Being a Positive Influence

Dietetic Internship adventures at the Memphis VAMC continue!(Previous week's blog posts can be found to the left under the navigation by date headings.)

DIETETIC INTERNSHIP: Weeks 8 & 9  (of 41)

Weeks 8 & 9 - General Medicine

In this rotation I experienced my very first inpatient setting…  the General Medicine wards.  I had become so used to Outpatient that I wasn't exactly sure how/what went on in the hospital.  On Day 2 I was quickly caught up to speed as I saw an obtrusive red sign on the patient’s door, nearly shouting at me, “Caution! Caution”  Not knowing what to do, I called my preceptor (which is like a mentor and boss during a rotation), “Umm, help?!”  

She graciously informed me that this patient was under isolation and droplet precautions, and I needed to re-outfit myself.  She helped me get suited up in a head-to-toe yellow gown, face mask, and gloves… then I entered the room.  What kind of encounter was I headed to?  Aliens?  Nope, a patient with the flu and other complications such as COPD and hacking every 2 minutes.  “Contact Precautions”  I don’t want your flu or anything else!  I suited up many, many more times over the course of the day, and the following two weeks.  (It is really hot under a face mask!)

The Veteran Clockmaker

Here we go again with more patient and Dietetic Internship adventures at the Memphis VAMC!(Previous week's blog posts can be found to the left under the navigation by date headings.)

DIETETIC INTERNSHIP: Weeks 6 & 7  (of 41)

Weeks 6 & 7 - Home-Based Primary Care

Nationwide, the VA has a great program called, Home Based Primary Care(HBPC), which sends medical practitioners to a patient’s home if travel for an appointment would prove extremely difficult.  The HBPC team includes doctors, nurse practitioners, nurses, dietitians, social workers, etc…  The frequency of specialty visits is dictated by the patient needs, but he or she is usually visited by at least one practitioner every other week.

Entry into one’s home can be a very private and privileged experience.  A person’s home is very personal and unique, and entering such a dwelling offers a glimpse of a his or her life.  This week, I entered >15 different homes (with another RD), and each presented exceptionally different experiences.  Some were in quite insalubrious neighborhoods, while others were more nourishing.

Patient tears

Here we go again with more patient and Dietetic Internship adventures at the Memphis VAMC!
(Blog post for Weeks 1, 2, 3 can be read HERE)


DIETETIC INTERNSHIP: Weeks 4 & 5 (of 41)
Week 4 - Outpatient at the hospital
Week 4 ushered in a similar, but slightly different patient: Outpatient at the hospital.  Just as if you might go to the hospital for appointments with your cardiologist, have blood drawn at the lab, etc, you would also see your Registered Dietitian.  

I am coming to (quickly!) learn: Every rotation has new challenges.  This one started with 2 enormous assignments that took about 40 hours (outside of work) to complete, teaching a food demo, co-teaching a cardiology healthy living class (cholesterol focus), and a truckload of online training courses due this week. Oh, patients, too.  Let’s not forget about them   And a presentation on Friday.  To top it off, a fun transition from an 8:00am start time to 7:00 am.  I like getting up early.  I don’t like the loss of an hour change!

Some highlights from this week:

Patient 1

On Wednesday morning, my patient was an 86 year old man that had never had a visit with an RD.  He was progressively gaining weight, particularly in the past few years he had put on significant weight, yielding uncontrolled diabetes mellitus, high blood pressure, and high cholesterol.  I started with the basic appointment questions, and quickly surmised that something was amiss.  I probed.  I gently questioned.  My empathetic connection has always been well-oiled and running, and soon this gentleman was in tears.  As was I.  He had terrible, unabashed tears.

Coffee IV & Earwax

Alas my 10-month Dietetic Internship has finally commenced! (Oct 2012... I'm just a tad late in postings!)  My applications were due back in Feb 2012, and I was matched April 2012 to the Memphis VAMC.   Master degree + thesis + graduation, followed by a 3.5 month journey to South Africa, and I have finally installed myself in The Bluff City!

DIETETIC INTERNSHIP: Weeks 1, 2, & 3  (of 41)
Weeks 1 & 2 - Orientation & Training

The first two weeks of a much-anticipated start date were significantly less eventful than expected....

The entirety of days 1 & 2 were consumed by an all-facility orientation for all new Memphis VAMC employees.  Every single person that steps through the door as an employee is required to attend (endure) a 2-day orientation of a revolving door of speakers on various topics:  IT Security, Privacy, Confidentiality, Biosecurity, Parking, the 5-foot greeting rule, Ethics, etc… 

It was boring, it was tiring.  Occasionally some doctor’s pager would sound and everyone would whip around, lusting that it he who was needed to step out of the room.  Who knew sitting in a chair listening to   people talk could be so exhausting!?

Next step: Dietetic Internship

Many miles from the last place I called Home, I have now fully installed myself in Memphis, and on the second full calendar week in October 2012, I began my 10-month (41 weeks, 1,436 hours) required Dietetic Internship at the Memphis Veteran’s Affairs Medical Center (VAMC). 

So…  a required Dietetic Internship venture?  In a nutshell, to become a Registered Dietitian, one must, at least:

• complete a Bachelor’s of Science degree,
• complete specific, relevant nutrition coursework at university, and
• complete a minimum 1,200 hour dietetic internship at an accredited facility.

This last one is the trickiest…

The Bluff City AKA Memphis

Many miles from the last place I called Home, I have now fully installed myself in Memphis, Tennessee.
(THANK YOU, Mom, for all the help moving me here!!)

This city is definitely different from other metropolises where I have previously lived, and I am excited to learn what makes it tick.  It is located in the most Southwest part of Tennessee, and is separated from Arkansas only by a river.  A very large river.  The Mississippi River! 

Driving around, I have noticed that there are a lot of:  barbecue restaurants, car washes, and donut shops.  I’m not sure if these are related… stay tuned, I will inspect them all carefully.  The city has a pro basketball team, the Memphis Grizzlies, and thanks to a new owner (who is 34 years old, a millionaire, handsome, and of course, married) and a 'Welcome to Memphis' column for him, I have had a crash course on a new quotidian:  (Thank you, Geoff Calkins of The Commercial Appeal, for this list)

Betty & Jessie visit Elvis

1. Elvis jokes in Memphis are like Toto jokes in Kansas.  Best to skip them.

Home with open arms

3.5 months out of these 2 bags.
All repacked and ready to go in Cape Town

Alas, after nearly 3.5 months in South Africa, my inaugural visit here has ended.  It was with ambivalence that I entered the airport destined for my home country, leaving behind a newfound home.  South Africa has much beauty in its natural landscape and people, and it would take little convincing to move to some cities.  I would readily move to CapeTown, but many other cities, such as intense Johannesburg, would take a lot of persuasion.  The country still has a long walk to economic and social equality, but continues to progress in the right direction.  Overall, my impression remains: I would like to travel to this “Rainbow Nation” again.

Next stop?  33 hours and 24 minutes of flights and layovers.  Cape Town à Johannesburg à Frankfurt à Chicago à Orlando.  I went through security 5 times, two times of which my bags were subjected to a bomb search.  (I was negative both times!)  I can blame this double treat to bringing home two carved ostrich eggs...