Dietetic Internship: Week 12

This week was our halfway mark for our clinical rotation — say whaaaaat?? Crazy to think that I’m already halfway done with this semester, it feels like just yesterday I was walking in with no clue what to expect. For my first week back from our “mini break”, it was a pretty uneventful/typical week. 

Monday, October 12, 2015: Monday’s are always a little hectic after coming back from the weekend. Beds fill up, and we’ve got lotsa patients to see! We finally got a patient that had to be put on TPN, so I finally got to practice calculating the rate, grams, and kcals in the bags. The one downside to being at a smaller hospital is definitely not seeing “complicated” patients as often. The hospital I’m at is a “sister” hospital to a much larger one in Asheville, so if patients good too bad, we often send them to the larger hospital so they receive more specialized care. Hopefully I will be able to spend a few days with the metabolic support dietitians there in November! 

Tuesday, October 13, 2015: Having the vast majority of patients I work with be senior citizens that are typically 75 years and up, I’ve learned that “senior citizens say the darndest things” should be the phrase instead of “kids say the darndest things”. Many of them have no filter, and tell it to you like it is, which I love. They also love to offer relationship advice; for instance, today one patient to me to “never settle for just any man, make sure he treats you RIGHT”. Noted.

Wednesday, October 14, 2015: I got to go in late because my preceptor had CPR training, so I ended up reading over some articles she gave me on a vegan diet and it’s effect on diabetes and blood sugar control. I won’t lie, it was definitely interesting! The study focused on two different groups, one following a low-fat vegan diet, the other following the standard ADA diet, and their health outcomes after 24 weeks. They found that the group that followed the vegan diet had lost more weight, were able to drop at least one diabetes medication, lowered their HgA1C and LDL levels. A lot of times people are concerned that people who follow a vegan diet will become deficient in iron, however in this study they found that the vegan-eaters actually had better iron levels than those on the standard ADA diet. I don’t foresee myself becoming a full-time vegetarian or vegan any time soon, but I have cut back on my intake of animal products and have upped my intake of whole grains and plant protein. 

Anyway, I went in at 10:30 and got straight to work seeing patients before our weekly care plan meeting with the nurse, PT, and OT in our rehab unit. I rounded out the afternoon seeing the remainder of the patients left, as well as sending out outreach letters to outpatient clients that had missed prior appointments, or had yet to return our phone calls. 

Thursday, October 15, 2015: Was only at the hospital for half the day because my preceptor had gone in for a couple hours over the weekend, so I headed back to Asheville after lunch to get some work done at the cutest little coffee shop, Odds Cafe. I have a couple days next week with the dietitian that works at the cancer center, and he had sent me a handful of articles to read and review, so that’s the “work” that I did. A couple focused on soy intake and its effect on breast cancer. It seems like the media has mixed reviews on whether or not soy intake can encourage tumor production and breast cancer reoccurrence, but the studies I reviewed found no negative effects of soy intake on breast cancer prognosis.

Friday, October 16, 2015: FRIDAY! We had a pretty crazy schedule for it to be a Friday — I didn’t get off until 5:30! Our transitional care unit (aka TCU, aka inpatient rehab) filled back up, and we had a handful of follow-up visits and initial assessments to complete before the weekend rolled around. I think I’ve said it before, but I love working with the patients in TCU because they are on the road to recovery and usually have a little more to offer to the conversation 🙂

Oh! I also got to see a modified barium swallow study done by the SLP (speech language pathologist). This study is often done for patients that have dysphagia, or trouble swallowing. They swallow foods and liquid with barium and the SLP and radiologist are able to see the barium as they take an x-ray of the patient swallowing. If patient’s had a hard time swallowing certain textures or consistencies of foods or liquids, the SLP can recommend a texture-modified diet that will decrease the chances of choking or aspiration.

Saturday, October 17, 2015: I woke up to 43* and a perfectly sunny, fall morning, which got me super pumped for my run at the park. I ended up going 9 miles! Which is why I’m sitting on my couch at 8:13 on a Saturday typing up this blog post — I. Am. Pooped. I haven’t gone that far in a while. I whipped up an easy dinner…and made my 4th (5th? 58th?) loaf of my pumpkin banana bread 😉 I was thankful to hear that my UGA dawgs pulled out a win….yeah, I don’t get 99% of channels on my TV, so unless the game is on ABC, chances are I can’t watch……

Sunday, October 18, 2015: I woke up early craving pancakes, which is certainly a change up from the same oatmeal that I have had every day for the last week and a half!! I mixed in some canned pumpkin with my pancake mix, and it turned out perfect! Syrup usually makes my feel jittery and makes my stomach a little uneasy, so instead I opt for thinning out some PB2 mixed with cinnamon. I highly suggest it for a little change up! After church, I got straight to work completing my weekly competency log and tracking logs, answering emails, rereading some cancer articles, and even squeezed in a 5 mile walk/run at the park because the weather is UNREAL!!

I got home to whip up some dinner and get all my snacks prepared for the upcoming work week. My go-to snacks during the work day are typically a hardboiled egg mid-morning, some type of fruit mid-afternoon, and then mid-late-afternoon (ha) I have baby carrots/snap peas/jicama sticks with hummus. I’ve seriously been following this snack schedule since I started, and it has become such a habit. I find myself looking forward to my veggies and hummus every day at 5! 

I’m excited for the upcoming week — I get to spend two days with the dietitian at the cancer center to gain a little more experience in a different area of care. Then, I’m heading out of town to celebrate my great aunts 94th birthday with my cousin!! Not to mention the weather is going to be even MORE fall-like. I’m in love. Do y’all have a big week planned? Hope you make it a great one!