Charles River, Boston MassachusettsYesterday, in an attempt to escape the world of scrubs and sanitizer, I laced up my running shoes and walked home from the hospital. 90 minutes later I arrived at my doorstep with sagging shoulders (I think my bag gained 10 pounds along the journey), and brimming over with fresh musings about the dietetic internship. I'm currently working with the dietitian on the Surgical Intenstive Care Unit (SICU) and Medical Intensive Care Unit (MICU). Here's some thoughts.
Longfellow Bridge, looking into downtown BostonWhat's to like about the Intensive Care Units (my opinion!):
- Morning rounds. I enjoy listening to the MDs and residents talk their stuff, and it's much easier to stay updated on my patients. I like to measure my learning progress by counting the number of terms and abbreviations I don't understand. Each day the long list is shrinking!
- Complex medical conditions. Our body is smart, but so much can go wrong. Amazing pathophysiology. I want to know more.
- Calculating tube feeds and IV nutrition (TPN). This is why the doctor needs a dietitian!
Intensive Care Units, Dislikes (my opinion!):
- Minimal patient interaction. Once a patient is sedated and on a breathing machine, be prepared for a one-way conversation. *wink* But honestly, I do not like spending the entire day talking only with the medical team and family. Talking with a patient makes me feel like I am helping them.
- The limited scope of nutrition in critically ill patients. I feel silly worrying about a patient's eating when the rest of the team is working hard to keep their heart pumping, their lungs breathing, and their blood vessels open. It's frustrating, but I understand.
How does a dietitian justify his/her usefulness in the ICU, without overstepping his/her scope of practice? Do you know what I mean?
How does a dietitian assimilate to the medical plan, while also gracefully asserting his/her nutrition recommendations? Hopefully this comes with experience.
Welcome to new readers! I'm very pleased to make your acquaintance.
Cheers for Thursday,