CMC Union week 2

I can't believe how much I've learned in the past week. It was a hectic week last week because one of the three full time dietitians was gone all week, but the dietitians that were there did a great job of letting me ask lots of questions. Slowly I'm picking up on lots of useful information, such as what tabs to be sure to fill out on the electronic chart. The dietitians are also big fans of giving me things to research, so I am learning a lot from that. This weekend I researched how tight control of blood sugars in the ICU affects certain outcomes like sepsis and mortality. Surprisingly, one study found that tighter blood sugar control led to an increase in mortality in medical patients in the ICU shorter than 3 days. For patients in the ICU greater than 5 days it decreased mortality. The explanation for this was unknown, but it presents a problem of knowing how to treat patients since it's sometimes not clear when they enter the ICU how long they are going to be there. They wanted me to research this because somebody in charlotte actually invented something called the EndoTool that they use in the ICU to control blood sugar, and they are not sure which patients it is best to use it with.

On another note, I got to watch a diabetes education with a Spanish translator today. There is a very large hispanic population at CMC Union, so I've already seen two patients that don't speak English. Although I speak some spanish, I don't offer to translate unless it's something simple. The translator today was far better at it than I would have been, but I was able to help her out by telling her what the word for snack was in spanish :) It was very interesting to watch the translator session. The dietitian had handouts that were in spanish and english. She would explain the handouts to the translator, and then the translator explained them to the patient.

Lastly, I came across a patient on a neutropenic diet today. The patient had cancer and was immunocompromised. One thing that I didn't know (or forgot) was that patients on a neutropenic diet can't have deli meat even though it's been processed. I guess it could become contaminated during storage.