Dietetic Internship: Weeks 21-24

Hi Friends!

Just popping in with a quick update to fill you in on the long-term care rotation of my internship! As usual, I’m behind on my recaps. In fact, I only have ONE MORE WEEK of my internship left. Which means I’ve already completed 3 weeks of my very last rotation.

So, I thought I’d spend a few minutes filling you guys in on what I did in February. It was a lot of the same stuff day after day.

{sign on my preceptor’s door}

The place that I did my longterm care rotation was actually a  Transitional Care and Rehab facility. It’s both a long-term care facility, with a dementia unit, and a rehabilitation facility. Long-term care is not my favorite thing, but luckily for me, my preceptor primarily covered the rehab units…which I liked a lot better. There was a Diet Tech that covered most of the LTC patients, and then since my preceptor was an RD, she handled some of the more complicated cases in that involved tube feeds, serious pressure ulcers, etc.

I liked the rehab units because there was such a wide range of patients. We saw older patients recovering from fractures and surgeries, patients with cirrhosis, patients recovering from motor vehicle accidents and much more.

{I had a 45 min drive each way so I saw a lot of pretty sunrises. Bonus!}

Here are some of the things I did while I was there:

• Attended weight and wound team meetings with the RD and the nurse unit managers. Patients that triggered for weight loss/gain and any patients with wounds or pressure ulcers were discussed.
• Provided diabetes education to newly diagnosed diabetic patients. I taught them how to count carbs, how to read labels, etc.
• Conducted admissions assessments with patients to determine food preferences. These assessments also cover any recent weight loss/gain, chewing/swallowing problems, food allergies, usual body weight, labs and any other nutritional concerns the patient has.
• Attended care conferences with patients and families to discuss comments, concerns and questions about their care.
• Reviewed and assessed weight change and meal intake reports.
• Used the nutrition care process to write ADIME notes. These notes include an assessment, a nutrition diagnosis that has to be written using certain standardized languages, what your interventions are going to be to correct their nutritional problems and how you will monitor/evaluate changes in their condition.
• Used the Point Click Care computer system to chart electronically and navigate patient records.
• Set goals for weight loss, improved labs, wound healing, etc and recommended supplements (Ensure, Healthy shot, fortified shakes) when necessary for extra calories and protein.
• Referred patients for speech therapy consults for swallowing issues.
• Recommended diet changes when necessary.
• Visited patients to discuss weight changes.
• Calculated tube feeds.
• Completed assessments (monthly, quarterly and annual)

Although this wasn’t my favorite rotation, I liked my preceptor and it actually went by pretty quickly since I was only there for four weeks. I got to interact with a lot of patients and I got tons of practice charting, writing PES statements and coming up with interventions and goals.

I also had to select a patient to do a case study on. My patient had alcoholic cirrhosis and hepatic encephelopathy. I’ll be presenting my case study to my class next week.

So there you go! Like I mentioned, I’m currently finishing up my very last rotation. I’m at the Central Ohio Diabetes Association and I’m loving it. Recap to come soon!

Enjoy!
–Lindsay–

PS. If you want to read more about my previous rotations, here are my recaps:

My Path & Big News

Dietetic Internship Orientation and Week 1

Dietetic Internship Weeks 2 & 3

Dietetic Internship Weeks 4 &5

Dietetic Internship Weeks 6-9

Dietetic Internship Weeks 10-16

A Day in the Life & Nobody’s Perfect

Dietetic Internship Weeks 17-20