Date: 8/03/18 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, supplements, and nutrition support (and any changes needed) to doctors
- Attended patient rounds
- Dietitian weekly huddle
- Nutrition support – calculated enteral nutrition needs and goal rate for NGT
- Observed a nutrition-focused physical assessment
Comments / Thoughts / What You Learned / Challenges: For the beginning of this week, I was assigned to the labor and delivery/post-partum and psych floors. The rest of the week I was assigned to the surgical and step-down PCU and psych units. 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 performed patient charting for patients I saw as well as the patients I observed with my preceptor. 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. This week I had the opportunity to work with patients receiving enteral nutrition support via NGTs. I recommended appropriate formulas and calculated/recommended the appropriate goal rates to meet their nutritional needs. There were also several patients with malnutrition/suspected malnutrition and I had the opportunity to observe my preceptor perform nutrition-focused physical exams on them. I also attended weekly full-team rounds twice this week – once for the post-partum/labor and delivery floor and once for the surgical and step-down PCU floor. 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: Head Up, Phone Down
- Food Safety Weekly Message: Sodexo Food Complaint Reporting Process
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 7/30/18 → 9:00 AM – 5:00 PM (8 hours) – Labor and Delivery/Post-Partum/Psych w/ Diana Hu
- Tuesday 7/31/18 → 9:00 AM – 5:00 PM (8 hours) – Labor and Delivery/Post-Partum/Psych w/ Diana Hu
- Wednesday 8/01/18 → 8:30 AM – 4:30 PM (8 hours) – PCU (Surgical & Step-Down)/Psych w/ Anna Olik
- Thursday 8/02/18 → 8:30 AM – 4:30 PM (8 hours) – PCU (Surgical & Step-Down)/Psych w/ Anna Olik
- Friday 8/03/18 → 8:30 AM – 4:30 PM (8 hours) – PCU (Surgical & Step-Down)/Psych w/ Anna Olik