Dietetic Internship Week One and Two!
So this whole working-40-hours-a-week thing and teaching yoga has actually turned out to be much more demanding than I expected! As such I did not get the chance to blog about my first week at the Inner Door Center (IDC). It's an outpatient eating disorder clinic that combines multidisciplinary therapy, dietetics, and (guess what) YOGA THERAPY! How perfect is that for someone with my skillset?
I've felt right at home at Inner Door. The first day I spent going through the program with clients. IDC is actually very unique because it also has a PHP (partial hospitalization program) approved by the Joint Commission, even though it isn't a hospital. The participants in the program have all been very welcoming, open, and candid with me. I've been lucky enough to sit in on a nutrition assessment, nutrition check-ins, and I've already designed and run two nutrition groups!
Here's a general structure of what my day looks like...
When you look at it, I actually spend a lot of my day eating! We eat snacks with the clients, monitoring their snacks based on their exchange-based meal plan (like diabetic exchanges). Each client has their own meal plan based on their caloric needs (including yoga as an activity factor) and weight maintenance, gain, or loss (very rarely is weight loss a focus). Yoga at 9am was something I expressed great interest in--I wanted to learn how language and classes are modified for patients with eating disorders. Consequently, I attend usually 3 yoga classes a week. Or at least I have the last two weeks, in the coming weeks I will likely be taking on more responsibilities like grocery shopping two days a week (gotta keep the fridge stocked for all those snacks and meals!), meal planning, and prepping Facebook posts for the IDC page, blog posts for the IDC website, and nutrition groups. This is mainly what the category "Work" in the above schedule entails. When I'm doing "Work" the clients are participating in various groups with therapists in the program focused on body image, process group (to discuss how things are going overall), movement therapy, and others!
Usually the day "ends" at 3pm and appointments are scheduled. Sometimes I sit in on a nutrition assessment for an hour, or a check-in meeting for half an hour with either of my preceptors (both RDs). Shadowing like this has been one of the most helpful aspects to see motivational interviewing in action, patient/RD interactions, and also to develop a better rapport with the clients individually. I've been speaking up every so often in appointments with my own questions or clarifications. These meetings sometimes also occur during the day and can happen during the "Work" portion of my day.
I also work on nutrition notes. The IDC keeps amazingly detailed notes on every patient from each clinician/therapist/RD/MD, one of the reasons they are such a great treatment team in my opinion. We make notes for Lunch about what clients ate, any notable statements or actions, or any reactions to the meal. We also make notes for nutrition group (once a week on Thursday). I've been fortunate enough to be able to design the last two nutrition groups, and the clients have seemed to really enjoy them! My first one was about seeing with our third eye, rather than just our two eyes. In this lens, rather than seeing a big bowl of pasta, we can see the fiber and B vitamins in the grains, or we can see vit C in an orange, or vit A in a sweet potato. Rather than just fuel for our bodies, these foods provide even more great things to keep us healthy. My second group was focused on drawing our "Tree of Recovery." The roots are safe foods, positive coping mechanisms, and DBT skills. The trunk and branches are challenges we face on our recovery. The leaves and the fruit are what we envision as recovery. Additionally, I am doing a case study on one of the clients, and got some experience writing a PES statement for her!
Lastly, I also get to sit in on team meetings to discuss clients and their status, possible incoming clients, and other things to be aware of. These happen three times a week for about an hour and give a much fuller picture of each client; there is so, so much more to their story than an eating disorder diagnosis.
Honestly, the worst part is really just the commute. It's about 50 minutes on a good day, but it can take me as long as 90 minutes to get home if I leave IDC when rush hour creeps in. But considering that I am supremely well-fed, my grocery money has just transferred to gas money. And even if it didn't, the rotation is fantastic enough anyway to where I wouldn't care :)
Overall, I love this rotation. I thought I would like it, but it's just been truly amazing. I've learned a great deal and know my skills and confidence will only grow in the next two weeks I have there. I keep joking that at least I will have this rotation to look back on when I am not faring so well later on... at least I know I'm good at something! ;)