Thursday, May 26, 2011

a conglomeration of randomness

First of all, thanks for the bday wishes! I now have high expectations that 26 will be even more fantastic than 25…

At the farmers’ market this past weekend, there was definitely a musician with a parrot roost attached to his bicycle. And said parrot danced to the music.

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There were so many plants and vegetables seeds that I got kind of sad because I really have no space to grow anything…and then I remembered that I kill plants anyway.

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We ate black bean burgers and drank local beer at the Upland Brewing Company. I’ve had a lot of veggie burgers, but the best ever award goes to the Northstar Cafe in Columbus, OH.

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It has rained pretty much everysingleday this month, which is awesome for white noise but not so awesome for being productive. It makes me want to drink coffee and sleep, which really don’t go together?

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You might be curious about what a clinical dietitian does all day…we usually don’t set foot in a kitchen, which is a shocker to some.

A lot of my nutrition interventions involve nutrition support, which includes enteral (tube feedings into the stomach or small intestine) or parenteral nutrition (nutrition into the veins).

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Examples of situations where enteral nutrition would be used include: a patient who can’t eat enough by mouth to meet his or her caloric needs (failure to thrive, prematurity, cardiopulmonary disorders, etc.), has problems digesting regular food, or has a neuromuscular disorder that prevents safe swallowing.

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First, we calculate estimated calorie, protein, and fluid needs. We then choose a formula based on the patient’s age and medical condition.  Next, we determine if we will feed continuously or do several bolus feeds over the course of the day. We figure out the rate per hour for the tube feeding and feeding volume.

Once these things have been decided, we monitor our patients closely to ensure they tolerate the feeds. We start off at a slower rate and gradually increase to full feeds to avoid gastrointestinal upset. Things get trickier when we have to add electrolyte supplements (sodium bicarbonate, sodium chloride, etc) to the formula and adjust based on laboratory results. Being a dietitian actually involves a lot of math!

So that’s a little slice of my day…different than what you visualized a dietitian doing in the hospital setting? Are there things about your job that people find surprising?

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11 comments:

  1. It's been raining a lot here too, and I agree, it just about depresses me! Ha, I love that the sun is finally shining today, definitely brightens the mood!

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  2. Before going to college I actually did a lot of research into becoming a dietician! There are some days I still wish I had taken that path, but I suppose I can always go back to school if I really feel the calling :)

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  3. I never thought that the job of dietician is to feed people with a tube! well.... some people are just not as lucky as we are. It's interesting that you calculate the nutrition intake of the patients in order to feed them. i wonder how you determine a person's nutritional needs? just weight and height? anything else?

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  4. you will love 26! :) i am turning 28 in 4 months, oh dear~~ hahaha. wow thanks for sharing a slice of your life as a dietitian at the hospital.

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  5. so cool to hear about what you guys do and good to know for when I go back to clinics!
    Sounds like you had a great birthday! (ps--do you have a favorite veggie burger recipe? I've bene waiting long enough to make my own!)

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  6. Emily I wouldn't be surprised if we've passed each other in the hospital sometime! I work in the child life activity rooms. :)

    I've known a bit about NG/G-tubes, but this made it even more clear. so thanks!! :)

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  7. I had always thought dietitians lectured a lot. I went to a hospital last spring to job shadow a woman RD and she showed me some of the nutritional drinks and compounds that they feed to people and I was like woah.

    I think it is really noble that RD's know HOW to feed the little babies just the right amount of food for them to survive, then thrive :) Awesome!!

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  8. Oh wow, that was a nice little review. I think I would be in serious trouble if I ever lost my job and had to become a clinical RD. I would certainly need to take a class on it again....it's been so long, I wouldn't even know where to begin!

    I'm glad you had a nice birthday. Local beer sounds deeeelicious. And I agree, NorthStar Cafe veggie burgers are simply amazing.

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  9. hello all- comments should be working again!

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  10. Hey Emily!

    I'm usually on 6 mott as well! Always on Sundays, and I'm there Mondays and Tuesdays where ever they need me (so sometimes 5, sometimes 6, and sometimes 7)! I'll be on the lookout for you :)

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  11. Most people have no idea what a nurse actually does. :) Drives me nuts!! I know I just emailed about about this (kinda), but how much input do you actually have/how much do the doctors actually listen to you? Do you feel like you're making a difference? I really feel like dietitians are put on the wayside in hospitals. Just wondering what your opinion on that is!

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