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.

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