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Monday, May 20, 2013

Being a Positive Influence

Dietetic Internship adventures at the Memphis VAMC continue!(Previous week's blog posts can be found to the left under the navigation by date headings.)

DIETETIC INTERNSHIP: Weeks 8 & 9  (of 41)
Weeks 8 & 9 - General Medicine

In this rotation I experienced my very first inpatient setting…  the General Medicine wards.  I had become so used to Outpatient that I wasn't exactly sure how/what went on in the hospital.  On Day 2 I was quickly caught up to speed as I saw an obtrusive red sign on the patient’s door, nearly shouting at me, “Caution! Caution”  Not knowing what to do, I called my preceptor (which is like a mentor and boss during a rotation), “Umm, help?!”  

She graciously informed me that this patient was under isolation and droplet precautions, and I needed to re-outfit myself.  She helped me get suited up in a head-to-toe yellow gown, face mask, and gloves… then I entered the room.  What kind of encounter was I headed to?  Aliens?  Nope, a patient with the flu and other complications such as COPD and hacking every 2 minutes.  “Contact Precautions”  I don’t want your flu or anything else!  I suited up many, many more times over the course of the day, and the following two weeks.  (It is really hot under a face mask!)

Part of my assignments this week (of which there are several) included presenting a Case Study to my fellow colleagues.  Basically that means you identify a patient with interesting and/or challenging medicaI and nutrition diagnoses, and report patient condition, limitations to care, and how he/she was treated nutritionally by you.  I chose a 60 year old female Veteran with Crohn’s Disease.  ).  She had a lot of complications, partial bowel removal, colostomy bag, etc…  I first met her when I visited with her 2 times for nutrition counseling and education (with her husband, the self-titled home cook, present), and 1 additional time primarily for goodwill (and I was a little attached to her wellbeing.

On the 3rd visit, she told me she was SO glad that I had comeback, as she wanted to share some comments with me:

“Your delivery has been more informational than dictatorial, which has been my experience with dietitians in the past.”

“Your information has been invaluable.”  “You have been a very positive influence, and I think it is going to continue for some time to many people.”

Her (obese) “country cook” husband was present during the first nutrition education and counseling; 3 days later he said to her, “we need to make some changes” and was talking about baking/broiling, and other non-frying food prep methods, as well as trying frozen fruits and vegetables.  (Previous ‘barriers’ included cost, preference, and convenience.)

Needless to say, my eyes watered up while I was standing in her room.  I work in a hospital where most of the ‘glory’ is focused on doctors and nurses, while dietitians (and dietetic interns) get shoved into the non-important category.  The learning experience is undeniable, while also humbling.  It felt so good to be elevated to a higher place of recovery in this patient’s eyes, and to truly make a difference.

"I do believe we're all connected. I do believe in positive energy. I do believe in the power of prayer.  I do believe in putting good out into the world.  And I believe in taking care of each other."
--Harvey Fierstein --

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