Saturday, December 20, 2008
Butterflies
So it's happening again. But this time it's different. Even though he's 10 hrs away, I feel like he is in the same room with me sometimes. I can't really explain it and I'm sure many of you know what I mean when I mention the "butterly" feeling when I'm talking to him over the phone. But then it all gets even better when I can spend a week with him at a time! Yep, in our homeland of Kansas :). In the blustery cold winter days when we can help our dads with chores and remember the good ole days. We grew up around the same surroundings and we know the same "hang outs" and coffee shops and we never really even knew each other. I mean, we knew of each other cause we were in high schools only 15 minutes away. Not rivals really, their team sucked :). Actually don't quote me on that who am I to talk. I don't follow sports and he does, but that's probably good because if we were always together every second it wouldn't be exciting. We have a very fun thing in common - we're totally fascinating with the medical world and we talk on the subject forever I think. I ask the year 2 Med Student all my burning questions :). He has this grin on his face a lot and he has this baby face that is so adorable and I do NOT want to go back to Indy now! But alas he is coming for nearly a week for New Year's so everything is just peachy. It's exciting to think what life has in store for each of us and whether this feeling will last, I certainly hope that it does.
Wednesday, November 19, 2008
What do dietitians in hospitals actually do?
I was talking to my boss one day about hopefully obtaining some sweet clinical privileges (ordering labs, writing orders, placing feeding tubes) and she said she tried to get something by the medical executive committee at the hospital last year for the dietitians and they replied with "What do dietitians do?". Are you kidding me? Is that what the other medical professions think of us? I am here to change that, let that be a warning. Gone should be the days of dietitians sitting in their office aimlessly wading through the patient's medical record, questioning a height that seems to be 10 inches off. Get out of the office and go take a look at the guy! Get on the ward and talk to the other health care professionals. Get your face and voice out there so the doctors will respect you and realize how integral a dietitian's role can be. It blows my mind that dietitians are still paying attention to silly labs that mean nothing in the way of nutrition. And it astonishes me that they don't try to stand up for themselves. We went through the same rigorous training as a Speech Pathologist and they are a lot more respected than the profession of dietetics. It must be the nature of dietitians - don't want to step on any toes. But anyone who knows me knows that that is not the case with me at all. I will step on all the toes I have to in order to provide the best patient care possible in the end.
Like for instance.. physicians shouldn't be writing the nutrition orders. Dietitians should. Why? Because we know the evidence based practice behin the nutrition care provided to the patient. Physicians have about 1 credit hour worth of classes in all of medical school (don't quote me, but it's close) devoted to nutrition. We are the experts, not them, so we should be writing the orders. This will improve patient satisfaction and ultimately patient outcomes in the end.
Dietitians are very detail-oriented. Physicians do not have time to dwell on tiny details. Resident physicians managing the patient have to juggle every aspect of that patient's care, including what tests they must order, what procedures should be done, what services to consult, where to send them after discharge (home vs. extended care facility in the elderly for instance), NOT TO MENTION the nutrition care for the patient. They don't want to be bothered by that. They want someone do figure it out for them, like a dietitian. But the medical world has evolved that only the medical provider responsible for the patient's outcome should be privileged to write any type of order, including nutrition. But in medical school it's taught to them that nutrition "isn't their job". Yet we don't have the privileges to perform those duties. Well I'm here to say that every dietitan (who is competent) should be able to perform those duties.
And there are a lot of dietitians around the country that are doing just that. They are managing insulin orders, writing for IV nutrition and IV electrolyte replacement, ordering labs, placing feeding devices, and the list goes on. I want to be that dietitian. Then the medical community can look at the dietitian in a new light; a health care team member who can contribute to the team in a postitive light instead of having this elusive job that no one can quite grasp. I think it's silly. We go to school for a reason - to be the nutrition expert. Yet we aren't able to perform the functions that will put it to the best use. Blows my mind.
So pretty much my mission within the next 5-10 years is to garner those skills and change people's opinion about dietitians in my facility. And then hopefully take that to a more global level to impact the nutrition care provided at other health care institutions, like the VA. There won't be anyone quesitoning what the role/perceived importance of a dietitian is. They will come to the dietitian for help rather than denying him or her the privilege that should have been theirs to start with. The End.
Like for instance.. physicians shouldn't be writing the nutrition orders. Dietitians should. Why? Because we know the evidence based practice behin the nutrition care provided to the patient. Physicians have about 1 credit hour worth of classes in all of medical school (don't quote me, but it's close) devoted to nutrition. We are the experts, not them, so we should be writing the orders. This will improve patient satisfaction and ultimately patient outcomes in the end.
Dietitians are very detail-oriented. Physicians do not have time to dwell on tiny details. Resident physicians managing the patient have to juggle every aspect of that patient's care, including what tests they must order, what procedures should be done, what services to consult, where to send them after discharge (home vs. extended care facility in the elderly for instance), NOT TO MENTION the nutrition care for the patient. They don't want to be bothered by that. They want someone do figure it out for them, like a dietitian. But the medical world has evolved that only the medical provider responsible for the patient's outcome should be privileged to write any type of order, including nutrition. But in medical school it's taught to them that nutrition "isn't their job". Yet we don't have the privileges to perform those duties. Well I'm here to say that every dietitan (who is competent) should be able to perform those duties.
And there are a lot of dietitians around the country that are doing just that. They are managing insulin orders, writing for IV nutrition and IV electrolyte replacement, ordering labs, placing feeding devices, and the list goes on. I want to be that dietitian. Then the medical community can look at the dietitian in a new light; a health care team member who can contribute to the team in a postitive light instead of having this elusive job that no one can quite grasp. I think it's silly. We go to school for a reason - to be the nutrition expert. Yet we aren't able to perform the functions that will put it to the best use. Blows my mind.
So pretty much my mission within the next 5-10 years is to garner those skills and change people's opinion about dietitians in my facility. And then hopefully take that to a more global level to impact the nutrition care provided at other health care institutions, like the VA. There won't be anyone quesitoning what the role/perceived importance of a dietitian is. They will come to the dietitian for help rather than denying him or her the privilege that should have been theirs to start with. The End.
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