What's It Like Being A Dietetic Intern? A Peek Inside My World As A New Recruit

My long awaited journey as a dietetic intern began at the Miami Jewish Health Florida PACE Centers, where I was able to observe and fulfill the coveted role of a clinical dietitian and food service manager.

Today’s article is all about sharing my experience as a new intern.

I know many of you are in the application process and both nervous and excited about what’s to come.

Some of you are dying to know what lies ahead, and maybe some of you are not even sure an internship is right for you!

If any of the above sound like you, I promise you will learn a heck of a lot from today’s article.

Let’s start the process by describing where all the magic happens, the facility itself.

Where I Work

As I mentioned in the intro, my placement takes place at the Florida PACE Centers in Miami. PACE stands for Program of All-Inclusive Care for the Elderly and it's a very unique program.

Sometimes when people get older they become less functional physically, they decline cognitively and as a result they have increased medical needs, which often leads them to end up in a nursing home or assisted living facility.

Well, the goal of PACE is to redefine the experience of adults 55+ by helping them to manage their medical needs, not in an institution, but at home. It's a health care system for the frail elderly, geared to make an impact in their quality of life.

There are currently 4 PACE centers in South Florida and they function as an adult day-care facility, but it's more than that. When a participant enrolls in PACE, an interdisciplinary team devises a care plan for them based on their needs. This team consists of a: primary care doctor, nurse practitioner, nursing team, home care coordinator, physical therapist, occupational therapist, recreation specialist, social worker, and dietitian.

What Did I Do As An Intern?

So now that you know the WHERE, it’s time for me to share the WHAT.

In other words, what kind of stuff do I get to do as a dietetic intern?

Here is a sample of tasks that I might do on any given day:

Attend interdisciplinary team (IDT) meetings every morning. In this meeting all of the disciplines (PT, OT, RD, RN, MD, etc.) meet to discuss the participants in the program. There are usually 2-3 participants up for discussion at each meeting. This meeting is really cool because you get an idea of how the participants are doing from various perspectives.

Complete nutritional assessments, re-assessments, and care plans. An initial assessment is done for each participant as they enroll in the program, and then they get re-assessed every 6 months. These nutrition assessments are super simple!

We usually ask them if they have any chewing or swallowing difficulties, if they need help preparing meals or grocery shopping, if they've lost any weight in the last 6 months, if they have any nausea, vomiting or diarrhea, how their appetite has been, how many meals they typically consume in a day, etc. Simple right?

Then we create a progress note that looks a little bit like this:

Disclaimer: this is a hypothetical participant, the values listed are not actual records of any participant.

Weigh participants monthly and assess for significant weight loss or weight gain. I know alot of dietitians are shifting away from defining someone's health based on their weight, but weight monitoring in this setting is crucial! It's used as an indicator and can provide some insight about what's happening with the participants.

For example, if they have significant unintentional weight loss, it could be that they aren't eating, or maybe they have cancer, for example. I know this might sound far-fetched but this was actually the case for someone. Or if they have significant weight gain it could be due to fluid accumulation from congestive heart failure, for example. Yikes!

Receive breakfast and lunch from catering company. Now we all know food has a special place in everyone's heart (or stomach lol). Our breakfast and lunch is catered and delivered each day. Once it arrives, we check the temperature of all the foods to make sure they weren't within the temperature danger zone, then place in hot or cold holding until lunch. Lunch time is what alot of people look forward to so we make it extra special for them.

These are just some of the tasks from a dietetic intern/dietitian standpoint. Throughout the day the participants engage in some sort of recreational activity (bingo, arts and craft, movie, dancing, fun game, etc), wellness class or physical therapy. PACE is nothing like a nursing home, it's so much more fun and engaging!

What did I learn at this placement?

Now’s the part where I share some serious insights into the lessons I learned from this placement, and I promise you will find them both interesting and valuable!

You guys are really gonna like the first thing I learned… because its the fact that clinical dietetics isn't as hard as they make it seem in school.

Medical nutrition therapy is often presented in a way that makes you want to quit and forget that you ever wanted to be a dietitian, but it's not that bad when you make it over to the other side, the real world of dietetics. Actually, everything comes to life and makes so much sense!

I almost didn't follow through with starting the internship because I felt like I didn't know enough. But that's what your preceptors are for. And my preceptors were AMAZING! I loved my experience purely because of them. They taught me everything I needed to know, and whatever fears I had completely faded away.

The second thing that I learned is that prevention comes in different forms.The PACE program may not seem preventative, but it really just is a different level of prevention.

As much as I would like to help people prevent chronic diseases, the reality is that many people already suffer from chronic disease, especially at the ages of 55 and up.

But you can still help such people live healthier and better lives!

How? By preventing the complications that come with such diseases or preventing them from declining further, physically and cognitively.

For example, uncontrolled diabetes and hypertension often leads to kidney disease and ultimately kidney failure, requiring dialysis, but that's highly preventable with appropriate dietary education and management.

Perhaps some people aren't able to safely cook for themselves, and we assist by providing breakfast and lunch at the center or sending them home-delivered meals.

That makes a big difference in someone's life!

PACE is all about increasing quality of life in the elderly population and I love that. Older adults are living longer than ever before and the expertise of a Registered Dietitian is essential.

Final Thoughts

I wrote today’s article as a reflective piece to fulfill my desire to summarize my experiences thus far.

Perhaps even more importantly though, today’s article will provide all of you aspiring dietitians with some extra motivation and insight to not only push you through a demanding time of year, but to help you better understand what it’s really like to be in my shoes.

I can't wait to share my next experience with you guys! I'll be talking about what it's like being an intern in a long-term acute care hospital working with medically complex patients. So stayed tuned! Make sure you subscribe to be notified of when I post.

Until next time,