This morning I was working in In Patients. We only actually saw one patient all morning which isn't a lot but I got to work on a tube feed order for the first time. There was a patient transferred to PEI last night and is now at the hospital where I am. We don't carry the type of product that she was being fed and they sent over a couple bottles of the product she was being tube fed but she wasn't being released anytime soon and there was only enough food sent over for a day or two max. I spent most of the morning finding a comparable product carried by the company that supplies my hospital and then doing all the calculations to make sure that the new product was providing enough calories and protein for her injury needs. Protein needs increase quite a bit when we're sick or injured, and she has several open wounds which made her protein requirements particularly high. Unfortunately, none of our products fit both the calorie and protein needs, so I also had to figure out how much additional protein she would need via protein powder. Once the calories and protein are figured out, we needed to make sure her fluid requirements were also being met by this tube feed, and then adjust the rate of administration accordingly. So we figured it all out so that she's getting enough calories, protein, fluids and at what rate in mL / hr it would be given to her. So fun!! I can't wait to get another tube feeding patient!
The actual patient we saw today wasn't all that exciting. We had a patient with diverticulitis, which I actually knew everything about already because I already saw an Out Patient with it, but when we went to her room to talk to her she was being wheeled away for x-rays. We normally visit about 3 people a day who are either sleeping or not in their rooms or being attended to by other hospital staff so we have to leave and come back. Sometimes we'll visit someone as many as 4 times in one day without ever actually getting to talk to them. We got lucky with our patient today though as she was in her room and ready for us to talk with her. She was being counseled on weight loss...not my favorite. But the fact that she was a mental health patient spiced things up a bit atleast!
This afternoon I went to the Diabetes Education Center for the first time and met a new preceptor. Another classmate is already placed there so we were both doing stuff together all afternoon which was nice. We saw two clients but it was kind of boring. Diabetes isn't really my most favorite topic. Specially type 2 which is essentially a weight loss consult anyways. Although I do really like how many lab values are associated with diabetes. Blood sugars, Glucose A1C etc. I like looking at lab values and being able to interpret them.
The highlight of the afternoon was the Bowel Buddy! The diabetes center often gets products sent to them to be handed out free to clients. I guess the theory is that if the client gets it for free and likes it, they might go out and buy it themselves when their free supply runs out. Makes sense. The dietitian refuses to give any one anything that she would not eat herself, regardless of how diabetic friendly the product is. Today we tried Bowel Buddy Pomegranate Bran Wafers. Sound yummy don't they? Well at first bite, they taste exactly like they sound...like sawdust. But by the end of the cookie...for those who manage to stick it out to the end..they start tasting ok. Still not fabulous but edible and somewhat pleasant. My preceptor hated them. Couldn't even finish half a cookie and was going to throw them out unless I wanted them. Free cookies? Yes please! I realize that this is a little bit pathetic. Why on earth would I want diabetic fiber cookies even if they are free? I just really hate seeing food get thrown out, and I love cookies...even the gross kind. On the bright side they have 5 grams of fiber per cookie, and only 3 grams of sugar! The recommended consumption of fiber per day for a women my age is 25 grams. So naturally I ate three of them on the drive home. The third one took a bit of good old H2O to get down though, but none the less I am very content with the giant bag of them sitting in my pantry. Bowels need buddys too.
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