I’m almost through my 4th week of my IPC rotation! Last week, I rotated with the RD in the ICU. This week, I rotated with the RD on the general patient floors. I’m not sure which one I like better at this point.
The ICU rounds are really intense! We (myself and the RD) rotate patient rooms with nurses, pharmacists, the intensivist, and a speech therapist. It is really interesting to talk so in depth about a patient. The intense part is when they start talking about medications, interactions, and using big medical jargon. I definitely take a lot of notes! The one thing about ICU, is you don’t get to interact with patients much. You look at a ton of labs and do ventilation calculations (calculating energy requirements for a patient on a ventilator, taking into account the medications they are on). You also write a lot of TF or TPN recommendations, but that’s about it.
When I rotate on the patient floors, I get to do a lot more educations (Coumadin, CHO-controlled diet, Renal diet, etc). You really get to chat with the patient about their home eating and the diet they are on. You might recommend/initiate a supplement and you track what the patient eats as well. Some patients are way more talkative and inviting than others. Also, don’t judge anyone by their age. I met a patient today, who was in her 90s, still living on her own and cooking all her meals. She was lively and in relatively good health. Later today, I went on a home care visit and met a lady in her early 60s. She was using a walker, had uncontrolled diabetes (BG levels in the 500-600s), and was achy and in pain. She was an “interesting” visit, to say the least. Some of my favorite quotes from her were, “I only buy pork chops to chew on the bone,” “Why do I even have to eat protein?” and my favorite, “I may eat some spar-a-grass tonight (aka asparagus).”
Some of my other favorite moments/quotes of the week were:
1. “My weight has been stable at home, but high. But that is because I eat a lot. I eat cake cookies, candy. I know I shouldn’t but I do anyway.” (Patient had: T2DM, CHF, Obesity, Renal failure etc)
2. “Your name sounds like a nice soft kitty.” (From an 80 year old patient to me. What she meant, I don’t know).
3. Patient: “You won’t believe me when I say why I am here. The KKK are after me and my neighborhood and I can’t believe it is not covered on the news yet.” (enough said).
4. Meeting a 3 year old patient in PEDs with a PEG tube in. He was so cute and sweet! He was born premature, but looked as normal as could be now. He was my first PEDS patient thus far 🙂
So far, I really like the rotation. It is very busy! I come in and do research on patients (medical/food and nutrition history, diet orders, etc). I calculate TF and calorie/protein/fluid requirements on a daily basis. I do all of the nutrition assessments when I rotate with the RD and I have been doing most of the patient educations. I feel like I am getting to know some things like the back of my hand. I really like the fast paced nature of the hospital. It is always different and there are always, always interesting patients to see 🙂