My clinical rotation was split into two different rotations at two different facilities, I will talk about each one separately since they were very different!

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Clinical Part. 1: 7 weeks, 300 beds, 3 RDs 

Whew okay.  I expected to be treated like a student going into this, but boy was I wrong.  On day one my preceptors started the orientation process as if I was a new employee!  

After week one, here are my thoughts:

• Make sure you schedule out time for expectations

• Keep the list of procedures/conditions you want to see and write it somewhere you and your preceptor can see.  That way if it comes up they/you will remember (and you don't have to constantly remind anyone).

• Bring a notepad/book and write down all the things you don't know so you can look it up-or just ask the RDs and write the answer down.  Don't be embarrassed if you don't know all the medical terminology yet!

• If you're on a specific floor, be sure to prep for that floor (common procedures, medication, dietary recommendations etc) before hand so you know what you want to see/experience during that time. 

• Show your preceptors how you track your hours, and the assignments that you have to complete, that way they can see what information you will need!  

• The first week will not be very heavy with assignments, so use the time to get ahead if/when you can! Life will not stop around these rotations, but you can set yourself up for success and allow for weekends off if you stay ahead of schedule.

• This first rotation gave me the opportunity to choose which patients I wanted to see or follow each day.  I shadowed my preceptors for three days, then on the Thursday of my first week I was given 2 patients to chart on my own, and the number kept increasing for the rest of my time there.  I know other interns were assigned for days/weeks on  certain floor, so it just depends on your facility.

• If you can, bring your computer with you every day! If there is any down time you can work, but more importantly you can complete your case studies MUCH faster! I was able to input my information straight into the assignment, instead of having to copy it over twice.  This can be really time consuming, and you canNOT take patients information or pictures of the charts home (#HIPPA).  This was approved by my preceptors, every facility may be different, but I noticed I had decreased stress levels compared to my colleagues that could not work on site. 

• ASK QUESTIONS, OFFER TO TRY, and most of all, when it comes to your turn to start talking and asking questions, don't shy away from your professionalism! 

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Week 5 rotation update:

• Practice asking the nurses questions, and answering theirs

• Practice reading the tube feeding machines, mostly walking into the patients rooms (and right up to to their beds) and acting like you below there!  

• I sat in on interdisciplinary rounds in the ICU pretty regularly, and got to see how everyone works together, that was great!

• I'm starting to feel more like an employee now which is cool.  I am seeing about the same number of clients as my preceptors, and getting less corrections on my charting

• Don't get complacent and don't forget to stay organized! It's easy to get in the groove and think you can get lazy and start doing other things-don't risk it!

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Rotation recap: Wahoo!!

• I felt bad, the whole last week I was feeling SO ready to go, I wasn't bored exactly...but I did feel like I had gotten all I really would from that rotation.  I started to get less nutrition focused feedback, and more clerical feedback. 

• Despite the feedback aspect, I was treated like a real employee which was great, I was allowed to see patients by myself, and it was only at the end of the day in which we would review all my notes. 

• Ask to see procedures as much as you can, I got to see a few EGDs, and ESRDs, colonoscopies and a PEG placement, and I wish I could have seen more.

• Two weeks before your next rotation, contact your next preceptor.  2 WEEKS. 

Clinical Part 2: 6 weeks, 245 beds, 7-8 RDs

• I started shadowing different RDs until I got my own computer access, which took almost a week.

• This facility had me with one RD for a certain period of time.  This means I was on the renal/metabolic/surgery floor for 2 weeks, then changed gears to oncology for a week, then to ICU for a week.  I/we chose to put me on the renal floors for longer than the rest because that was where my experience lacked. 

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Week 4 update:

• DON'T GET COMPLACENT! If you finish ahead of time, you get to practice what it feels like to just *be* an RD and that is so fun.  You also get to start studying for the RD exam which is helpful. 

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Rotation recap:

• I have no words that could be sufficient in expressing my gratitude for this group of RDs and how helpful/supportive they were in these past 6 weeks.  They welcomed me in quickly, and immediately tried to figure out where I was at, so they could give me tips and show me where to improve.  

• My learning curve was less steep this time around, and I was able to really focus on my interviewing skills and feeling comfortable in the rooms and on the floors.

• I was given the space to work freely and grow confident in my assessment skills and charting, in my evaluations of a disease state and in my decision/diagnosing capabilities.  I feel so much more confident now than I did 6 weeks ago, and feel great about calling myself an RD!

Overall tips for clinical:

• Always ask the facilities what resources they have, there are some great online resources that ISU said was mandatory for me to purchase, but one of them I ended up refunding since both my clinical rotations provided it.

• The eNCPT on the other hand, is GOLD.  Get it, use it, love it.

• You do not have to get your preceptors anything at the end, but a card is a nice gesture.  I got my preceptors at my first facility a Starbucks card, and they took me out to lunch on my last day.   At my second facility I got a bunch of snack-y foods for them to keep in the office, and a card for those who I worked with one on one since there was so many of them. 

• Practice your professionalism and CONFIDENCE!  The medical nutrition knowledge is key, but without confidence you will not be as successful!