Monday:
I spent today with Alix in the Surgical Trauma ICU. We went over a lot of the nutrition protocols and research that guide her practice. One of the main things that some of the research shows is that if enteral feedings are initiated within the first 24-28 hours in the ICU setting, the outcomes are much better. The patients in this ICU are pretty interesting, and by interesting I mean crazy! One of the patients was described as "pedestrian vs. train." Another patient jumped off of a balcony and fell 40 feet. There never seems to be a lack of gunshot wound patients at Ben Taub either. Reading patient histories was definitely interesting. Alix and I headed to the ICU for rounds with the medical team. Right when we were supposed to start, one of the patients decided to code. He originally came to the hospital to have his appendix removed and ended up going into septic shock. It was an exciting start to the day. While the medical team was working on the coding patient, Alix and I practiced some TPN calculations and went over nutritional implications of common medications used in the ICU. I assessed/wrote a note on a patient that was in a really bad car accident. He hit a pole and it took prolonged extrication at the scene to remove him from his car. I learned a ton today from Alix. She recently took her exam to earn her CNSC credential, which means she is a certified nutrition support clinician through ASPEN (American Society for Parenteral and Enteral Nutrition). She is really up to date on research. Gross fact from today. Alix and I were in the ICU to give the medical team our recommendations. While I was standing about 5-10 feet away from one of the patient's beds, the patient coughed and I simultaneously felt something land in my hair.....eww....The patient's trach was uncovered. He managed to cough up something through his trach and have it land perfectly on my head. I was definitely excited to go home and shower.
Tuesday:
I was with Alix again today in the ICU. We spent some time going over more ICU information and nutrition support. So many notes to take...This morning started with another patient coding. Two days in a row! This patient coded about 5 times overnight and ended up passing away. We also went over cultural/religious implications in end of life care. There are so many things to consider. Alix helped me practice TPN calculations a lot more today too. Today I assessed the patient that coded the morning before, as well as some other patients on the floors. I really liked the ICU with Alix. I feel like I learned a lot from rounds and just from working with Alix.
Wednesday:
I spent today with Esther. She's the dietitian in the NICU at Ben Taub. We spent the morning going over the guidelines used for nutrition with the NICU babies. They were written by Texas Children's Hospital for the Baylor medical staff. The NICU is a whole different world for nutrition support. We went to rounds with the medical team and saw all the cute, tiny babies. Since it was Wednesday, I had to go over to UH for our weekly intern meeting. It's always fun to catch up with the other interns.
Thursday:
Today I had to go to Texas Children's for orientation. Luckily I didn't have to go to their new employee orientation like I did at Ben Taub. Apparently I'm the only intern that Texas Children's is going to have until the spring. I just spent a few hours with a couple of the dietitians to go over my schedule and some of the differences clinically when you work with pediatrics. It was nice to meet some of the dietitians I'll be working with and see some of the hospital. I feel really lucky to be able to do both of my clinical rotations at the Medical Center. Fun fact, the Texas Medical Center in Houston is the world's largest medical center. Pretty cool right?
Friday:
My last day at Ben Taub :( I spent my last day with Kendall in the Neuro ICU. I love going to rounds with Kendall. She works with a good team of residents in her ICU. Her patients are always interesting, and I've really enjoyed the ICU environment. I was able to do assessments on quite a few patients today. It was good to be busy for my last day. I won't go into a lot of details. It was a pretty typical day in the Neuro ICU with Kendall. I was really sad to leave Ben Taub. I loved working there a lot more than I thought I would. The dietitians I was able to work with and get to know were awesome! They were so fun to work with and I learned so much from them. It was an interesting hospital for sure, but I'm really grateful that I ended up having this rotation in my schedule. Can't believe how fast my first rotation went! I finally took pictures too!
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| Kendall, me, and Alix. Not pictured: Carmen who had to cover at Quentin Mease on my last afternoon. |
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| They didn't even let me keep my ID badge as a souvenir. |
