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Week of October 29th 2018- Obgyn Dietetic Internship Rotation (Favorite Clinical Rotation Yet)

Monday, October 29th– Another Rotation, Another Dead-End Day

I know I do this to myself. I know I’d be less stressed if I didn’t procrastinate. But that doesn’t stop the procrastinating. Today we went to the hospital in this town about an hour and a half from where my internship partner, Gia, and I reside in San Juan, Puerto Rico. If you haven’t read the drama about us getting down here. Read last Friday’s blog here. The rotation itself is fine. We are evaluating pregnant women or women who’ve just given birth. This is the first rotation that did not train us at all about how to do the evaluations. The dietitian who’s supervising us (our preceptor) just gave us an evaluation form and took us up to the floor. For points, she did tell us where to find some basic information in the medical file. This isn’t the interesting part of today though.

Now, I know spies read my blog. Despite me telling them not to and her agreeing not to. So, because Karen is most likely still reading my blogs, I don’t feel at the liberty to tell y’all the really interesting part of the day. I’ll just say this: the grand majority of us don’t want to be here. The preceptors (dietitians who supervise us in one of 20+ areas we rotate through), they make us feel small and worthless. We are educated people. Every one of the ten of us interns have at least a Bachelor’s degree. Three also have a Master’s degree. We aren’t stupid. And even if we were, we’re human beings. Why treat us like we are a beaten-up Roomba?

It sounds weird, but that’s what it feels like. They look down on us and give us just the kick needed to get us going and no more. Then we are on our own. Picking up after their messes. And being told we went in the wrong direction when they didn’t give us any instruction other than do something.

Oh, and those assignments due on Friday? We explained to our Trauma preceptor that we aren’t in town due to a rotation this Monday through Friday. She very kindly gave us until Saturday. At 8am. Our rotation ends at 4:30pm on Friday. … I hate my life. Now I have to rent a car and drive us back Friday right after the rotation. …….I hate my life.

Tuesday, October 30th– The Best Part of Today was the Impromptu Pasta I Made

Preceptor was out today. So, we had a substitute supervisor. Since he does things differently, it doesn’t matter if we followed the instructions from our preceptor yesterday to the letter. He would correct us. Oh well. We only had two patients. Seems most of the Ob/Gyn floor is pretty calm this week. (Please don’t jinx anything!) Afterwards Gia and I walked back to the Airbnb we are staying at and took an hour-long break before starting to read the new guidelines for diabetes management during pregnancy that we have to present together this week.

In the middle of it I made some delicious pasta with some $3 meat, some salt, pepper, butter, and a lime. Oh! And sour cream! That finished it off! That was great. I’m learning how to cook with whatever’s at hand. That’s super useful. After this impromptu meal, we finished the presentation on the diabetic guidelines and I fell asleep against my will. I planned to work on this brochure I have to make, buuuuut…. Nope. My body demanded sleep.

Wednesday, October 31st– 5th Halloween in a Row without Giving Out Candy to Trick-or-Treaters

~Another wonderful day in Puerto Rico!~ That was sarcasm. *sigh* I want to go home. But instead, I woke up and began looking for pictures of pregnant women exercising. It’s for a brochure I have to make. It’s not some weird thing I’m into! Anyway, soon after, I got dressed and walked to the hospital with Gia. We were assigned two patients which we finished evaluating before noon. Then the preceptor gave us the choice to either take up another patient or work on our assignments. Assignments, DUH! However, I fear she’ll take that choice as does not show initiative. Oh well. I needed it. I finished that kinky brochure…erm… I mean, that brochure on physical activity in pregnant women. *ah hem* and got an outline of the case study presentation done.

Another trick question from the preceptor: she told us we could go home for the day to continue working on assignments. I trust no one. I don’t want her to cut my hours. I do NOT want to explain that to the director. I’m on a tight string with her as it is. So, currently, I’m typing this at the hospital. Gia left about half an hour ago and I still have another half hour before 4:30pm when we are supposed to leave. Afterwards, I plan to pass by the grocery store to buy some Halloween candy. It’s my favorite holiday and it stinks that I don’t get to hand out candy. …For the fifth year in a row. ☹ That’s my favorite part about Halloween. I know it’s not the healthiest thing, but the children get so happy! Plus, since my family never spent too much on candy to give to random kids (AKA trick or treating) I usually gave them something else. A couple years I gave out balloon animals and another I gave away my collection of Goosebumps books. (Kind of regret that second one, but hey, I gave the gift of reading that year.) Ahh, happy children. I haven’t been blessed by that on Halloween since before I went to university. Maybe next year… 6th year’s a charm?

Thursday, November 1st– Taking the Time to Educate a Patient

Things got a little crazy this weekend, so actually it’s November 5th when I’m writing this. But that’s okay, ‘cause you’ll get only the more important information. Today I got a patient from the labor and delivery floor. This is different than the maternity ward where women go when they’ve already had their baby or before they give birth. A woman isn’t expected to suddenly give birth there. They are in the labor and delivery floor! Luckily, that didn’t happen to my patient today. Because of patient confidentiality, I’ll just say this: my patient had gestational diabetes and seemed interested in the medical nutrition therapy AKA what to eat to make you feel better when you are sick. That’s the essence of a clinical (hospital) dietitian’s job. Interest in our services is rare. Most people look at me funny and ask if I’m going to put them on a diet when I tell them what I studied in university. It’s not funny. Not then, not now.

Anyway, she was interested, so I gave her some generic handouts then, after a moment, asked if she’d like me to come back after I calculated her diet and show her how I’d divided her carbohydrates for the day. (Carbohydrates are recommended to be distributed consistently in patients with diabetes to avoid severe spikes or dips in blood sugar [glucose].) She said yes, and after finishing my work for the day, I wrote out a little how to guide on carbohydrate counting with her diet as the example. All by hand on a blank piece of paper. *phew! Minimal white out, so a success. I went back to show her and briefly explain it to her. I hope it helped.

Later that night (read: the whole night) I worked on a grant proposal due for my internship. I had a crazy change of heart and mood which gave me the energy to work through the night on it.

Friday, November 2nd–  Last day at Ob/Gyn …I wish I’d gotten a hug from the preceptor

Today, the preceptor told us we’d just have to present the new diabetes nutrition care guidelines to the staff and then we could leave. This was great news for two reasons: able to travel back home to San Juan early and so that I could sleep a bit before working on the assignments due for the Trauma rotation. But…She gave us patients. Trust no one. She also gave us our evaluations. Which is nice since most of the preceptors don’t. Blah, blah, blah I need more leadership skills, I’m quiet, blah!

Welp, that was over! I wanted to hug the preceptor. She’d been so nice. This was the clinical rotation I’ve enjoyed the most. The staff wanted to learn from us. It wasn’t just doing assignments to do them. I regularly used the handouts from previous interns to educate patients. The case study I presented was on lupus and I know it was probably the first refresher in a long time about that disease for the staff. (Lupus is not unheard of, but it’s not common.) I felt good about the work I was doing there, so I wanted to do it and I wanted to do it well.

Ultimately Gia and I went back to San Juan in an Uber. Expensive, but worth it to sleep a couple of hours on the way. With that, our out of town rotation adventure in Ob/Gyn was over!

Saturday, November 3rd– After Two All Nighters, A Day of Sleep

We got back around 8pm on Friday and I arrived to Gia’s apartment to work on the Trauma rotation assignments from last week due today at 8am. I worked all night. Second all nighter in a row. Gosh. After turning it in, I fell asleep around 2pm and didn’t wake up until 6am on Sunday morning.

Sunday, November 4th– First Volunteer Event of the Internship and Water Shut Off

No immediate pending work. So, I spent the morning anxiously relaxing. I was still buzzing from the last couple of all nighters and assignment panic, so I couldn’t truly relax. At 3pm Gia and I went to a diabetes volunteer event we’d almost forgotten we signed up for. It worked out though, because Karen couldn’t get the shower water to turn off, so they had to bring a professional to shut it off. Until Monday. After the volunteer event, Gia and I worked on a hand out for next week’s rotation: Intensive Care. *~* It took until 1am. So tired.



* * *

Notes: Sorry it took so long to post. As you have read if you made it to this point, it was a busy weekend. And it gets better… Next week Gia and I go to the Intensive Care Unit (ICU) Rotation. Since it’s Tuesday as I write this, here’s a teaser:
  • Gia and I are forced to talk to the director. Remember she had said she needed to talk to us last week? Yep. Here’s that talk.
  • Gia and I play in the mud. Actually, we just kind of sank in it. In our hospital skirts and heels. XD That was hilarious!
  • I have a casual conversation with Karen for the first time in a couple of weeks. Before essentially telling her she’s being too loud when she starts ranting to Gia (who came over to give me a sheet of paper). And it’s only Tuesday when I write this!

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