Date: 8/17/18                            Rotation: Clinical           Location: Woodhull Hospital

Activities / Assignments:

• Patient risk screenings
• Patient assessments
• Patient re-assessments
• Patient follow-ups
• Patient education – verbal and with written materials from the AND nutrition care manual
• Documented assessments/re-assessments/food preferences in Quadramed and CBORD
• Recommended diets and supplements (and changes to either) to doctors
• Attended patient rounds
• Dietitian weekly huddle
• Nutrition support – calculated enteral nutrition needs and goal rate for NGT
• Conducted a nutrition-focused physical assessment on a patient

Comments / Thoughts / What You Learned / Challenges: For most of this week, I was assigned to the cardiology medical/surgical and psych floors. On Tuesday, I was assigned to the surgery/GI medical/surgical and detox floors. I had the opportunity to observe the dietitians perform the NCP for multiple patients, and I also had the opportunity to do it myself, both with them shadowing me and on my own. I provided nutrition education to patients about the diets they were currently prescribed – explained why they were on a certain diet and if I was going to recommend the doctor prescribe a different diet. I provided oral education using the teach-back method and written materials, both in the patients preferred language. If their preferred language was not English, either an in-person translator or the translator phone was used to communicate with the patient. I performed patient charting for patients I saw as well as the patients I observed with my preceptor. I worked with more patients receiving enteral nutrition support via NGTs. I again recommended appropriate formulas and calculated/recommended the appropriate goal rates to meet their nutritional needs. I also attended the weekly full-team rounds for the cardiology medical/surgical unit and the surgery/GI medical/surgical unit. During this time, the doctors and nurses went over each patient’s condition and status, social workers went over discharge plans/issues that need to be resolved, and the dietitian gave updates on needed changes to prescribed diets/supplements.

I also attended the weekly dietitian’s huddle where the following topics were discussed:

• Health and Safety Weekly Message: Know the Symptoms and Care for Heat
• Food Safety Weekly Message: Food Protection
• Customer Service: dietitian’s need to make sure they treat all patients and the interdisciplinary team with care and respect; supervisor is going to arrange a customer service training for the dietitian’s where we will do some practice amongst ourselves (e.g. role-playing exercising and commenting on each other as a group)

Learning Objectives Met: CRDN 2.1, CRDN 2.3, CRDN 2.4, CRDN 2.10, CRDN 3.1, CRDN 3.3, CRDN 3.6, CRDN 3.8, CRDN 4.1, CRDN 4.10

Clock Hours: 40 Hours

• Monday 8/13/18 → 10:00 AM – 6:00 PM (8 hours) – Cardiology Med/Surg/Psych w/ Dorcas Adegbola
• Tuesday 8/14/18 → 9:00 AM – 5:00 PM (8 hours) – Surgery/GI Med/Surg & Detox w/ Agnes Amat
• Wednesday 8/15/18 → 10:00 AM – 6:00 PM (8 hours) – Cardiology Med/Surg/Psych w/ Dorcas Adegbola
• Thursday 8/16/18 → 10:00 AM – 6:00 PM (8 hours) – Cardiology Med/Surg/Psych w/ Dorcas Adegbola
• Friday 8/17/18 → 10:00 AM – 6:00 PM (8 hours) – Cardiology Med/Surg/Psych w/ Dorcas Adegbola