- Critical Care
Preceptor: Malissa Warren, RD
Location: PVAMC B1A
This rotation
introduced me to the ICU and to critical care patients. I was able to
work with a preceptor who allowed me to focus on an area of nutrition
and dietetics that I previously have had little exposure to: Enteral and
Parenteral nutrition. During this rotation I only reviewd and charted
on patients in the ICU who required a tube feeding or a TPN order. For
patient care, I not only wrote notes and made suggestions for tube
feedings, but I had multiple opportunities to consult nursing staff
about the patient status, as well as consulting with physicians on
changing diet orders.
I was also
able to participate in the ICU rounds with the other medical team
members including physicians, residents, nurses, and pharmacists. My
preceptor also collaborates with the staff at OHSU, which allowed me to
sit in on rounds at OHSU, as well as sit in on grand rounds in which the
OHSU residents and medical students present patient cases. This was a
really fascinating and interesting hour to sit in.
I was also allowed to watch an endoscopic esophagectomy and J-tube placement in the OR as well as follow-up with the patient the next day to write his new tube feeding diet order. The last day of my rotation I had the opportunity to watch two colonoscopies and an endoscopy. The gentleman undergoing the endoscopy had previously had a nissen, which was nice to be able to see from the inside. Both procedures were interesting to watch to actually see the various portions of the gastrointestinal track.
The following are two chart notes written for patients seen on this rotation:
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