I finally started my internship. This week has been amazing. For this rotation I will be a Dietetic intern at the James Graham Brown Cancer Center! I have been blessed with such an inspiring and passionate preceptor and her name is Mrs. Loran Griffith! Every morning we get to the office around 7:30am and we check our schedule at the beginning of the day. I have my own desk and we just upgraded my laptop to a desktop computer. ![]() Mrs. Griffith is so organized and in the first week we had all of my access turned on so I could get into the cancer center, my passwords to log on to the system, and my parking lot access. In the first week we started by seeing patients and touring the facility. It’s so funny because on the first day of the internship classes were cancelled at UK due to snow and I was nervous to drive in the snow because I usually don’t in GA. I made it safely and when I got to know my preceptor during our weekly lunch chats she told me she lived in Alaska with her husband before moving to Louisville!! Talk about a lot of snow!! She said her coworkers would cross country ski to work!! I’m overjoyed and blessed to be able to experience my community rotation at a cancer center! Usually when you think of a community rotation you think YMCA and children’s nutrition. I was pleasantly surprised when I read I would be at an outpatient cancer center for my community rotation. I’m so glad my teachers saw this would be a great fit for me because I love it! I enjoy getting to talk to the patients to see how they are doing. Most of the patients at the brown cancer center have head and neck cancer, but we see different kinds of cancer everyday day including but not limited to: breast, pancreatic, liver, colon, prostate etc. It’s amazing to see the progression of chemotherapy and radiation treatment. Most patients complain of extreme burning sensations and swallowing difficulty when they have had around 10 cycles of treatment. On the outside the treatment site has a similar look to a very bad sunburn. I am glad I have the opportunity to learn more about different kinds of cancer. My nana passed away from lung cancer and we also see a lot of patients with lung cancer as well. The high amounts of head and neck cancer is due to the excessive amounts of smoking, alcohol intake, and HPV diagnoses in the area. Some people have to travel from different areas in Kentucky to come to their appointments at the Brown cancer center and they come almost every day. You can only imagine the emotional stress this can place on the patient and the families. During some of the consults with patients they can get emotional and it’s important that you recognize that they are going through so much and it’s important to listen and give them the best nutrition assessment you can! This is an example of CRDN 1.3 Justify programs, products, services and care using appropriate evidence or data. We had to give a nutrition assessment to a patient on the first day of my internship. I watched my preceptor ask all the pertinent questions regarding how the patients is feeling and if they are getting adequate nutrition. This week I counseled my first patient on my own. I had to first prep my counseling visit by getting the necessary patient background. then I had to locate where the patient was in the hospital. then I had to use the counseling skills of motivational interviewing to see why the patient had such a low BMI. This was due to thelack of taste and difficulty swallowing that comes with H&N cancer patients. I learned about cancer cachexia and how important it is to keep patient weights stable during treatment ( Buchalla, 2017). Then I had to see what I could do to help the situation by providing different nutrition supplements to help them gain weight. I had the opportunity to watch a tube feed teaching session from my preceptor to a patient with a newly placed PEG tube. She did a great job of breaking down the steps to the family of the patient. The family had a lot of questions and she provided them with a info booklet and step by step written directions regarding the care and maintenance of the tube. It’s important that the patient continue swallowing for as long as they can to keep the throat muscles strong. The PEG tube is a feeding tube that goes directly to the stomach. Another activity I had the chance to participate in was a presentation done by one of the Registered Dietitians in the area on wound care. She spoke about the importance of knowing the different stages of wound care and knowing when to increase protein in patients with wounds. The correct answer is through all the stages you want to increase protein. The healing benefits of protein really allow patients to get better faster. I had the chance to watch a laryngectomy patient have their treachoesophageal prosthesis (TEP) placed today. This tube pushes air from the windpipe to vibrate against the esophageal walls. This creates a “burpy” sound that will be the way that patient talks for the rest of their life. Lastly I had the chance to see a barium swallow test. This barium swallow test was interesting because the patient had a heated high flow nasal canula. This funnels 55 liters/min of oxygen into the patient!! If you breathe through your mouth regularly you are only taking in about a liter of oxygen. This week I did a great job at working with others in a professional setting (CRDN 2.4 Function as a member of interprofessional teams.). I would like to work on CRDN 2.8 Demonstrate negotiation skills. Competencies Fulfilled:
CRDN 1.2 Apply evidence-based guidelines, systematic reviews and scientific literature CRDN 1.3 Justify programs, products, services and care using appropriate evidence or data. CRDN 3.8 Deliver respectful, science-based answers to client questions concerning emerging trends. CRDN 2.2 Demonstrate professional writing skills in preparing professional communications. CRDN 1.1 Select indicators of program quality and/or customer service and measure achievement of objectives. CRDN 1.4 Evaluate emerging research for application in nutrition and dietetics practice. References: Buchalla , N. (2017). Computed tomography diagnosed cachexia and sarcopenia in 725 oncology patients: is nutritional screening capturing hidden malnutrition? Retrieved January 29, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/29271097
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1/30/2018 06:58:15 am
Jada,
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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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