Tag Archives: dietetics

Thursday Thoughts: Clinical Rotation - Week 1

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So I’m almost done with my first week of my Clinical nutrition rotation. Uh, pinch me?

Where do I begin…

On Monday, I went in around 8:30 and met with the Clinical Coordinator, who oversees all of the clinical dietitians. In terms of the hierarchy, it goes a little something like this

Director*

Executive Chef Clinical Coordinator

Cooks Dietitians

This is a very shortened version but just so you guys understand a little better, I spent my Management rotation with the Director, and more time on the foodservice side. Now, I’m obviously on the other side of the spectrum, and am reporting to the Clinical Coordinator.

Anyway, she and I planned out my next 8 weeks at the hospital. Since there are 6 dietitians on the schedule each day, I will be spending one week with each, except for the Trauma ICU dietitian, that will be 2 weeks. And then my last week will be pretty much whatever I want to do, whether that’s going back to a specific unit, or doing random staff-relief.

Guess what I got thrown into first? Trauma ICU.

huh what

Holy (explicative). I’ve worked in hospitals so I’m fine with the clinical setting, but spending most of my day in the ICU… now that’s a different story.

This unit has the patients of, well, the worst cases. For the most part, bed-ridden and usually comatose. Oh, and mostly on nutrition support (a.k.a. tube feeding)

The first day, I was just kind of acting as a sponge, listening and looking… taking in as much as I could without running out the door screaming. Ok, it’s not that bad, but still. It’s one thing just briefly walk by, seeing the patient and all of the tubes going in and out.. but then reading their chart notes with their story, it’s kind of scary.

After the first day, I was trying to wrap my head around specific cases, getting in the mindset of being a day-to-day dietitian that has to consult the patient for X, Y and Z. I understand now how the ICU staff becomes so desensitized to everything going on… you don’t really have a choice. It’s you’re job to keep these people alive.

Luckily, since I’ve been in kind of a daze with all the new information, I have not one but two weeks with this dietitian in the ICU. She is an amazing dietitian and is really making it easier for me to grasp the key concepts of nutrition support. She doesn’t expect me to do consults or charting just yet, because seriously? These patients need someone that knows what they’re doing. But surprisingly, I’m glad that they shoved me into the deep-end first, because now I think the rest of my Clinicals will feel like a breeze.

Honestly? When I come home at the end of the day, my mind is racing and my heart hurts for patients that are struggling, but do I like it? Maybe, I don’t know. Hopefully as the weeks go by, I’ll know how I feel.

How do you do in hospitals?

Thursday Thoughts: Internship Things

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Thanks for your input on yesterday’s post! As much as this blog serves as my outlet, I definitely want to be posting things that you all actually want to read. So with that said, I do like the idea of “What I Ate Wednesday”, but depending on the week it may be a collection of my favorite meals from that week, or if I had a particularly interesting day then it will be a full day of eats… since I know people are naturally curious as to how an almost-dietitian eats! Ha :)

Speaking of ‘almost-dietitian’, we have some catching up to do!

Yes, I’m still in my internship, and no, it hasn’t killed me yet. I just haven’t posted about it since back in December when I completed my Management rotation. We had a few weeks off for the holidays and January wasn’t exactly anything to write home about, so I spared the details.

The past 4 weeks have been spent in the classroom giving our brains a nice, refreshing blast of clinical nutrition. What this means, in a nutshell, is nutrition related to specific disease states. This is the part that gets me all excited, because this is what ONLY registered dietitians are capable of doing. Legally, no one else can provide nutrition education and counseling for specific disease states, which encompasses everything from diabetes and heart disease to trauma patients and cancer. Yes nutritionists and health coaches can provide education on incorporating nutrition into a healthy lifestyle, but the line is drawn here.

Some dietitians like clinical nutrition, others don’t. I’ll be honest, for a while I was pretty turned off to the whole idea of being a clinical dietitian in a hospital setting, but what I’ve come to find out is that there are certain areas of interest for me. I absolutely LOVE love love cardiovascular disease, and I think it’s because I see it as the most influenced by nutrition intervention. It also hits close to home because it is so prevalent in my family history. Maybe that’s why I loved doing that catering event for the American Heart Association Heart Walk back in my Management rotation? Who knows!

Anyway, along with clinical nutrition comes enteral and parenteral nutrition support… in layman’s terms: tube feedings. Now, I like science. That’s why I got into this whole nutrition thing. But math, while I can handle it, I definitely don’t like it. Nutrition support is like a numbers game. You don’t want the rate too high because the patient might not tolerate it, but you don’t want it too low because you need to meet the adequate calorie and protein ranges. It’s okay if you have no idea what I’m talking about, I don’t blame you… just pointing out that this is an aspect of clinical nutrition that I don’t enjoy.

Now that those 4 weeks of classroom work (coughbusyworkcough) are over, on Monday I’m headed back out into the real world for my dundunduuuun… Clinical Nutrition rotation! And holy shit am I nervous, ok and excited but mostly nervous.

Luckily, I was able to return to the same hospital that I rotated through for Management, so I know my preceptor (she’s awesome) and have a good idea about the clinical dietitians I’ll be working with. Another bonus is that the hospital is a Level 1 Trauma Center, so there will be an endless variety of patients to see. I’m just nervous because I’ll be responsible for the care of actual, real-live patients… people! Their lives are in my hands, or well, in my binder at least.

Despite my nerves, this really is the part I’ve been waiting for. I’ve heard that in order to be a well-rounded and knowledgeable dietitian, you need a solid base of clinical nutrition. And that’s what I want to be.

I think I’ll need a long, relaxing weekend before this all starts… any suggestions?

 

Dietitians/interns, feel free to chime in on clinical experiences and tips!!