Week 2

Starting Clinical

I was so excited to start with my first week of real rotations! My first rotation is clinical 1 at Ben Taub Hospital, which is part of Harris Health Systems. Harris Health Systems is a large network of hospitals, clinics, and other healthcare service locations throughout Harris County (my home county, woo!). Ben Taub is an elite Level 1 trauma center in the Texas Medical Center. Ben Taub is a teaching hospital, and is staffed by faculty and residents from the Baylor College of Medicine. They also have students and residents from the University of Texas Medical School at Houston. Ben Taub is also a community hospital. Most of the funding comes from Harris county tax dollars, followed by Medicare/Medicaid, and then private insurance, etc. Orientation told us that more than half of the Harris Health System employees are African American and more than half of its patients are Hispanic. A little different than my hospital experience in Utah...

Those are the official facts of Ben Taub, but here are the Ben Taub facts according to Megan so far. Ben Taub is a pretty old hospital, although I'm probably biased after working at the Intermountain Medical Center which was only about 7 years old. Spoiled, I know. A lot of the patients don't speak English. A lot of the patients are homeless, uninsured, and/or come from really interesting and unfortunate social backgrounds. Since Ben Taub is such a good trauma center, it receives most of the severe trauma patients in the city. In the words of my mom, "gun shots and knife stabbings." Throw in really terrible car accidents and that pretty much covers most of the ICU patients. All that being said, I am really grateful to be at Ben Taub for half of my clinical rotations. I already have, and will continue to get really good experience working with the dietitians and patients here. I'll get to see a wide variety of patients and learn a lot! 

Ben Taub Hospital in its retouched internet glory

The weekly run down.....

Monday:

I won't bore you with the details from this day, because frankly, I'd put myself to sleep. After a week of orientation at UH, I was excited to have my first day at Ben Taub. That excitement was short lived because today was a full day of new employee orientation. Imagine you're at new employee orientation for a company you don't get paid to work for. Sounds awesome, right? The employee leading orientation did remind me of a bald, slightly less thrilling version of Steve Harvey hosting Family Feud though. It might have been because he had a mustache and said that all the employees are a family. Could've helped a little bit, right? I did get to leave a little early since I'm not an employee receiving benefits, so it was nice to avoid sitting through some of the useless information. 

Tuesday:

Today was....more orientation! At least they provided some free breakfast snacks. Today was only a half day of orientation, so it wasn't quite as painful as Monday. I did get to spend the afternoon with Carmen the dietitian. I'll spend most of my time here with her. She is awesome! She's really good at her job. She handles the oncology units and a medsurge floor (basically stabilized patients that used to be traumas). Most of the dietitians at Ben Taub are really young and it's one of their first jobs out of their internships. It's really encouraging to see how capable and confident they are so early in their careers. There's hope for me :) Tuesday afternoon was a good chance to meet the other dietitians and watch Carmen do some assessments.

Wednesday:

Just when I thought orientation stuff was over, I spent Wednesday morning in computer training. It wasn't terrible. We ended up getting done two hours early, so can't complain about that! That meant I could run to the scrub store by the Med Center.

Side note: I finally get to fulfill my dream of having a legitimate reason to wear scrubs every day without being a nurse or a surgeon! I'll be honest, the scrubs are one of the best things about this clinical rotation. Who knew you could be so comfortable at work. I feel like I'm wearing pajamas all day long. Which is great because scrubs are much more socially acceptable than pajamas. They're super soft too! Okay, I'll stop freaking out about my scrubs....But really, I'm wearing them right now after "work" and it feels great.

Other side note: I will refer to most of my days as an intern at work, simply because it is easier and flows better. Remember, I don't get paid for any of my labor as an intern. Rip off? Probably. Required to be a dietitian? Absolutely.

Back to Wednesday... I got to spend more time working with Carmen today. I also found out I get free lunch and free drinks. I'll take it! I learn so much every day at the hospital, it's hard to remember which day was which! I learned a new way to calculate fluid needs that I had never learned before and is more accurate according to the dietitians here. (Nerd alert: Apparently I get excited about new formulas to calculate how much fluid someone needs in a day.) One thing I did notice while learning the best way to write chart notes was the way you have to word your recommendations as a dietitian. It's an interesting balance between making a firm recommendation and staying within your scope of practice. 

Thursday:

My first full day with the dietitian! I even got to see my first patients by myself! Nothing like jumping right in. Both were pretty similar patients, so it was nice to get the repetition. I am so grateful for my job at IMC last year. I didn't realize how helpful it would be in the moment, but I already feel so comfortable in a hospital environment and visiting patient rooms. If nothing else, that alone is so valuable to my internship already. It's been great to already be seeing my own patients. I learn so much faster by doing, so it's really helpful to just get thrown right in this week.

The dietitians in the office (Carmen's office is shared with the two ICU dietitians) have also recommended some really good research articles and other resources to find research to support our standards of care. I'm so impressed with how well versed they are in current research. One of the dietitians recently passed her test to be a CNSC (certified nutrition support clinician). I'm really excited for the days I'll get to spend with her because she knows a ton about enteral nutrition (tube feeds) and parenteral nutrition (nutrition support through an IV line). 

Friday:

I was able to work up some more patients on my own today and add to my lists of "things I learned," "abbreviations I don't know," "things to look up later," etc. Carmen is bilingual, so she had me do some of her Spanish patient's assessments and translated for me. Today was the first day that I felt a little sad working with cancer patients. It's a lot harder to work with younger patients who have families and have really progressive cancers. It also makes me really appreciate what you can do as a dietitian and I really feel like what I'm studying makes a difference. Friday was a great day and a good way to end the week!

Overall Highlights:

• FINALLY getting my ID badge and parking pass figured out with the lovely security office at Ben Taub
• Note, this was also a "low light" because of how frustrating it was
• Getting the $30 parking pass for the onsite garage instead of the $75 pass for the offsite garage with a shuttle 
• Celebrating one of the dietitian's birthdays with free Yogurtland frozen yogurt that the manager brought to the hospital
• Having good hours that help me avoid prime rush hour 
• When the dietitians told me that I'm much more prepared than they were for their internships :)
• Assessed my first (probably of many) gun shot wound patients. Welcome to Ben Taub!
• Did I mention the scrubs?

It was a great week! I'm liking my clinical rotation a lot more than I thought I would so far. I celebrated by sleeping in on Saturday :) and going to a fun beach activity with the church group of young singles from Houston. Who knew Surfside was so much *nicer than Galveston?

*key word "nicer," still not what I would call a "nice" beach :)