First day!

Hello everyone,

I hope you all had great days today! I had to go to orientation for Carolinas HealthCare System this morning, and then around 11 I headed over to the hospital and met up with my preceptor, Alice. CMC is a HUGE hospital- it almost feels like a college campus, so it will be interesting to try to learn my way around there. Alice is a nutrition support dietitian and works in pediatrics, but she is currently covering for a dietitian on maternity leave in Rehab, which is conveniently my first rotation. We spent some time going through the formulary, the standard equations for the hospital, and then talking about some of the supplements that they use at CMC. She then had me going through the computer system looking up lab values from bloodwork. Since it is rehab, the main things that I was looking for were albumin and prealbumin to make sure that the patient's protein statuses are good (to prevent pressure ulcers mostly). We then went out on the units and started going through the medical records and noting any changes that the physicians or nursing had made, and she started working on her medical notes. She did a few with me, then had me start doing the assessments and writing my own. Since none of the patients were new, most of the medical notes were just information about prealbumin/albumin, weight changes, any formula or modular changes, and those kinds of things. I asked a TON of questions to make sure that I was doing everything right, but she was very supportive that it was important that I learn-even if it means going slow.

Rehab is a very interesting place to be because there weren't any new patients from the last time that she had done rounds, and it is an environment where the nurses, physicians, the dietitian, OTs, PTs, and everyone else seem to really know each other. There is some stress there because a lot of the patients are sad stories and are also unhappy to be there, but they all are really supportive of what everyone else is doing. There is only one dietitian in the rehab facility, and she is very independent from the other dietitians. They even use a different type of charting/medical record in rehab compared to the main hospital. Very interesting.

Looking forward to hearing how everyone else's first days went!