Some Fun/Gross Happenings

One of my units I recently completed focused on critical care patients. During this rotation I had the opportunity to see some crazy stuff that you would think was only shown in movies.

(if you're queasy about blood/injuries, I would suggest skipping over the next couple of paragraphs)

One of the patients had extreme gangrene on the leg and was having to have it amputated. You could barely tell that it was a leg/foot. It was dark black and swollen. They had already had the other leg amuputated from the same condition.

Another patient had a hematoma explosion (basically a big bruise, the blood comes out of the blood vessels and accumulates in the space below the skin) on the leg. The blood had gotten so pressurized in its compartment under the skin that it had no where else to go but out, so the skin seemed to tear itself apart and there was a flap just hanging out on the side of the leg and I was able to see what was underneath the skin. (blood, muscle) Awesome! I think I just found my case study patient.

I love horror movies, so blood and guts don't bother me. One thing me and my husband have in common.

Bring on the Blood! :)

On a lighter note... A small group of us held a cooking demonstration for a senior center that focused on baking with sweetners versus real sugar. We made Pumpkin Chocolate Chip Muffins, Peanut Butter Chocolate Bars, Pudding and Lemonade. I of course brought my pink kitchen utensils from home to demonstrate with :) and got a lot of compliements from the ladies. One of the audience members thought I was there promoting Williams Sonoma. (I wish! Dream Job!)



Chocolate Chip Pumpkin Muffins

During my cardiovascular unit I had the opportunity to give a heart healthy education to a patient who had just recently undergone heart surgery. And did I flop that one... I stumbled many a time during the session, my information didn't flow well and I'm sure the patient thought how the he$$ did this girl get in here?! Needless to say I think I need ALOT more practice providing patient education. Luckily the patient had already had a full education by one of the dietitians, she just let me "re-educate" her for some practice.

The Fort Worth Dietetics Association had it's monthly meeting this month and the topic was on the independant film "My McDiet: A Drive-Thru Weight Loss Story". I purchased a copy at the meeting, but still have yet to find the time to sit and watch it. Apparently its a rebuttal to the 2004 film "SuperSize Me" by Morgan Spurlock (which I get sucked in to watching it anytime it's on TV, just fascinating!) But I am interested to see this new take on the fast food industry. Once I watch it, I'll let you know! You can find more information here: My McDiet

Fun Fact of the Week: One of the beers my husband enjoys drinking, the name of it just happens to also be a medical condition. Delirium Tremens. The medical definition: a severe form of alchol withdrawal that involves sudden and severe mental or nervous system changes. The beer: produced by Huyghe Brewery in Belgium, it features pictures of pink elephants that patients have hallucinated during their own delirium tremens, latin for "trembling madness", recovery.

~Brittani

"Blessed is the man whom God corrects; so do not despise the discipline of the Almighty, For he wounds, but he also binds up; he injures, but his hands also heal." ~ Job 5:17-18

Brief Beginning

It's been a few weeks since beginning my rotation at the hospital and it has been busy busy busy!

Part of my first unit instructions included auditing a couple of trays delivered to patients. I had to follow the trays upstairs and then evaluate them based on taste, texture, temperature, etc. Hospital food gets a bad rep, this I know... However, the food this hospital is serving is pretty good! I basically ate three lunches that day, because I had the two audit trays and still had my normal lunch break. I was not starving for dinner at the end of day.

And if you can believe it, the food I had to taste was beef stew!! (I don't eat red meat, for those of you that don't know) But I didn't actually taste the meat itself (I hope my professor and preceptor aren't reading this... :) ) but the broth and vegetables were pretty good, and no this has not turned me into a red meat eater. I was hesitant at first because I figured it would receive a bad taste test from me, but it wasn't too bad. I ate almost all the sherbet on one of the trays and the potatoes of another.

I had the opportunity to sit in during a stent placement for my cardiovascular unit. That was pretty interesting to watch. They use wires to get through the arteries and plaque buildup and it's almost like threading a needle through a maze, because you have to get to right place and avoid alot of forks. The doctor performing the procedure had to try a couple of times to get the wire in the right place because the build up was pushing it to go another direction. Overall the procedure itself took almost three hours!

While watching the stent placement, I had to wear a heavy lead apron to protect my insides from the radiation from the x-ray machine. Those things are heavy! My shoulders are probably going to be sore for a couple of days, I don't know how the techs wear them all day long. Putting it on though was an adventure. I ended up with my head through one of the armholes, I'm sure they got a kick out of me attempting to dress myself with this 10-15 pound cloth.

I have begun seeing patients on my own, doing the assessments, consultations and educations that the Registered Dietitians perform. Due to HIPPA, some of my descriptions of patient visits will be limited because I can't give out too much information that someone could see and know who I'm talking about.

One thing that I have come to see the benefit of are the electronic charts. The hospital I am interning at uses electronic medical records (I think almost all hospitals use these now instead of paper charts). I have not had any experience with these before this rotation and I like that it is so organized and physician notes are typed so anyone can read what they are documenting instead of having to interpret scribble. It makes finding the information you need so much easier! I think all physicians take an anti-handwriting class because I have yet to see one that I can actually read.

I am excited for this semester. I'm actually feeling like a real dietitian!

~Brittani


"Do not work for food that spoils, but for food that endures to eternal life." ~John 6:27

Week 1, Year 2

First week done of my last year as an intern, I was really glad to get back to school and see everyone again.

After all my summer homework, I feel as though I have been in school for months. We had modules to complete for our clinical rotations this semester that covered nutrition therapy for various disease, such as cancer, pulmonary conditions, AIDS, bariatric surgery, etc. These took up a lot more time than I had originally anticipated, but I know getting a basis for some of these conditions will help me out over the semester.

Tuesday was spent in meetings from 9:30 AM to about 6:15 PM, and surprisingly every minute of them was filled with information. I had previously thought 8 hours of information would be way too much time, but I could not have been more wrong.

Wednesday we had a test that was over the modules we completed over the summer as well as the information we learned the previous semester. We were all nervous, but I think I did ok, however grades haven't come back yet. :/

Thursday was my first day at my hospital site for the semester. It was a deja vu moment, as I have previously worked at my facility about 4 years ago. Some of the people are the same, some are not, but I didn't think anyone would remember me, it was so long ago! A few people did remember me!

For some reason that morning, my stomach would not quit making noises, and no I did not have gas. I ate my normal breakfast, followed my normal routine, but it just decided it wanted to make "hunger" noises all morning long. (I hope you know what I'm talking about, the sound your stomach makes when you're hungry, grumbling and rolling) I wasn't hungry, I'm thinking it was just nerves, but it was embarrassing and of course very noticeable because the office the dietitians work in is a pretty quiet one.

Somehow, two years in a row, I do something embarrassing. I must be great at making first impressions!!

But besides all of that I am really excited for this semester because I definitely want go the clinical route as an RD. My preceptors are easy to get along with, nice and extremely helpful so I know I'm going to learn a lot over this semester. I hear this is the hardest semester of the Coordinated Program, so I am also slightly anxious, but as they say "this too shall pass."

~Brittani


"Whatever you do, work at it with all your heart, as working for the Lord, not for men." ~Colossians 3:23

How To Be A Registered Dietitian

I have been living in the nutrition/dietetic student mode for almost 10 years now and have realized that many of you don't know what it takes to become a Registered Dietitian, so I figured this was a good time as any to give a brief breakdown of the requirements.

To become a Registered Dietitian requires two steps:

Step 1: Receive a Bachelor of Science Degree from accredited university

Step 2: Complete a 1200 hour Supervised Practice Program (aka Internship)

Seems simple right?! Well considering it took me almost 3 years to secure an internship, it's quite the contrary.

There are two ways to complete these requirements.
Option One: Coordinated Program: this entails completing the internship hours while also completing your Bachelor's Degree
Option Two: Complete Bachelor's Degree and apply for internships after graduation

I highly recommend if you plan to be a RD, choose Option One!! It will be more work at the time, but less headaches later as I have come to realize.

I originally enrolled as an option two graduate during my first round at TCU, completed my Bachelor's Degree and applied to internships. Applying to internships is not like applying to graduate school, it is based on a computer matching program that occurs twice a year.

To be matched for an internship you send in your application to all the internships you are interested in, this could be 1 location, 5 locations or as many as you wish. Once your information is submitted, you rank each internship you applied to as 1st choice, 2nd choice, 3rd choice, etc. This is where the computer "matches" you to your location, as the individual internships rank you as well: top choice, 2nd choice, 3rd choice, etc. however many rankings they have. On match day, you will log into your account and either get instructions to contact you matched internship or a message stating you were unmatched, this day could be awesome or depressing. Essentially if you rank the internship the same way they rank you, you've matched. Congrats!!

Supervised Practice/Internships are offered on their own or in combination with graduate school. Some locations offer Master's Degrees with completion of internship hours, this usually is about two years, and some offer graduate school credit with internship completion and others are solely internship hours, these are only about a  year. Almost all programs are unpaid, so you are paying to work for them. Hooray!

Now for my take on this computer matching system... I don't think it works quite that simply, my theory is that you are only matched if the internship you rank 1st choice also ranks you in their top tier, and I say this because statistically only 50% of applicants are matched each round. (statistics from www.eatright.org) So 50% of students that complete their Bachelor's Degree are stuck in limbo to either try again next round or go for Plan B.

(As a side note, the internships receive over 100 applications for typically only 8-12 spots.) There are just not enough internships available for students.

And I was that 50% rejected for three years as I applied, reapplied and reapplied again to be matched for an internship. Strike 3 you're out!!! I was already on my way to completing my teaching certificate (my plan B) when I got the phone call to apply for TCU's Coordinated Program. No computer matching required! AMEN!! I am one of the lucky few, as unfortunately many Nutrition and Dietetic students are unable to complete the second requirement to be a RD.

The Academy of Nutrition and Dietetics has recently become aware of this situation and is trying to come up with a solution. One problem is that there is a novel's worth of paperwork to complete just to be a preceptor/supervisor. To start up a new internship program is a huge task and encyclopedia series worth of paperwork and red tape. So it seems they want to expand the possibilities, but not make it easier for individuals to offer more availability. (just my opinion)

Their current alternative option they are working on is called ISPP (Individualized Supervised Practice Pathway). The student will submit their application to the currently 9 schools participating and if accepted, will line up their own supervisors in their area to complete the 1200 hours. This is new program launched September 2011 and I'm interested to see the turnout and how successful it is.

To any of you interested in this career path get good grades, network, be involved, network, volunteer, good luck, and did I say network? I love my field and feel extremely honored and blessed to be where I am now and if you're willing to put in the effort go for it. Networking is how I got to be where I am, by keeping in touch with my TCU professors, which is why I can't stress enough the importance of it. I am one lucky girl. Rah Rah TCU!!!

~Brittani

"There is surely a future hope for you, and your hope will not be cut off." ~Proverbs 23:18

One of my favorite verses and so appropriate:

" 'For I know the plans I have for you,' declares the Lord, 'plans to prosper you and not to harm you, plans to give you hope and a future.' " ~ Jeremiah 29:11

Summer Vacay!!!

So it hasn't been all work and no play over my last summer break as a student. (This post has nothing to do with school by the way, just a fun one, with lots of pictures)

Earlier in the summer we went to visit my parents in Austin over Memorial Weekend. Did some shopping, sleeping, floating in the pool, played with my cats, and ate at the Oasis one night. Check out our view!!

Hanging out before the sunset



Davis and Mom



Me and Mom



Andy, Me, Davis (can't you tell He's ExCiTeD to be there)



 Later in the summer we went to the Annual Summer Mummers in Midland.

One of my favorite activities! You get to watch a melodrama, be almost as loud as you want to, drink and get to throw this stuff EVERYWHERE!!!

By the end of the show you are basically swimming in popcorn out the door. I Love It!!! My arms were sore the next day from throwing bag after bag after bag, but totally worth it. It's amazing what little crevices those buttery oily boogers will find their way into...

(sorry, not many pictures, didn't want to get the camera gross from popcorn)

Two days after that, we were on our way to Las Vegas to celebrate my Mother In Laws birthday!! She was surprised with a limo to take us from the airport to the Wynn Hotel. Of course the food is my favorite part of the trip! We had the privilege of eating at Bobby Flay's Mesa Grill



Mango and Spice Crusted Tuna Steak



 




Chocolate Pretzel Tart

  For MIL's actual birthday we went to Botero at the Wynn (Steakhouse). It was delicious!!

Appetizer: Seafood Extravaganza

Happy Birthday Kay!!

 

Ice Cream and Chocolate Lollipops



Smores Doughnuts (Amazing!!)



Our last trip of the summer took us to Costa Rica for a family friend's graduation celebration. (Congrats Claire!) It was beautiful! Bright green everywhere (compared to the brown I'm used to Texas) and very relaxing. I had the opportunity to zip line though the rainforest, which was awesome!! (highly recommend if you get the chance) We swam, ate, relaxed and I got to use what little of my spanish I remember, which isn't much. Our time there flew by way to fast, but a great trip to end the summer on.



The view flying in



The view from the lobby, look at all that green!



These guys were everywhere and they were HUGE





This was waiting for me at check in :)





I would say a very successful and worldly summer :) I can't believe it's almost over as I start back Monday the 20th. Hope you all had wonderful summers and didn't melt in the Texas heat!!

~Brittani

"Come to me, all you who are weary and burdnened, and I will give you rest." ~ Matthew 11:28







Halfway There!

One more semester down and I am halfway to completing the program and becoming an RD!! Woohoo!!

The year has been over for a little over a month now and time has flown by. (I feel like I say that every post, but it's true!) Our Class Pictures: 

Coordinated Program Junior Year, Class of 2013!!

Yay, Go Frogs!!



Overall it was a good semester, I had a lot of fun working at the hospital and especially the site swap weeks. I kept an open mind throughout, even though I knew it was not what I wanted to do. This semester definitely confirmed my preferences for when I am looking for jobs. Being foodservice management focus entailed ALOT of business, which is not my cup of tea. Thankfully that's my husband's specialty, so he helped me many a time through the semester.

I will definitley miss the people at my site. It was a good group of personalities that all worked together really well. And those chefs impressed me with their talent.

Next semester is mainly in a hospital setting as well, but with a different focus, it's our clinical rotation. I am looking forward to working more with patients one on one and provide education and counseling. We will also be working at a dialysis center, diabetes clinic and long term facility. This is more of what I want do as a Registered Dietitian, so I am excited to get back to school. I hear this is our most difficult semester, so I may be holed up in our study or at the library the majority of the time studying/completing units.



Still have MNT on the brain, saw this at a Midland Boutique and of course thought of NJ tube feeding

For the remainder of my summer break, along with working, I have quite a bit of homework/studying to do. This is to help us prepare for the upcoming semester since some of the nutrition information we haven't learned yet in class. (Example: nutrition and cancer, respiratory care, and wound care) Also we have to take a test the first week back in class over some of the information. Woohoo!!!

I must recommend this one blog I have become a loyal reader to. http://www.pbfingers.com/ I came across this blog from the crazily obsessive website Pinterest Julie, from Florida writes daily about workouts, healthy foods, books to read, and she has really motivated me to live a healthier lifestyle (not that I don't live a semi healthy lifestyle, I am studying to be a Regsitered Dietitican, so I have the food part down). Its a good reference tool for workout tips, and she's a really good writer. I'm hooked.

Copyright: Peanut Butter Fingers http://www.pbfingers.com/

Hope everyone is having a good summer! Just to make you slightly jealous I will be here in a week :)

But more about that later... :)

~Brittani

"Let perseverance finish its work so that you may be mature and complete, not lacking anything." ~James 1:4

Site Swap Weeks

Over the past couple of weeks I had the opportunity to partner up with one of my fellow Coordinated Program classmates and show her around my site for a week and the following week she showed me her semester internship site.

The two sites could not have been anymore different.

During the week at my site, a hospital, we were able to deliver patient trays, take cookies to patients recovering from joint replacement surgery, taste test different nutritional supplements, help prepare food for an event and set up for the event taking place on the Friday.

Taste testing the nutritional supplements was an interesting experience. We tried all the available ones in stock, including the thickened liquids. Glucerna, Suplena, Ensure, Boost, Ensure Enlive, Boost Breeze, Thickened water, thickened apple juice and thickened milk. For the most part they tasted good, chocolate was our favorite flavor, the Enlive tasted like apple juice but had a very dark color, the Breeze tasted like super sweetened Kool-Aid, and the thickened liquids had a very interesting texture. But at least we have an idea for clinicals what to suggest to patients who need supplements.

During that week, much of our focus was on the event being held on that Friday, Doctor's Day. The hospital was hosting a lunch to thank all of the doctors for their hard work. It was an Italian Garden Theme with a Pasta Station, Carving Station, Cheese, Meats and Crackers, Dessert station and various Italian themed foods. The best display was an ice carving of a Gondola one of the chefs made in the kitchen, to hold the shrimp and oysters. They are truly talented chefs working at the hospital!!

Cutting the ice with a chainsaw



Before



The finished Gondola

The week spent with my partner was a lot of fun. I really enjoyed being able to see a site/facility so different from mine. It is cafe and catering company and most of the week was spent making deliveries to various locations throughout Fort Worth. Several of them were made to TCU campus and it was fun being able to be out and about during the work day. (I am so used to being indoors with fluorescent lighting) We also helped prep several dishes at the cafes for the deliveries and cafe service.

Of course I got to try some of their food, and my favorites were their chicken salad and of course the macaroni and cheese. YUM!!!

Tuesday was interesting, it was reported approximately 12 tornadoes touched down in the DFW area, but we had finished our deliveries before the storm really hit!! When our day was up, we made a run for the car in the torrential rain pour, it wasn't letting up anytime soon, so we got soaked, but we were laughing at the insanity! Luckily we missed most of the real damage from the storms.

Wednesday night we catered an event in Fort Worth. We helped set up the location: tablecloths, napkins, silverware, glasses and desserts, and throughout the event assisted in clearing dishes and replenishing food on the buffet line. I knew it was going to be a late night, and at the beginning I was slightly anxious about working such a large crowd, but the time flew by and everyone attending the event was very polite. (I honestly have no prior table waiting experience, so this was first real crack at it!)

I wish I could see every one's site and how they function, but there is definitely not enough time in one semester. That being said I am super glad I was partnered up with my partner! Overall it was great experience both weeks.

Just a few more weeks and I have one year of my internship completed!!

~Brittani

"Perfume and incense bring joy to the heart, and the pleasantness of a friend springs from their heartfelt advice." ~Proverbs 27:9