It is amazing how fast all of the weeks have passed! It is already the ⅚ week of the internship! I have 1 week left!! Time flies when you are having fun right!? :) One activity that I experienced was the Kentucky Legislative day! It was a great experience and our group had the chance to talk to Ruth Ann Palumbo! We spoke to her about House Bill 200, senate Bill 112, and the Drug screen for SNAP recipients bill. The House Bill 200 helps to provide fresh food to benefit the needy and kentucky farmers. Senate Bill 112 was important because it provides reimbursement for telehealth services, and it affects patients who have medicaid insurance. The opportunity to provide telehealth to patients who would otherwise not be able to make it to the hospital is HUGE, and health providers would get reimbursed for this. Lastly, we also spoke about the possibility of SNAP recipients being drug screened for qualification. We did not agree with this because a lot of SNAP recipients have children and we believe the children should not be affected by the possible actions of their caregivers. Ruth Palumbo agreed to vote with us on these issues and she also took a picture with us!! CRDN 1.3 Justify programs, products, services and care using appropriate evidence or data. CRDN 2.7 Apply leadership skills to achieve desired outcomes Another activity that I did this week was the presentation to breast cancer survivors! It was such a great experience. I planned for it for 2 weeks and it was very rewarding. I enjoyed being around so many inspiring and strong women. I would definitely do this again! I gave them a presentation on the ketogenic diet and breast cancer. The women were so appreciative of me giving them the information dn they were engaged throughout the entire conversation. The presentation was at the Gilda’s Club in Louisville. I would definitely go back!! CRDN 3.4 Design, implement and evaluate presentations to a target audience. CRDN 2.9 Participate in professional and community organizations. Over the last week I had the chance to have several counseling sessions with patients. It is very interesting to see how the couples interact with the strain of cancer on their relationship. After one counseling session the goal of the meeting was to change the patient's tube feed formula so that the patient will get more calories with less volume. The patients go through a lot throughout their diagnosis and treatment. After our counseling session my preceptor and I walked the couple to the elevator and the care and unconditional love shown between the couple was so amazing to see! It’s great to know that even after news that seems like it can be overwhelming people can still see the bright side of life. CRDN 2.4 Function as a member of interprofessional teams. CRDN 2.11 Show cultural competence/sensitivity in interactions with clients, colleagues and staff. CRDN 3.3 Demonstrate effective communications skills for clinical and customer services in a variety of formats and settings. CRDN 3.6 Use effective education and counseling skills to facilitate behavior change One competency that I achieved this week was CRDN 2.9 Participate in professional and community organizations. I did this by attending the competency meeting for the Registered Dietitians in the Kentucky area. This meeting was held in the University of Louisville Hospital Meeting room. One dietitian had to give a presentation and every came to support! Something new that I learned this was from a presentation that I went to for an inpatient Dietitian who works at the University of Louisville Hospital! Her name is Kathy Murakami, and she did a wonderful presentation on Chyle Leaks. A chyle leak is a milky odorless fluid from the lymph system. It is specifically lymph coming from the small intestine via the thoracic duct. My preceptor and I had a patient with a chyle leak and Kathy used the patient as a case study at the end of the presentation (Bibby, AC). CRDN 2.9 Participate in professional and community organizations. One activity that I did well was the presentation to breast cancer survivors! Competency: CRDN 3.4 Design, implement and evaluate presentations to a target audience. One activity that needs improvement is CRDN 4.9 Explain the process for coding and billing for nutrition and dietetics services to obtain reimbursement from public or private payers, fee-for-service and value-based payment systems. We talk about this sometimes when billing for tube feed formulas. I sent my first order the other day! We coordinate with LinCare/Option Care depending on patient insurance. References: Bibby AC, Maskell NA. Nutritional management in chyle leaks and chylous effusions. Br J Community Nurs. 2014 Oct; Suppl Nutrition: S6-8. doi: 10.12968/bjcn. 2014. 19, Sup11. S6. PubMed PMID:25381927.
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This week has been amazing! The first activity I did this week was a swallow study with the speech language pathologist Jen! I had to wear protective gear during the video swallow study. During the swallow study the patient couldn’t swallow without aspirating (choking). The swallow study wasn’t completed, so the patient couldn’t be cleared for a specific consistency of liquid. The next activity I completed was a counseling session with a phone interpreter. The patient required a Spanish interpreter, and the quickest interpreter was a phone call away. I remember learning about this during our counseling class! There were two phones, one for the doctor to speak in and one for the patient to speak into. It was very interesting to see how language barriers can affect health care. You could see the patient’s verbal reactions, but not understand what they were saying at that specific time. Then the interpreter listened over the phone and translated from Spanish to English. It’s also so interesting to watch the interaction. The doctor would make eye contact with the patient and then there would be a delay in the translation, and then the patient would respond. Sometimes the conversation would be delayed and the patient and the doctor would speak at the same time. If this happened the interpreter would first say the doctors response and then the patient's response. The interpreter told us she would do this in english, then she told the patient in spanish. It was a barrier in communication but everything ended up working out for the patient. It was a very serious conversation, so the patient was a little frustrated with the delay and the content of the conversation. The last activity I did was the completion of a breast cancer flyer for a breast cancer nutrition education session! I used canva and it came it came out so well! I had to put the James Graham Brown Logo at the top of the handout. In the education session the patient came to Loran’s office and wanted to know of some healthy ideas to add to her diet currently. In the session the patient was already eating a lot of health conscious foods. She just wanted to make sure she was doing the right thing in relation to her breast cancer. I made sure to tell her the importance of having smaller portions, limiting fat intake, and increasing fiber and protein. If she did this she would feel full for longer periods of time. The nutrition education session went well and I gave her the handout at the end of the session. I achieved CRDN 3.5 Develop nutrition education materials that are culturally and age appropriate and designed for the literacy level of the audience. On Monday I have my presentation to a breast cancer survivorship group. The presentation I am giving to them is about the ketogenic diet and breast cancer. The ketogenic diet is high fat, low carbs, and moderate to low protein. The group is looking to learn more about the ketogenic diet and how it affects breast cancer. The ketogenic diet was historically used to treat epilepsy in children (Champ, CE). The ketogenic diet is a very strict diet that requires a gram scale to weigh your food, and ketone urine strips to test your urine. The diet has not been approved to manage cancer by itself, but some people are very interested in learning more about it. One activity that I did well was forming a handout for the breast cancer counseling session CRDN 3.6 Use effective education and counseling skills to facilitate behavior change. One CRDN 4.10 Analyze risk in nutrition and dietetics practice. Competencies Achieved: CRDN 2.2 Demonstrate professional writing skills in preparing professional communications. CRDN 2.3 Demonstrate active participation, teamwork and contributions in group settings. CRDN 2.4 Function as a member of interprofessional teams. CRDN 3.5 Develop nutrition education materials that are culturally and age appropriate and designed for the literacy level of the audience. CRDN 3.6 Use effective education and counseling skills to facilitate behavior change CRDN 3.8 Deliver respectful, science-based answers to client questions concerning emerging trends. Sources:
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AuthorHello! My name is Jada Linton and I am Dietetic Intern at the University of Kentucky. Welcome to my blog, follow me on my journey through my internship, it is going to be exciting!! Archives
March 2018
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