Download Interns/Upper Level

Expectations for Students/Interns
PROFESSIONALISM:
1. Show up on time. Arrange arrival time with each preceptor prior to the first day
of rotations. Call your preceptor well in advance to make arrangements.
2. Look professional in appearance. First impressions count!! Be sure you are
dressed professionally, no fingernail polish, no distracting jewelry, or hairstyles,
etc. All students working in Intermountain facilities must wear the appropriate
identification tag at ALL times.
3. Keep cell phone use (calls and texting) to a minimum: Discuss with your
preceptor the appropriate use of cell phones for any personal phone calls and
texting and plan to leave phones in you backpack, purse, or bag.
4. Have a positive attitude: Your overall attitude is key to having a successful
experience. There may be parts of your rotations that are not exciting or that you
feel may not be applicable to your future career goals. However, the most
successful interns show enthusiasm for learning in ALL areas and rotations and
often discover new areas of interest from keeping a positive and open mind.
5. Expect to put in a full day. Your internship is teaching you what it is like to be a
dietitian in a variety of settings. This includes the daily working hours. DO NOT
expect to leave early.
6. Come prepared. You are responsible to bring ALL materials to the rotations
(pens, paper, calculators, basic reference materials, etc.). Do NOT rely on your
preceptors for these items.
7. Take notes and ask questions: Be attentive on the first day, take LOTS of notes,
READ any manuals provided by the facility thoroughly, and ask questions when
applicable. Keep your preceptor informed if the pace is too fast or too slow and
decide together the level of independence that is appropriate for you.
8. Be familiar with resources and use them. Examples of resources include but are
not limited to: nutrition care manual, evidence analysis library, drug nutrient
interaction books, pub med, etc.
9. Be assertive and confident, yet respectful: Be prepared to talk intelligently with
patients, nurses, doctors and fellow health care professionals. At the internship
level, it is expected that all students come with some experience in
communication skills pertaining to this area. Practice your communication skills
if needed.
10. Use good customer service skills with dietitians, physicians, hospital staff,
patients, and visitors.
11. Prepare for staff relief. Interns and upper level students will provide a period of
staff relief. During staff relief, you are expected to fully assume the
responsibilities of the RD you cover for. You will be most successful during your
staff relief, if you have prepared and asked questions well before.
12. Sick time. If you are sick and unable to fulfill your training, notify your preceptor
ASAP. You are also responsible to schedule any “make-up” training that may be
needed.
SKILLS:
First Year Coordinated Program
1. Be able to calculate estimated calorie, protein, and hydration needs for patient’s based on
age, weight, medical status.
2. Be familiar with hospital patient care standards -- prior to beginning rotation.
3. After observation, practice, and study (it is anticipated your skills will increase as
your progress through your rotations)
a) Have a knowledge of various disease states, nutrition labs (i.e. Alb, Prealb,
CRP, electrolytes, cholesterol, amylase, lipase, HgbA1C), medications
(i.e. lasix, bowel care meds, diabetes, etc.). Be prepared to research
diseases, medications, etc., and verify findings with your preceptor.
b) Know common diet orders and how to assess the appropriateness of them
c) Be familiar with basic MNT for different disease states i.e. 2gm Na diet
for CHF, Renal diet for CRF, Consistent Carbohydrate diet for diabetes,
low fat diet for cardiac, etc.
d) Be able to instruct patients on common diet restrictions, i.e.: cardiac, low
sodium, low fat, etc.
4. If possible, be familiar with hospital formulary; know products available in the
facility.
5. Understand the coordination of services between Clinical Nutrition and Food
Services.
6. Chart for the assigned patients in the facility-approved format. This includes the
medical chart documentation using the nutrition care process and PES format and
the Nutrition Cardex charting.
Interns/Upper Level
Be competent in above skills for first year coordinated program and the following skills.
Note: Facilities may provide more specific expectations for specialized service lines.
1. Understand indications and contraindications for TF, PN, and PPN.
2. Accurately calculate calories, protein, and fluid in enteral and parenteral nutrition
orders.
3. Assess appropriateness of nutrition support prescriptions, based on labs, diagnosis
and clinical course. Understand rationale for nutrition support in various ICU
diagnoses including: respiratory failure/ARDS, liver failure, trauma and sepsis.
Evaluate tolerance of nutrition support.
4. Understand indications for specialized TF products
5. Be familiar with appropriate micronutrient supplements.
6. Have knowledge of nutrient needs for wound healing.
7. Be familiar with different types of feeding tubes (small bowel, G-tube, etc.)
8. Be familiar with disease specific labs, tests, medications, and procedures.
9. Understand “Refeeding Syndrome” and be able to make appropriate
recommendations for kcals, protein, fluid, vitamins/minerals and feeding
progression.
10. Be able to prepare and teach classes in both inpatient and outpatient settings.
Pediatric
1. Plot ht/wt on growth chart assess rate of growth
2. Be familiar with typical medical diagnosis and how they may:
a. Decrease nutrient intake
b. Cause malabsorption of nutrients
c. Increase need for nutrient intake
3. Have an understanding of common food allergies
4. Be able to calculate nutrient needs: calories, pro, fluid, for normal and catch-up
growth
5. Have an understanding of types of infant and pediatric formulas and modular
components
a. Formula categories: Standard, premature, semi-elemental, elemental, etc.
b. Modulars: Microlipid, polycose, etc.
6. Have a general understanding of parenteral nutrients and adjustments
7. Be prepared to educate families on basic nutrition interventions such as:
powerpacking/wt gain, formula mixing, and weight management.
8. Assist the dietitian in educating families on complex nutrition interventions such
as: Diabetes, gluten intolerance, tube feeding for home, allergies, etc.