Inpatient vs. Outpatient Care

During the past two weeks I was given the opportunity to shadow several dietitians within a variety of settings. I shadowed recent UMDCP Dietetic Internship alumni at Franklin Square Medical Center & Surgical Specialists of Anne Arundel Medical Center; inpatient vs. outpatient. Could there really be a clear favorite for dietitians?

Franklin Square Medical Center (photo courtesy medstarhealth.org)

First up was Franklin Square, a hospital that held significantly more beds than my first rotation at Carroll Hospital. I immediately assumed I would be overwhelmed with the influx of patients. Half of my day was spent rounding with resident physicians in the intensive care unit. As a lowly intern and student, I felt like an outcast among the many intelligent physicians surrounding me.  I was brimming with questions and unable to participate due to my lack of knowledge. However, as I was observing the residents interacting with patients, they too struggled to provide answers. I soon realized that everyone is constantly learning, and no one can fully grasp every branch of medical care. The RD was requested for brief education, diet advancement, enteral feeding, parenteral feeding, and supplementation. As the day progressed and we saw more patients, it became apparent that the intention of the RD is to provide immediate nutritional support to warrant better outcomes so patients can go home as soon as possible.

Anne Arundel Medical Center (photo courtesy of aahs.org)

The following days were spent at the Weight Loss and Metabolic Surgery Program of Anne Arundel Medical Center. The switch from an inpatient setting to an outpatient setting made me uneasy. I initially wondered how interesting it could possibly be providing the same lecture to every patient. After coming to the realization that RD’s do more than just lecture, I realized how wrong I really was. RD’s assess patient progress, physically and emotionally gauge patients to determine the most effective motivation strategy and focus on how to reach the goals of their patient. Education was more in depth, focusing on supplements, diet, and exercise throughout the phases of pre- and post-operation.

The real takeaway for inpatient vs. outpatient settings is that no matter what, the delivery of care is tailored towards the patient. Inpatient care is immediate and provides some education when necessary to prevent the patient from returning to the hospital. Outpatient care allows you the opportunity to build relationships with your patient as you educate them to enact lifestyle changes. No matter which setting, the RD is a vital part of a patient’s success.