Outpatient Nutrition Clinic

My rotation in the burn unit is complete, and I'm moving on to the outpatient world. Specifically, my rotation is through the Nutrition Clinic. I am working with a super friendly and fun dietitian named Natalia. Yesterday was only day one for me, so I don't have a ton of updates. So far I like outpatient WAY more than inpatient, though! It seems much more laid back and there are many more opportunities to use my motivational interviewing skills.

For those of you who are unfamiliar with motivational interviewing, it's a way to counsel people in a way that is conducive to behavior change. It helps people come up with their own solutions to problems they may be facing by setting their own goals which they believe they can accomplish. The counselor must ask questions that will enable the client to see that they need to change and, in addition, use reflective statements to confirm what the client has already stated. For example, I might ask something like, "What have you heard about diabetes?" This would show me what the client may already know, but at the same time may reveal some misconceptions they may have about the topic. If the client were to say, "Well, I know that when you have diabetes, you can't eat carbs, because they turn right into sugar and that's bad," I might respond with something like, "You're afraid that if you eat carbs, it might have some sort of negative effect on the treatment of your condition." The client might go on, or I could say, "This might sound different than what you have heard, but carbohydrates are an essential part of the diet, even for people with diabetes..." and so on. The whole process may take longer than me simply saying to the client "You need to balance your carbs into your diet by doing this, this, and this," but would that make the client feel good? Probably not.

If I've learned anything in my internship so far, it's that people just want to be heard and treated like...well...people. No matter how sick they are, they deserve to be treated the same as anyone else. That's why motivational interviewing is held in such high regard. It allows the client/patient to feel confident in what they already know, feel like they are being heard or understood, and also to motivate them to change without  overwhelming them with research, facts, figures, etc.

From the sounds of it, this week I will just be observing while Natalia does the counseling. She said we would also do some role playing so I could practice my counseling skills before I have to actually counsel her patients. Then the last two weeks, I get to be the main counselor, while she helps me out if I miss things. I'm pretty excited because nutrition counseling has always been an interest of mine. She said most of our patients have diabetes (type 1, type 2, or gestational), IBS, or Celiac disease. I have been doing a lot of reading on these topics, especially regarding the nutritional impact, and I have to say, I have learned a lot! I know I learn best by doing things, so I have confidence that I will continue to grow in this rotation.