I grew up as a Coast Guard brat, moving around the country every few years. I ended up spending my entire high school years in Maryland, where I also ended up attending the University of Maryland, College Park as well as my dietetic internship. Watching my mom deal with all the moves when I was growing up made me decide that I would never want to marry into the military life, and I loved Maryland.
Fast forward: in college I met an Army ROTC cadet who I ended up marrying during my internship in 2011. (Guess you can’t really help who you fall in love with, right? And turns out he’s worth it to deal with the whole Army thing 🙂 ) And now, here I am, an Army wife who last summer had to relocate to a strange new place, leave all my friends and family behind, adjust to married life, and…oh yeah, pass the RD exam and start my career…
Last summer I moved to El Paso, TX, which is a sprawling city (pop ~650,000) in west Texas that immediately borders Juarez, Mexico. Before you jump to conclusions about what it’s like to border one of the most dangerous, “murder capitals” of the world, El Paso has recently been named one of the safest cities of over 500,000 people, which I can agree with. Plus our neighbor has some WONDERFUL influences on us, not to be forgotten – Juarez contributes a lot of beautiful art, delicious cuisine, and citizens from both sides of the border are the friendliest population group I have ever been among. Bordering Mexico does have challenges, however, such as a HUGE cultural shift from the East Coast, including the language, food, and lifestyle.
**Note: I really enjoy living here! Of course adjusting was difficult but El Paso really is a wonderful place. I encourage anyone to visit before they judge it!**
I decided early on that finding a job working in clinical nutrition was probably my best bet in this locale:
- It would be a good experience to work in clinical right out of my internship to continue sharpening my skills in assessing, interviewing, educating, and intervening in a variety of patients and conditions.
- All the community nutrition jobs (primarily for low-income El Pasoans) required you know Spanish, and for good reason. Hospitals have staff that could help translate – I only know a small amount of conversational Spanish. (¡qué lástima!)
- Many organizations such as dialysis centers required at least 1 year of experience outside of the internship. I had 0.
- Working for a national hospital company may benefit me in the long run by allowing me to relocate within their system as I need to move around with my husband.
- I like clinical!
My internship provided me with so many rotations in so many different places, and as a result that experience REALLY helped. As I interviewed for jobs, I had a lot of insight on how various facilities can differ in terms of management style, workplace culture, RD job duties, and patient population.
I was thrilled when I found an RD position for a medical center nearby, working alongside a few other dietitians, only one of whom is Hispanic and Spanish-speaking. Not to say it hasn’t had its challenges!
I’d say about half of my patients do not speak ANY English. Some of them don’t even live in El Paso – they came from across the border. I’ve learned that in my facility, asking nurses to help translate is the best option, if they’re available to help. Most of the nurses are from around here and are fluent in Spanish. One time I made the mistake of having a patients grandson help to translate what was supposed to be a brief, simple education, and boy was that a mess. He didn’t understand what I was trying to say, so the patient ended up even more confused; I ended up having to wait for the nurse to come help anyways! Plus the nurses are usually familiar with the educational content I provide, so they know exactly what I’m trying to say as well as how to explain it, unlike a family member.
Often times I also ask for assistance from the Spanish-speaking RD on staff, who has been extremely helpful! She’s also helped teach me about common food items and other cultural differences in El Paso that I’m not used to.
Here’s my main point: My advice to any dietitians (or even nurses, doctors, or other healthcare workers) who must move to an unfamiliar place…immerse yourself in their culture, and find a local to enlighten you on how people live. Joining the local dietetic association was also really helpful- you’ll meet RDs who have lived there forever. I realize El Paso is a pretty extreme example, but the same advice applies.
The bottom line is if you don’t know your patient population, you can’t do your job well. This is especially crucial when you’re dealing with their eating and lifestyle habits – I can’t tell a person of Mexican descent to stop eating tortillas, that would just be loco. Number one rule of nutrition counseling is to work with the patient to make small changes to gradually lead to big improvements. I need to know the baseline diet of the average person here in order to meet them on their level. To do that, I’ve visited the grocery stores (including the Mexican markets), read the local paper for specials and restaurant reviews, explored menus, grilled my coworker who is a born and bred El Pasoan, and even sampled the local delicacy – Chico’s Tacos (the locals love it but I had a hard time stomaching it haha).
It’s a whole different world than the one I came from, but it turns out I have adjusted pretty well and now I am really enjoying my time here. Working as an RD in a foreign place is a challenge, but I know it’s making me a better dietitian in the long run!
If you have any tips on adjusting to different cultures in the nutrition or healthcare industry, please share them!