Weekend Day at the VA

I worked on Sunday with a Dietetic Tech. I had been warned that weekends are busy, but I hadn’t realized how busy! I guess it makes sense, because normally there are 3 Diet Techs and 2 or 3 dietitians, but on the weekend there is just one Tech and no RD’s. The Tech works on Sunday and must see the new admits from Friday night, all day Saturday, and maybe even the ones that come in Sunday morning. I have a lot of respect for the Techs at the VA.

I was not able to help as much as I would have liked because I am still fairly new, but it was a very good learning experience. I spoke with three patients and wrote up drafts of their assessments. The Tech and I discussed the cases and revised the notes together before they were submitted.

I assessed two people in the main hospital and one from the psych ward. I had a difficult time with all of them. Two of them were classified as moderate, so the RD will see them next week. I believe they both had a history of Crohn’s Disease and they both mentioned swallowing difficulties, which was an interesting coincidence. The third I classified as mild, but he was just barely mild. I found the assessments stressful because I was afraid of making a mistake, or missing something critical. The conditions of the patients on Sunday seemed more serious than the ones from Friday; also, on Friday the Tech stood next to me as I was talking with the patients. I talked with two patients alone on Sunday. However, it is reassuring that the RD will see two of the three, and I wrote a note to the Tech who will be in charge of the person I did not refer to the RD, and I know that she sees her patients almost daily for meal rounds.

Knowing where to look in the patient’s file for the pertinent information is one of the hardest things. The Tech showed me some very useful sources, for example, the note written about the patient’s admission to the ER. I hadn’t even realized that they had come in through the ER! So I have a lot to learn about the patient files. I appreciated the fact that some of the questions in my assessment overlap with questions asked of the patient upon admission. I had one patient for whom I questioned what I had recorded, but when I checked the admission note it matched mine, which made me feel better.

Another interesting thing was that I was able to get current weights on 2 of the patients I had assessed on Friday. The new weights changed their nutrition status, but unfortunately the Tech was very busy and so I will have to talk to people on Tuesday to find out how to change a patient’s status. Neither of the changes indicated a need for immediate action.

All in all it was a good day, but I was exhausted by the end.