Clinical Nutrition >>>-
Northwest Texas Healthcare System (Sodexo)
Northwest Texas Healthcare System is located in Amarillo, Texas (https://www.nwths.com/). It is an acute care hospital with 495 beds. During my time there from July 2018 to May 2019, I rotated through the Cardiac ICU, Cardiology, Medsurg, Behavioral Health, and Acute Rehab Unit. My main duty was to manage adult inpatients with nutrition-related diseases and conditions such as malnutrition, pressure ulcer, end stage renal disease, hepatic encephalopathy, and type II diabetes. Aside from adults, my responsibilities also involved the pediatric behavioral health unit, where I assessed children who were underweight or had eating disorders.
Picture source: https://www.nwths.com/
For every new patient, I would obtain information from medical records and in-person interviews to assess the patient’s nutrition status. Based on the assessment, I would come up with nutrition diagnosis and interventions to address the patient’s problems. Common nutrition interventions that I made include diet modification (e.g., from regular to low salt, from chopped to minced), oral nutrition supplement order, and tube feeding management. I always try to tailor the intervention based on each patient’s specific needs to provide them with individualized nutrition care. For patients who lack the knowledge to manage their disease at home, I would provide them with nutrition education at bedside.
Follow up visits were provided for patients with longer stays. At follow up sessions, I would reassess patients’ nutrition status, see if nutrition goals from the previous session were met, and come up with new interventions as needed. Although not everyone makes progress in an acute care hospital, I did see a good number of patients reaching a better nutrition status after I implemented nutrition interventions for them. For example, patients with poor denture improved food intake after I changed their diet from regular to chopped; malnourished patients with decreased appetite met their daily caloric goal and maintained weight by drinking oral nutrition supplement. I always felt really happy to see my effort turn into positive changes in my patients.
This work experience has definitely consolidated my understanding of a variety of nutrition-related disease state. However, what made this work experience truly impressive is that I also learned a lot about communication and teamwork from it. Besides interacting with patients, I also collaborated with peer dietitians, nurses and doctors all the time. While my dietitian colleagues provided me with valuable technical support, healthcare professionals from other disciplines inspired me with new perspectives. At the same time, no teamwork succeeds without challenges. When confusion or misunderstanding happened at work, I always choose to stay calm and listen to the reasoning from the other side before making too many comments. Many times, I found myself developing more respect and understanding towards the other party during the process of problem-solving.
Dietetic Internship Experience
Scripps Health is a San Diego located healthcare system (Link https://www.scripps.org/). I completed 12 weeks of clinical rotation at Scripps Health from January to April 2017. I rotated between several inpatient campuses including Mercy San Diego, Mercy Chula Vista, and Green Hospital. The following include some of the projects I completed during this rotation
Picture source: scripps.org
Renal Transplant Clinical Case Study
For this project, I selected a renal transplant patient from Scripps Green Hospital. I conducted background literature research, assessed the patients’ nutrition status, evaluated the precepting dietitian’s nutrition diagnosis and care plans for the patient, and developed suggestions to improve the current care plan.
I orally presented my case study with a PowerPoint in front of my preceptors. My presentation was about 20 minutes long, and there were around ten preceptors in the audience. Through this project, I learned about the nutrition implications of renal transplant, and also practiced my presentation skills. Please click on the following links to access my case study write-up, presentation PowerPoint, and preceptor evaluation.
Oral Nutrition Supplement Thickening Project
Oral nutrition supplements can be good nutritional aids to patients. However, many products do not always come in appropriate consistencies to accommodate patients with swallowing difficulties. Therefore, under the guidance of preceptors, I thickened several oral nutrition supplements that Scripps Health currently serves with a commercial thickener. Different oral nutrition supplements produced different consistencies after being thickened. To find the best combination, I compared the thickened supplements to pre-existing commercial liquids with the desired consistency and recorded my observations in a report. Please click on the following link to read about my report.
The above pictures shows all the oral nutrition
supplements that were studied in this project.