Welcome to Medical Nutrition Therapy

(5/22-6/4) MNT

Welcome to Medical Nutrition Therapy

I have finally made it to my last and final internship rotation, Medical Nutrition Therapy (MNT). This rotation is taking place at UofL Jewish Hospital in Louisville, KY. I am utilizing AHEC as my source of housing and got lucky to be placed with Raven, an intern also from UK. We actually went to high school together in Lexington, so it was nice to see each other again and become roommates. :)

Thanks Be to the Community Rotation

Almost every dietetic student and intern looks at the MNT rotation as the scary one. I expected a fast paced, non-stop, overwhelming environment. At times, it can be overwhelming, especially in ICU rounds with the interdisciplinary team, however, MNT is not as fast paced as I thought it would be. I will say that I definitely always have something to do whether its screen patients, visit them, or chart, but fortunately, it doesn’t feel chaotic. Because I had never been in a hospital setting, I did not have many expectations in regard to the day to day schedule. Before starting MNT, I expected to interact with patients that are more alert and aware; lots of patients seem to be unalert and tired or weak. I also did not expect to get comfortable with patient interaction so quickly; I thank my community rotation for that.

After the first two weeks, MNT seems to be similar to my community rotation as far as assessing patients, interviewing/educating them, and then charting using similar content & language. Because of this, I feel more prepared for MNT than if it was before my community rotation. However, with a wide variety of sites, the similarities and differences between rotations are going to be different for everyone. If you do not have much experience in clinical nutrition and you have the opportunity, try to have MNT as one of your last rotations so you can go into it with more confidence and preparation. But overall, go into each rotation with an open mind, ready to learn more than you imagine.

Day to Day

As far as my day to day in the hospital, I arrive at 8am and leave about 4:30pm. Like mentioned earlier, the day involves screening patients before you see them to learn of the problem at hand, actually visiting the patient to see how they are tolerating the current diet, and charting on the patient to communicate with other professionals your intervention. As my preceptor says, the two most important things in clinical nutrition are patient interaction and patient intervention. You should not give an intervention before seeing the patient as reinstated by the Nutrition Care Process: Assessment, Diagnosis, Intervention, Monitor/Evaluate. Assessment requires screening the patient as well as physically talking to or visiting the patient, and then writing a diagnosis and implementing an intervention (Raymond & Morrow, 2021).

Straight to the ICU

When it comes to first day crazies, I can definitely test to it. My first day at the hospital, I witnessed two tube feed placements. I also participated in rounds in the CVICU among the interdisciplinary team. Off the bat, I was able to meet CRDN 2.4 by functioning as a member of interprofessional teams. The ICU is the floor that may be most overwhelming and distressing for some, but I have noticed with more visits and trips to the ICU, it becomes less stressful. My first week, I also saw an ileostomy bag and observed a nutrition focused physical exam. To say the least, MNT throws you in and you might just see it all within your first few weeks.

Written by Brianna Starr, UK Dietetic Intern

References

Raymond, J. L., & Morrow, K. (2021). Krause and Mahan’s: Food & the nutrition care process (15th ed.). St. Louis, Missouri: Elsevier.