Ending on a High Note

My last week of staff relief definitely had its ups and downs, and I was pretty much exhausted for most of it, but it was a great week in the end. I followed several patients over the course of the week, and it was great to get to know them and help them. I did a lot of instructions, and most of my patients were remarkably receptive, making the experiences really positive. (However, I did learn that you should NEVER calculate someone's energy needs on the fly because it is way too easy to make a mistake, and then you have to go back looking like an idiot.)

I heard some interesting food beliefs from several people: 1) when you add salt during cooking instead of at the table, it doesn't add sodium to the food, and 2) sea salt has less sodium and is better for you than table salt.

The exception to my feeling of being able to help everyone was my very last case: a woman with a h/o severe hyperemesis gravidarum. As I dug into records from previous admissions, it became clear that there isn't much we can do for her - jejunal feedings and TPN have both failed in the past, and she ultimately had to terminate a pregnancy. I spoke with her briefly to let her know that the RD's would follow her and give her all the help possible, but really, this woman just has some tough choices in front of her.

Overall, this has been a really challenging but educational and rewarding. I will really miss the RD's at Rex - they were so helpful and fun to work with. They've all been very supportive, including Lyn (the demanding clinical nutrition manager), who went out of her way to compliment me on Thursday. I'll take that as an H.