Friday, February 27, 2015

A Day in the Life of a Clinical Dietitian (An Intern's Version)

Throughout the last five weeks I have had the opportunity to work with three RD's at Meritus Medical Center in Hagerstown, MD. There are five RD's at MMC, and each cover different units. Also, three of the dietitians work at outpatient facilities such the Wound Center, the Weight Loss Center, and the Cancer Center. These dietitians play many roles, which keeps every day interesting!
While interning I have noticed that the RD's follow a certain schedule, but since all patients have unique cases, there is always wiggle room!
A typical day at Meritus Medical Center goes something like this....

Investigative Work 
In the morning, the patient nutrition screening report is printed. This document informs the dietitian which patients to visit that day based off of certain criteria. 
Patients can be screened for:
  • Low BMI
  • Poor PO intake
  • CVA
  • Pressure Ulcers
  • CHF
  • Missing Data
  • Bariatric Surgery
  • And many more!
Once the dietitian sees what patients have screened on their floor, they print out their nutrition care record. This record contains the patient's diagnosis, height/weight, past medical history, and all recent lab values. Then the investigative work comes in. It is important to look through each patient's medical record to find any information that may be helpful to the dietitian when they do the assessments.

Meritus Medical Center in Hagerstown, MD

Going to rounds is surprisingly fun! Rounds are when the doctor, pharmacist, care management team, social worker, RNs and RDs gather to talk about each patient on the floor and their future plan of care. It is also a great time for the intern (me) to learn about medications and disease states/conditions. I always keep a pen and paper handy to write down terms that I did not know before hand.

Visiting Patients
This is always the most rewarding part of my day (depending on the patient, of  course). I have talked to a variety of patients, both interested in talking to me and those who are not. When I go to visit patients I gain a better idea of how they are eating, if they need snacks or supplements, or if they are interested in any additional education pertinent to their condition. I have had some great conversations with patients who really do desire to learn more about nutrition. It's great to use all of the information I learned in MNT in college!
I was able to try a nectar thickened supplement, not that bad!

Document, document, document!!
Documenting may be the most critical part of the job. Without stating what you did and why in the medical record, you might as well have looked at Facebook all day! Filling out nutrition assessment notes allows other members of the health care team know what the RD's are doing to help patients with their nutritional needs. Learning the verbiage used in nutrition notes is probably the most difficult part  of documentation. There are so many abbreviations to learn, but with writing more notes everyday it is becoming a lot easier. 

Although a typical day at every hospital is very different, this is what I have taken away from interning at Meritus Medical Center. The key to being a clinical dietitian is flexibility! This week marks my half way point in clinical, and I am so excited to learn much more!
Me and the Registered Dietitians

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