Dietetic Internship Week 16: Nutrition Care II (Surgery)

Happy 2015!

This was my first week back from Christmas break and it was a bit of an adjustment returning to an inpatient setting once again. I’m on the surgery ward at RCH, and most of my time is spent with general surgery patients who’ve received some sort of GI surgery. There’s been a lot of new medical / surgical procedures that I needed to learn, and I’ve been trying to read up on them during my spare time.

Being in nutrition care II, the expectations of this rotation include coming up with nutrition care plans independently. This is something that’s been challenging for me throughout my NCI placements. I think part of the reason I struggle with finding an appropriate intervention is I’m not able to assess the patient’s status appropriately– I’m missing information or not realizing the clinical significance of a piece of information at hand. Sometimes it’s also hard for me to recall what exactly a patient’s nutrient requirements are for a given disease condition, so I don’t have a clear goal to work towards (knowledge gap). Part of the reason is that I’m not aware of the possible interventions available– I need to build up my reservoir of available tools and choose the most appropriate one for the given situation.

One aspect of my performance I really want to improve this week is coming up with a good intervention and backing it up with a logical rationale. To do this, I need to ask lots of questions– why questions: why am I choosing this intervention? why do I think a patient needs _____? why is this the most important nutrition problem faced by this person? When I can answer those questions… then I’m ready.

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