A Day in the Life: Alexandra O’Keefe, Nutritionist for the Women, Infants, and Children (WIC) Program

  • Alexandra O’Keefe sitting behind her desk at the Hamilton Health Center

    In her last semester at IUP, Alexandra O’Keefe applied for internships using DICAS, but she did not get matched for an internship. Dietetic internships are competitive. In order to move forward with her career and not waste any time, she networked with a friend who provided Alexandra the contact information of one of the vendors at a local career fair. Alexandra applied for several positions within the company and received an interview with the Community Progress Council, York County, Pennsylvania: Women, Infants, and Children (WIC) program. She worked there for two years gaining valuable experience in the food and nutrition field.

    Alexandra said, “The Life Cycle Nutrition course at IUP was extremely helpful because it provided me with the knowledge necessary to implement my daily job responsibilities.” For example, at IUP Alexandra studied about the importance of monitoring iron levels, and, at WIC, she was provided the opportunity to draw blood and test iron levels, provide treatment, and counsel her patients.

    Working as a WIC nutritionist, there are many policies and procedures that must be followed from the state agency as well as the USDA. Alexandra studied and reviewed the WIC policies in her spare time. She enjoyed the knowledge she was gaining, and wanted to make a difference for people by creating and changing policies. Alexandra has a food allergy and thought public administration would allow her the opportunity to advocate for a cause and still remain in the health field. A coworker encouraged her to apply to Penn State University (Harrisburg campus). She applied and was accepted into the master’s program for public administration. Then, she applied to work at the Hamilton Health Center in Harrisburg, which is close to her university, and was offered the position in March 2017.

    Alexandra shares with us what it is like to work in the Pennsylvania York County WIC program.

    7:00 a.m.

    Alexandra leaves her house and commutes to her WIC nutritionist position, where she has to clock in by 8:00 a.m. Her first client is scheduled to arrive at the office promptly at 8:00. She immediately logs into the data system called QuickWIC, which is used by the state of Pennsylvania WIC to access her first clients’ appointment details. Alexandra reviews previous assessment notes and the goals that were set at the previous appointment. Those goals will be reviewed with the client during today’s appointment.

    A bell rings to notify her that there is a client in the waiting room. Alexandra walks out to greet her client and then walks with her into the patient room where she takes her weight and height. Today, she also walks her patient to the lab room to draw blood, since her patient has typically had low iron levels. After drawing blood, she walks with the patient back to her office and begins inputting data into QuickWIC. She reviews the dietary questionnaire the client filled out prior to the appointment for any red flags or nutritional risks (e.g., more than four ounces of juice a day, more than three cups milk a day, defrosting food on countertops, excess screen time, picky eating/poor appetite). During a quick conversation with her patient, she is able to verify her client’s responses from the questionnaire. Then she moves on to discuss the results of the patient’s iron levels, provides education, and gives educational handouts. Finally, she prints out WIC food vouchers to provide to her client, and schedules her a follow-up appointment.

    12:00 p.m.

    Alexandra takes an hour lunch break with her coworkers.

    1:00–5:00 p.m.

    Alexandra returns to her office and reviews her schedule to prepare for afternoon appointments. She logs back into QuickWIC and reviews the client history in their chart. Her next appointment is a new mother who is deciding to breastfeed. In the waiting room, she greets the new mom and requests her to fill out the dietary questionnaire. Then she walks the client back into her office and explains the WIC program and how to use WIC food vouchers. Alexandra is pleased to learn that her patient is interested in breastfeeding, and so she explains how WIC promotes breastfeeding and goes over a breastfeeding questionnaire with her client. She then verses the new mother on breastfeeding basics, such as skin-to-skin contact, milk supply, and dietary needs for the breastfeeding mother. Some of the dietary tips that she provides are to educate the client about healthy eating during pregnancy, the importance of folic acid, and prenatal vitamins.

    The appointment ends with goal setting, providing the client with WIC food vouchers, and scheduling a follow-up appointment. Upon the client’s three-month checkup, Alexandra checks the client’s weight, discusses any breastfeeding and pregnancy updates, and updates the client’s goals.

    Some days are hectic and busy with Alexandra seeing up to 16 clients a day. Other days may be slower with Alexandra only seeing six clients.

    Every Friday, Hamilton Health Center WIC has half-day clients, then the rest of the day is for catching up on paperwork, charting, organizing client files, and pulling out files for clients who will be coming in for an appointment the following week. Alexandra enjoys her Fridays because she has time to review WIC educational materials that she provides to her clients. 

    After work, Alexandra squeezes in a workout and then makes dinner. Her long day is not done yet, as she logs into her university account and completes upcoming assignments for her master’s program coursework. 

    Alexandra reminds IUP Food and Nutrition students that there is no set career path for food and nutrition professionals. Many first-year students plan on completing the common pathway to become a registered dietitian via the DICAS application process. However, if students do not get matched in their senior year at IUP to a dietetic internship program, they can always apply again the following year while jumping head-on into the profession and getting more hands-on experience in the field. 

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