Nutrition Support at Rex

I finally started working with the Nutrition Support Dietitian (she's a CNSC). I was feeling a little behind since everyone else has been calculating EN and PN prescriptions for weeks, but I've only made a few EN recommendations. I was nervous going into today since I hadn't really brushed up on TPN calculations since MNT refresher. (It was 4th of July weekend, after all...) It turned out surprisingly well, though. It all came back to me like riding a bike. The CNSC was impressed that I could actually calculate a new TPN prescript on on my first day. (I think she's used to dealing with pharmacy interns who aren't nearly as well prepared.) It was fascinating to learn about all of the things you have to consider when setting levels of electrolytes, insulin, etc. One new fact: ICU pts are frequently given meds that decrease peripheral circulation, which can lead to falsely low accucheck readings, so you have to be careful when assessing blood glucose readings to adjust insulin. I really like that nutrition support is very analytical, but there's still an element of intuition. I think I'll miss patient interaction, though.