Welp, my first rotation has come and gone, and I’m just now getting to blog about it. Can we say BUSY much?!
Between ‘working’ at one of our local hospitals and keeping my gym schedule, I was doing 12-hour days all week. So this is what a real job is like…
As a re-cap, I’m in my LAST semester of my LAST year, (PTL) which is broken into three month-long rotations. My first rotation was my ‘senior practicum,’ in which I shadowed a Registered Dietitian. Many of my fellow students chose specific areas of practice, such as pediatrics, long-term care or Bariatric Surgery. I chose to work with one of our existing preceptors at Erie County Medical Center in a more general hospital setting. Because I’m not planning to work full-time in acute care, I wanted to make sure I got some clinical experience before graduation. I worked with Jennifer Oswald, RD, on her medical and surgical floors, as well as some ICU work with another RD.
A typical day started with Jennifer giving me 4-5 patients who needed new assessments or follow-up assessments. Because there aren’t extra computers in the nutrition office, I usually wandered up to one of the floors and grabbed a computer at the nurses’ station, where I looked up each patient in the Electronic Medical Record and began charting.
After beginning their assessments, which included information such as their diagnosis, past medical history, lab values, medications and current diet order, I would track each patient down in their rooms and ask them a few questions. Most of the time, I discussed their allergies, GI function, last bowel movement, nausea, vomiting, diarrhea, constipation and intake prior to admission.After I saw each patient, I’d go back to a computer and finish writing up the assessment and provide a recommendation, such as:
“Recommend Heart-Healthy diet with Ensure supplement 2 x day. Monitor: PO (by mouth) intake, weight, labs/lytes, skin, BM, hydration.”
On one of my last days, I did a test tray from the kitchen. ECMC is beginning to implement an ‘on-call’ system for the kitchen, which is like having a short-order cook instead of set meals that go up on trays at specific times. I ordered an egg salad sandwich with chips and fruit. I checked the temperature of the hot and cold items, and filled out a questionnaire about taste, texture, appearance, etc…While at ECMC, I accompanied Jennifer to her outpatient counseling sessions on Wednesdays. I really like outpatient counseling, which allows you to go much more in-depth with each person and individualize the session to their needs. I also made a ‘craft’ to display nutrition labels for teaching:Overall, I was very pleased with my rotation. I was able to get a lot of clinical experience with both general medical and surgical patients, as well as those in the ICU and on tube feeds. Additionally, I was able to get some outpatient counseling experience. I absolutely HATED getting up and out in time to drive into Buffalo in the mornings (in the worst weather EVER), which just solidified the fact that I do not want a full-time, in-Buffalo, hospital job. It’s just not for me. I hated being away from the house ALL day long. I did, however, surprise myself with how much I liked the clinical atmosphere and the ICU. I could see myself working 1-2 days a week in a clinical setting to keep my skills sharp, but not full time.