HOW COVID-19 AFFECTED MY DIETETIC INTERNSHIP

I’ve always been one to always have a positive outlook, realistic optimism, and hope. I still posses those characteristics, but COVID-19 introduced a cocktail of ever-changing emotions to the picture. These emotions are both foreign and familiar. I’m struggling to digest what is actually happening in the world and to articulate how I feel about it…

When the COVID-19 pandemic started, I had less than 4 weeks left in my clinical rotations.

Going into the clinical semester of my dietetic internship, I was EXTREMELY nervous; I never saw myself as a “clinical dietitian.” I spent countless hours in the library studying for my rigorous MNT (medical nutrition therapy) classes and stress chewed enough spearmint gum to give an army GI issues. I thrive when I’m able to express my creativity but at that time, I perceived clinical rotations to be dry.

To be completely honest, part of me wanted to have an “easy” clinical rotation; I wanted to be in and out of the hospital and to go on my merry way, but taking the “easy route” doesn’t challenge me or change me. What’s the purpose of putting in 55 days at the hospital to hold my breath and count down the 440 hours?

Ryan Holiday quoted his mentor, Robert Greene and said,

“In this life, there are two types of time. There is alive time or dead time. One is when you sit around, when you wait until things happen to you. The other is when you are in control, when you make every second count, when you are learning and improving and growing.”

Sure, I wasn’t that ecstatic about clinicals, but why not make the most of it? Why not take control, have my nose in the book –err, patient’s chart–, make ever damn second of my clinical rotation count, and learn and improve and grow to become a well-rounded, competent Registered Dietitian?

My fearful mindset would be horrified with my clinical rotations schedule at Loyola University Medical Center (LUMC). These rotations included: neurology, liver transplant, cystic fibrosis, lung transplant, oncology, burn, outpatient dialysis, SICU/MICU, heart transplant, kidney transplant, and staff relief.

#woof 😳

From day one, I kept my nose to the grindstone; I took notes on everything my preceptors taught me, studied charts to nail down medical terminology, prepared questions tailored to each patient’s unique conditions and disease state, and studied my notes when I got home.

Every week was a new obstacle as I had to overcome the learning curve of a new specialty area. I’d take note of the feedback I received from my preceptors at the end of every week, examine it, and jump into my next rotation with that feedback top of mind. I was quite exhausted, but I was “ALIVE”; I learned something new from each patient and improved every week with the feedback I received from my preceptors. I was growing closer and closer to achieving my goal of becoming a well-rounded, competent Registered Dietitian.

The week of March 8th, I was in my ICU rotation. In the ICU, I covered the MICU (medical intensive care unit) and SICU (surgical intensive care unit). On Monday, I walked into the hospital with my backpack carrying my 53 page excessively annotated and highlighted ASPEN article. I was excited for this new challenge! I wanted to make every damn second count.

Thursday, March 12th, was my fourth day in the ICU. At this point, I was a walking zombie; I’ve been waking up at 4:45AM everyday so I could get a head start to screening patients. At this point, there was concern and conversation about the coronavirus and how it may hit LUMC.

My preceptor was scheduled to work on the weekend, so she took Friday off. I handed her my evaluation form that Thursday so she could take her time providing her feedback from the 4 days I worked under her supervision. I joked that I was a “little orphan intern” and would have a substitute preceptor the next day, but little did I know that I wouldn’t be returning to the hospital.

I left LUMC around 4:00PM and drove to the hair salon half asleep to get a balayage. I was so tired that I noticed my fly was undone when I checked in at the front desk of the hair salon.

CAN WE JUST TAKE A MOMENT !!! 

It was a shameful walk back to my hair colorist’s chair, BUT I digress… 🤣

While my the hair colorist brushed my hair, I opened my email inbox so I could catch up on the gazillion emails I put on the back-burner. The email at the top of my inbox was from my DI program director and it stated that we are putting supervised practice on “pause” due to the coronavirus.

“Hmm.. I’m not sure how i feel about this.”

Friday morning, I took my sweet time getting out of bed. I slept in late, walked downstairs in my pink pajama set and pig slippers, and sipped on my collagen coffee in my quiet kitchen. It was peaceful; I haven’t leisurely enjoyed my coffee since before clinicals started.

At that time, my parents were visiting my grandparents in Florida. I Facetimed with the ‘rents to catch up. I told them about my exciting and challenging experiences in the ICU and updated them on supervised practice.  I also chatted with my Aunt who is a nurse practitioner and grandparents. I felt relieved that I could catch up with my family and not feel rushed. For the first time in a long time, I felt grounded.

The following week, I went balls to the walls creating content for AHTK. It was almost like a reflex; I was excited to have the extra time to connect with AHTK readers and provide valuable and timely content.

As the week progressed, assignments and case studies to fufill the remaining hours of supervised practice trickled into my email inbox. The RD who monitored our supervised practice hours called each intern in my dietetic internship class to check in and discuss our plan for the rest of the clinical rotation. I was very grateful for her communication and patience. We discussed what case studies I’ll work on after I finish the TPN and TF case studies my former preceptor provided me with to get additional practice. That’s when it really hit me…

I hung up the phone and felt EXTREMELY overwhelmed and anxious. I was drowning in uncertainty. I wasn’t sure where the internship was heading and what it meant for my future as a Registered Dietitian.

The anxiety and uncertainty were quickly joined by frustration. I overcame the “imposter syndrome” of working in the hospital. That voice in the back of my head that said, “I’m not ready yet. I don’t have enough experience or credentials to survive in clinicals” stopped as I conquered my fears of interning at a rigorous hospital. I learned how to make progress my metric for success as an intern, not perfectionism; I progressed from gen med to the ICU! But now… it’s all over… just like THAT.

Guilt was then added to my cocktail of emotions. I was safely visiting patients and providing nutrition interventions in the ICU less than a week ago with no PPE (unless stated otherwise in the patient’s chart) and working alongside the ICU nurses and doctors who are now risking their lives and fighting in the trenches as they restlessly battle the invisible enemy while I’m safe at home.

I took a moment to step back from AHTK and supervised practice assignments. I wasn’t quite sure how to deal with this emotional cocktail hangover; there aren’t enough electrolytes, sleep, or water that could cure this hangover…

What helped me was gratitude.

I’m not one to lean into the “woo woo foo foo” stuff, but it has been the best way of coping with the flip in the switch.

I’m grateful to have Facetime which allows me to connect with my family. I’m grateful for an opportunity to pause and take a step back from the hustle and bustle. I’m grateful for the AHTK community and to have a platform that connects me with strong, driven women. I’m grateful for the challenge and rigor I experienced during my clinical rotation at LUMC that enabled me to become more confident and competent as a soon-to-be-RD. I’m grateful for the healthcare workers who are working in the trenches to keep patients infected with COVID-19 alive. I’m grateful for my family and friend’s health.

The other interns and I finished the remaining hours of our clinical rotations. Our next rotation would be food service management and long term care. Per zoom call last Thursday, we learned that we will be completing those hours through assignments and projects. We have a few weeks break in between our clinical rotation and food service management.

I reverted back to the Robert Greene quote I applied to my clinical rotations.

There’s a dichotomy to how I spend my time in quarantine — it can be ALIVE TIME or DEAD TIME. It’s my choice.

We don’t know how long quarantine will go. We don’t know what the economy or health of our nation will look like when it’s all over.

What we do know is that we have a choice and that choice is binary: do we choose to make the most of this time or do we label this time as “unfair” and become a victim of circumstances?

I refuse to allow “fair” to become the disabling device that forbids me from taking action. As Ryan Holiday and Tim Ferriss noted in The Tim Ferriss Show:

“Unfair is a disabling word that puts us in the passenger seat of life where we feel like we don’t have options nor are allowed to take action; it’s paralyzing and it’s going to compound your fear.”

I have the power of choosing ALIVE time.

With my free time, I’m taking care of my mental health by going on long podcast walks, checking in with friends and family over wine on zoom, practicing yoga every morning, and journaling. I’m connecting with the AHTK community by chatting over DM; creating content to inform, entertain, and educate; and working on my short and long term career goals. I’m preparing for the RD Exam by studying for a few hours every week.

We all have been affected by COVID-19. We all have immense uncertainty around the future of our careers and health. Allow yourself to grieve and incorporate self care into your new routine. I encourage you all to focus your energy towards what you can control and to choose positivity!

I love you all SO SO much and I hope you’re taking care of yourselves!

Let me know what’s helping YOU at this time in the comments!

xx hails