This week was my second in the ICU. However, just like last week I picked up some patients from other units to round out my workload since our ICU isn’t very big. I also did a presentation for National Nutrition Month on whole grains. To catch up with my previous clinical experience, check out:
DI: Week 18 – Clinicals and a Seminar
DI: Week 19 – All the Clinicals + Diabetes Education
DI: Week 20 – More Clinicals + Finally Official
DI: Week 21 – Clinicals + Site Visit + Another Seminar
DI: Week 22 – Clinicals + Moving Into a Trailer
DI: Week 23 – Clinicals + Finding a New Normal
DI: Week 24 – Clinicals, a Seminar, and Big Changes
DI: Week 25 – Starting in the ICU
In order to maintain patient confidentiality and privacy, I’m being deliberately vague when blogging about where my rotation is and the patients I’m seeing. You can find a more detailed explanation of this in my Week 18 post.
Here’s what my week looked like:
Monday:
Surprisingly, it was actually a busy day in the ICU. Mondays are generally busy hospital-wide for us since there are no weekend dietitians, but it was also the first day that I’ve actually had more than a couple of patients to see in the ICU. I still ended up picking up a couple of patients from general medicine/surgery, but it was nice to spend more time in the ICU. One of the patients I’m following in the ICU has a neurodegenerative condition and can’t eat as a result. They aren’t sure yet what disease he actually has (waiting on tests), but they’ve started the conversation around potentially starting tube feedings. I wrote tube feeding recommendations for him today in case they do decide to go forward with initiating a tube feed.
For our night class this week, my preceptors from the bariatric clinic (Week 2, Week 3, and Week 4) came in to talk about obesity and related treatments. It was nice to see them again, and get a refresher on what I learned while interning there.
Tuesday:
In huge contrast to yesterday, today was extremely slow. I covered both the ICU and intermediate care today, and still only had two patients. I picked up one patient from general medicine/surgery, but even that unit only had a few patients who needed to be seen by a dietitian. One of my patients was a follow up who was extubated yesterday. He had an infected dental abscess that needed to be drained. After the surgery, he went into respiratory distress and had to be put on mechanical ventilation to breathe. Yesterday, they were finally able to discontinue mechanical ventilation and he can now breathe on his own. Since he’s been intubated for a while, he hasn’t eaten anything for almost a week. We were thinking about started him on tube feedings (not the same patient as yesterday), but held off since they suspected they’d be able to extubate him soon. It’s a good thing we did, because he’s doing much better now and is able to eat a regular diet again.
Wednesday:
Full day in the ICU! I spent my morning seeing all of my patients. Then, I did a presentation for National Nutrition Month over lunch. Every year, the hospital promotes a different topic for National Nutrition Month. This year, we promoted whole grains. I made some whole grain handouts and did whole grain trivia in the cafe at lunchtime with hospital visitors and employees. The main whole grains I was promoting were brown rice, quinoa, farro and bulgur. It was fun to interact with people and talk about whole grains and their benefits. It was interesting to see how some people knew a lot about whole grains while others didn’t know anything. After that, I did all my charting on the patients I saw in the morning.
Thursday:
I covered the ICU and Intermediate Care today, plus picked up a couple of patients from gen med/surge. Most of the patients I saw this week were follow ups from earlier in the week. I also saw another patient for a heart failure diet education. He eats a lot of fast food, so a big part of our education was helping him find lower sodium fast food options. Diet educations are largely based on where a patient is currently at. Ideally, this guy would eat all homemade, fresh food instead of fast food regularly, but that’s where he’s at.
Friday:
We had a research symposium at Loyola to attend today. A lot of different people presented on the research they’re doing in different areas of healthcare. There was a presentation about body composition and its importance which was very interesting. After the symposium, my parents came to town to visit! We went out for dinner at Dover Straits in Mundelein, Illinois to get some seafood. It was delicious, and the restaurant had a fun, nautical interior.
Weekend:
We went to the Lincoln Park Zoo in Chicago since my parents were in town. It was a lot of fun, and we got to feed cows. :P Then, we ate lunch at the Chicago Diner. They serve meat-free dishes and vegan milkshakes. I had a chocolate mint milkshake and quinoa chili which were both delicious. The wait time was a little long since the place is so tiny, but was well worth it. We went out for drinks and appetizers later that night since we had a late lunch. Sunday morning, we went out for breakfast at Wildberry Pancakes & Cafe. I had their specialty wildberry pancakes which were absolutely amazing.
Next week I’ll be finishing up in the ICU and starting staff relief at the hospital. Until then!