa! This means that, not only do I get to finish up my masters over the next year, but I also get to stay here! I have an interview this week for a teaching assistant position, which would be great, and also possibilities for another part-time RD job opportunity. No, I don’t have all the details worked out, but at least I have a general plan. And, just like last year, I’m excited, thankful, and utterly blessed.

      So, I’ve been realizing that this blog has turned into more of a life story than just internship-related things, so just let me know if there is ever something you’re dying to know about my program. J I finished up staff relief last week in inpatient pediatrics/pediatric ICU, and have thus completed the 5 months of clinical work required in my program. I still can’t quite believe that I won’t see another patient as an intern. As of today, I am now in community rotations, which is as it sounds. We work with dietitians involved with schools, Hy-Vee, prisons, nursing homes, etc., which will be interesting. We’re definitely in the home stretch to June 7^th, however, which is crazy in and of itself….

     Thanks for reading my ramblings on thankfulness! As always, God providentially provides and blesses us with more than we ever deserve. Senior dietetic students and other applicants who may be reading this, know that I’m praying for you as this week unfolds. April 7^th will indeed answer many questions for you, irregardless of the outcome. In the meantime, try to freak out as little as possible and rest in the fact that God has your back. Always.

Happy RD Day!

Happy Registered Dietitian Day! Yes, this is an actual day, albeit one that it is not as popular as other calendar holidays. Nonetheless, it is important to recognize the role that dietitian's play in our nation's health and wellness. As you can see from the above graphic, RDs are advocates, something that was repeatedly reinforced to me during undergraduate courses and now I have seen in action during my time as a dietetic intern. That means that, while I'm not the one ultimately calling the shots for my clients/patients, I am responsible for presenting their wishes and opinions, as well as overall championing what is best for their nutritional health. To do this properly, I have to be well educated, base my recommendations in current, evidence-based research, and, most importantly, have spent time with the individual. I promise, RDs do more than it may seem at first glance!

Given that today is RD Day, and even though probably none of these individuals read my blog, I wanted to thank the many dietitians who have been part of my education and learning to this point. From job shadowing in high school to didactic learning in undergrad to now my supervised internship, I am incredibly grateful for all of the knowledgeable, friendly dietitians who have been willing to teach and mentor me in the dietetics profession. While I know that there is ever-more to learn, I do feel confident in my abilities in becoming a dietitian this summer, thanks to all these individuals.

And, as you are also probably unaware, March is National Nutrition Month (NNM)! Celebrated each year, the theme for 2013 (the 40th anniversary of NNM) is "Eat Right. Your Way. Every Day," focusing on the choices we all make each and every day in regards to our diets. There is not a set in stone diet that is appropriate for every individual, nor is every day going to be a model of optimum nutrition. Rather, it is about making healthier choices and, overall, consuming a balanced, varied diet.

NNM has been a switch for me this year. I've been accustomed to being a NNM champion during undergrad, organizing promotional materials, booths, activities, etc. This year, my only involvement has been assisting in planning a health fair for hospital staff, patients, and families with the other interns. Irregardless, it should be fun, and it is nice to have a bigger budget for materials and giveaways. :) The fair is today, which is appropriate given that it is also RD Day!

So, here's to nutrition, health, and dietitians! Next RD Day, I'll be able to celebrate for real!
 

A season of reflection

     Maybe it’s the weather. Maybe it’s because we are in the season of Lent. Maybe I’m just worn out from everything. Maybe my brain is overloaded from being in 7 different high-level care areas in 7 weeks. Maybe I’m overly anxious because I have no idea what my life holds after June 8^th. Maybe it’s because I’ve at long last reached my almost-breaking point. But, I’ve been in a funk for the past week or so, and have honestly felt alternately depressed, inadequate, down on myself for feeling these things, questioned my choice of careers, and then am once again back to normal. Nothing like roller coaster emotions! While I’m not sure what’s been going on, I know that having a low-key weekend has helped immensely, the snow and sunshine are lovely, and being outside truly makes Martha a much happier person.

     I don’t mention these things to be a downer, or to draw attention to myself, or to make you all start thinking something is terribly wrong with me. Because, quite simply, none of these things are true. Rather, as you all know, I’m an honest person and I also know that many people struggle with similar things on a regular basis. So, in sharing my struggles, I hope to encourage those of you who have been feeling the same way. We are normal, I promise! And, best part is, God is still in control, and loves us even though we truly are a mess (even at our finest moments).

     Enough of my philosophizing. Time for updates all around! Lots of rotations, per my usual. J

Pediatric ICU Once again, I LOVE peds! I enjoyed being able to complete assessments of older kiddos (versus the tiny neonates), observe a new diabetic education for a young child, do an obesity education on my own, and interact with the peds care teams. I was once again reminded of how important it is to build camaraderie with patients, considering myself successful when I cracked a smile out of a previously stone-faced teenaged male patient. And, as always, the RD’s in this area (as in every area I have been in) are absolutely amazing. I only hope to one day be as knowledgeable as they!

Behavioral Health Off to psychology! I chose this rotation because I’ve always been interested in eating disorders (EDO), and UIHC has both partial and in-patient programs for EDO. Substance abuse and in-patient psychology are also part of this area, but the primary focus was EDO. Even though I was not as involved in counseling and assessment (due to the nature of EDO treatment), I nonetheless learned so much about EDOs and this patient population. It was interesting to see how interviewing, presenting information, etc., have to be altered in this area, due to the many other diagnoses and issues experienced by these individuals. Truly, my heart was daily saddened at what I observed (especially with the young patients) and the hurts that were visible on these patients’ faces from past abuse, neglect. etc.  In the end, I’m thankful that individuals seek treatment from these disorders, and that dietitians are able to help them restore their bodies.

Medical ICU Shocking, I know, another ICU. J This ICU is an incredibly busy area, admitting patients with conditions such as diabetic ketoacidosis, lung conditions, substance abuse, etc. Always changing and ever challenging. Naively, I didn’t realize that lung disease was such a common issue, or overdoses either, for that matter, but this rotation opened my eyes to both. The MICU dietitian was a nurse before becoming an RD and thus is a great teacher for how to physically assess patients (examining hair for nutrient deficiencies, examining skin for edema severity, etc.). Also, given that she has a minor in biochemistry, she has immense physiological knowledge, which I thoroughly enjoyed. I just wish I could have soaked up more of her wisdom!

Surgical Cardiology My last clinical rotation before staff relief! Looking back, I wish I would have done more cardiology, but I honestly didn’t think I would enjoy it and thus didn’t pursue it at the time. However, I really enjoyed this area and am glad for the knowledge I was able to gain. The surgeries done at UIHC are intensive (left ventricular assist devices, coronary artery bypass grafts, heart transplants, ECMO, etc.) and dietary precautions with such patients follow suit. Many biochemical, medication-related, and lifestyle factors to consider, resulting in challenging and yet rewarding assessments.  I was also able to interact more with the diet techs and menu system, which made me feel like I was able to make more of a difference in these patients’ lives. Additionally, my RD previously worked in renal for many years, so I was glad to be able to gain even a little of expertise in this area. Oh, and, the other cardiology dietitian’s name is Martha. Enough said.

      As much as I enjoyed these rotations, in the last three I particularly noticed a common theme: Lack of hope. From my EDO patients who were struggling with so much, to my MICU patients who tried to overdose one or more times, to my cardiology patients who (often) had been making poor lifestyle choices and now have to deal with the consequences, I’ve been left daily pondering just how much these people need Christ. Don’t get me wrong, I’m not saying that I think we need to overtly evangelize while treating patients, or that medical treatment isn’t necessary (because it is). What I have realized is just how dark, dreary, and, at the cost of being repetitive, lacking in hope this world is without Him.

     So, friends, I encourage you to ponder just how much Christ has given us, even in the little things, and realize how completely lost and helpless we are without Him. That’s what Lent is for, reflecting on our absolute depravity and need for God’s grace. During this season, I charge you to reflect on these things, looking forward to the celebration of our Savior’s resurrection.

      Staff relief starts tomorrow! I’m blessed to have received my choices, which consist of two weeks in NICU and two weeks in in-patient peds. I know it will be intense, I will be doing lots of research at home, and I will be daily (and hourly, for that matter), challenged. However, I’m still excited for this opportunity to learn and gain more experience in these areas.

P.S. I ran a 4 mile race today, the Chili Chase in Davenport, IA, in a little under 34 minutes (not sure of the official results yet), which was under my goal time. This was probably due to training with someone who runs significantly faster than my usual speed. Yay for a running buddy! In the end, my time was good enough to be in the top 40 women finishers and receive a sweet new stainless steel travel mug to that effect. Perfect for use during my 7 AM mornings in the NICU. J

Rotations, Rotations, Rotations

1) I am in denial of the fact that I am already three weeks into this semester. Time flies!

2) As usual, I’m behind at updating on my rotations…which means I’m now restricting myself to one paragraph per rotation due to having five (yes, five) on which to report.

      To give you a better understanding of my life this semester, we change clinical rotations each week for seven weeks this semester, which is great due to giving lots of experiences and challenging due to switching areas every five days. I’ll start staff relief in February (so excited!), but more on that when it happens.

     So, here are my brief synopses on my rotations as of late:

Production/Catering 

This rotation was just as it sounds, with lots of hands-on work in the kitchen, primarily due to being there during the holiday season. We also were able to see cook-chill, a unique operation in which food is cooked, bagged, rapidly cooled in special equipment, being then able to be safely stored in refrigeration for a few weeks. My fellow intern and I were also able to assist with catering functions, work on cost analysis and new ideas for daycare menus, observe the receiving process of food items, and many other tasks (such as pre-plating holiday meals for 500+ people. No big deal). Additionally, five other interns and I planned, prepared, and hosted a holiday appreciation meal event for the Food and Nutrition Services workers. Our theme was Candy Land and it turned out splendidly. Even better, Child Life Services at the hospital are going to use all of our decorations for the pediatric patients!

Mother’s Milk Bank of Iowa
Each intern at UIHC has the opportunity to spend a week at the Mother’s Milk Bank of Iowa, a facility of UIHC in which donor breast milk from eligible nursing moms is procured, properly stored, pasteurized, and shipped to neonatal intensive care units and eligible infants across the Midwest. I was able to pasteurize milk, assist with packing milk for shipping, learn more about milk banks, and help “log” milk (a system for keeping record of how much milk is donated per donor, how much donor milk is on hand, etc.). Before this rotation, I didn’t realize that such operations were unique (only 11 in the United States) and governed by strict food safety protocol and contamination checks. Overall, however, I now understand how important milk banks are for infant health. The benefits of breast milk are numerous, and through MMB, premature infants (whose own mother’s milk may not have come in yet or who have inadequate milk expression for their baby’s needs) are still able to receive all of the benefits of breast milk.

Sidenote: Please “like” the MMB of Iowa on Facebook! Such establishments truly save lives and getting the word out that MMBs exist is important.

Outpatient Nutrition Clinic
My first rotation of 2013 was at the outpatient nutrition clinic, now housed at Iowa River Landing (the new outpatient clinic for the University of Iowa). Even though it was a slow week while I was there, I was still able to observe the two outpatient dietitians counsel a variety of patients. I also completed my first solo diabetic education, so I was pretty excited. J I really enjoyed seeing patients from so many different walks of life, and, as I have mentioned before, assist them in changing their lifestyles to healthier behaviors. Even though many individuals are referred to such clinics by their physician, I still feel that they are farther along in their readiness to change than someone who is recovering at the hospital, making the educations much more personal and in-depth (due to greater availability of time). Also, the outpatient dietitians are true educators, appreciated and valued by their clients. I was able to learn so much through observing and working with these R.D.s.

Trauma/Burn
Definitely a switch from outpatient, but interesting nonetheless. UIHC has a specific intensive care-style unit for burn patients, in which hydrotherapy (cleaning of the wounds), excision of the wounds, etc., are all performed. Due to my naiveté, I didn’t realize the prevalence of frostbite, with my week in this unit consisting of many assessments of individual’s with TMAs (transmetatarsal [toe] amputations) and leg amputations. Also saddening, I followed some pediatric patients, who sustained burns through freak accidents and common home happenings gone wrong. Definitely an intriguing patient population, one with heightened calorie and protein needs, which is great for an R.D.! I do enjoy helping people find more foods to eat instead of encouraging moderation and restriction.

Neonatal Intensive Care Unit (NICU)
I finish my NICU rotation tomorrow and truly am left in awe of what I have seen in this unit. Babies that are as young as 24 weeks gestation are admitted to this unit and treated until they are able to go home and continue normal growth and development. While most all of the infants are premature, some are also term babies who have genetic abnormalities, critical health conditions, etc. Nutrition is, obviously, a huge component of proper growth and development, making the two R.D.’s who work in this five bay, 76 bed unit an integral part of the care team. Truly, these women are absolutely phenomenal and I am beyond impressed with their clinical knowledge, judgment, and ability to assist in treating these babies. Not possessing previous exposure to premature infants, it had not occurred to me that they are unable to consume foods orally for some time (due to having immature sucking reflexes), thus necessitating enteral (into the gut, if it is medically appropriate) and/or parenteral (into the veins) nutrition support. The calculations for such recommendations are, shall we say, complicated, and so many factors must be considered that are not as critical in the world of adult nutrition. However, I have absolutely loved this rotation, probably due to its complexity and the necessity of a strong science background in order to properly assess and help treat these “kiddos” (what the patients are fondly called on the unit).

      As always, I’ve managed to bore you all to tears with my lengthy updates. ;) Now, onwards and upwards to the pediatric intensive care unit (PICU) next week! Oh, and, our grad classes start again this upcoming week, too. Busy times in the life of a UIHC intern. :)

My 2012

What is a blog if it doesn't have an end-of-the-year recap? This past year was undoubtedly one filled with more changes, challenges, opportunities, and decisions than I could ever have imagined. I am definitely blessed beyond measure, which, while sometimes making me feel guilty, makes me ever-grateful for my heavenly Father who has given me these things to enjoy. God is faithful. So, here's to 2012!

My 2012 Top 12 (in no particular order, I might add)

Graduation Four years of learning, friendships, memories, and being molded into who I am today. How am I old enough to have a bachelor of science degree?!?!

April 1^st, 2012 A day that will live in infamy. I was accepted to the dietetic internship at the University of Iowa Hospitals & Clinics!  (Go Hawks! J)

Moving to Iowa City Settling into my adult life by moving everything I own minus some books and my American Girl doll to my new city.

Joining One Ancient Hope Presbyterian Church. God has providentially, as always, placed me in a church that I can serve and grow. My faith in the body of Christ has been restored.

Enjoying existing friendships Self-explanatory, but I can’t be thankful enough for these people! You know who you are. ;)

Making new friends Moving to a new city is cool and all, but, if it wasn’t for the gracious people who have let me become a part of their lives, I’d be pretty lonely.

Being in my first wedding It was such an honor to be in the wedding of my dear friend, who was also my former roommate and lab partner. I’m just glad my decorating skills were (surprisingly!) up to par.

Running the Chicago Marathon A challenge I didn’t realize was really that great of one until after the fact. After running 26.2 miles, why do I now struggle with a 3 mile run?

My grandparents moving to Aledo What I’ve wanted to happen since I was little finally has come to pass! I’m excited to see more of them as this year progresses.

Scholar Week Celebrating four years of hard work with the best cohort and faculty anyone could every request. Being able to present my research was definitely an honor.

Road Trips Spring break in Arkansas, a post-graduation trip out West, senior ladies retreat in Michigan, weddings across the Midwest. Fun times!

Hy-Vee Career Day Not only a great experience, spent with one of my favorite coworkers, but also an opportunity to see where my education and talents can help serve other people.

I am anticipatory of where God will take me this year. We'll see if it's another 2012. "I know not where He leadeth me, but I know with Whom I go." With that behind me, how can I help but be excited? No room for worrying about RD exams, grad school, getting my first real job...right? Right.


 Wishing you all the best, my friends, as we enter this new year.