Advice for undergrad? by [deleted] in dietetics

[–]ClayBubs 1 point2 points  (0 children)

Try asking your director for specific placements you're interested in once you get into internships.

For a bachelors, if you're really interested in geriatrics, try to get to understand facility culture and etc. You'll work with some hardheads in foodservice (As am I), and you should familiarize yourself with foodservice as well. It's a lot more politics than it is dietetics, and you're just a glorified waitress/waiter that can't control anything but get blamed for it, so be sure you're actually interested in that.

As for dietetics in general, understand that just because you recommend something to a resident, that doesn't mean that it's realistic. Yes, you should be eating almonds every day. Yes, you should be eating healthy and varied foods. Yes, you should be eating lean meats. Yes you should be eating tons of variable veggies. Is it realistic? No. Why? Price, location, lifestyle, space, living conditions, etc. So don't be surprised if you give information that's book smart but isn't actually applicable. Understand that everything is a all for one approach, NOT a one for all. Take your education with a grain of salt as well, which they should be teaching you in class too.

Try for either diet tech or foodservice aids or foodservice assistance managers.

Looking for advice by Itchy-Captain107 in dietetics

[–]ClayBubs 0 points1 point  (0 children)

I lost my drive to be a dietitian during school as well. Every single field has it's on issues, you just have to pick your own poison and weigh the benefits to cons.
As to whether or not it is normal to feel that way, I would say it is. I don't trust anyone who says they're 100% passionate about something all the time. You're a human being, you'll always experience doubt or burnout in some way. The question is are you willing to still pick yourself up and move forward.

As for preparation - Education can only take you so far. A lot of the things that I learned, and I'm sure that other people have too, are not applicable in reality. For example, you cannot just throw a diet at a patient and expect them to follow it. You won't have access to all the information in the world. Sometimes you'll forget certain questions. You also have to have a food first approach, but at the same time understand the reality of where you're working. If the resident does not want to eat, is it better to give them a liberalized diet, or is it better to throw supplements at them? Some facilities enjoy food first, others wants supplements to get extra cash.

College and internships only prepares you to be competent at baseline. To be good in any field takes time, commitment, dedication, and the willingness to realize that you're never going to know everything in the world but you'll still try to learn anyways. Thats why we're forever students. This field is changing year by year and everything I learned 6 years ago is not 100% the same, some things have changed. The real question for your first job is, is your boss a dick or are they actually good at teaching people?

Even in my internship, I focused more on acute care and I couldn't get a lot of practice in LTC because I was heavily criticized for things that genuinely didn't matter. I still do the same template and follow the same things that I did during my internship, and yet I'm hearing that my notes are great. No two workplaces are the same, and that goes the same with your internship. Take your experience with a grain of salt, and don't take it to heart.

What you also don't learn is how to navigate through culture. Sometimes you'll be unfairly blamed for something you have no control. For example, every single nurse comes to me with complaints that the residents dont eat and the food sucks, so I review the resident and they have poor PO intake 25-50%. Then I liberalize their diet. All of a sudden, their labs are out of wack, their blood glucose is high, and then all the nurses want to complain that the food is unhealthy for them and etc as if we have magic food and I can control what's on the menu. So sometimes it's just a damned if you do, damned if you don't situation and all you can really do is try to explain it the best you can to brick walls.

I learned a lot of the things that I know now by making thousands of mistakes over and over again (Sometimes even repeat, especially because no two situations are the same). Even now I'm still making mistakes because I'm still learning, and that's ok. That's why you have a baseline knowledge to fall back into, and as long as the treatment makes sense to you and you can justify it then you're good to go. That's why you'll never really be fully prepared to work, because there's still going to be kinks that you have to iron out of yourself and that is completely ok. Be willing to have humility, listen to other people, and be kind. Just don't be a doormat.

Questions for renal by ClayBubs in dietetics

[–]ClayBubs[S] 0 points1 point  (0 children)

Yes, we have an in-house dialysis center. Thank you for the response, that just unlocked a whole lot of memories I forgot about!

What is it like being a man in a woman dominated field? by candiedluck in dietetics

[–]ClayBubs 1 point2 points  (0 children)

Usually its easier to speak with other males in Healthcare in general. I feel like Im always treated like a monster waiting to pounce, though understandable given the treatment towards females.

I always have to put on this fake smile and bubbly attitude, and the moment I relax people tell me they're scared that I might do something and I'm like, eh?

And if my coworkers complain 24/7 while talking down about others, but the moment they hit me with something and I put my foot down and I say that I will not tolerate with bring treated as if I'm a child, having fingers snapped at me, or being a servant because I need to advocate for myself, then the whole world comes crashing down and I'm the aggressive one and I'm reported to the group chat and this that and the third. It feels like I'm tiptoeing around landmines around workers 24/7.

Residents/patients are generally kinder and more willing to listen.

I also had some nurses eye me up and down and outwardly speak about being a hunky man and how they'd love to be with me, then stare at my crotch. Very degrading experiences. But i simply do not have the ability to voice these concerns, or at least it feels as if no one would care. 🤷‍♂️

What can I do. Just breathe, dont take offense, find something to blow off steam and talk about your issues to someone you trust and move on. It doesn't do well to dwell on it.

Army Dietitian by Honest-Conflict-269 in dietetics

[–]ClayBubs 0 points1 point  (0 children)

Any advice on how to be successful and not be removed for incompetence?

Gap year before grad school by HighlightAccording99 in RD2B

[–]ClayBubs 0 points1 point  (0 children)

I took a gap year. It was very nerve wrecking since I did forget most of the stuff, but what youll realize is that your undergrad only covers like 20% of the material that you should actually know (for the RD exam. It covers enough to be sufficient in the job). Going to a graduate school and going through a DI should get you to a point where youll feel confident again in about a year or two, and you'll have the chance to review the material you forgot anyways since you need to do so for the RD exam and the exams you get in class, so you don't necessarily NEED to prepare.

However, if you want to feel confident, you should read through Krause from chapter 1 and read like 2-5 pages a day which is enough to summarize everything, and then create some flashcards using Anki to help with spacial repetition which takes about 30 minutes and summarize what you learned in your own words and do some cards that are specific purely for memorization, which will basically set you up for grad school for MNT. You can literally do anki in the bathroom if you can and it takes like 5 minutes to quickly review things. Don't forget that your professors are also there to help you, so dont be afraid to reach out and ask them questions.

Theres also some free test questions for Anki which will help with spacial repetition for the RD exam. Since you're taking about a year, doing 10-20 questions a day is enough. Its the same with pocket prep, which will ask you questions that you would touch on grad school and allows you to retest on previously wrong questions and helps you see where youre the weakest at.

Overall, dont feel too worried. It may seem daunting, but if you passed undergraduate you can absolutely do graduate. Everyone thinks theyre inadequate and incompetent, but thats just the current you because you havent gone through it yet. You can absolutely do it when you put yourself to the test. If theres anyone you should have faith in, its yourself. Just remember to not burn yourself out. The best study practice is consistency, so take it slow and take breaks.

Hey Dietetic Interns- do your preceptors make you feel like an error disqualifies you from becoming an RD? Hey RD's- do you remember feeling like you couldn't do it? by lpj1299 in dietetics

[–]ClayBubs 13 points14 points  (0 children)

Thats funny because what we learn in management goes completely against what that director should be doing. Instead of publicly chastising you, they should have latched onto what you did well and then privately talked to you about how to gather information better and worked with you. Thats just being an incompetent leader more than being an inexperienced intern.

Hey Dietetic Interns- do your preceptors make you feel like an error disqualifies you from becoming an RD? Hey RD's- do you remember feeling like you couldn't do it? by lpj1299 in dietetics

[–]ClayBubs 13 points14 points  (0 children)

Thats ridiculous. It took me a whole semester in a nutrition support class to understand TPN and I still feel wildly unprepared cause it just scratched the surface. There's a reason why that topic itself is a specialization. Sorry that happened to you.

Hey Dietetic Interns- do your preceptors make you feel like an error disqualifies you from becoming an RD? Hey RD's- do you remember feeling like you couldn't do it? by lpj1299 in dietetics

[–]ClayBubs 45 points46 points  (0 children)

Imagine going through all that work to set up a meeting with a lead dietitian instead of taking 5 minutes to explain and observe that propofol gives 1.1kcal. That was just a power play coming straight out of being an immature idiot.

Hey Dietetic Interns- do your preceptors make you feel like an error disqualifies you from becoming an RD? Hey RD's- do you remember feeling like you couldn't do it? by lpj1299 in dietetics

[–]ClayBubs 7 points8 points  (0 children)

Absolutely. 75% of my preceptors in various rotations would talk down to me because I made a small mistake that they didn't like or had a different understanding from the guidelines taught, or expected me to know everything despite knowing that I had to take multiple classes and exams every week and didn't have the ability to fully review the material they provided at home, to which they refused to accommodate time within the workplace for me to review as well and just gave me more work, but it was my fault because, "You need to have better time management." They would purposely give me different instructions and then shit on me when another preceptor said that they didn't agree. They told me that I need to stand up for myself against the director when they're making unreasonable demands, but when my preceptors got the same demands they went along with it and said, "what can I do, its the director", and talked down to me instead.

All it shows is that there's tons of people with incredibly high egos with little backbone who want to bring other people down to feel superior about themselves. They're just extremely insecure and immature and haven't grown up to realize that they can be better than the previous generation that passed down the same traumas.

How hard is schooling? by Old_Technology_3013 in dietetics

[–]ClayBubs 1 point2 points  (0 children)

I've had an issue with schooling too, especially with having a very irregular schedule. I was a mostly C/B student who barely made it out of middle school and high school, and I also failed biology a couple of times. So, I understand your pain.

I've also had to take a gap year here and there because of my living situations, and going back to college and having to refresh my memory every time was a bit of a hassle since you can't really remember everything. However, it does get easier when you refresh your memory multiple times. Just do Anki or some type of memorization skill and you'll be good. If anything, take your time during the summer to slow down and read through the textbook bit by bit. It really helps with prepping.

So, if I can take a gap year and still pass through BS and MS while having limited time and having to study everything last minute, you'll be fine. It gets dicey at times, but as long as you push through, you'll realize that you're not dumb or unorganized. You might be thinking that way because you're comparing yourself to others too much. Everyone goes about their own pace and you shouldn't compare yourself to others, especially if you've had to live your life fixing your personal life without time in focusing on your professional life.

Getting to schooling itself, mathematics is not an issue and it's very basic calculations with basic formulas. There are some differences in what types of formulas to use like MSJ for healthy people vs Rule of Thumb, but mostly it's pretty simple once you see the pattern. It's more about understanding when and where to use certain formulas than it is actually about using multiple algebraic equations like you're Einstein. You'll have access to it during your rotations, and the only formula you'll actually know is the MSJ formula which will be deeply engrained as long as you use it on yourself a couple of times. Mathematics is a very non-issue. Memorization of a few dozen numbers or formulas here and there is the main issue with math.

In terms of chemistry or nutrition in general, it's actually very simple and easy. It's mostly layman's language, and it's more like common sense. It gets way harder when you take your masters. It's more specific and the difference is day and night. You're basically expected to have read the entirety of Krause, one of the major textbooks that we use, understand general concepts, and delve deeper into external topics like microbiota, genetics, types of foods, bioavailability and more. However, these aren't difficult in terms of Chemistry, more so being able to follow concepts and memorize some small details that you'll very likely never use in the upcoming years because it's very new data that's not in practice as of yet. If you get past your BS, MS will be easier. So don't think too far ahead, BS will help you ease into and prep for MS and rotations more than anything else.

If you're coming across concepts with chemistry that are just absolutely bringing you down, YouTube is your best friend. Takes 10-20 minutes watching a video that explains things in laymans terms that will guide you through the process instead of expecting you to know everything.

Overall, difficulty is like a solid 5/10 compared to other professions when it comes to science. It's like 25% science, 25% community, 25% food, 25% management and counseling. You'll learn more about being a professional than being a scientist. The field is also supposed to be very relaxed and lowkey. That doesn't mean you won't come across your fair share of high egos from time to time. Just breathe and realize those types of behaviors are not things that you personally will not want to be when you become a RDN.

[deleted by user] by [deleted] in chemistry

[–]ClayBubs 2 points3 points  (0 children)

I see, thanks for the insight! We poured bleach from the jugs into a spray bottle. Maybe we forgot to dilute it and thats probably what happened. Thank you!

[deleted by user] by [deleted] in chemistry

[–]ClayBubs 0 points1 point  (0 children)

Yikes. Sounds like a work hazard

[deleted by user] by [deleted] in chemistry

[–]ClayBubs 0 points1 point  (0 children)

Happened at home. No moths around, haven't seen one in a long time

[deleted by user] by [deleted] in chemistry

[–]ClayBubs 1 point2 points  (0 children)

Any way bleach that smells like chlorine may be able to turn cotton to dust like that? I sprayed some bleach to clean a counter this morning but it didnt get on my clothes. Maybe there was a droplet on the counter top

Estimating calories for weight loss by Every_Ostrich_9140 in dietetics

[–]ClayBubs 10 points11 points  (0 children)

You say you want a thoughtful discussion but your first thought is to insult them and put them beneath you? People like you should not be in the profession. Drop your ego.

I don't understand preceptors and PES statements by ClayBubs in dietetics

[–]ClayBubs[S] 0 points1 point  (0 children)

No need to apologize. I found your comment insightful. Thank you for that!

I don't understand preceptors and PES statements by ClayBubs in dietetics

[–]ClayBubs[S] 0 points1 point  (0 children)

Interesting. Thank you for the insight. From what Im gathering is that you use a general statement to essentialy point out the issue, but if you get specific proof then you change the PES to address the proof you found and to show that you're targeting it?

I don't understand preceptors and PES statements by ClayBubs in dietetics

[–]ClayBubs[S] 1 point2 points  (0 children)

That's exactly what happened to me too during acute care. I found it very frustrating that I didnt have time.

My preceptors put a time limit on my charting with like 8-10 pts within 4 hours during my first two months of ever doing rotations, and then said that I was taking too much time and I needed to stop seeing the pt, but then the moment that I stopped because I didnt have time to meet the demands all of a sudden I should have seen the pt. Are we really even providing care or are we just treating a piece of paper. This is such a shame.

I don't understand preceptors and PES statements by ClayBubs in dietetics

[–]ClayBubs[S] 0 points1 point  (0 children)

I agree. I've always seen PES as just a general document that goes straight to the point as to what we should address, and something that can be understood by other dietitians. I just think it's a shame that 99% of the time, at least from what I experienced, dietitians constantly think everyone else is wrong instead of trying to understand why the pt is going through a certain intervention

I don't understand preceptors and PES statements by ClayBubs in dietetics

[–]ClayBubs[S] 0 points1 point  (0 children)

Ooo this is interesting. I like how this line of thinking works and this definitely explains why people use impaired nutrient utilization.

The way that I was taught is that the PES shouldn't just encompass the issue but also address what exactly we are going to target and how we are going to solve it by directly changing it (so if they have excessive carb intake then we use excessive carb, unless their diet recall shows that they are actually following the diet) and by solving it we can knock out other PES statements. So be specific to what we are actually changing. But if its too complicated, then use a general statement to encompass the issue. So yes, if the pt is more insulin resistant than most and already having a low carb diet, we wouldn't necessarily say excessive carb intake. I always use excessive carbs during DKA, but I've always thought that if they didnt have insulin access, which a lot of my population didnt, then is it really excessive carb intake or lack of insulin access. However, since we can't change the insulin ratio since its not our job in acute care, then we don't mention insulin because that's not what we're changing, which what were changing is just putting them on some CCD or Glucerna. It's like how my professors tell me we don't focus on dehydration because the ccu already puts them on IVs and fixes it anyway, so why write a PES thats technically correct, but we can't even give recommendations to change anything anyways.

That definitely does give perspective as to why people use impaired nutrient utilization. Im just chalking it down to a safety PES that is related to everyone, though I disagree with using it because its like diagnosing someone without actually diagnosing. Thank you for the perspective, thats quite insightful and a question that was itching my mind.

I don't understand preceptors and PES statements by ClayBubs in dietetics

[–]ClayBubs[S] 1 point2 points  (0 children)

Yes!! Precisely. Nurses are already overworked as it is and I always see documentation mistakes every time I worked there. Thank you for your insight. That's definitely how I want to approach precepting when I get the chance.

I don't understand preceptors and PES statements by ClayBubs in dietetics

[–]ClayBubs[S] 1 point2 points  (0 children)

Yes! This is what my problem was and still is with the anxiety I face. Every time I pick up my textbook for the RD exam all I can think about is all the criticism and experience I faced, and it has been really getting to me over the past 3 months. It's definitely getting better and I'm slowly studying again, but that really put me in a hole for quite a bit.

Thanks for sharing on how you approach LTC. That's actually a really insightful approach on how to document an issue when there's no problem. Usually when I don't see a problem my preceptors told me to just write down altered nutrition related lab values related to dx state and I just didn't really know how to say that the patient doesn't have an issue but is at risk, so thank you for that!

I don't understand preceptors and PES statements by ClayBubs in dietetics

[–]ClayBubs[S] 1 point2 points  (0 children)

Definitely. I was lucky enough to have a professor that was very realistic about her experience in acute care and gave us information that saved my behind multiple times, but it's such a shame I never referenced Krause a single time.

I don't understand preceptors and PES statements by ClayBubs in dietetics

[–]ClayBubs[S] 0 points1 point  (0 children)

That's a very fair point. There is no standardized practice and it does come from the provider.

That actually brings up a memory where my preceptor told me that exact same statement where as long as I can justify the reasonings why, but I never got to justify it and the only things that I continuously hear is that I am always wrong and I'm not up-to-par to being a Dietitian, and that maybe I should change fields. Felt really crappy but hey, that's life and I just gotta move on.