I'm a little behind on posting after working the weekend shift, which was about 9-10 hours both Saturday and Sunday. It was hard - I saw ~10 patients entirely on my own both days, and since I was covering all non-TF/TPN patients in the whole hospital, I saw everything from a colonovaginal fistula to narcotic bowel syndrome to severe dementia to a 16 yo girl who hadn't stopped bleeding from her tonsillectomy 11 days prior. Our bypass doc has been working around the clock the past month since an insurance change went into effect today that would bring him less money per surgery. He was cranking out several per day, even on Sundays, so he kept me busy with instructs all through the weekend. Oh, and I did a calorie count on a man who consumed 3500+ kcals two days straight.
This week, I spent a morning at the outpatient cancer center, which was SO different from the hospital. The RD just walks around to the patients as they get chemo and addresses their concerns, right then and there. She's really gotten to know some of the patients and gets to talk about lots of different things - although she always gets back to protein somehow. I also got to see where they make individualized lead plates to put over the radiation beam to better target treatments. This one woman has a little workshop in the hospital where she heats lead to 1300 degrees in a coffee urn-looking thing.
I've continued to follow my pt with the mystery illness. The MD's are still considering everything from endocarditis to cancer to Addison's. In the meantime, they finally placed a nasoduo tube. It's a little frustrating that we suggested nutrition support 4-5 days ago and it's just now happening. Apparently RD notes rarely get read at Rex...
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