Working with Rex patients (or should say "pts"?)

Hi everyone!

I finally got to talk to pts on Thursday and Friday. My preceptor even stood outside the door and let me do some follow-ups and initial assessments entirely on my own! Some funny stories from the experience:

1. My first pt ever was REALLY chatty. The conversation ranged from an upcoming wedding she wanted to get out of the hospital to attend to her daily enemas to relieve constipation. She asked all sorts of crazy questions about foods that would be easy on her stomach - she was even thinking about trying baby food. She then lifted up her hospital gown to show me all of the water wt she's been gaining. Lesson learned: leave your pager on so that your preceptor can rescue you after 30 minutes.

2. My preceptor and I did a diabetes instruct with a woman who expressed interest in meal planning during a follow-up. She's had a stroke and a heart attack, but no one's ever taught her how to manage her diabetes! The idea of CHO counting was totally new to her. She was pretty interested, but she was distracted by trying to plan her discharge. She took ~5 phone calls while we were in there. Frustrating. Lesson learned: refer pt to an outpatient RD if they can't focus and have a lot to learn.

3. I observed an instruct with a woman who was back in the hospital after gaining 10 lbs of fluid wt (ascites) in the week following her discharge. She had been on a liquid diet in the hospital for testing, and the MD never told her to go back to solid foods once she went home! She hadn't been in the hospital long enough to have a follow-up assessment before discharge, so the RD didn't see her before she went home, either. She was supposed to be on fluid restriction no less! The MD ordered a nutrition consult this time, and we made sure to instruct her on fluid and salt restriction. Lesson learned: good discharge planning and pt education save time and money.

Next week, I'm looking forward to observing some procedures finally.

Enjoy the weekend!