Hi Everyone! My name is Ashley Eastland. I am currently interning at Lehigh Valley Cedar Crest Hospital where I am finishing up my clinical/MNT concentration rotations. My journey began back in September when I first started clinical. My first day I was anxious and excited to begin my clinical rotation. I remember feeling like I was going into my first day of high school, not knowing what to expect, but finally being able to say I was in high school.
Now to get into more interesting parts of my internship experience. I’ll never forget my first time practicing a nutrition focused physical exam on a patient. I felt so nervous like I was going into my biochemistry final. My preceptor was very encouraging and the first couple of times actually did the assessment before me and then I would perform the assessment and after leaving the patient’s room we would go over what we thought from the assessment if the patient was mild, moderate, severe malnourished or was properly nourished. This helped me gain confidence in my physical assessment skills and now, when able, I feel confident performing nutrition focused physical exams.
Another part of my internship I found to be interesting was the TPN team. At my site, there is a dietitian that is assigned to the total parenteral nutrition (TPN) team daily to see the patients who require TPN. The dietitian puts in order recommendations for dextrose, amino acids, lipids, and micronutrients like sodium, potassium, magnesium, and phosphorus which then gets looked over by a PA and the pharmacist. I was overwhelmed with all the components that go into assessing a patient on TPN. My preceptor helped demonstrate what to look for and showed me videos and PowerPoint presentations on TPN basics for me to feel more comfortable. Now, coming to the end of my rotation I am more comfortable and confident in my critical thinking skills about the labs and knowing when and why to increase or decrease the macronutrients or micronutrients in the TPN bag.
One message I would like to share with all of you: challenge yourself. Ask yourself the critical thinking questions, try something that might be outside of your comfort zone and don’t be afraid to ask questions if you aren’t sure about something. This internship experience has been nothing like I have ever done before or ever could’ve imagined. All of my preceptors have been extraordinary teachers to me.
Now to get into more interesting parts of my internship experience. I’ll never forget my first time practicing a nutrition focused physical exam on a patient. I felt so nervous like I was going into my biochemistry final. My preceptor was very encouraging and the first couple of times actually did the assessment before me and then I would perform the assessment and after leaving the patient’s room we would go over what we thought from the assessment if the patient was mild, moderate, severe malnourished or was properly nourished. This helped me gain confidence in my physical assessment skills and now, when able, I feel confident performing nutrition focused physical exams.
Another part of my internship I found to be interesting was the TPN team. At my site, there is a dietitian that is assigned to the total parenteral nutrition (TPN) team daily to see the patients who require TPN. The dietitian puts in order recommendations for dextrose, amino acids, lipids, and micronutrients like sodium, potassium, magnesium, and phosphorus which then gets looked over by a PA and the pharmacist. I was overwhelmed with all the components that go into assessing a patient on TPN. My preceptor helped demonstrate what to look for and showed me videos and PowerPoint presentations on TPN basics for me to feel more comfortable. Now, coming to the end of my rotation I am more comfortable and confident in my critical thinking skills about the labs and knowing when and why to increase or decrease the macronutrients or micronutrients in the TPN bag.
One message I would like to share with all of you: challenge yourself. Ask yourself the critical thinking questions, try something that might be outside of your comfort zone and don’t be afraid to ask questions if you aren’t sure about something. This internship experience has been nothing like I have ever done before or ever could’ve imagined. All of my preceptors have been extraordinary teachers to me.
