Clinical recap

Oops, It’s been a long time since I’ve updated this blog. I’ve been a lot busier since moving on to clinical and I’ve kinda let this slide… Anyway, here’s an update on the past 5+ weeks.

I started clinical with a two week rotation through renal transplant and general medicine. I’d say it was 90% renal (+a multitude of complications) and maybe 10% general medicine. It was a tough area to start in but I’m glad I did because I’d rather tackle the tough stuff first. My first patient on my first day of clinical was a total train wreck, end stage liver disease, end stage renal failure, a post-operative ileus (his GI track temporarily froze up after surgery) and he had a few other issues going on. It was intense! But I love intense so that was great.

After a great 2 weeks on the floor, I moved on to a 2 week ICU rotation with some liver transplant patients mixed in there. That rotation was awesome, lots of tube feedings and I was able to observe a donor nephrectomy (the kidney donor’s surgery). I had to stand for over 4 hours in a freezing room but it was totally worth it to watch the doctor pull the kidney out of an incision just large enough for his hand and arm to pass through.

After the 2 weeks in the ICU I moved on to a week of out patient renal clinic, which I surprisingly enjoyed. I didn’t realize I’d like giving educations all week but it ended up being lots of fun. At first I was intimidated to give educations to patients because I wasn’t sure I could remember everything I needed to cover and do so in a cohesive manner but I’m getting more comfortable with them and have begun to enjoy doing them. I’ve given educations to adults on post-transplant nutrition and food safety, type 2 diabetes, weight loss (for kidney donation eligibility) and heart healthy eating.

Now I’m in a lengthy (about 2 months) pediatric rotation so I’m spending more time educating parents on how not to starve their children and am learning to do newly diagnosed type 1 diabetes educations. Everything is more complex and intense in peds… so of course I love it! I’ll admit that today I wanted to pull my hair out after spending over an hour trying to calculate a crazy tube feed combo only to find out that the doctor had changed the concentration of the formula earlier that morning without recording the change… which would have made it much easier to start but at that point I had to re-calculate everything and wanted to scream. I also had to learn how to dose vitamins, which is totally new to me. One great thing about peds is that the doctors not only listen to the dietitians but they rely on them (and the dietetic interns to some extent) because doctors know very little about nutrition therapy and it is very important in peds.

Anyway, I know this is a brief summary of the past 5-6 weeks so if you have any questions I’d be happy to answer them. Enjoy the holidays and good luck with internship applications!

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3 responses to “Clinical recap

  1. Wow, your life has been so exciting! Good luck with everything and very happy holidays! 🙂

  2. Glad everything has been going well!

    Happy Holidays!

  3. Hi Kim, Enjoyed reading all of your comments from the beginning through the end. I appreciate your candor! Sounds like we’ve been well prepared at Sac State for the internship experience.

    I’m meeting with the Dietetics Director today for a tour, so I wanted to have your experience fresh in my mind.

    I’m curious about the in-service training you gave to some of the kitchen staff on renal diet-what did that entail?

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