Sunday, January 22, 2017

RD? Check! Job? Check!

After a super long hiatus, I am back!

University of Kentucky Coordinated Program Internship Class of 2012


For the past four years I have been working as a Clinical Dietitian and Director of Food Services in Rural West Virginia. There have been moments of growth and bumps along the way, but overall this experience has been positive for myself and the patients, clients, and customers I serve. I would not have wanted to start my Dietitian career in another setting. Before accepting this position I was offered an almost hard to turn away job in a gym setting in Chicago! I weighed the pros and cons and easily decided my passion and path lie in the gorgeous mountains of West Virginia. I have been able to develop my own workplace wellness programs, community nutrition programs, and finally become a Preceptor to a Dietetic Intern enrolled in a long-distance internship (Learn more here)! I enjoy working in a clinical position with many great opportunities that many Dietitians in Clinical Nutrition are not able to enjoy. On any given day, I am assessing inpatients or providing individual MNT (Medical Nutrition Therapy) to outpatients as well as presenting nutrition topics to my community. I am also working towards becoming a Certified Diabetes Educator (CDE) which will give me the ability to develop a Diabetes Self Management Program.

So, what's next...?? Well...

The future is looking very optimistic and I have several goals to share very SOON!



Since moving to West Virginia I have met some amazing people with amazing talents, skills, and passion for people and exploring! Mountain biking came into my life like a whirlwind several years ago and I am addicted to it just like I'm addicted to my career. It has taught me that any obstacles I conquer on the trails are just like the obstacles I conquer in life. I am stronger and more confident because of the moments I enjoy with my mountain biking buddies.

Next up is my West Virginia Mountain Biking Association season! This year I will be competing, again, in the Expert Women's Open class in Cross Country (XC) racing, Ultra races, and I plan to try out some super gnarly Enduro races! Check out the 2017 race schedule here!

RIDE ON!









Sunday, March 4, 2012

Life As A Dietetic Intern: End of First Rotation


Hey Everyone!

It has been a hectic past few weeks, while I've been working to complete my projects for my Community Nutrition rotation. During each rotation all interns are expected to complete competencies set by The Academy; each competency is geared toward the learning objective for each type of rotation (i.e., Community Nutrition, Medical Nutrition, and Food Service Systems Management). Community Nutrition is 7 weeks with the fewest set amount of competencies while Food Systems Service Management is 3 weeks longer and has almost double the amount of competencies. Some rotation sites do not accommodate each competency, in which case that competency transfers over to your  next rotation. Luckily, I was able to knock out all of my CN competencies at the UK Cooperative Extension Office.



Friday, March 2, 2012 was my last day with Cooperative Extension. It was an interesting day, especially because much of the state was under a severe weather threat. I spent the majority of the day organizing my projects and related documents to submit on BlackBoard. Before we were released to the storms, the ladies at the office prepared a nice "going away" lunch from Yummy Yummy Asian Cuisine in Lexington - it was delicious and I felt bad that we had someone else to risk their life in the severe weather. However, it was delicious and while everyone chowed down I opened my "nutrition gifts". I'm going to miss all of those ladies, but they will always be a part of my life. 



"Don't cry because it's over. Smile because it happened." - Dr. Seuss

Week 5
This week started the first round of Assistant training. This training will last for several weeks and is geared towards the newly hired Assistants (these are individuals who will be working out of different counties and providing the LEAP nutrition education program to primary school age children). Yesterday I was able to sit in on their second day of training - this was pretty awesome because I was able to observe my preceptor present on nutrition basics, MyPlate, and food behavior. She was so energetic, funny, and relayed solid information in a very simple manner. I will be presenting my first CBNFE (community-based nutrition and food education) next week during another training session, so I will be tweaking my speech to better captivate the audience. Prior to the start of yesterday’s training, I introduced myself to the trainees and many of them felt comfortable and asked me several nutrition related questions. We ended up discussing energy drinks, we all know the misconceptions and misunderstanding that looms around this topic, so I was able to add in some pieces of knowledge to de-bunk some of their questions ;)

This week my preceptor and I traveled to Frankfurt to the Department of Agriculture for a Farm to School Resource Manual meeting. I’m really excited about this program because it’s one of a kind that hasn’t been implemented in the state of KY...yet! However, with the efforts of my preceptor, public health professionals, USDA officials, KY Dept. of Education staff, and Agriculture experts this program will hopefully start it’s piloting stage as soon as this summer. The purpose of the meeting, we attended, was to finalize ideas, strategies, and organization for the F2S manual that will be distributed to food service directors, farmers, and community members. A lot of great ideas were thrown around the table including how to improve purchasing between the food service director and the farmers; one idea was to have a F2S position at all Co-ops that work with schools and farmers - this will eliminate some of the procuring barriers between food service directors and farmers. Hopefully, there will be some grant money available for this program’s implementation because I believe F2S will have a big impact on high school students’ nutrition beliefs, understanding of where their food comes from, how it’s harvested, and overall health. 

Farm to School

Week 6
As this is my 2nd to last week at the Extension office, I’ve managed to squeeze in two CBFNE (nutrition education presentations) to meet my CN competencies. I’ve had a lot of fun creating my support material and designing the format and content for each presentation. My first CBNFE took place on Tuesday at the Good Barn on campus and I had the opportunity to present basic nutrition to newly hired Extension Assistants. My first topic involved introducing the Assistants to the LEAP program that they will be using to educate their community. I really enjoyed this presentation because LEAP’s target audience is primary aged children and their parents, so I had the freedom to be really expressive and creative describing child content topics. I wrapped up my presentation with a brief discussion on child sized food models; I prepared an interactive activity, so the Assistants could get some hands-on experience with the models and feel more comfortable using them with their clients. Although I didn’t have enough time to explain every little detail on my handouts, they really liked the format and the information provided.

Yesterday I had my first experience doing a t.v. spot with Lexington's WKYT-TV. I had prepared two outlines for my Meatless Meal segment, just to be prepared for any questions thrown at me. I was relieved to know that I was able to send two prompting questions to the news station a few weeks in advance. However, when it came down to the shoot, Bill Bryant and Barbara Baily had some questions of their own. I really liked their enthusiasm and interest, and didn’t at all mind that they didn’t use the questions I provided; I flowed with their sequenced interview and it was over before I knew it. I have learned so much about social marketing from my preceptor and I’m glad that I took a small stride yesterday to promote a healthy cause. I look forward to having the opportunity to do more t.v. spots in the future. Strategic planning and social marketing is where it’s at; it’s definitely opening my eyes to a future in public health, communications, and marketing.





Week 7 (last week at Extension Office)
This week has been a collection of different events and activities, much like it usually is at the Extension office. On Monday my preceptor and I traveled to Perry County for their fourth round of Plate Waste Studies - I'm glad they chose to implement the LEAP program in this county because it has the highest child obesity ratings in the state. The kids are always interested in our study and why we are taking pictures of them. They are so enthusiastic and seem to be picking up on the nutrition lessons. I had a boy from the third grade explain to me the differences between whole grains and refined grains. I was very impressed and love to see the change in knowledge and behavior.

On Tuesday I was able to attend my first professional meeting solo, without my preceptor! I definitely felt like a "big girl" and made some good connections and met a lot of different professionals from Lexington. This meeting was for the TWEENS Coalition, which was established by Anita Courtney (which by the way, is a great contact and resource to have if you're able to work with her eventually). Their mission is to promote, support, and create a healthier community - with a focus on preventing childhood obesity. During the meeting, they reviewed the status of "Better Bites" (Anita is in the process of changing this name into a fun, more creative, captivating title; in hopes to target teenagers. I will attach a flyer with more information. Everyone who enters a new title suggestion is in a running to win $100 until the March 31, 2012 deadline)! Better Bites is a program that targets teenagers by way of implementing healthier menus in community venues (Park and Rec., after school programs, high school Booster events, UK campus events, etc.). Currently, they have assessed the community's needs and interests as well as the financial ramifications and are looking to pilot a healthier menu at a public pool this summer. I love this idea because a child who swims for 2 hours can burn 430 calories and can eat well over 600 calories by choosing common items (i.e., hot dogs, fries, soda) at the current concessions. They are also currently researching the needs and ways to provide fresh food and produce in Lexington corner markets. This was a great learning experience because they detailed the entire research, implementation, and monitoring process that would be involved in jump starting this program.

Better Bites needs a new slogan! Enter to win $100!


Tuesday, February 7, 2012

Life As A Dietetic Intern: My Bulletin Board!


I finally added my finishing touches to my bulletin board. The idea behind it was to eliminate the discrepancies between the MyPyramid icon and the new MyPlate icon as well as improve the use of MyPlate as a dietary tool.


I created an evaluation document that I will email to all faculty and staff to assess whether I reached my goals :D


Hope everyone is having a great week!!

Saturday, February 4, 2012

Life As A Dietetic Intern: Community Nutrition Projects


Hey Everyone!

It’s been another busy week at the UK Extension Office! I’ve been working away on several nutrition educational tools and I’m coming up on my deadline for my Extension Office bulletin board titled, “MyPyramid To MyPlate: What Are The Differences?”. I plan to have this finished by the end of today and will take a picture of it to post by next week!! It has required a few weeks to wrap it up because I’ve been tackling several projects at once. I really love the versatility of the office and really enjoy the diversity between projects. My preceptor works on several community committees and is a part of creating nutrition programs for KY schools, so I’m in a position to intercept and work on some of her nutrition tools. I absolutely love having the freedom and creativity to use my knowledge from undergrad to create nutrition materials to large audiences that would otherwise not have access to such beneficial information.

Here’s a preview of one slide from my bulletin board:


I have also been able to work on a project where I’ve been creating a brochure and bulletin board slides for the elderly and those who are losing their eyesight, the illiterate, and Spanish speaking populations. The information that I’m covering is titled, “Poisonous Look-A-Likes”, which shines light on common consumer products that share similar packaging and labels (such as, candy nerds and mice pellets, regular gum and nicotine gum, Parmesan cheese and comet dish detergent, and many more). This has been a great project because there’s a wealth of products that can easily be mistaken for their poisonous look-a-like. Once created, my brochure and bulletin board slides will be passed out and used by the Extension Agents when they’re educating certain clientele all over the state of Kentucky.

Here’s a preview of my slides:


Aside from all of my mini-projects, I’ve been traveling the roads with my preceptor. This past week we spent a day in Hazard, KY doing a plate waste study (this was the second to last plate waste study of my preceptor’s research on the effectiveness of the LEAP Program) to evaluate the effectiveness of the LEAP Program (to see whether or not 1-3 graders consume more fruits and vegetables after receiving nutrition lessons). If you’re familiar with plate waste studies, this study design may be very similar or very different from your experiences. Instead of weighing the food and beverages after consumption, we set up cameras on tripods by the cash register in the cafeteria (to take the “before” pictures - that allows us to gauge if the children are choosing more fruits and veggies) and we setup more cameras on tripods near a table where the children would usually dispose of their plates (to take the “after” pictures - that allows us to gauge if the children actually consumed the fruits and veggies they put on their plate). These pictures will be compiled into data spreadsheets and analyzed before a report is created. It was a very interesting experience, especially since I was in charge of taking all of the before pictures along the buffet line. Many of the cafeteria workers automatically placed the entree items (meat, etc.) on each place and didn’t place fruits or veggies on a child’s plate, unless the child specifically asked for the item. The vegetables were on the buffet line (in front of the children) whereas the fruits were in a freezer cooler placed against a wall (behind the children and out of sight) - some of the children didn’t even notice the fruits and veggies. It would be an interesting study to see whether or not the marketing and placement of fruits and veggies, and suggestion to choose fruit from the cafeteria workers would impact consumption of these items. My guesses are that it definitely would. There’s clearly more that can be done to increase fruit and vegetable consumption among children than we’re able to control/effect solely in nutrition education. This is why the Public Health professionals are so important to continue receiving grants to fund their programs as well as pushing the USDA to continue to make changes to the School Lunch Program. We will be returning to Perry County on the 13th and traveling to Laurel County on Tuesday to do another plate waste study.

I've been contemplating whether or not to apply to a PA (Physician Assistant) program. A PA provides a wealth of services that were traditionally performed by a Physician. PA's conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventative health care, assist in surgery, give medical orders and write prescriptions. Many MDs do not have the same training and nutrition background that RDs have, so a PA with an RD credential, in my mind, is a valuable member to the health care team. However, PAs are trained and licensed to work under the supervision of a Physician. Usually the Physician isn't required to be physically present, but everything the PA does must be signed off by the MD. Last week I met a PA that will be moving to Covington, KY to work at the Saint Elizabeth Regional Diabetes Center and he really stressed the difficulty that comes with finding a job as a PA because Nurse Practitioners (who usually have more schooling and do not require a MD supervisor) normally receive the jobs that PAs are qualified to perform. So, now I definitely have more to consider about that career option.

Thursday, January 26, 2012

Life Of A Dietetic Intern: Community Nutrition Program


Hey everybody! I’ve been getting very busy at the UK Extension Office and one of the programs I’m learning a lot about and am practically falling in love with is the Farm To School Program (F2S). This program is the first of it’s kind in Kentucky and it’s seriously the creme de la creme of nutrition education programs that will be implemented first into a high school setting. The following has been adapted from a F2S Publication.

What is it?
F2S enables every child to have access to nutritious food while simultaneously benefiting communities and local farmers. In addition to supplying nourishing, locally grown and produced food in schools, F2S programs offer nutrition and agriculture education through taste tests, school gardens, composting programs, and farm tours. These experiences help children understand where their food comes from and how their food choices affect their bodies, environment, and community.

This program is so important because more than 30 million children eat school food five days a week, 180 days a year. If school food can improve the health of kids, develop new marketing opportunities for farmers, and support the local economy, it’s a win-win for everyone.

Why F2S?
    • ⅓ of U.S. children are obese and overweight
    • The typical food item in the U.S. travels 1,500 to 2,400 miles from farm to plate
    • With only 2.2 million farmers, the U.S. has more prisoners than farmers

Benefits of F2S
    • The choice of healthier options in the cafeteria through F2S meals results in consumption of more fruits and vegetables with an average increase of 0.99 t 1.3 servings per day, including at home.
    • Schools report a 3 to 16% increase in school meal participation when farm-fresh food is served through F2S programs.
Reasons To Buy Local Food
    • Locally grown food looks and tastes better. The crops are picked at their peak and farmstead products like cheeses are hand-crafted for best flavor. Livestock products are processed in nearby facilities and typically the farmer has a direct relationship with processors - unlike animals processed in large industrial facilities.
    • Local food is better for you. The shorter time between the farm and your table, the less likely it is that nutrients will be lost from fresh food.
    • Local food preserves genetic diversity. Small local farms often grow varieties of crops to provide a long harvest season, unlike a modern agricultural system.
    • Local food is safe. Local farmers aren’t anonymous and they take their responsibility to the consumer seriously.
    • Local food supports local families. The wholesale prices that farmers get for their products are low, often near the cost of production. Locals farmers who sell direct to consumers cut out the middleman and get full retail price for their food - which helps farm families stay on the land.
    • Local foods benefits the environment and wildlife. Well-managed farms provide ecosystem services: they conserve fertile soil, protect water sources, and sequester carbon from the atmosphere. The farm environment is a pathwork of fields, meadows, woods, ponds, and buildings that provide habitat for wildlife in our communities.
How Does F2S Work?

How To Start F2S In Your Community

Before my preceptor and her colleagues implement this program into the school system, they have several more steps to take (i.e., receive guidelines from the USDA) and finish the Reference Guide. As an intern, I'm helping with some of the Reference Guide content, which has been an awesome learning experience. Thanks for reading!



Sunday, January 22, 2012

Wanting To Become A RD? 10 Things Undergrads Need To Know.

After reading an interesting post made by an newly announced Dietitian, I've decided to share it forward. Deciding on a college major, for some, is a difficult venture; especially when you don't have a lot of insightful information from current/graduate students. I've decided to compile some helpful insights for becoming a RD. This list was put together with help from RD Exposed and my undergrad experiences. Let me know what you would add to the list and what you found to be helpful and surprising! Enjoy!

The Academy of Nutrition and Dietetics


1. Know What You're Getting Into. As mentioned by the The Academy, Dietitians are expected to be the nutrition "expert" in food science, food service, community nutrition, and medical nutrition therapy. One thing that some students do not realize is that many patients, especially in a clinical setting, do not want to hear one word we have to say. Sometimes the word "Dietitian" is associated with "food nazi" and skinny women/men that absolutely cannot relate; which is absolutely untrue if you've taken a good psychology and Dietetic Communication course. I suggest shadowing several RDs to grasp a diverse understanding of what different types of dietitians do.

2. Consider If You Like Nutrition More As a Hobby Than a Job. Some people have a niche towards community nutrition, clinical nutrition, or dietetics administration, but some of these areas and there duties may surprise students. Not all positions are flexible and allow you to cover trends in nutrition and not all clients/patients want to hear about these rising trends and benefits. Shadowing several dietitians wills give you access to multiple types of nutrition work and will help you decide which area is best suited for you.

3. Are You a People Person? It's hard finding a dietitian that struggles with people skills because this is the root of being a dietitian. Dietitians need to be able to engage with any type of person they come in contact with and this is especially important for success. Gaining volunteer experiences during your undergrad will help advance these skills and definitely consider a leadership course or experience (this also looks great on your resume)!

4. Can You Keep Cool Under Pressure? Many patients/clients may become defensive when they do not believe they have a problem or even considering change, so being able to remain cool, calm and collected comes in handy. You'll need to be able to express reasoning in tense situations without stepping on toes. Any type of hospital or community nutrition experience would be great to work on this important trait.

5. Do You Have A Love/Hate Relationship with Science? Many people seem surprised by how much science is involved with a Dietetics degree. Get ready for some chemistry plus labs, biology plus lab, microbiology plus lab, and biochemistry. Not to mention statistics, accounting, microeconomics and management classes are needed as well.

6. Are You Wanting To Make A Ton of Money? Dietetics will set you up for a nice salary, but you're not going to be rolling in it. Dietetics can prepare you for professional schools such as denistry, physician assistant, physical therapy, pharmacy school and many more.

7. Are You Prepared For Getting Through Undergrad and Not Getting An Internship The First Time Around? It is true. Landing an internship is very challenging and there are more nutrition students than there are dietetic internships. Make yourself more marketable and diverse from the rest by having varied volunteer experiences - this will give you an edge over other students applying for internships.

8. Are You Prepared To Work For 10 Months Without Pay? During your internship you will be working full-time and paying tuition. The experiences that you gain are extremely worth the investment; not to mention, you need your internship to sit for your RD exam.

9. Are You Willing To Move/Commute? You may need to commute to get to your undergrad/masters program, internship sites, and place of employment. This along with the type of program you want is definitely something to consider.

10. Are You Okay With Working Weekends, Holidays, and Snow Days? Inpatient and some food service systems require dietitians to work these days. You must be flexible to work towards what you want.

Additional Tips
  • Start utilizing your advisers and professors to your advantage; make connections and create bonds. These are the professionals that will be writing your letters of recommendation when you apply for your internship.

  • Start volunteering as soon as possible. Your internship may require 100 plus hours, so beginning soon will be helpful. Try to get as many diverse experiences as possible.

  • During your undergrad you will receive many certifications (ServSafe, Manage First, etc.) - begin to organize and file these away, so they will be handy once it's time to begin your internship.

Thursday, January 19, 2012

Preview of My First 3 Days At My Community Nutrition Site

After a short hiatus, I am back ;p I officially started my internship on January 17th! Initially I was a little nervous heading into my first rotation at the UK Extension Office located in downtown Lexington, KY, but once I arrived and sat in on an all-employee conference meeting I was feeling very welcomed and confident. The Extension Office is funded by the USDA and supported by grants to provide education - nutrition, hygiene, life skills, and other programs that build and strengthen families and individuals within all 120 counties in Kentucky. 

The UK Extension Office is a part of my school at UK!


My first day consisted of observing the Extension Specialists and other staff members go over their nutrition program progress, plans, and evaluations; this may sound boring, but with an energetic and comedic staff, it’s hard to be bored. We took a break at noon to head over to the very awesome and super close Village Host! The Host has one of my favorite salad bars in all of Lexington! They have 50 fresh produce items to choose from, including avocados. So delish! I tried a cup of their awesome white chili chicken soup, which had tons of sodium but was insanely good, along with a huge pile of freshness from the salad bar. I thanked the Department Director for the wonderful lunch, but that’s not hardly the end of this story. We were forced to stay an extra hour at the restaurant due to strong winds and a heavy thunderstorm that moved through the metro area - before reaching Lexington the same system produced a tornado in Louisville that caused a lot of damage to businesses and several homes. We braved the storm and returned to our office without incident and that was definitely the climax of the day.

The Village Host offers a variety of awesome pies!


Day 2: I traveled with my preceptor to Laurel County Schools where she observed an Assistant (an Extension employee who is trained by Agents (Family and Consumer Science, 4-H, or Agriculture Agents) on educational material that will be presented in several formats: public schools, Head Start Agencies, Libraries, etc. to eligible/limited resourced individuals). During this trip, my preceptor’s purpose was to observe an Assistant present a lesson on “Increasing Fruit & Vegetable Consumption Among Primary School Kids” and determine the effectiveness of the Assistant’s information, methodology, and delivery to the children and whether it causes behavioral changes. I have read a lot of studies during my undergrad where the thesis focuses around theories to increase fruit and vegetable consumption among adolescents, so learning about the grant writing and research process from my preceptor is pretty awesome. Not to mention, these type of experiences are meeting my Community Nutrition competencies established by ASCEND and the Academy of Nutrition and Dietetics (formerly known as ADA: American Dietetic Association), which are needed to graduate from my internship and to sit for my RD exam.

We traveled 1.5hrs south of Lex. to reach our destination


Day 3: I’m getting to know all the staff members at the Extension Office and I’m beginning to think that it will be hard to leave them in several weeks when I head out to do my MNT (Medical Nutrition Therapy) rotation at the Saint Claire Hospital in Morehead, KY. All of the employees are ladies who specialize or have a different knowledge foundation - I still do not fully understand the depth of their positions, but I will definitely understand the full operation of this office after I complete my Agency Report. Day 3 is my most recent day at the office and I spent it learning up (reading) over 100 pages about the Literacy, Eating and Activity for Primary Youth Health (LEAP) curriculum. Definitely information overload, but it will help once I begin to revise and re-write parts of the curriculum to meet the newest dietary requirements for adolescents. 



Today I had my first opportunity to meet a well-defined competency. Basically, I'm required to field consumer/customer/client questions about nutrition and provide evidence based answers. Today was my first encounter where my preceptor forwarded an email to me about the popular "onions absorb bacteria" urban legend:


The Urban Legend follows that onions possess healing powers due to their absorptive property. It has been said that onions absorb bacteria and viruses in the environment, which includes "curing" individuals of the flu. An Assistant had been asked about this legend and my preceptor handed it off to me to field. This is what I put together for the Laurel County Assistant:

"This is the first time I've heard about this folk remedyand I found some interesting "de-bunkers" online. After reviewingSnopes.com, The Wall Street Journal and a few other news resources, Ifeel it's safe to say that we can lay this urban legend to rest and
pin it as "false".
 
Many of these news resources pointed out the demand for "home
remedies" when it comes to the flu because of how many people it
affects each year. The flu wreaks havoc on 10-20% of all U.S. Citizens
each year, which costs Americans $10 billion each year in lost wages
and medical expenses. And as we know, the influenza virus is very
debilitating; in some cases it leads to hospital visits and potential
death.
 
Although there's a lot of speculation floating around about using the
onion to absorb bacteria that causes colds and serious illnesses,
there isn't any scientific evidence to prove the healing power of
onions. Viruses, like the flu, require a living host (human or animal)
to replicate and spread to other humans; onions do not possess this
property.
 
Onions - cut, peeled or otherwise - are not going to "free" your
environment of this year's flu or next year's flu. Instead, if you
want to stay healthy, wash your hands and avoid being around sick
people.
 
To touch on the Mayonnaise issue concerning whether or not mayonnaise can cause/contribute to food poisoning, I found  this legend to also be fiction. I found a few articles and read a few studies about this controversy and they all agree with the chemist in the email. Mayonnaise contains vinegar and other ingredients that make it acidic – the acidity is what prevents the food from becoming contaminated by harmful bacteria that can cause food poisoning. Problems typically result from other contaminated or low-acid ingredients (like chicken or seafood), improper storage and handling or homemade versions that contain unpasteurized eggs. Some other high risk foods (those that can easily become contaminated by harmful bacteria) are raw shellfish, bulk ground beef and unwashed fruits and vegetables. The bottom line is that despite its reputation, mayonnaise can reduce food contamination."


Day 4 (tomorrow): we plan to return to Laurel County Schools to observe another Assistant present a part of my preceptor’s initiatives for her research. Shall be interesting!