Clinical Nutrition · Life

a day in the life

I get asked very frequently by people who are interested in becoming dietitians or who have no idea what I actually do, “So what does your day look like?” For some reason, it’s always a challenge for me to describe my day. Usually, I try to explain that every day is different, but it’s also the same. Confusing? Basically, what I mean by that is that the work flow of every day is the same, but either my patients are different, or the needs of my patients that I’m following consistently are different.

On Friday I paid extra attention what I ate to outline what my day actually looks like. So here’s Friday, from the beginning to the end 🙂

6:00 am- Wake up, get ready, pack up my lunch.

6:40 am- Out the door, drive to work. I’ve started taking the more scenic route to work because it really doesn’t take any longer and Oregon is beautiful. Plus I get better gas mileage when I’m not driving fast on the highway.

7:30 am- Arrive at work, clock in, get coffee from the cafeteria, heat up my breakfast.

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Last week I ate quiche for breakfast, so I didn’t eat until I got to work. Sometimes I eat on the road, it all depends on what I’m eating. I was HUNGRY by the time I got to to the hospital! Sometimes if I’m hungry before I leave I’ll eat at home. It all depends on the day.

7:45 am- Screen all the new patients in my units. I’m currently doing maternity leave coverage for the Intermediate Care Unit (IMCU) and the Neuro/Trauma Care Unit (NTCU). Once I have the new patients screened, then I build my list for the day and determine how many patients I have, and if I need any help.

8:00 am- Start my chart reviews and start prioritizing patients. I always see my nutrition support (enteral and parenteral nutrition) patients first and start off with a chart review in my office. Then later during the day I’ll do initial assessments and the after that, my follow up assessments. Once I finish my chart review, I head out to the floors to talk to nurses/see my patients.

10:00 am- Snack time!

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For some reason I wanted something sweet, so I went down to the cafe and bought this cereal. I snacked on it as I charted on some of my nutrition support patients.

12:30 pm- Lunch time! The RD crew always eats lunch together, which I love. It was nice on Friday so we ate our lunch outside.

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I buy my lunch about once a week at work. To me, the menu items are really affordable for what we get, but I know some people think they’re a little pricey. I usually go for one of the made to order entrees, and Friday just happened to be taco salad day! I had chips on the bottom, a pile of lettuce, shredded chicken, cheese, olives, jalapenos, salsa, and a pile of guac. I’m not a salad person at all, but I love taco salads!

This lunch was super filling and kept me full for a few hours. Lunch was full of lots of laughter on Friday, I just love my coworkers. Although it may not always be easy to work on a team, I’m lucky that there is a solid group of us that consistently collaborate, respect each other, and have each other’s backs.

1:15 pm- Return from lunch. Friday was a busy day, I didn’t actually get to start on my initial assessments until after lunch. My usual routine is to do a chart review, write down some key details, and then go speak to the patient.

One of the big roles of RDs in the hospital is identifying malnutrition. We no longer use BMI or labs like albumin as a marker of malnutrition, but instead we identify it by weight loss, poor intake, and a nutrition focused physical exam (NFPE). My initial assessments always include these components. I find myself asking “were you eating normally prior to admit?” “have you had any recent weight changes?” and “what is your usual body weight?” alllllll day long. I have learned that it’s important not to ask leading questions (“weight changes?” vs “weight loss?”) since the role of a clinical dietitian is often confusing for some people. Rapid weight loss paired with poor intake in the presence of an illness is not a good thing, and I find myself explaining that all the time to patients. I found that if I ask about weight loss, it’s mistaken as me suggesting that they need to lose weight. In the hospital, I want to see my patients maintain their weight!

I also do non-invasive NFPEs with most of my patients to assess for any muscle or fat loss. I typically looks at their clavicles, scapula, triceps, neck, and temporal muscle to determine if there is any wasting present. I’m getting much better at the NFPE, it takes a lot of practice to know what you’re looking for.

4:00 pm- I would normally be leaving work, but Friday was extra hectic, so I was still working.

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I ate my snack and continued to chart away! I had some canned tropical fruit (pineapple & papaya) with fresh strawberries.

5:15 pm- Finally able to leave work! Drive home.

6:00 pm- Arrive home. Immediately pour myself a glass of wine because of the chaos of the day.

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Not a huge fan of this sangria, but it’s not bad.

6:45 pm- Dinner!

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Cooked Trader Joe’s mini ravioli’s and mixed them with spinach & feta chicken sausage, white beans, and spinach that I had sauteed. Topped with cheese & pepper.

7:15 pm- Clean up from dinner and relax. I worked the weekend, and Friday was actually my Monday, so my evening consisted of catching up on Grey’s Anatomy (um, what is happening this season!?) and going to bed early.

9:15 pm- Bed time!

 

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