Clinicals: Week 4

I’m nearly halfway through my clinical rotation, and guys…this setting is growing on me!! I never thought I’d be interested in or enjoy my clinical experience, but here I am…doing just that, and in the middle of a pandemic at that! I attribute my liking to clinical greatly to the amazing dietitian team at Swedish Covenant Hospital. Each one of them is amazing, both personally and professionally. I think patient, kind and guiding mentors make all the difference. I was lucky enough to get connected to them through one of my professors in my DPD program. I simply asked her if she knew any clinical RDs, and come to find out, she works there part time! Never be afraid to ask or network. It’s how I got 3 of the 4 of my rotations (of which I had exceptional experiences at each).

I also think I’m enjoying clinicals more because 1) I’m getting really good at navigating the EMR and charting, and 2) because I have the freedom to see patients by myself. I love that independence. It may seem scary to do this at first, but I suggest embracing the scarier because that’s how you grow! Practice is key. You won’t be perfect from the start. I have forgotten to ask a few questions or dig deeper for clarification with some patients, only to realize this later when I need the info for charting or for assessing malnutrition. That’s okay! Do the best you can. Also know that you can always call the patient’s room or visit them again later on to get this information. Is it ideal? No. But can you do it in a learning environment? Hell yes!

Besides the normal screening, assessing, diagnosing, and charting, here are some other noteworthy things I did this week.

  1. Attended rounds with med students on the GI floor. I LOVED listening in on their reports because I learned so much, but also felt like I was on Grey’s. lol
  2. I learned more about nephrology and palliative care. Unfortunately, we’re seeing a lot of elderly patients transitioning to palliative care due to COVID.
  3. We had a lunch and learn about the latest food insecurity initiative that launched at the hospital last week.
  4. I presented my first nutrition education to a patient with diverticulitis and who was post-op from a Hartmann’s procedure (resection of the sigmoid colon). OMG, I got to see a stoma with this patient too- aka hole in the abdomen to a part of the digestive tract (in this case, the colon)! It was literally plugged by gauze. Like what?! That was crazy to see.
  5. I also got fitted for an N95 mask (finally). We don’t wear these on the floors, even with COVID patients on them, but they are required for TB+ rooms. It was kind of neat to experience how this is done. You choose a size mask that you think will fit your face well (small, medium, large). You position it with the two straps. Then they put this plastic covering over you and spray a scent into this covering. You’re supposed to count to 20 out loud as if you were normally talking. If you can smell or taste the spray after that, then your mask is too big because the droplets made their way in. If not, you good. I passed on my first try with my small face. haha

Other than that, the week wasn’t as crazy as the last few with learning and increased hospitalizations. I even got to leave early a few days, which was SO nice and makes all the difference in your energy levels and rest of your day. There was a sad COVID story, but I don’t think we need another one of those right now. Reach out if you’re curious.

Let’s cover the terms and abbreviations I learned. Notice, the length of the lists are getting smaller as I’m learning more. 🙂

Terms

  • Rhabdomyolysis: muscle injury and breakdown where fibers are released into the bloodstream and negatively impact the kidneys
  • Myelodysplastic syndrome: bone marrow disorder that doesn’t produce enough red blood cells
  • Esophageal varices: enlarged veins in the lower esophagus
  • Pyelonephritis: kidney infection, example is a UTI
  • Uremia: elevated urea levels in the blood
  • Ischemic bowel: inadequate blood flow to the small intestine
  • Necrosis: cell death in tissues or organs
  • Edematous: having edema
  • MRCP/ERCP: imaging done to get better clarity on the gallbladder, pancreas, and liver

Abbreviations

  • LBP: lower back pain

So, that was week 4 friends. What do you think? What questions do you have? I’d love to hear your thoughts. I have 1 more week untilChristmas break! (one week) Then powering through 5 more weeks until I’m completely through with my internship! I’m going to push myself to start studying a little each week to start preparing for the RD exam. The plan is to drive to MT and stay out there all of February when I’m studying, then take it as soon as I return. I hope to be licensed by February 15th, 2021! Eeeek!

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