Internship Update: Critical Care Unit
What does a dietitian in a critical care unit do? That's what I spent my last hospital based rotation finding out! My placement within this internship is a small hospital with about 10 critical care beds. So what's different about this floor?
CCU Dietetics and Nutrition:
- The majority of patients are on vents...and unconscious. There's not a lot of opportunity for patient interviews, so gleaning all the information you can from the chart is key.
- Get good with your math skills. Many of these patients are tube fed or on TPN. That means you need to calculate needs and compare them to the formulas your hospital carries. So while you may want the formula specifically is for renal patients on a vent...chances are you're not getting it. Pick what fits needs best within what you have.
- Protein, calories, and fluid are based on disease and vent status. Say it with me. No lung work? On TPN (no thermic effect of food)? No need for the usual calorie amount and you don't want to overfeed.
- Be careful and double check. These patients are critical.
- Remember your job, be empathetic, but be a professional. Sometimes emotions will get to you in this patient population. You see sad things. Sometimes patients 'expire'. But you are there to help patients in any way you can as a nutrition expert. You cannot fix everything but you can be an expert for them in what you know best.
I have a huge amount of respect for CCU/ICU dietitians, but I don't think that's the place for me in the world of nutrition. If you've been reading this blog for a while now, I think it's pretty easy to tell I love wellness promotion and helping people get healthier outside of the hospital!
Did you always know where you fit best within your profession?
Carlene