Clinical Rotation –  Week 9 Journal

Dates of rotation: Monday – Friday (June 4, 2018 – June 8, 2018); Thursday (May 30, 2018)

Location: Harlem Hospital OB Clinic

Activities & Assignments:

Wednesday, May 30, 2018 (8:30 am – 5 pm) 8 ½ hours

• Harlem Hospital new employee orientation

Monday (9 am – 5 pm) 8 hours

• Met staff at OB Clinic and WIC Clinic
• Observed preceptor counseling sessions
  • Preceptor showed me the steps she follows when conducting assessments and follow-ups of clinic patients.
  • Preceptor gave me a paper copy of the assessment form she fills out during her sessions. I got to fill out the assessment form and do calculations (BMI, IBW, IBW %, calorie needs, macronutrient needs).
  • Some patients do not speak English, so the use of translator is needed. The most common languages patients spoke were Spanish and French.
  • Thoughts: It was interesting to observe my preceptor’s counseling style. She was compassionate and extremely knowledgeable. She is thorough while making sure that the counseling session does not go on for too long.
  • Thoughts: The patients we saw today were extremely diverse. Because of this, the way one counsels needs to be personalized for each patient.
• Preceptor showed me how to chart new assessments and follow-ups in the hospital charting system.
  • Thoughts: The charting system is very detailed especially for the initial patient assessment. Follow-up charts were much shorter and did not involve as much questions.

Tuesday (8:30 am – 5:00 pm) 8 ½ hours

• Morning team huddle
  • This is done every morning in order to inform the staff of how many patients the clinic is expecting for the day, which doctors are working, and the goals of the clinic for the day and for the week.
• Observed counseling of high-risk patients
  • Took notes and did calculations.
• Charted assessment notes for new high-risk patients of the clinic
  • Thoughts: Since high-risk patients have more issues, the assessments were more involved.

Wednesday (8:30 am – 5:00 pm) 8 ½ hours

• Charted follow-up clients from the day before
• Went through patient note cards (RD makes it for each patient as a written record) to take out the note cards for patients that have already delivered.
• Read the NY State Medicaid Prenatal Care Standards
  • Read the one that had to do with nutrition
  • Thoughts: The RD needs to follow everything that this document stated since this is the regulation stated by New York State.
• Read and summarized a study titled “Association of Gestational Weight Gain with Maternal and Infant Outcomes”
  • Made a chart that summarized results for the RD to use as reference
  • Thoughts: Every Wednesday, the RD makes sure that she is up to date with the research especially when it comes to nutrition during pregnancy.

Thursday (8:30 am – 5:00 pm) 8 ½ hours

• Staff huddle
• Observed patient counseling
  • Took assessment notes and did calculations
• Charted patient notes
• Counseled follow-up patients
  • Thoughts: It was interesting to look at the files of the patient and follow-up regarding their condition. My preceptor let me do this on my own which was an exciting learning opportunity.

Friday (8:30 am – 5:15 pm) 8 hours 45 mins

• Staff huddle
• Observed counseling of new clinic patients
  • Fridays are specifically for new patients of the clinic
  • Took notes and did calculations.
• Charted new assessments

Learning Objectives Met:

CRDN 1.1: Select indicators of program quality and/or customer service and measure achievement of objectives.

CRDN 2.1: Practice in compliance with current federal regulations and state statutes and rules, as applicable and in accordance with accreditation standards and the Scope of Nutrition and Dietetics Practice and Code of Ethics for the Profession of Nutrition and Dietetics.

CRDN 2.3: Demonstrate active participation, teamwork and contributions in group settings.

CRDN 2.4: Function as a member of interprofessional teams.

CRDN 2.5: Assign patient care activities to NDTRs and/or support personnel as appropriate.

CRDN 2.10: Demonstrate professional attributes in all areas of practice.

CRDN 3.1: Perform the Nutrition Care Process and use standardized nutrition language for individuals, groups and populations of differing ages and health status, in a variety of settings.

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.

CRDN 3.8: Deliver respectful, science-based answers to client questions concerning emerging trends.

CRDN 4.1: Participate in management of human resources.

CRDN 4.3: Conduct clinical and customer service quality management activities.

CRDN 4.10: Analyze risk in nutrition and dietetics practice.

Total Clock Hours: 50 hours 45 mins