So, now the second post about staff relief! Turns out that yesterday and today went much more smoothly than Monday. I wasn't getting constant pages and I'm getting the hang of what I need to do and when I need to do it. Now with the small amount of extra time I have at the end of the day, I look toward the next day and figure out what will need to be done, who I'm going to see in clinic (what I might do pending how they're doing), and maybe even start my reassessment notes.
My two BMT patients are doing well. One of the patients has a rather stubborn mother when it comes to tracking intake and providing supplementation and those sorts, and yesterday I had my first experience with standing my ground. She wanted to decrease the cycle time of TPN, in which would cost her daughter much needed calories and protein. I stood firm on that she'd go home on what I wanted her to, and put up a good fight. I still lost, but I didn't back down to what she wanted to do. She still wouldn't give in to ordering supplements, though I suppose I should just take it one triumph at a time.
In this position, I also cover one of the general pediatric services. There's not too many crazy conditions in this position, just more of kids who may be coming from the PICU, in for simple infections, or monitoring after surgery. Tomorrow I'll write more about some of the side conditions these kids have, which are very interesting...
I can't believe my first of three weeks is already halfway done, and I've survived! Tomorrow all the interns are having our pictures taken so there is a picture of us on our graduation program, as well as our director hangs the picture in her office. On Friday I have my end-of-the-year evaluation with the internship director, along with returning all of the books she provided us. After that, it's time to start studying for the RD exam, which I hope to pass in August.
What is really nice at this point is not having 5,204,183 projects and papers to work on when I get home. It's nice to just relax and do something for myself at the end of the day.
15 days!
Wednesday, June 15, 2011
Monday, June 13, 2011
Staff Relief
I'm so overly excited that this is my final stretch. 3 weeks of staff relief. I was placed in one of the most challenging positions - pediatric bone marrow transplant (BMT).
Let's just say that today was incredibly overwhelming. Definitely do-able, but overwhelming. It's like being at a new job and you know what needs to be done, but it all seems to come flooding in on the first day. Rounds got started late, 2 big patients came into clinic, 4 inpatients (2 incredibly needy ones), plus the pager never seemed to stop.
What is nice is that I have no more big projects or papers to write. Thank goodness!! That is one thing that I'm glad to have a break from.
So my day is as such...get to work at 7:15-7:30am, chart and catch up on patient labs and medications until 9am, when rounds are (supposed) to start. Then, rounds last until around noon-ish. After that I have to order the TPN for the patients for the next day, altering them as needed. Then, I complete any new assessments or reassessments for patients on the general service (which my position also covers). If there are any patients coming into clinic, I have to escape rounds/visiting patients/charting to visit them. All the while altering TPN prescriptions, tube feeding orders, and encouraging everyone to eat. Not to mention the 9,387,104 pages that I get and attend to. I usually work right up until 4pm, when it's time to go home.
The nice thing is, is that I get to come home and do whatever I want. So today I went for a nice walk, painted my nails, and read my book. Things definitely even themselves out. I'm sure I'll have more to write later when I get the hang of things and settle into a routine.
But until then...
17 days left!
Let's just say that today was incredibly overwhelming. Definitely do-able, but overwhelming. It's like being at a new job and you know what needs to be done, but it all seems to come flooding in on the first day. Rounds got started late, 2 big patients came into clinic, 4 inpatients (2 incredibly needy ones), plus the pager never seemed to stop.
What is nice is that I have no more big projects or papers to write. Thank goodness!! That is one thing that I'm glad to have a break from.
So my day is as such...get to work at 7:15-7:30am, chart and catch up on patient labs and medications until 9am, when rounds are (supposed) to start. Then, rounds last until around noon-ish. After that I have to order the TPN for the patients for the next day, altering them as needed. Then, I complete any new assessments or reassessments for patients on the general service (which my position also covers). If there are any patients coming into clinic, I have to escape rounds/visiting patients/charting to visit them. All the while altering TPN prescriptions, tube feeding orders, and encouraging everyone to eat. Not to mention the 9,387,104 pages that I get and attend to. I usually work right up until 4pm, when it's time to go home.
The nice thing is, is that I get to come home and do whatever I want. So today I went for a nice walk, painted my nails, and read my book. Things definitely even themselves out. I'm sure I'll have more to write later when I get the hang of things and settle into a routine.
But until then...
17 days left!
Wednesday, June 8, 2011
Project Healthy Schools
Yesterday I spent pretty much the entire day driving around Ypsilanti Public Schools. It was SO incredibly hot, but very worthwhile.
Project Healthy Schools (PHS) is a health and wellness initiative for local Ann Arbor and Ypsilanti schools, aiming to improve their overall outlook on healthy diet and exercise. Yesterday started off by visiting Ypsilanti Middle School, where we promoted asparagus. They had asparagus they had on the hot lunch line was baked with some salt and (lots) of pepper. It was pretty good! We also put the informational fliers that I made on the tables, as well as went around with samples for all students to try. It was really fun encouraging kids to try new foods. Some really liked it, some said it was ok, some hated it, and some wouldn't even look me in the eye. It was awesome being around kids and having them be interested in a new food, or at least being more aware of what it is.
After that, we went to a local high school to do a screening of a student. With PHS, there have been a handful of published studies on the program, and whether or not it makes a long term effect. This student had been exposed to PHS when he was in middle school and now MHealthy staff members are following him, every year completing a survey. The survey includes data such as height, weight, blood pressure, cholesterol, blood glucose, and a lifestyle questionnaire. They take his and thousands of other student's information and compare it to students who weren't involved in PHS, to see if it makes any difference.
After the high school, we stopped at an Ann Arbor elementary school to drop off informational booklets to a teacher who is getting more involved with the administrative side of PHS.
So, needless to say it was a very long day on that aspect. Not to mention it felt like 100 degrees outside.
So after PHS later in the evening, I attended a MHealthy Weight Management class for adults. The class I attended was all about rearranging self-talk from negative into positive, and how it can change the overall outcome.
Today's weather is supposed to be even worse. But luckily I'm not doing much traveling and will be spending the morning with one-on-one MHealthy counseling. More on that later...
22 days until graduation.
25 days until my birthday.
26 days until I start my new job!
Project Healthy Schools (PHS) is a health and wellness initiative for local Ann Arbor and Ypsilanti schools, aiming to improve their overall outlook on healthy diet and exercise. Yesterday started off by visiting Ypsilanti Middle School, where we promoted asparagus. They had asparagus they had on the hot lunch line was baked with some salt and (lots) of pepper. It was pretty good! We also put the informational fliers that I made on the tables, as well as went around with samples for all students to try. It was really fun encouraging kids to try new foods. Some really liked it, some said it was ok, some hated it, and some wouldn't even look me in the eye. It was awesome being around kids and having them be interested in a new food, or at least being more aware of what it is.
After that, we went to a local high school to do a screening of a student. With PHS, there have been a handful of published studies on the program, and whether or not it makes a long term effect. This student had been exposed to PHS when he was in middle school and now MHealthy staff members are following him, every year completing a survey. The survey includes data such as height, weight, blood pressure, cholesterol, blood glucose, and a lifestyle questionnaire. They take his and thousands of other student's information and compare it to students who weren't involved in PHS, to see if it makes any difference.
After the high school, we stopped at an Ann Arbor elementary school to drop off informational booklets to a teacher who is getting more involved with the administrative side of PHS.
So, needless to say it was a very long day on that aspect. Not to mention it felt like 100 degrees outside.
So after PHS later in the evening, I attended a MHealthy Weight Management class for adults. The class I attended was all about rearranging self-talk from negative into positive, and how it can change the overall outcome.
Today's weather is supposed to be even worse. But luckily I'm not doing much traveling and will be spending the morning with one-on-one MHealthy counseling. More on that later...
22 days until graduation.
25 days until my birthday.
26 days until I start my new job!
Monday, June 6, 2011
MHealthy
MHealthy is a health and wellness promotional program for U of M staff members. This program also encompasses Project Healthy Schools, a health initiative for local schools to improve physical activity and diet choices.
My day started off by going to a staff meeting where they discussed a big health fair they're going to be doing in September and October of this year. They're going to be doing cooking demos, having lots of health stations, and raffles and prizes. After the meeting, I met with one of the coordinators for Project Healthy Schools (PHS) in which she told me about what's going to happen tomorrow. I'm going to be going to a local area school to talk with them, promote, and give samples of asparagus! I also created a handout for tomorrow which gave fun facts and recipes for asparagus, and even a word search.
For the second half of the day, I went to a PHS site to figure out logistics of a field day that MHealthy is helping to put on. It was interesting to go to the schools and see the locations that MHealthy is working at and trying to help kids build healthy diet and lifestyle habits.
Overall, I'm just ready to head back to the hospital.
24 days.
My day started off by going to a staff meeting where they discussed a big health fair they're going to be doing in September and October of this year. They're going to be doing cooking demos, having lots of health stations, and raffles and prizes. After the meeting, I met with one of the coordinators for Project Healthy Schools (PHS) in which she told me about what's going to happen tomorrow. I'm going to be going to a local area school to talk with them, promote, and give samples of asparagus! I also created a handout for tomorrow which gave fun facts and recipes for asparagus, and even a word search.
For the second half of the day, I went to a PHS site to figure out logistics of a field day that MHealthy is helping to put on. It was interesting to go to the schools and see the locations that MHealthy is working at and trying to help kids build healthy diet and lifestyle habits.
Overall, I'm just ready to head back to the hospital.
24 days.
Thursday, June 2, 2011
Not so much.
I'm ready for this week to be over.
Yesterday I worked with another RD who does general nutrition counseling as well as works in the ALS clinic. This was definitely an interesting population with varying degrees of illness. We had some patients who you'd never know they had a degenerative disease that is eventually fatal, while others were no longer verbal, on ventilators, and completely dependent on others. The RD's role in this population is to make sure they don't lose weight, especially when their intake starts to decrease. This would happen because they lose motor neurons in their throat and lose the ability to coordinate a swallow. The patients, while they may be slightly overweight, are encouraged to have high calorie and protein intake. In doing so, it will preserve their muscle and prevent excessive weight loss.
Otherwise, today I was with the ketogenic diet RD. Again, we had no patients. It's definitely frustrating as I've just (literally) sat at the computer for 8 hours today and played around on a ketogenic diet calculator. Definitely frustrating. It doesn't help that I got my written case study back today and the RD who graded it was rather harsh. Guh.
But, tomorrow I'm with the general nutrition counseling RD and it seems as though we have a wide variety of patients to see. One is an extremely obese pregnant woman and another is a man who has had bullet fragments in his abdomen for the past 10 years and is having some GI issues, which may or may not be related?
28 days. Please hurry up.
Yesterday I worked with another RD who does general nutrition counseling as well as works in the ALS clinic. This was definitely an interesting population with varying degrees of illness. We had some patients who you'd never know they had a degenerative disease that is eventually fatal, while others were no longer verbal, on ventilators, and completely dependent on others. The RD's role in this population is to make sure they don't lose weight, especially when their intake starts to decrease. This would happen because they lose motor neurons in their throat and lose the ability to coordinate a swallow. The patients, while they may be slightly overweight, are encouraged to have high calorie and protein intake. In doing so, it will preserve their muscle and prevent excessive weight loss.
Otherwise, today I was with the ketogenic diet RD. Again, we had no patients. It's definitely frustrating as I've just (literally) sat at the computer for 8 hours today and played around on a ketogenic diet calculator. Definitely frustrating. It doesn't help that I got my written case study back today and the RD who graded it was rather harsh. Guh.
But, tomorrow I'm with the general nutrition counseling RD and it seems as though we have a wide variety of patients to see. One is an extremely obese pregnant woman and another is a man who has had bullet fragments in his abdomen for the past 10 years and is having some GI issues, which may or may not be related?
28 days. Please hurry up.
Tuesday, May 31, 2011
Oh hey, heat.
Goodness gracious it's super hot outside.
And, it doesn't help that I don't have air conditioning in my car.
But, it does help that I'm back at the hospital this week and they have air conditioning there. This week I'm in the Nutrition Counseling Center working with two different RD's in two different areas. One of them works mainly with initiating and following-up with kids who are on the ketogenic diet. The other RD works mainly with patients who have ALS, or amyotrophic lateral sclerosis.
Today I worked with the RD who works with kids on the ketogenic diet. Unfortunately she pretty much has no patients this week which makes me kind of frustrated. So I'm just working with some of their nutrition programs and reading up on the ketogenic diet. If you don't remember, I also worked with a ketogenic patient my first week ever of the clinical rotation. So, luckily I've at least had some background experience with what goes on and what the diet is like. But...I'm afraid no patient interaction this week. Boo.
Tomorrow I'm working with the woman who has ALS patients. I've never worked with this patient population so I'm very excited. I'm hoping to at least have some experience with working with the patients this week, or be able to sit in on a counseling session.
Otherwise, it was SO NICE to have a three day weekend. It reminded me of the summers I used to have when I was in school. No more of those now, though! It's into the working world for me.
Speaking of working world, remember the job interview that I went on? Well, they contacted me for a second interview, but I actually turned it down. The job would be for a federal health program and making house calls to people who are using the program. While it would be a job, it's not what I want to do. I really enjoy the clinical realm and I believe that there is another job out there that will lead me to my professional goals. And anywho, I have my temporary position at U of M for the summer...yipee! It's crazy where the last 9 months have put me, I'm excited to see where the next month goes and then after that, the next 3.
30 days left...yayy!!
And, it doesn't help that I don't have air conditioning in my car.
But, it does help that I'm back at the hospital this week and they have air conditioning there. This week I'm in the Nutrition Counseling Center working with two different RD's in two different areas. One of them works mainly with initiating and following-up with kids who are on the ketogenic diet. The other RD works mainly with patients who have ALS, or amyotrophic lateral sclerosis.
Today I worked with the RD who works with kids on the ketogenic diet. Unfortunately she pretty much has no patients this week which makes me kind of frustrated. So I'm just working with some of their nutrition programs and reading up on the ketogenic diet. If you don't remember, I also worked with a ketogenic patient my first week ever of the clinical rotation. So, luckily I've at least had some background experience with what goes on and what the diet is like. But...I'm afraid no patient interaction this week. Boo.
Tomorrow I'm working with the woman who has ALS patients. I've never worked with this patient population so I'm very excited. I'm hoping to at least have some experience with working with the patients this week, or be able to sit in on a counseling session.
Otherwise, it was SO NICE to have a three day weekend. It reminded me of the summers I used to have when I was in school. No more of those now, though! It's into the working world for me.
Speaking of working world, remember the job interview that I went on? Well, they contacted me for a second interview, but I actually turned it down. The job would be for a federal health program and making house calls to people who are using the program. While it would be a job, it's not what I want to do. I really enjoy the clinical realm and I believe that there is another job out there that will lead me to my professional goals. And anywho, I have my temporary position at U of M for the summer...yipee! It's crazy where the last 9 months have put me, I'm excited to see where the next month goes and then after that, the next 3.
30 days left...yayy!!
Wednesday, May 25, 2011
Flooded.
Nope, not with homework tonight. With water. Our basement flooded. I'm taking a 2 minute break from pumping out the water.
More later.
GUH.
More later.
GUH.
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