Approaching the Finish Line

During the initial months of my internship, I was challenged to record regular reflections on my internship experience. I did routinely do this, however, due to the intensity of the internship not all reflections were documented on my blog or even on paper. Reflecting allowed me to ascertain the learnings I had experienced in my day/week/rotation and enriched my overall internship experience. It is a practice that I will continue upon successful completion of my internship (graduation day is July 20th, 2012 which is also my final day of internship).

Highlights:

§  Public Health

o   Interacting with people from different communities in the District Health Authority (DHA)

o   Seeing and experiencing rural Nova Scotia! Great people and beautiful scenery.

o   Learning the intricacies of public health policies

o   Not an area of dietetics in which I see myself practicing (although, I will not rule out the possibility), but I have enormous respect for Public Health Nutritionists and the complexity of their roles with public health.

§  LTC

o   Participation in resident special activities: Christmas teas and Christmas concert

o   The comfort I felt in the role and excitement I had going to work daily. I really enjoyed being amongst the Residents, staff, and other health professionals. Definitely an area I would love to work in.

§  Clinical

o   Increasing comfort level with enteral and parental nutrition prescriptions. I am proud to say that it did not take me the better part of an hour to write out a total parental nutrition (TPN) prescription by the end of my 13 weeks. Furthermore, I, most importantly, became trusting of my eduction and knowledge and what I wanted to recommend for patients. Confidence in my skills grew over the course of my 13 weeks in clinical (+ 1 week in the Diabetes Education Centre).

o   Increased comfort interacting with patients and providing diet education.

o   Observing the dietitians during patient and family interactions. Learn tips and tricks in diet education and various ways to interact with patients and their family. I learned methods that I'd like to emulate in my practice, and methods that I will try to avoid.

o   Working with the Speech-Language Pathologist (SLP) for swallow assessments and Modified Barium Swallow tests.

o   Interprofessional Learning Experience (IPL) - which I blogged about previously. I was also given the opportunity to co-facilitate an IPL team. Which I found enormous benefit in - but this I speak more of in my "Most Significant Learning Experiences" section below.

§  Administration/ Food Service

o   Co-facilitating IPL

o   Program planning and implementation

§  Completing projects and assignments relevant to the workplace

§  Collaborating with interns from other DHAs for projects.

·         Admin - Patient satisfaction survey; food service staff information session on NS Healthy Eating Initiative: Salt by Request provincial TeleHealth session.

o   Participating in dietitian and food service supervisor interviews

o   Conducting reference checks for interviewees

 

Most Significant Learning Experiences

§  My most significant learning experience occurred when speaking with the other dietetic interns in the DHA who recently began or returned to complete their internships. I found myself enjoying sharing what I had learned and instructing them on certain topics. I got excited when they got excited about internship and what they too will learn. I hadn’t before experienced the joy that came with sharing my knowledge and it made me excited for when I am a preceptor for an internship program. Additionally, co-facilitating the IPL team in oncology and palliative care was a great experience. This spring there were two IPL sessions running simultaneously. A stroke team and an oncology/palliative care team. Disciplines representing in the entire group included: SLP, dietetics, nursing, occupational therapy, diagnostic cytology, and respiratory therapy. I was eager to plan the team meetings and search for resources for the students. I enjoyed hearing them reflect on the multidisciplinary rounds they attended and of their experiences in the hospital. I believe that I will really enjoy the preceptor and instructor component of being a dietitian.

§  The importance of a supportive environment

o   Research results: my internship research  projects focused on factors that contributed to a supportive environment for the Food and Nutrition Policy for Nova Scotia Public Schools.

o   Experiences in internship with preceptors and other health professionals

§  Majority of my preceptors fostered learning: encouraged me and gave me a push when I needed it. When I wasn’t provided with the supportive environment, I felt initially discouraged, then used it as fuel to try and excel to show me, not the preceptor or other health professional, what I was capable of when I only had myself to depend on.

 

Unexpected Learning Events

 §  DC National Conference

o   Interactions with others

§  How I treat others and how I want to be treated. Respect!

§  Perhaps it is because I am naive and want to think the best of everyone, but I was taken aback when conference delegates didn’t want to interact with me aside from the basic “I’m from ___” (which seemed to usually be just the province, not city or town) and then stopped the conversation with that.

§  Additionally, I was surprised by an encounter with a dietitian whom I had met previously and corresponded with. I'll spare you the story, but the situation definitely took me by surprise and solidified in my mind that I will treat each person with respect and make an effort to remain positive despite how I am feeling that day, even if someone is being rude to me. I’m not certain why I was regarded with such disrespect, but I know that I will take it as a learning experience for the kind of professional and person I want be.

§  With that said, there were many dietitians whom were eager to interact even if just briefly. I went to the Conference with a goal of meeting as many new people as I could – and was delighted when people took an interest in me as well. I believe that professionally, networking is key in an ever-changing profession such as dietetics. I was delighted to discover that the majority shared this belief and practice. The conference itself was so much fun! I really enjoyed seeing Acadia University alums, made some new friends and acquaintances, and learned a lot from the sessions (educational, key note speakers, and research displays). I'm so grateful that I was given the opportunity to attend (I received sponsorship from the Gerontology Network of Dietitians of Canada as a student member - I applied, they granted).

§  Discussing my casual position with a friend, I was explaining how I deescalated an angry principal who thought I had the power, and the intention, of closing down the school’s cafeteria. As I was explaining the situation to this friend, I could hear the difference in my approach to the situation, in comparison to when I initially started my internship. My friend pointed out this change as well. I let the principal express his concern fully and when he was finished calmly responded. I told him that he is not alone with his concerns and that I had heard them from numerous principals in schools I assessed (which is true). I then explained that I have no intention, or capability, of saying or doing anything in regards to whether the cafeteria remains functioning. My job was to ask questions and to observe the food service workers do their jobs so that I can find ways in which the school board and public health may be able to help them comply with the NS Food and Nutrition Policy. I let him know that I was in the school simply to find ways in which we could support the food service workers in their role. So quite the opposite to shutting down the cafeteria. This conversation showed me how far I have progressed in my education during my internship and was a real "ah-ha" moment for me in my internship.

Challenges I Encountered

 §  Trying to keep sane while completing all internship assignments and projects up to my standard of quality.

o   Organization is important! Throughout my career as a student in both culinary school and at Acadia University, I started projects and assignments as soon as they were given to me. I did this in case something came up in the future that would limit my time available to complete the project and do so well. In the past, the quality of my work declined when it was completed close to the due date, so I knew to not leave assignments to the last minute. In my internship, I continued to start and complete assignments as soon as possible, however, the timelines and due dates got shorter and the quantity of work increased immensely. I found that I was able to rise to the challenge and produce high quality work in short periods of time. My stress level was high, but I’m proud to say that I not only got through it, but received positive feedback from my preceptors on my assignments/projects.

Key Message I Learned During My Internship

§  A supportive environment in which to learn and to teach is important and I believe a key to success and satisfaction in one's position – whether it be a professional environment such as the workplace or social environment. I will strive to obtain and maintain a positive and supportive environment in which co-workers (and myself) can work together and where students feel supported to learn, ask questions, and most importantly, feel that it is okay and accepted to make mistakes. 

I only have 4 weeks remaining in my internship and I know that they will fly by. I am grateful for this internship opportunity and even more grateful that I was able to do it in SWNDHA. My preceptors were knowledgeable and supportive, I got to see and experience areas in NS that I wouldn't otherwise have had the chance to, and I feel prepared to enter the workplace as a dietitian. I have started applying for jobs in Calgary, AB and even have had a couple interviews this past week. I am excited to start my career!

Thanks for reading!