Dietetic Internship Program

Bay Pines VA Healthcare System

Program Intro Program Information Program Rotations Program Mission & Goals Financial Information Application Information Life in Bay Pines Bay Pines VAHCS Web Site About the Hospital.

The Paul M. Russo Dietetic Internship is a full time program completed in 24 months. It integrates a Master of Public Health, concentration in Nutrition and Dietetics, that starts in August (fall semester) and finishes in August (the following summer semester), following completion of six semesters of graduate coursework.

MPH Concentration in Nutrition and Dietetics (42 credit hours) 

*Elective could be taken at a different time if desired.
**PHC 6934 Nutrition and Dietetics Practicum is an approved alternate to PHC 6945.
***Credit hour break down could vary depending on need for financial aid.

Distance Education
All coursework in the MPH program is online. The supervised practice portion of the internship program begins in August of the second year and ends late June or early July depending on calendar year. Supervised practice rotations are primarily onsite. The following starred supervised practice rotations may include a hybrid schedule of onsite and telework based on preceptor schedules. Interns must have a telework agreement in place and be assessed at the appropriate level of supervision to provide patient care using telehealth modalities. VA specific training modules may also be completed to increase the intern's competence and skills in telehealth. Interns will need their own personal computer with functional webcam and microphone. The organization provides a PIV card reader and headset. Depending on personal computer configuration interns may need to procure appropriate USB connectors. To be successful, interns will need internet connectivity at a speed to support Teams calls with preceptors or for learning activities offered through distance education as part of the program's curriculum. No additional costs are incurred related to distance education. 

Supervised Practice Component (August to June)

Orientation to Nutrition Screening and Assessment (1 Week): Prior to the start of rotations, interns will spend one week becoming familiar with the computerized medical record system, nutrition screening and assessment, Nutrition Care Process (NCP), charting and documentation, available education materials, and the daily procedures of the dietitians. Interns will be assigned to a dietitian to observe and practice nutrition assessments, diet educations, meal rounds and documentation with planned discussion and classroom time with the Internship Director.

Cardiology (3 Weeks): In this rotation, interns will focus on the complex nutritional needs of cardiology patients. Interns will work closely with the interdisciplinary team and spend time in both inpatient and outpatient settings. Interns will assist in providing consultations and nutrition education to patients in the Heart Success Clinic and Cardiac Rehab. There are opportunities to observe various procedures common to these areas while in rotation.

Geriatrics/Long Term Care (3 Weeks): The Community Living Center (CLC) is a specialized nursing facility designed to care for patients who require rehabilitation and restorative care.  Interns will spend time working in this long term care setting to understand the effects of aging on the body system and its implications with nutrition. While working in the Community Living Center, interns will participate in the Cultural Change initiative and attend interdisciplinary team meetings.  Areas of practice will include developing transitional feeding plans, monitoring enteral nutrition, and dysphagia. Additionally interns will care for patients after discharge from an acute care hospitalization.  Interns will perform nutrition assessments with patients who have a variety of medical conditions including cancer, chronic infections, heart disease, and diabetes. There is a special emphasis on wound healing and interns will have an opportunity to attend wound rounds and learn first-hand from the nurse assigned to provide wound care.  There is a strong interdisciplinary team on this unit and interns will have the opportunity to interact with all members during weekly walking rounds and care planning meetings. The intern will also have some limited experience on the Hospice unit to provide exposure to the quality of life and ethical issues that people face when they are given a terminal diagnosis.

Medicine (3 Weeks): In this acute care setting, interns will provide nutritional care to a population living with a wide variety of conditions, including obesity, HIV/AIDS, cancer, and diseases of the cardiovascular, neurologic, hepatic, gastrointestinal, hematologic, endocrine, pulmonary, and immune systems. Interns will apply their medical nutrition therapy knowledge and skills of the Nutrition Care Process by reading and interpreting computerized medical records, screening and assessing patients, performing nutrition-focused physical examination, diagnosing nutritional problems, using the nutrition care process, planning and implementing nutrition interventions, establishing goals, monitoring and evaluating patients' progress toward nutritional goals, conducting meal rounds, providing nutrition education to patients and/or caregivers, and arranging for follow-up nutritional care as needed. Interns will review patients' current and past medications, identify potential drug-nutrient interactions, and provide food-drug education as needed. Interns will select and implement tube feeding formula for patients requiring enteral nutrition support, monitor tolerance, and assist with transition to long-term feeding regimen. Interns will gradually progress during the rotation from caring for patients with one to two diseases to caring for patients with complex, multiple diseases. The interns presence in the patient-care areas will allow interaction and collaboration with a variety of professionals (e.g., Physicians, Nurses, Social Workers, Pharmacists, Physical Therapists, Speech-Language Pathologists) to discuss patient treatment and discharge planning. Interns may observe various procedures such as modified barium swallow and/or tube feeding placement. 

Surgery/Critical Care (3 Weeks): During this rotation, dietetic interns will use their knowledge of medical nutrition therapy while being exposed to a variety of surgical patients, some of which include general surgery, bariatric, orthopedic, ears/nose/throat, vascular, and plastic surgery. Time is spent in the medical and surgical intensive care units where advanced nutrition skills are broadened in dealing with complex medical conditions. Interns will participate in assessment of nutrition support, development of parenteral feeding regimens and follow the care of more critically ill patients. Additionally interns may participate in interdisciplinary team rounds. Interns gain experience developing transitional feeding plans, calculating tube feedings, as well as becoming acquainted with TPN. 

Inpatient Experience (3 Weeks): During staff experience, interns assume the role of the dietitian in an inpatient setting on a selected ward. The intern is totally responsible for the care of the patients; the RD preceptor is available as needed.

Diabetes Clinic (2 Weeks): Interns will spend time working in an American Diabetes Association Recognized Diabetes Self-Management Education and Support Program. Interns will progress from observation to interviewing and developing meal plans for patients using the patients specific nutritional needs and considering the impact of diabetes medications. Emphasis is placed on the individualization of meal plans based on various factors including cultural and economic needs, readiness for change, and lifestyle preferences of the patient. Time is spent observing the analysis of continuous glucose monitoring and insulin pump instruction when available. Interns will teach a diabetes education class while incorporating other interactive education materials.

Home Based Primary Care (1 Week): During this rotation interns will drive with the HBPC dietitian to make home visits to homebound Veterans whose medical complexity and functional impairment precludes treatment in an ambulatory care setting. The goal is to enable Veterans to remain in their own homes as long as possible. This rotation provides a unique experience as you observe firsthand the patient in their home environment, allowing you to better understand the specific education needs and vital role of nutrition for each patient.

Mental Health Residential Rehabilitation Treatment Program (MHRRTP)/Whole Health (1 Week): In this rotation, interns will gain exposure to both the MHRRTP and Whole Health Programs. Within MHRRTP the intern will learn about the following: Domiciliary Residential Rehabilitation Treatment Program (DRRTP), Substance Abuse Treatment Program (SATP), Posttraumatic Stress Disorder Integrated Recovery Program (PTSD-IRP), and Center for Sexual Trauma Services (CSTS). Interns will participate in individual and group sessions emphasizing the importance of nutrition in recovery. Whole Health is VA's approach to care that supports the Veteran's health and well-being. Interns will understand the role of the whole health dietitian in the Veteran's health journey as well as work with other interdisciplinary team members to develop a thorough understanding of the whole health model and its integration into the health care system.  

Oncology Clinic (2 Weeks): Interns will obtain experience assessing patients with different cancer diagnoses and undergoing different types of cancer treatments. They will learn the different side effects related to chemotherapy agents and radiation treatment that impact nutritional intake. They will oversee initiation and/or manage enteral feedings, participate in screening oncology patients at nutrition risk, and provide appropriate nutrition counseling and education to manage side effects related to treatment and/or cancer.

Outpatient Clinic/Patient Aligned Care Team (PACT) (7 Weeks): During this rotation, interns will partake in observation and then progress to independent completion of individual and group nutrition education sessions, education of modified diets and risk factor prevention techniques. Interns will be responsible for implementing and managing nutrition care plans for patients with multiple diagnoses including obesity, diabetes, renal and cardiovascular disease and weight management while also considering life experiences, cultural diversity and educational background. Interns will develop education materials appropriate for Veteran population in accordance with classes scheduled during the rotation and refer patients to other professionals and services when necessary. Interns will coordinate and deliver Managing Overweight/Obese Veterans Everywhere (MOVE!) weight management classes. Interns will receive experience in pre- and post-operative counseling for bariatric surgery patients.
This experience culminates in 3 weeks of outpatient experience where interns will assume the assigned duties of an outpatient dietitian.

Food Service Administration and Management (6 Weeks): In the administrative rotation, interns will apply their knowledge of food service and understand the functions of the dietitian in food service administration and management. Interns will work in pairs to plan, organize, staff, direct, and monitor food production and service. Interns will plan and carry out a theme meal which will incorporate designing the menu, testing and costing recipes, specifying and ordering the food, serving, and evaluating the outcome. Throughout the rotation interns will participate in inventory, food production, sanitation inspections, menu planning, employee training, sensory evaluations and kitchen design. Interns will conduct quality assurance activities and compile reports based on data collected. The final week of this rotation focuses on clinical management at which time interns will work with our clinical nutrition managers on consult and follow up quality metrics, nutrition screen breakdown, event capture and productivity, clinic practice management for nutrition clinics (access, modalities of care, clinic utilization, etc.), program development and staffing justification, functional statements, competencies and scope of practice, and leading people.  

Community (1 Week): Interns will participate in aspects of food service and provision of nutrition care and education at Feeding Tampa Bay. Interns may complete surveys on clients and summarize results, participate in a mobile food pantry, and develop medically tailored meals for the food insecure.

School Food Service (2 Weeks): The Pinellas County School District provides interns the opportunity to learn about food and nutrition assistance programs for children including the School Breakfast Program and National School Lunch Program. Interns will assist in the development and implementation of initiatives that promote increased participation in school meal programs and the cafeteria as a learning environment for good nutrition. In addition, interns will obtain experience in menu planning, site reviews, and wellness policy implementation. 

University of South Florida (USF) Student Health Services (1 Week): During this rotation interns will be exposed to many aspects of nutrition care in a campus health clinic. This includes prevention, health promotion, and education as well as the team concept, community participation and self-responsibility. Interns will learn about how the student health dietitians collaborate with others on campus and in the community to best serve the USF student body. In this rotation, interns will learn about food insecurity on the college campus and how the Feed-A-Bull pantry helps to reduce this. 

Special Project (5 Weeks): An important part of the internship program is completion of a major project that demonstrates professional and self-development in the planning and pursuit of a topic of personal interest and to benefit Veterans at BPVAHCS. Additionally, interns will demonstrate competency of public health theories, concepts and competencies as applicable to an area of interest. This is a self-directed project with each intern responsible for selecting, planning, organizing, and presenting their project. It provides interns the opportunity to further develop project timelines and coordinate with their project preceptors and other project stakeholders. A poster session will be scheduled at the end of the year where interns will display and discuss their projects and recommendations for staff dietitians and any other project stakeholders including the university College of Public Health. Posters/abstracts may also be submitted for local or state Academy meetings.

Suggested topics may include, but are not limited to, the following:

• Administrative studies or projects in food service management.
• Development of clinical tools or protocols for medical nutrition therapy.
• Application of data analysis techniques in a clinical nutrition environment.
• Policy issue/analysis in Nutrition and Food Services.
• Program evaluation or development or implementation of a nutrition program.
• Piloting or revising nutrition education materials.

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