We've officially reached the point in the internship when I'm starting to get in the swing of things. I know this because I've been sleep talking about dietetics, related to being in the hospital for extended periods of time, as evidenced by the following conversation relayed to me the next morning. How's that for a PES diagnostic statement?:
Me: (Asleep...it's 9 pm.) *Burst of loud laughter*
Fiance: Hey- What's so funny?
Me (still asleep): My patient! He's so honest! I was just charting and he said the only way he would eat broccoli is if it was covered in chocolate.
Me: Let me go back to sleep and figure this out.
The hospital where I am spending my clinical rotation has 170 beds, but for the past 2 weeks of this particular rotation segment, oncology has been BOOKED solid! Every bed has been filled with wonderful and kind patients coming in for a round of chemotherapy and dealing with a newbie RD in training. I met with people diagnosed with Non-Hodgkins Lymphoma (which is actually rare...just apparently not here) and a breast cancer patient. By the second week, I felt comfortable knowing what to ask this patient population. Mainly, we focus on managing side effects of chemo, like changes in taste, nausea, and loss of appetite, to encourage adequate nutrition intake. Patients on chemo are usually on a neutropenic diet at this hospital, meaning food safety is the big priority. According to the diet manual, they are not allowed to have un-peelable fruits or veggies, so they're getting bored of bananas and canned fruit! Don't even mention Ensure or Boost supplements.
Think of this floor as the grab bag floor. Normally, you would have a wide variety of diagnoses, but all of my patients happened to have pancreatitis or chronic abdominal pain. The types of questions you would ask this group would be different than those in oncology. I always focused on recent changes in eating habits and GI concerns when I interviewed patients in Med-Surg. The diet orders on this floor were very different, from consistent carb for people with diabetes, to clear liquids for an acute pancreatitis case. If you like to be challenged in your knowledge of different types of nutrition needs, Med-Surg is for you!
My next two week rotation is in PCU (pulmonary care unit) and CCU (cardiac). I feel a DASH diet education coming on...