Monday, June 3, 2013

Your Clinical Survival Guide

If you’re anything like me, you may find yourself a little intimidated by the prospect of going into your clinical rotation.  In my case, it had been a few years since I took MNT, and didn’t have any hospital experience.  I’m here to tell you that it’ll all work out!  In case you would like to prepare early though, here are a few ideas to help you get a jump start on your clinical rotation.

1.       Get the standards of practice and formulary.  Most hospitals have a small pocket guide for their recommendations… common equations, protein and calorie recommendations for different populations and disease states.  This is extremely helpful when going to see patients!  Your formulary is your guide to all the tube feed formulas and supplements available at the hospital along with their macronutrients. 

2.       Keep a cheat sheet.  One of the best things I could have done for my clinical rotation was to get a small notebook you can keep in your lab coat pocket.  In this notebook, keep lists of all the important things you may need, like labs, common medications, equations and nutrition care manual recommendations.

3.    Know your labs.  Most hospitals now are using electronic health records (EHR) and don’t require you to memorize normal lab values, but that doesn’t mean you shouldn’t know them.  Get an idea of what the norms should be, and know why they may be off.  Why might BUN be high?  Why could sodium be low?  These are all great things to put in your little book.

4.       Know the systems.  Remember in school, learning about glycolysis, the function of the kidney, etc?  Brush up on them.  You don’t need to memorize them, but try to remember the basics on how the functions work.  It will better help you understand when something isn’t working right.

And most of all, don’t worry.  We all have to start somewhere.  No one is an expert right away.  Be willing to take a step back and admit you might not know something, and look it up.  There are a lot of disease states out there that you may have never heard of.  Quickly looking things up can help you find what you need and make the right recommendations.  

So now you can relax and be confident that you, too will succeed in clinical!

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