2) As usual, I’m behind at updating on my rotations…which
means I’m now restricting myself to one paragraph per rotation due to having
five (yes, five) on which to report.
To give you a better understanding of my life this semester,
we change clinical rotations each week for seven weeks this semester, which is
great due to giving lots of experiences and challenging due to switching areas
every five days. I’ll start staff relief in February (so excited!), but more on
that when it happens.
So, here are my brief synopses on my rotations as of late:
Production/Catering
This rotation was just as it sounds, with lots of hands-on
work in the kitchen, primarily due to being there during the holiday season. We
also were able to see cook-chill, a unique operation in which food is cooked,
bagged, rapidly cooled in special equipment, being then able to be safely
stored in refrigeration for a few weeks. My fellow intern and I were also able
to assist with catering functions, work on cost analysis and new ideas for daycare
menus, observe the receiving process of food items, and many other tasks (such
as pre-plating holiday meals for 500+ people. No big deal). Additionally, five
other interns and I planned, prepared, and hosted a holiday appreciation meal
event for the Food and Nutrition Services workers. Our theme was Candy Land and
it turned out splendidly. Even better, Child Life Services at the hospital are
going to use all of our decorations for the pediatric patients!
Mother’s Milk Bank of
Iowa
Each intern at UIHC has the opportunity to spend a week at the Mother’s Milk Bank of Iowa, a facility of UIHC in which donor breast milk from eligible nursing moms is procured, properly stored, pasteurized, and shipped to neonatal intensive care units and eligible infants across the Midwest. I was able to pasteurize milk, assist with packing milk for shipping, learn more about milk banks, and help “log” milk (a system for keeping record of how much milk is donated per donor, how much donor milk is on hand, etc.). Before this rotation, I didn’t realize that such operations were unique (only 11 in the United States) and governed by strict food safety protocol and contamination checks. Overall, however, I now understand how important milk banks are for infant health. The benefits of breast milk are numerous, and through MMB, premature infants (whose own mother’s milk may not have come in yet or who have inadequate milk expression for their baby’s needs) are still able to receive all of the benefits of breast milk.
Each intern at UIHC has the opportunity to spend a week at the Mother’s Milk Bank of Iowa, a facility of UIHC in which donor breast milk from eligible nursing moms is procured, properly stored, pasteurized, and shipped to neonatal intensive care units and eligible infants across the Midwest. I was able to pasteurize milk, assist with packing milk for shipping, learn more about milk banks, and help “log” milk (a system for keeping record of how much milk is donated per donor, how much donor milk is on hand, etc.). Before this rotation, I didn’t realize that such operations were unique (only 11 in the United States) and governed by strict food safety protocol and contamination checks. Overall, however, I now understand how important milk banks are for infant health. The benefits of breast milk are numerous, and through MMB, premature infants (whose own mother’s milk may not have come in yet or who have inadequate milk expression for their baby’s needs) are still able to receive all of the benefits of breast milk.
Sidenote: Please “like”
the MMB of Iowa on Facebook! Such establishments truly save lives and getting
the word out that MMBs exist is important.
Outpatient Nutrition
Clinic
My first rotation of 2013 was at the outpatient nutrition clinic, now housed at Iowa River Landing (the new outpatient clinic for the University of Iowa). Even though it was a slow week while I was there, I was still able to observe the two outpatient dietitians counsel a variety of patients. I also completed my first solo diabetic education, so I was pretty excited. J I really enjoyed seeing patients from so many different walks of life, and, as I have mentioned before, assist them in changing their lifestyles to healthier behaviors. Even though many individuals are referred to such clinics by their physician, I still feel that they are farther along in their readiness to change than someone who is recovering at the hospital, making the educations much more personal and in-depth (due to greater availability of time). Also, the outpatient dietitians are true educators, appreciated and valued by their clients. I was able to learn so much through observing and working with these R.D.s.
My first rotation of 2013 was at the outpatient nutrition clinic, now housed at Iowa River Landing (the new outpatient clinic for the University of Iowa). Even though it was a slow week while I was there, I was still able to observe the two outpatient dietitians counsel a variety of patients. I also completed my first solo diabetic education, so I was pretty excited. J I really enjoyed seeing patients from so many different walks of life, and, as I have mentioned before, assist them in changing their lifestyles to healthier behaviors. Even though many individuals are referred to such clinics by their physician, I still feel that they are farther along in their readiness to change than someone who is recovering at the hospital, making the educations much more personal and in-depth (due to greater availability of time). Also, the outpatient dietitians are true educators, appreciated and valued by their clients. I was able to learn so much through observing and working with these R.D.s.
Trauma/Burn
Definitely a switch from outpatient, but interesting nonetheless. UIHC has a specific intensive care-style unit for burn patients, in which hydrotherapy (cleaning of the wounds), excision of the wounds, etc., are all performed. Due to my naiveté, I didn’t realize the prevalence of frostbite, with my week in this unit consisting of many assessments of individual’s with TMAs (transmetatarsal [toe] amputations) and leg amputations. Also saddening, I followed some pediatric patients, who sustained burns through freak accidents and common home happenings gone wrong. Definitely an intriguing patient population, one with heightened calorie and protein needs, which is great for an R.D.! I do enjoy helping people find more foods to eat instead of encouraging moderation and restriction.
Definitely a switch from outpatient, but interesting nonetheless. UIHC has a specific intensive care-style unit for burn patients, in which hydrotherapy (cleaning of the wounds), excision of the wounds, etc., are all performed. Due to my naiveté, I didn’t realize the prevalence of frostbite, with my week in this unit consisting of many assessments of individual’s with TMAs (transmetatarsal [toe] amputations) and leg amputations. Also saddening, I followed some pediatric patients, who sustained burns through freak accidents and common home happenings gone wrong. Definitely an intriguing patient population, one with heightened calorie and protein needs, which is great for an R.D.! I do enjoy helping people find more foods to eat instead of encouraging moderation and restriction.
Neonatal Intensive
Care Unit (NICU)
I finish my NICU rotation tomorrow and truly am left in awe of what I have seen in this unit. Babies that are as young as 24 weeks gestation are admitted to this unit and treated until they are able to go home and continue normal growth and development. While most all of the infants are premature, some are also term babies who have genetic abnormalities, critical health conditions, etc. Nutrition is, obviously, a huge component of proper growth and development, making the two R.D.’s who work in this five bay, 76 bed unit an integral part of the care team. Truly, these women are absolutely phenomenal and I am beyond impressed with their clinical knowledge, judgment, and ability to assist in treating these babies. Not possessing previous exposure to premature infants, it had not occurred to me that they are unable to consume foods orally for some time (due to having immature sucking reflexes), thus necessitating enteral (into the gut, if it is medically appropriate) and/or parenteral (into the veins) nutrition support. The calculations for such recommendations are, shall we say, complicated, and so many factors must be considered that are not as critical in the world of adult nutrition. However, I have absolutely loved this rotation, probably due to its complexity and the necessity of a strong science background in order to properly assess and help treat these “kiddos” (what the patients are fondly called on the unit).
I finish my NICU rotation tomorrow and truly am left in awe of what I have seen in this unit. Babies that are as young as 24 weeks gestation are admitted to this unit and treated until they are able to go home and continue normal growth and development. While most all of the infants are premature, some are also term babies who have genetic abnormalities, critical health conditions, etc. Nutrition is, obviously, a huge component of proper growth and development, making the two R.D.’s who work in this five bay, 76 bed unit an integral part of the care team. Truly, these women are absolutely phenomenal and I am beyond impressed with their clinical knowledge, judgment, and ability to assist in treating these babies. Not possessing previous exposure to premature infants, it had not occurred to me that they are unable to consume foods orally for some time (due to having immature sucking reflexes), thus necessitating enteral (into the gut, if it is medically appropriate) and/or parenteral (into the veins) nutrition support. The calculations for such recommendations are, shall we say, complicated, and so many factors must be considered that are not as critical in the world of adult nutrition. However, I have absolutely loved this rotation, probably due to its complexity and the necessity of a strong science background in order to properly assess and help treat these “kiddos” (what the patients are fondly called on the unit).
As always, I’ve managed to bore you all to tears with my
lengthy updates. ;) Now, onwards and upwards to the pediatric intensive care
unit (PICU) next week! Oh, and, our grad classes start again this upcoming
week, too. Busy times in the life of a UIHC intern. :)
Glad to see things are going great!! I get to do some trauma coming up here soon! Wish I could have done some NICU stuff, but I did have some experience in the Pediatric ICU (PICU) and on the OB/GYN floor.
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