How many of you reflect back on that one special person or dietitian that you admired either during your internship or your first “renal” employment opportunity in the field of Renal Nutrition?
How many of you still take that big “sigh” or “grumble” under your breath when you know dietetic interns are headed your way? Be honest, I know I have in the past. However, over the past 10 or so years, I have committed myself to being more positive in mentoring dietetic interns and also the “newer” renal dietitians.
As renal dietitian professionals, we have all been in the intern's shoes at one time or another and we've all been in the position of being the renal dietitian mentoree. Whether we've been in renal dietetics for 20+ years, or 10 or fewer years, we all should strive for being the best role model that we can possibly be.
We need to encourage, inspire, urge, and foster those interns and dietitians that will be following in our own footsteps. Be enthusiastic in the job that you're performing. As the mentor, we need to be open to their evaluations of us, including their suggestions and criticisms. This will only improve our own teaching techniques and enhance our Medical Nutrition Therapy (MNT) practices. You are a vital and key component of the renal health care team. This is what you want to convey to your mentorees. It will only help to nurture your successor.
With predialysis MNT reimbursement now being an ardent topic, it is important to instill in them just how much this has helped our specialty profession to be recognized by Medicare and the medical community. The advances in optimal patient care of the chronic kidney disease (CKD) patient has allowed our profession to expand our responsibilities for conveying higher standards of quality patient care and to keep us moving in a positive direction.
The CKD patients we deal with have multifaceted medical problems, psychosocial issues, and perplexing nutrition challenges that require teaming with the physician, social worker, nurse, dialysis technician, and other allied team members to reach achievable patient goals. Knowing this will only enable the mentorees to have a better understanding of the CKD complexities that are involved. We can all be role models in terms of team involvement as well.
Many new dietitians in the renal arena get “burned out” too fast without taking the time that is necessary to focus on the broader specialty range of renal dietetics. Many internships only allow for a limited, 1-week rotation in a renal dialysis clinic. With that short time frame, try to make some allowances for yourself by planning ahead to spend some extra time with being the absolute resource person, but at the same time allowing them to learn on their own. In addition, try to arrange a time to allow them to observe patient training for peritoneal dialysis and to observe the eye-opening process that hemodialysis patients go through.
Allow them to search through your education files, make allowable copies of handouts, or prepare a set of handouts, similar to those you give to your patients, which they can take with them or to use as references. Give them the time that is needed to “learn” and to let things sink in. Realize you may have to move at a pace that is determined by their individual needs. Try to obtain an informational “heads-up” from your colleagues that may have already been their internship preceptors. Be patient, kind and approachable, and by all means when the time is right, utilize a sense of humor when it can be professionally tasteful.
I make it a point to be honest and upfront with them and to inform them that I will not be hand holding them through their coursework or learning curve. I leave it up to the interns and new renal RDs that I have mentored to ask questions and encourage them to ask other team members in order to expand their contact with physicians, nurses, social workers, and dialysis technicians. If they need to extend their day to get their coursework done at the dialysis clinic, then so be it.
It is also very important for you as a preceptor to keep yourself up-to-date on the newer clinical information that is being published. One way I have found to be very beneficial to me has been with organizing an e-mail journal club with the CRN Executive Committee. Every month, one of the CRN-EC members summarizes a journal article and shares it with the entire CRN-EC membership. This is an easy, but educational, method to enhance our knowledge base and at the same time to cement our communication with this group of renal dietitians. Even though most of us on the CRN-EC are “seasoned” renal dietitians, we still mentor and learn from each other on an ongoing basis.
Use every moment of “idle” time to teach. For example, while you are waiting for an elevator, for a meeting to start, and even over lunch. These are perfect times to discuss the implications of laboratory values or a medication that is commonly used.
Take the time and the opportunity to leave some of your “dust” behind for others to learn from as you advance your career path. You will end up with a “win-win” situation for everyone involved in the mentoring process.
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