HALEY A. HERBST

Baptist Health System Dietetic Internship

I completed my dietetic internship with Baptist Health System in San Antonio, TX.  The internship required 1200+ supervised practice hours comprised of rotations in clinical, food service, and community settings.  I concluded the last 2 weeks of the internship with a self directed enrichment rotation at the Department of Veterans Affair Hospital in Nashville, TN.  Below, I have a description of my experiences along with pertaining work samples.  I have also attached research, case studies and management projects I completed outside of my rotations, as well as a picture gallery. 

 CLINICAL

FOOD SERVICE AND MANAGEMENT

Mission Trail Hospital

I worked for 5 weeks in Food Service and Management at Mission Trail Hospital. The long exposure and various projects during this rotation allowed me to understand the managerial role of a Registered Dietitian in Food Service.

• Organized, planned and directed a "Keep it Safe, Keep it Healthy" theme meal for 250+ employees attending the Safety Kick-off event at Mission Trail Hospital. The menu included two salads: Asian Steak Salad and Southwestern Chicken Salad. For the event, I developed a marketing plan and cost breakdown of each salad, created standardized recipes, recipe handouts with nutrition facts and "Keep Salads Healthy" handout for employees, and an advertisement dispersed throughout the hospital featuring the event menu.
• Created and designed a 3-day menu, and modified it to be applicable to each diet - regular, mechanical soft, cardiac, renal, and diabetic.
• Performed a can cutting with a written evaluation comparing Ocean Spray and Thirster juices - orange, apple, cranberry, and grape.
• Researched, analyzed cost, conducted taste test, and evaluated the diet modified product, Magic Cup.
• Conducted a 3 day plate waste study analyzing breakfast and lunch.
• Conducted and supervised patient meal rounds, chart audits, and tray assessments.
• Supervised ordering and receiving process of food.
• Completed a monthly operational report.
• Completed and supervised Environment of Care/Sanitation rounds.
• Reviewed departmental records including temperature logs and sanitizing charts.
• Developed educational material and delivered an in-service for the food service staff on high/low potassium foods and high/low phosphorous foods.
• Participated in the interviewing and hiring process of new employees.
• Created a drawing of the entire kitchen, mapping out the flow of food and work, along with recommendations for improvement.

Food Service/Management Work Samples:

COMMUNITY 

 The Social and Health Research Center

I spent two weeks working with The Social and Health Research Center.  During this rotation, I was exposed to the research and policy side of nutrition, as well as school nutrition.

• Particpated in the ongoing research study, Digital Food Imaging Analysis: Evaluation Research of Food Consumption & Nutrient Analysis for School Nutrition & Childhood Obesity Programs.  I conducted 24-hour Dietary Recalls and observed Food Frequency Questionnaires on 1st and 2nd grade elementary children as part of data collection for the study.
• Completed nutritional analysis on recipes using Nutrition Data System for Research (NDSR) software.
• Reviewed, edited and made improvements to the Bienestar Curriculum for elementary school aged children and educators on nutrition and exercise subjects.
• With two other interns, I helped create a lesson plan about MyPlate and then taught the interactive lesson to a class of 3rd graders.

H-E-B Supermarket

 As a foodie, I found this rotation with a Supermarket Dietitian intriguing and exciting.  H-E-B is a growing supermarket chain in Texas and Mexico.

• Partcipated in sensory evaluation of a proposed H-E-B Own Brand product.
• Created and cooked recipes in the test kitchen to be featured in the weekly H-E-B newsletter for the month of April - 5 dinner recipes, 1 "kid friendly" recipe, and 2 side dish recipes.
• Cooked recipes in the test kitchen upon request from the Dairy Council, then provided a written evaluation.
• Edited Read 3 curriculum (nutrition section), a program sponsered by H-E-B for children to children build reading skills. 
• Conducted cost analysis on recipes included in the Read 3 program - single ingredient cost, total cost per serving, and total cost per recipe.
• Created short descriptions for "ingredient highlights" to be included in the H-E-B January Newsletter.
• Attended a food stylist and photo session of recipes developed for the H-E-B Magazine.
• Participated in a professional corporate meeting.

Women, Infants, and Children (WIC)

I spent 2 weeks rotating at different WIC clinics.  During this rotation, I was able to learn about the Federally funded nutrition program catering to low income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age 5 who are at nutritional risk.

• Conducted nutrition assessments and provided nutrition counseling to high risk WIC participants.
• Counseled participants on breastfeeding and educated patients on the pros to breastfeeding.
• Developed a lesson plan on the differences between formula, cow's milk, goat's milk and breastmilk to be sent into state office for approval.
• Taught nutrition education classes to WIC participants on ways to prevent children from being picky eaters.
• Developed a Dental Referral Directory for participants in San Antonio. 
• Analyzed the flow of participants through the WIC system.
• Created an organizational chart of the WIC clinics, with written summaries of the leadership roles at WIC.

 Community Work Samples:

ENRICHMENT 

Department of Veterans Affair Tennessee Valley Healthcare System 

For the last two weeks of the intership, interns were allowed to select their own rotation site. I chose to complete my 2 week enrichment rotation at the VA hospital in Nashville, TN with a Supervisory Registered Dietitan.  I chose this site to gain more experience in the clinical and food service management settings, and see how a government hospital compares to hospitals I have already rotated through during this internship.  I am responsible for developing objectives and activities, including a written assignment for this rotation, followed by a written summary describing my experience and what I learned.  So far, I have had the opportunity to work with inpatient dietitians, the nutrition support team, and outpatient dietitians (including a Telehealth dietitian).

ADDITIONAL WORK SAMPLES

• Journal Club: 30 minute oral presentation the article, The protective effect of farm milk consumption on childhood asthma and atopy: The GABRIELA study.  I utilized the evidence-based guidelines to assess the article (Evidence Analysis Library), reviewed current literature pertinent to the topic, and discussed application of the results.
• Case Study #1: 30 minute oral presentation and written paper on a patient I assessed at a long term care facility with a Stage II pressure ulcer with multiple comorbidities.
• Case Study #2: 30 minute oral presentation and written paper on a patient I assessed at St. Luke's Baptist Hospital.  My patient was diagnosed with Parotitis, and was coping with complications from Sjögren's syndrome and Rheumatoid Arthritis.  I am currently working on this presentation and paper, which I will presenting on April 10, 2013.
• Business Plan: Completed a draft business plan for the start of a Nut Butter Company, HP Farm, in Boerne, TX.
• Evidence Analysis Library Research Project: A group project with a fellow intern using the Evidence Analysis Process to review two peer-reviewed research articles pertaining to current evidence supporting the supplementation of cinnamon in diabetic patients.
• Annotated Bibliography: Included 4 research studies from peer-reviewed journals addressing effective methods of nutrition counseling on the prevention/treatment of cardiovascular disease or stroke.
• Review Paper:  Review paper on coffee consumption and type 2 diabetes written as a student for my senior seminar class at Texas A&M University.
   

PICTURES 

Below are various pictures taken throughout the internship.  Click on the photo or scroll the mouse over the picture for a description.