My clinical rotation was at Betances Health Center. This is an outpatient health center that offers a variety of nutrition services including dental, medical and nutrition. I really enjoyed this rotation because I got to counsel my own patients and when they returned I got to build meaningful relationships with them. I learned how to recognize and treat a variety of diseases such as; heart disease, diabetes, HIV, and Hypertension. I also gained experience using electronic medical records. I gave several presentations to the weekly adult weight loss group and participated in two health fairs. I truly think I obtained a passion for counseling here and hope to pursue it in some way after my internship is complete.
BETANCES CLINICAL ROTATION
Week of : 02/01/2016- February 1st
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was my first day at Betances and I think it went very well. My boss, Renata, is very friendly and seems like she will be giving me a lot of free reign in counseling patients which I am looking forward to. I spent some of the day getting to know the facility and the program that the appointments are run on. I also got to sit in on two patients. One was a man about college age who needs help with stress eating. The other was a pediatric patient. I also helped call reminders for patients. There seem to be a lot of no shows or cancellations.
Hours Logged: 8
Learning Objectives: 3.1(a-e)
Week of 02/01/2016- February 2nd
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was another great day at Betances. I started in the morning by sitting in on a patient who is pregnant with twins. I also am trying to work on my spanish so I can counsel patients in Spanish. One of the other interns is fluent so I sat in on a patient with her. I also sat in on one patient with Renata which was helpful because I can then see how she counsels.
Hours Logged: 7.5
Learning Objectives: 3.1(a-e)
Week of 02/01/2016- February 3rd
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today I began the morning by working with a nutrition volunteer on filling the schedule for the rest of the month. What I did was go back in the calendar and look through the people who missed or canceled their appointments and try to reschedule them. I then sat in on the adult obesity support group. The topic today was diabetes and there was a presentation by an outside group that was very interactive. I then later sat in on another spanish speaking patient. This time the other intern had to leave the room for a little bit so she wanted me to speak with the patient in spanish. This was quite challenging but I think ultimately if I keep practicing I will improve a lot and maybe one day be able to practice on my own.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 4.1
Week of 02/01/2016- February 4th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was another day of counseling. I sat in on a few patients. Alos, tried to fill the schedule more.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 4.1
Week of 02/08/2016- February 8th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was really cool because I got to counsel my first patient alone. She is a 14 year old who has gained about 60 pounds in the last few years. This is too much and thus I counseled her on general ways to fix her diet and add exercise. She seems super motivated and thus I am excited to keep talking with her. I also did more spanish practice and pushed myself out of my comfort zone.
Hours Logged: 8
Learning Objectives: 3.1(a-e)
Week of 02/08/2013- February 9th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today I had another patient on my own. She is a young woman that is 21 years old. I feel like I do good with patients around my age because it is easy to relate to them. OUr counseling session went really well and she will be back soon to check in. I also counseled patients in spanish with my preceptor in the room but I did more of the talking. During down time I made a flyer about Fiber because one of the patients I counseled asked for one and the one we had was not very good.
Hours Logged: 8
Learning Objectives: 3.1(a-e),3.3
Week of 02/08/2013- February 10th
Rotation: Clinical
Location: Betances Health center
Activities/Assignments: Today I started the day with the adult weight loss group. This was a continuation of last week and had the same diabetes educator. After this I had a patient that I sat in on with another intern. She has binge eating disorder. However, it is a tough patient because we think there may be some issues with her home health attendant. what her attendant is doing is causing her to binge. I also had my own patient of a woman who has a 3 month old baby and wants to stay healthy and eat well by breastfeeding. I also had a pediatric patient who has epilepsy and is underweight. His mother was cooperative but has not been able to get the ensure supplement recently so we have to look into that.
Hours Logged: 8
Learning Objectives: 3.1(a-e),
Week of 02/08/2016- February 11th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today we had a health fair. We did a few assesments during it and also gave out yogurt parfaits. It was a good way to introduce people to healthy eating and also get new patients. I also counseled a patient who is tired a lot and I think it is because she is not eating enough.
Hours Loggd: 8
Learning Objectives: 3.1(a-e), 2.9. 2.5
Week of 02/16/2016- February 16th
Location: Betances Health Center
Activities/ASsignments: Today was a really bad stormy day so we did not have a lot of patients. this was great because it gave me some time to look around and decide who I want to do for chart reviews. I also got to brain storm for my service improvment project. I am going to make a bunch of new simplified handouts. To do this, I will first calculate how many handouts we have on specific nutrients (there are not many). Then I will create new ones and implement them in my counseling sessions. In addition, I sat in on one super diabetic patient who seems resistant to help sadly. He has a girlfriend that is enabling him.
Hours Logged: 8
Learning Objectives; 3.1(a-e), 3.2, 3.3, 1.1, 1.2, 2.1, 2.2, 3.1,4.11, 1.3,1.4, 1.5, 2.9,2.10, 3.2, 3.3, 4.4, 4.7
Week of 02/12/2016- February 17th
Location: Betances Health Center
Activities/Assignments: Today we had the group in the morning. A fellow intern did a presentation on fat in fast foods. We showed the participants how much fat is in a meal by using lard and scooping it out on a plate. There no patients I saw.
Hours Logged: 8
Learning Objectives: 3.1(a-e)
Week of 02/16/2016- February 18th
Location: Betances Health Center
Activities/Assignments: Today I started the day by having a patient that has some degree of mental retardation. This was an interesting case I have not seen before but I think I learned from it. He was very willing to learn but does have some limitations in meal prep so we had to start off with simple changes. I also counseled a young woman with obesity who wants to lose weight. I called patients to reschedule and worked on some handouts for my service improvement project.
Hours Logged: 8
Learning Objectives: 3.1(a-e),4.1, 3.2,1.3,1.4, 1.5, 2.9,2.10, 3.2, 3.3, 4.4, 4.7
Week of 02/22/2016- February 22nd
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today I saw a few patients. One is someone who has not been here for a while and it is a woman who has severely uncontrolled diabetes. Thus, we tried to counsil small manageable goals because she is having trouble focusing. I also sat in on a patient that my boss has had for a while. She wants to lose just 5 more pounds so we worked on trying to fit more exercise in with her school schedule. I also worked on some stuff for my in service and scheduled some appointments.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 3.2, 4.1, 1.3,1.4, 1.5, 2.9,2.10, 3.2, 3.3, 4.4, 4.7
Week of 02/22/2016- February 23rd
Rotation: Clinical
Locations: Betances Health Center
Activities/Assignments: Today was a slow day at the clinic. We saw a patient that has a lot of psychiatric troubles so it was difficult to counsel him. We ended up having to hand him off to the social worker. He was not really eating at all and has no appetite so it is difficult to recommend anything. I did not have any patients after this so I worked on my service improvement project.
Hours Logged; 8
Learning Objectives: 3.1(a-e), 2.7, 1.3,1.4, 1.5, 2.9,2.10, 3.2, 3.3, 4.4, 4.7
Week of 02/22/2016- February 24th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today we started the day with the adult weight loss group. Today the other intern was presenting on sugar, much like the presentation last week about fat. At the end of the presentation we measured out how much sugar is in each soft drink, juice etc. This was very eye opening for the patients. The rest of the day i planned out chart reviews and other projects. We did not have any patients because it was raining hard.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 1.1, 1.2, 2.1, 2.2, 3.1, 3.2, 4.11
Week of 02/22/2016- February 25th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today started the day with a patient we have been trying to help for a while. She has a Home health attendant that will not take care of her and we have been trying to build the trust to get her a new one. The patient is a binge eater and her attendant was interfering with our medical instruction. I think by getting a new attendant the patient will be a lot more successful in their nutrition goals.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 2.7
Week of 02/29/2016- February 29th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today I only talked to two patients today. One was a girl I met 3 weeks ago. She lost some weight and has made a lot of changes to her diet which made me happy. The other is a young guy who is struggling because he eats out a lot. Thus, we set relatively small goals and I asked him to bring in the menus from the places he usually eats out at so we can pick healthier alternatives if he does have to eat out. I also began putting together a presentation for the adult weight loss group that I am going to lead on Wednesday. My topic is salt.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 3.2, 2.4, 2.3
Week of 02/29/2016- March 1st
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was a very busy day. It was only my boss and I and for whatever reason every patient showed up and they were all spanish speaking. This was challenging but I think we managed pretty well and I got a few compliments on my spanish.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 2.11
Week of 02/29/2016- March 2nd
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today I gave a presentation to the adult weight loss group. It was on salt and information about it and how it affects hypertension and other health problems. I think it went pretty well and was eye-opening for a lot of people. Later in the day I had one patient that is a man trying to lose weight because he just had a baby. He seemed very interested in taking charge of his health so this was very motivating for myself.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 3.2, 2.3,2.4
Week of 02/29/2016- March 3rd
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today the morning did not have too many patients. However, one patient that I saw was a man with mental retardation. I have seen him previously and was very happy with his follow-up. He really made some changes and tried to follow the goals we gave him.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 2.4
Week of 03/07/2016- March 7th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was a relatively slow day because not a lot of patients came in. I worked on pickiing more patients for my chart reviews.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 1.1, 1.2, 2.1, 2.2, 3.1, 3.2,4.11
Week of 03/07/2016- March 8th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was pretty full of patients. I saw two patients with HIV. I also saw a young patient that has lost weight and changed his eating since the last time he was here. In the morning I saw a patient with my boss that is morbidly obese. I thought it would be challenging but she has actually recently taken some steps to take control of her health and is following a portion meal plan.
Hours Logged: 8
Learning Objectives; 3.1(a-e), 2.4
Week of 03/07/2016- March 9th
Rotation: Clinical
Location: Betances
Activities/Assignments; Today was a lot of missed patients but we did have the adult weight loss group in the morning. The presentation was about eating healthy on a budget and meal planning. At the end there was a little bit of exercise conducted by the trainer. Our binge eating patient that has the bad home health aide did not have an appointment with us but she came to us and wanted to get her health aide out which was really uplifting as we have been working on this for a long time. I saw my HIV patient follow up as well.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 2.7
Week of 03/07/2016- March 10th
Rotation: Clinical
Location: Betances
Activities/Assignments; Today unfortunately there were not too many patients. It was a really nice day outside so I am thinking people may have wanted to stay outside. However, I did see a woman who was here quite a while ago and wanted to get back on track. We also had a large patient who is really struggling. He gained 15 pounds in two weeks so we had to be a lot more strict on him this time. I also recommended him to start with the fitness intern because I think that this will help him stay on track and motivated.
Hours Logged: 8
Learning Objectives: 3.1(a-e)
Week of 03/07/2016- March 14th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today I started the day with a patient who speaks mostly spanish. She recently joined the adult weight loss group and is very motivated about her health. I communicated pretty well in spanish with her and it was nice because she is also trying to learn english. She was very receptive to the information and goals set and I am optimistic about her future. Next, I had a patient who has HIV and is on ensure supplements. She has gained weight since her last visit which is good. Next patient was a young woman who is just looking to lose weight and eat healthier as she has a young son. I also followed up with a young girl who is larger. Her grandma is the main force in her losing weight and we tried to create a small manageable goal for her.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 2.13
Week of: 03/14/2016- March 15th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was a slow day because of the weather. I took this time to replenish copies of some of the common handouts that we give to patients. I also helped my boss prepare for the health fair by going to the grocery store and purchasing fruits/vegetables for the raffle. We also selected some handouts to have on display.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 2.9
Week of 03/14/2016- March 16th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today in the morning we had a health fair. It was basically just a nutrition table where people could come up and ask questions and get handouts. We also had a raffle. We saw our patient that got the new health aide and the aide actually came into the session to educate herself on how to cook for the client. I also saw a successful HIV patient who has gained weight. Lastly, I saw a man in pretty good shape but that just wants to make sure he is healthy because he had a neighbor die early of heart disease. His counseling was more preventive.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 2.9, 2.4
Week of 03/14/2016- March 17th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was a relatively normal day. We saw a patient that has gained a lot of weight recently that we had to be very strict on last week. I think he is finally mentally ready so we set some pretty strict goals. I also saw my neurological patient. He is truly great at following our goals and although he hasn’t lost a significant amount of weight he is working towards making healthier choices within his limits.
Hours Logged: 8
Learning Objectives: 3.1(a-e),2.4
Week of 03/21/2016- March 21st
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was a good day. I started with a patient who was new. She was recently diagnosed with fibromyalgia so I counseled her on a healthy diet with exercise. My next was a follow up that really didn’t change much. She has irregular blood sugar so we are working to her eating more frequently. In the afternoon I did the recall for a woman who only speaks spanish but it seemed to go well. Also, I saw a patient who is doing great and is very health conscious.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 2.4
Week of 03/21/2016- March 22nd
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today I spent the morning doing research for a wheel chair accessible scale that can hold a large amount of weight. This would be useful for the facility because there are some patients that are over the 500 pound mark and the scales we currently have don’t work for that. We also have some patients who are in a wheel chair and can not stand up to be weighed normally. We also did not have many morning patients so I used this time to reorganize our handout cart. In the afternoon, no patients showed up so we prepared for the group presentation.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 3.5,
Week of 03/21/2016- March 23rd
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today we had the nutrition group in the morning. The presentation was about the importance of eating a healthy breakfast. Other wise, there were not that many patients. I did mainly administrative tasks. I had to reschedule some patients because my boss will not be in on Monday or Tuesday.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 4.1
Week of 03/28/2016- March 30th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was the nutrition group in the morning. It was presented by the medical practioner and was on diabetes. Then I counseled a few patients. One was someone we had seen the previous week and she had many so many changes it was really great. I also saw a new patient who has high blood pressure.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 2.4, 2.10
Week of 03/28/2016- March 31st
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was a slow day. I saw a few follow up patients but nothing significant just checking in on how they are doing. We are still struggling with a patient who says he is making changes but no changes on the scale.
Hours Logged: 8
Learning Objectives: 3.1(a-e)
Week of 04/04/2016- April 4th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today we had a new intern which was nice. I got to train her on a lot of the processes we do here such as how to use the computer and also how to counsel patients. I saw a few follow up patients and they all seemed to be lacking motivation. They know what to do they just don’t follow it very well. This was a little frustrating.
Hours Logged: 8
Learning Objectives: 3.1(a-e)
Week of 04/04/2016- April 5th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today there were a lot of patients in the morning. I effectively counseled one in all Spanish and this was really rewarding for me. I also worked on my chart reviews and having them be reviewed by my preceptor.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 1.1, 1.2, 2.1, 2.2, 3.1, 3.2,4.11
Week of 04/04/2016- April 6th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was my last participation in the nutrition adult weight loss group. I did the presentation on how junk food affects your body and what happens when you eat it frequently. This consisted of a powerpoint and also some videos. I think that everyone was very shocked by my presentation and did not really realize what was actually happening when they ate fast food etc. I saw a few patients as well. They were all follow ups so nothing of note.
Hours Logged: 8
Learning Objectives: 3.1(a-e), 2.3
Week of 04/04/2016- April 7th
Rotation: Clinical
Location: Betances Health Center
Activities/Assignments: Today was my last day at Betances Health Center. Bittersweet as it has been my favorite rotation thus far. I saw our patient who got a new health aide but now she has a problem sleeping which is affecting her eating. It really illustrated to me how other activities in your life are related to eating such as lack of sleep. I also saw two separate young patients with HIV. At night, I went and participated on a research panel for my new rotation. They needed an extra hand taking notes on one of the panels.
Hours Logged: 10
Learning Objectives: 3.1(a-e),2.4,