You know those weeks that you look back on and wonder to yourself how you possibly accomplished everything you did in that amount of time? This was one of those weeks… I continued my staff relief at the hospital and attended a two day RD Exam Review Workshop. 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
DI: Week 26 – Second Week in the ICU
DI: Week 27 – Finishing in the ICU and Starting Staff Relief
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.
My week looked like this:
Monday:
Remember last week when I was talking about how few patients I had to see, and how chill staff relief was? Psych! Today, I had 12 patients to see throughout the day, and I still had to leave early for my night class so I had one less hour to do it all in. The patient with oral cancer I was following last week got a G-tube placed today, so I wrote his tube feeding recommendations. Since he’s still able to meet most of his needs orally (through Ensure), I wrote up multiple recommendations based on how much he’s able to eat/drink. It’s very important to him to keep eating/drinking orally, so to respect that we’ll only recommend supplemental tube feedings for him. I also did a new education this week for gastric surgery. We have a patient with gastric cancer who just had about 70% of his stomach removed as part of his treatment. After a surgery like that, your ability to eat/digest food changes, so I talked to him about what he can expect. The rest of my day was spent running around trying to see all of my patients and finish charting before racing off to my night class.
At class this week we learned about cardiovascular disease. We also presented in groups about different heart healthy diets. My group presented on the Mediterranean diet and the research supporting its use.
Tuesday:
Today was a little calmer with only 9 patients for me to see. I was able to do some fun educations though, which definitely made my day better. I had a patient with heart failure to educate about a heart healthy diet. He asked a lot of great questions and was clearly interested and involved in this education. He was even taking additional notes on the handout I provided him with! I absolutely love educations like this because you truly feel like you’re making a difference. Obviously, I don’t know this man that well, but he’s motivated to make changes. It’s also just fun to have people actually have questions for you when you ask if they have any questions. :P
Wednesday:
Today was much more relaxed, with only 7 patients. One of the patients I saw was an older gentleman who was just diagnosed with diabetes. Despite multiple people talking to him about his new diagnosis he doesn’t think he has diabetes. I came to talk to him about the diabetic diet and he straight up told me he doesn’t have diabetes. He was still open to learning about the diabetic diet though, so I think he’s just having a tough time coming to terms with this diagnosis. In the afternoon, I went to a manager’s meeting. The dietitians at the hospital I’m at are part of the food service management team. They have regular meetings with the other members of the management team to discuss what’s going on in the food service department. It was really interesting to hear about what’s going on in the kitchen and to be able to relay what patients are saying about the food. Inevitably, when I ask a patient how they’re eating they’re going to tell me what they like and don’t like about the hospital food. Meetings like this are an opportunity to relay common themes we hear from patients.
Thursday:
My patient load went up to 10 today, but luckily, most of them were quick visits. I had quite a few patients today who were triggers based on answers they provided on their initial nutrition screen. When a patient arrives at the hospital the nurses ask about recent weight loss, appetite changes, etc. This alerts us to potential patients that we need to see. Sometimes, however, like today we have a lot of these patients pop up on our list who are actually eating fine and haven’t had any weight changes. This most often happens when patients answer that they “don’t know” if their weight has changed. This makes a trigger for us to see them just in case they have had significant weight loss. Sometimes we’ll follow up and learn that they have lost weight unintentionally, and other times their weight hasn’t changed.
Friday:
Today we had an all-day RD Exam Review Workshop with all of the other Chicagoland area dietetic interns. For us Loyola interns, it’s a little premature since our internship isn’t over until the end of June, but other groups finish earlier which is why our exam review was scheduled for now. It’s nice that we get a formal review like this as part of our program, but it was also very overwhelming, particularly since our internship isn’t over for several more months. The review materials will be helpful though once I can actually start buckling down on studying.
Weekend:
Saturday was day two of our all-day exam review. On Sunday, I ran a few errands and worked on my assignments and readings for the week. After having a six-day workweek the weekend went by way too fast. :P
Next week, I’ll be finishing my staff relief at the hospital and my rotation there as well. It feels crazy that I’m almost done with my clinical rotation! Until then!