Craven Week 1

Things are going pretty well at Craven so far. I've become very comfortable with their computer system and charting and I'm doing assessments and talking to some patients by myself now. Today I helped one dietitian calculate an enteral feeding and I followed up on another patient's tube feed to make sure it was adequate. I have been spending a lot of time in the ICU, CICU and NeuroMed units. There is very little education that goes on here because most of the people I have been seeing are very old and very sick. Most of the time they aren't even alert enough to talk to the dietitian so I have learned that nurses can be your best friends in these units and you can get a lot of good information from them regarding intake. My experience so far has put some nutritional ethics ideas into perspective, like whether or not tube feeding should even be initiated. I have shadowed two dietitians on and off so far, they do things VERY differently. It bothers me a little to be honest because I feel like it should be more standardized but in the end, I think they end up getting close numbers for needs. One of them insists on using a range for calculatiosn and the other things that is the wrong way to do it. One of the dietitians is very efficient and seems more into trying to talk to patients, she will wake them up if they are sleeping, which I don't know if I would do that personally. The other one does not like to wake them up and spends more time thinking about their lab values and talking to the nurse, she is more into the critical care aspect of things.

I sat in on a cardiac rehab class, which was very interesting. Except one guy was very ornery and kept telling the dietitian she was wrong but she brushed it off well. One thing that people were asking about was white wheat bread versus regular wheat bread. None of the dietitians were very sure about what to say, so I looked it up and discovered that "white wheat" bread is made from an albino variety of wheat that is milder and sweeter in flavor but delivers just as much whole grain! Just for y'alls information, in case you get a patient asking.... I hope everyone has a great Friday and weekend!