- Renal
Location: PVAMC Dialysis Unit, 9D
This rotation really opened my eyes to the world of renal nutrition. Although I had had some exposure to patients on dialysis or who had chronic kidney disease (CKD), this rotation allowed me to solely focus on this disease. Many of the patients I worked with had been coming to dialysis for years, and some had just started. Many of the patients also had various other comorbidities such as HTN, diabetes, CAD, etc.
I started this rotation by sitting down with Marcy, my preceptor, and going over a general schedule for the two weeks I was working with her. She also provided me with a large binder full of references, articles and great information about kidney disease, and industry standards for treating it. I also was able to shadow one of the dialysis nurses to get a better understanding of how the actual process of dialyzing worked. Throughout the rotation Marcy would take the time, an hour here or there, to help explain the details of kidney disease and how to treat it, allowing me to better understand the disease and to ask questions I had.
During the two weeks I saw various patients, most of them in the dialysis unit, only a handful of inpatients, and a couple of outpatients in the clinic. I helped Marcy to give an in-service to the renal fellows about nutrition and kidney disease, where I was able to explain the role of protein and tests to measure it. I was also able to accompany Marcy to the chemo unit, and help to teach people how to use a g-tube, and use a gravity bag for feeding.
Throughout this rotation I felt somewhat over-whelmed by all the information there was to know about renal disease. Marcy made it a lot easier and enjoyable. By the end of the rotation I felt comfortable counseling patients and talking about diet restrictions. The following are samples of my chart notes for this rotation:
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