Wednesday, March 30, 2016

Organize Me: Clinical Edition

My acute care clinical rotation flew by and although it was tough, I grew to love every single minute of it at the Baltimore VA Hospital. With my preceptors, and staff helping me whenever I needed pertinent information about a patient, I found myself appreciating them for every single thing they did. I created relationships there and this was essential for my success. Another thing that made me successful was my reference sheets. These became tools for me to make me more efficient at what I did.

When I was in clinical, my mind was going a mile a minute. Clinical is tough and it never slows down but I gave myself peace. This was done by making my own reference sheets for medications, supplements, formulas, PES phrasing, and more. These were essential for my success at clinical and I think it is useful to have on hand. As a current intern giving a future intern advice, try and prepare a quick reference sheet before you go to your clinical rotation. It shows initiative to your preceptors and can be your saving grace if you get in a tough spot.
Things to consider having on a reference sheet:
  • Common medications (brand name, generic name, use)
  • Common supplements: Nestle, Hormel, Abbott (kcal/pro)
  • Types of Insulin Chart
  • BMI chart
  • % Significant weight loss over time
  • Common PES statement 
  • Energy requirements (kcal/kg, Penn State, Mifflin St. Jeor, etc...)
  • Adjusted weight for amputation
  • Fluid adjustments for dialysis
You may receive a form with your hospital's assessment standards on it but it may not be organized in a useful way for you. I love making tables so this is the route I took when organizing my resources. As long as you reorganize it, make it colorful, and bold so that you use it effectively then you'll do great.  Not every technique you try will be effective the first time you use it. I made a list of over 100 common medications alphabetized before I went to my clinical rotation. Once in my rotation however I found that it was difficult to read and it took forever to find medications on it. After a few days of struggling with it, I went back and condensed it down by category of medications. This helped immensely. Your clinical rotation is a learning process, you learn what works and what doesn't. 

Another thing I made for myself was nutrition assessment sheet. It included everything I needed for a nutrition note at my hospital. I printed it out everyday and used this to organize the information I needed so I only had to look at this while I typed my notes. My notes were much more cohesive when I used my assessment sheets. You can create and adjust it for your clinical rotation and you may find yourself not needing as much information as you go through your rotation.

Things to consider having on a nutrition assessment sheet:
  • Name
  • Height/Weight
  • Room #
  • Labs
  • Meds
  • Diagnoses/Medical Hx: 
  • Skin
  • Intake from kitchen data or RN
  • Subjective Pt. Appetite/Intake
  • Nausea/Vomiting/Chewing/Swallowing/Diarrhea/Constipation
  • Energy requirements 
These are just suggestions of tools to make in order to have clinical success. Once I utilized these tools, my clinical rotation went much smoothly and I saw myself working more efficiently. I hope that this helps future interns because it helped me. Try new things and be a success. 

Cassie Burr
UMD Dietetic Intern 2015-2016
Twitter: @cassie_burr

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