Erin SmuckerErin Smucker graduated with her bachelor's degree in Dietetics Track/Nutrition from IUP in 2013 and is eligible for her Master of Science degree in Food and Nutrition, which she will complete in August 2018. She completed the individualized supervised practice pathway option reporting to IUP's internship director.* In 2018, having completed over 2,000 practice hours in oncology during her 3.5 years as a clinical oncology dietitian, she obtained her Board Certification in Oncology Nutrition (CSO).

8:00 a.m.

Driving past a small lake surrounded with beautiful landscaping in front of the hospital, Erin pulls up to the Newnan, Georgia, Cancer Treatment Centers of America. The center is unique because everything a patient needs is all under one roof. There is no need for patients to drive to another hospital to meet with different doctors and receive different treatments. Therefore, Erin more easily collaborates with all of her patients' doctors. Erin spends 30 minutes each morning in a meeting with the nine other dietitians on site, and then spends one hour reviewing her patient list and prepping for her day.

9:30 a.m.

Erin begins meetings with patients. She sees an average of 50-60 patients in a week, with a cap of seven new patients per day. All patients in the treatment center are provided with an initial meeting to explain dietitians' roles in their treatment plan upon entering the hospital. Today, her first meeting is with a new patient. She carries a laptop into the meeting to conduct data entry while she is face-to-face with a patient. She notices a missing documentation letter from the patients' provider, so she instant messages her patients' medical team to get a quick update on medical record notes. Each patient is equipped with a care team that coordinates aspects of the patient's care, such as scheduling patient appointments and treatment sessions. Erin loves that the physical distance between hospital departments is easily solved by technology, as, previously, patient updates and news were typically via word of mouth. The instant messaging system is used widely by care teams and doctors to solve the short lag between patient appointments, which are often scheduled consecutively, allowing little time for doctors and care teams to meet in person.

11:00 a.m.

Erin meets with a current patient that will be undergoing enteral nutrition (EN). Although her patient is hesitant, she takes time to explain the benefits of EN as being temporary in order to allow a continuation of cancer treatment via concurrent chemotherapy with radiation. Erin enjoys working with patients in acute care, as it requires her compassion. She is often helping people go through one of the biggest battles of their lives. She is humbled by her patient's bravery and honored to be a part of nutrition professionals in cancer treatment. Nutrition professionals are highly undervalued resources in many cancer centers and cancer patients' treatment plans. Some of her previous patients did not get to see dietitians at their previous treatment centers, and they really value guidance with nutrition related support.

1:00 p.m.

One of Erin's patients is exploring foods that she can eat to help out with taste changes and nausea during her treatment. Erin enjoys helping her patient discover different kinds of food solutions throughout their treatment. A subtle or drastic change in diet can have large impacts on the day-to-day energy and well-being of a patient. Erin's goal is to give guidance that will help her patients stay well-nourished and better enjoy their nutrition intake during and well after they are finished with cancer treatment.

2:00 p.m.

Erin meets with a new patient and has him hop on one of two fancy scales in the hospital called SECA, or the InBody. In short, the machines are body composition analyzers that break down a person's body composition using electro-connectivity. Today, she wants to get a good look at her patient's lean body mass, skeletal mass, water weight, water inside and outside of cells, and subcutaneous and visceral fat. More importantly, Erin wants to find out how much energy her patient is expending in a day to help him know how many calories to consume to prevent unintentional weight loss during chemotherapy and surgery.

4:00 p.m.

Erin stops seeing patients in person and begins to catch up from the day as well as take part in any coordination of patient care that is needed. Sometimes she requests follow-ups to be scheduled, rushes to have tube feeding (EN) orders signed by physicians, or completes patient phone consults. Her supervisor always encourages her to take time at the end of the day to reflect upon not only her patients, but her own well-being. Being a part of a cancer center can be rewarding, but it also requires much emotional support among the patient's care team and doctors. Erin foresees herself working in oncology for the remainder of her professional career.

*Please note that IUP no longer offers the individualized supervised pathway option. On the occasion that a student is not matched to a dietetic internship program, they may be eligible for alternate pathways.

Written by Marie Webb, graduate assistant
Edited by Sherita Jamison, graduate assistant