Monday:
Mondays are the worst, agreed? So hard to wake up this particular Monday. Not sure why, but it is what it is. I spent another day with Carmen working up her patients. At 9:30 we had to go to our weekly multi-disciplinary meeting. I think I described this before, but just in case I didn't... The residents from the different medical teams go through their lists of patients with the social workers, nurse managers, physical therapy, occupational therapy, and last but not least the Dietitian. It's a good way to hear what's going on with the patient from every perspective. It's also nice to find out which patients have plans to discharge so that we don't spend lots of time assessing them :) I also got some good practice calculating tube feeds. Alix, one of the ICU dietitians, showed us a CT scan for one of her patients. He a cocaine addict and ended up pretty much brain dead in half his brain. The CT scan was crazy! There was literally nothing going on in the scan once you reached a certain point.
I really like working with Carmen, because she lets me work really independently and practice making my own recommendations. She pretty much just signs off on everything. I'm better at making recommendations for some patients more than others, but Carmen gives really good feed back on why she does things certain ways. My biggest problem is having enough confidence in my recommendations. I'm still too worried about being wrong. Working on it....
Tuesday:
Remember how I was so excited that all of my computer logins were up and running? Imagine how disappointed I was when it stopped working :( For some reason, the charting software had me in the system as a registered nurse again. If I'm going to be assigned the title of Megan Thacker, RN, I think I should at least get a nurse's salary. Is that too much to ask? I guess I'll just stick with my intern "salary." Who wouldn't prefer to be paid in experience? Good news is they fixed it by the end of the day.
I spent the day with Carmen again. One of the things I haven't gotten a lot of experience with yet is providing patient education. I've done a few, but Carmen hasn't be consulted for hardly any educations since I've been there. Today I watched Carmen do a diabetes education. It was nice to see how she balanced providing the patient with the information that he needed, but not teaching above his understanding level. Probably best not to overwhelm someone.
Ben Taub sees a lot of HIV/AIDS patients. I've had so many patients that end up in the hospital because they're wasting away from AIDS. Can't say I saw a lot of that at the hospital I worked at in Salt Lake...
Ben Taub sees a lot of HIV/AIDS patients. I've had so many patients that end up in the hospital because they're wasting away from AIDS. Can't say I saw a lot of that at the hospital I worked at in Salt Lake...
Wednesday:
You know it's going to be a good day when you wake up a little before 4:00 am. Mornings with 5:30 rounds make me wish I had a shorter commute. This morning was especially fun because I couldn't find my keys or ID badge anywhere! (of course they were both in a pocket in my backpack I thought I had checked a thousand times). I've become really good at "losing" things just long enough to make me stress about it.
I enjoyed getting to work with Kendall a little more today. (she's the Neuro ICU dietitian). I mostly just enjoy being able to assess different types of patients. I also got to do two educations today: a renal diet and a cardiac diet. I don't love working with renal patients, so that education wasn't as fun for me, but it was good experience.
To end my day, I watched a speech pathologist conduct barium swallow studies. The person eats/drinks different textures that have barium in them. We then watched them swallow the different textures through an X-ray machine. It was so cool! I wanted to watch this test because as a dietitian, we refer patients to speech therapy for any problems with chewing or swallowing. Sometimes they have to get this type of test done to determine if they're safe to swallow certain types of liquids and solid food. Sometimes the X-ray will show a person aspirating, meaning that instead of traveling down their esophagus as normal, whatever they ate or drank travels down their trachea into their lungs. The barium swallow can also show other swallowing problems. Some of the things I saw while watching the tests were liquid collecting around the epiglottis, improper movement of the very back of the tongue when swallowing, and needing to swallow multiple times just to swallow one drink of water. The speech therapist that was doing the tests was really nice. She was super helpful and answered all my questions. There was also a med student there watching so she was fun to to talk to as well. I'm glad I was able to watch these tests. Never underestimate the power of asking for things. All I did was email the manager over the dietitians and she set it all up for me! Now, what else do I want to see/do at Ben Taub.... :)
On Wednesdays, we have a standing appointment at UH to meet as interns with our program director. This was the first week we could meet because of a few conflicts on our program director's part. It was fun to hear about everyone's different rotations! We also started our patho presentations that we prepared our first week during orientation. Mag presented his on C. Diff. Wednesday was a pretty busy day!
Thursday:
Today was another early day with Kendall in the Neuro ICU, but rounds started at 6:00 instead of 5:30. Yay for "sleeping in." Kendall ended up leaving early because she wasn't feeling well. Turns out she had strep throat! Luckily I am still healthy myself. Thank you disinfecting wipes and some good old fashion hand washing. I spent the rest of my day with Carmen finishing up her patients. Since I did a longer day Wednesday, I cut out a half hour or so early today. It was nice to beat traffic and have a shorter afternoon.
Friday:
Friday was a completely different day! I was at Quentin Mease, a community rehab hospital that is also part of the Harris Health System. They also have a geriatric floor. The best part? I didn't have to come in until 8:30 :) This hospital only has one dietitian, Ashley. Her patients typically stay for 3-4 weeks. A lot of them come from Ben Taub or Lyndon B. Johnson Hospital. Ashley assesses all of the patients at the hospital. She also does more education. I was able to observe a class that she teaches as part of a weight loss/exercise program for the patients. The class was on portion sizes. It was a pretty fun environment. Ashley knows the patients at the hospital really well since they stay for so long. It makes work a little more fun when you have a good relationship with the patients. I also got to see a patient that had transferred to this rehab hospital after a stay at Ben Taub. I knew he looked familiar, but I didn't realize I had assessed him until I reviewed his chart. I have such a good memory.... He's a sad patient. He's younger than I am and has really bad AIDS. He's super non compliant with his medication so he's ended up with toxoplasmosis in his central nervous system. A lot of the patients that come to the community hospitals don't have access to the care they need when they leave the hospital because of funding, lack of transportation, lack of family support, etc. Then they end up back in the hospital much worse.
Ashley was really cool to work with. She's really good with her patients and they all love her! I enjoyed getting to see a different hospital with some longer term patients.
Friday night I met up with some of the interns at a little Mexican Cantina for happy hour. Don't worry mom, I just had a diet coke and an enchilada ;) It was fun to get to know the other interns a little better over some good chips and salsa. It worked out perfectly because then I could hit a church activity afterwards before I headed back to Spring.
On Wednesdays, we have a standing appointment at UH to meet as interns with our program director. This was the first week we could meet because of a few conflicts on our program director's part. It was fun to hear about everyone's different rotations! We also started our patho presentations that we prepared our first week during orientation. Mag presented his on C. Diff. Wednesday was a pretty busy day!
Thursday:
Today was another early day with Kendall in the Neuro ICU, but rounds started at 6:00 instead of 5:30. Yay for "sleeping in." Kendall ended up leaving early because she wasn't feeling well. Turns out she had strep throat! Luckily I am still healthy myself. Thank you disinfecting wipes and some good old fashion hand washing. I spent the rest of my day with Carmen finishing up her patients. Since I did a longer day Wednesday, I cut out a half hour or so early today. It was nice to beat traffic and have a shorter afternoon.
Friday:
Friday was a completely different day! I was at Quentin Mease, a community rehab hospital that is also part of the Harris Health System. They also have a geriatric floor. The best part? I didn't have to come in until 8:30 :) This hospital only has one dietitian, Ashley. Her patients typically stay for 3-4 weeks. A lot of them come from Ben Taub or Lyndon B. Johnson Hospital. Ashley assesses all of the patients at the hospital. She also does more education. I was able to observe a class that she teaches as part of a weight loss/exercise program for the patients. The class was on portion sizes. It was a pretty fun environment. Ashley knows the patients at the hospital really well since they stay for so long. It makes work a little more fun when you have a good relationship with the patients. I also got to see a patient that had transferred to this rehab hospital after a stay at Ben Taub. I knew he looked familiar, but I didn't realize I had assessed him until I reviewed his chart. I have such a good memory.... He's a sad patient. He's younger than I am and has really bad AIDS. He's super non compliant with his medication so he's ended up with toxoplasmosis in his central nervous system. A lot of the patients that come to the community hospitals don't have access to the care they need when they leave the hospital because of funding, lack of transportation, lack of family support, etc. Then they end up back in the hospital much worse.
Ashley was really cool to work with. She's really good with her patients and they all love her! I enjoyed getting to see a different hospital with some longer term patients.
Friday night I met up with some of the interns at a little Mexican Cantina for happy hour. Don't worry mom, I just had a diet coke and an enchilada ;) It was fun to get to know the other interns a little better over some good chips and salsa. It worked out perfectly because then I could hit a church activity afterwards before I headed back to Spring.
Fun Facts of the Week:
- They do leech therapy for patients at Ben Taub. Leech Therapy. I work in a hospital with leeches. GROSS!
- Ben Taub has had about 3-4 people jump off their parking garage this year. I think they need better security or something.
- One new way doctors are treating C. Diff is with flora reconstitution, or as I like to call it a poop transplant. That's right, they are putting stool from a fecal donor into your intestines to try to introduce the good bacteria into your gut again. Eww.
- A nice old lady at Quentin Mease told me I have a baby face. She also told me I was cute, so I'll take it.
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