Today, I finished the first of my 2 weeks of long-term care! I can’t believe I am 4 weeks away from graduating from my internship. I’m at the point now where I am really starting to focus on studying for the RD exam (key word “starting”). So far, I have been making index cards from Inman’s Review to add to my stack of RD in a Flash cards. Since I have had such long commutes, I have been listening to the InmanCDs in the car on the way to my rotation. I just can’t stand her voice any longer after a whole day at my internship. Anyway, I feel like it’s been working well so far.
This week was an interesting experience. I went from being in my IPC facility where everything was computerized and organized to paper charting (huge binders for each patient) with utter chaos. Also, when you are in a hospital, you focus more on diet education and the occasional people not eating well. In the LTC facility, there are no educations! It is all about getting residents to eat, giving them supplements, checking weights, and doing wound assessments (and giving supplements to them as well). Did I mention it was very supplement based? Some patients are on diets, but it is much more liberalized than in an inpatient hospital. I mean if someone is 95 years old and wants some cake, she’ll get her cake…and eat it too.
One of the toughest things this week was getting used to another facility’s format. I felt like a chart-writing pro at my last facility. Now, I feel like I am starting from scratch with someone else’s preferences and their facility’s rules. I am very glad that I did my inpatient clinical rotation first because I feel like you are flying solo a lot more in LTC. Also, with paper charts, you have to sift through everything and find what is important (knowing medical terminology is helpful!).
I think my favorite story of the week happened when I was doing fluid restriction audits. I had the job of checking to make sure each patient on a fluid restriction had a palm tree picture outside their door and above their bed. As I went into one patient’s room, this was the conversation that occurred:
Me: Hi, I am just checking to see if you have a palm tree on your wall.
Resident: What? (very hard of hearing)
Me: I am looking for a picture of a plant on your wall.
Resident: Oh, that isn’t on my wall, it’s in my bathroom.
(So, I just think this lady is crazy; but, proceed to check in the bathroom. There in her shower was a huge plant.)
Resident: See, I told you I had a plant.
Me: You sure do.
Resident: Now, will you get someone to hang it up for me already.
Lesson learned: Sometimes the residents aren’t as crazy as you think! Definitely my good laugh for the day.