I worked at TMH's Diabetes center for one week. This was an outpatient setting. http://www.tmh.org/diabetes
The first day I came in and met my preceptor then sat in while she saw clients. I also sat in with the RN when she had clients. While with the RN, I sat in with clients who had Gestational Diabetes. That afternoon my preceptor and I saw a few pediatric patients. One pediatric patient was a new Type 1 patient. That evening I sat in on an Optifast class that the diabetes center offered. http://www.optifast.com/Pages/program.aspx
This center offers three diabetes education classes that are offered for adults who get a referral from their doctor. The second day of this rotation I attended the third diabetes education session then sat in with a dietitian all afternoon and saw clients. Tuesday evening I attended the second diabetes education session.
Wednesday I sat in on classes all day. I attended a Gestational Diabetes class in the morning followed by Diabetes Education Session 2 again. I sat in on class 2 again because I was able to teach part of it. It was a great experience to get up in front of the class and teach about food labels. After I taught the class I was able to sit in with a pediatric client with my preceptor.
Thursday I sat in on the center's case review with the endocrinologist, RN's and RD's. The rest of the morning I then sat with a dietitian and saw a few type 2 diabetes clients. That afternoon I sat with and RD who works for the Bariatric Center and saw a client who was focused on weight loss (no surgery). I stayed that night for another Optifast class that evening followed by a Diabetes Prevention Program class.
This rotation was a great experience and offered a lot of variety. It was really neat to work with so many different dietitians and see how they all council clients. I also learned a lot from attending all the classes that were offered the week I was there.
Friday, April 19, 2013
Saturday, April 13, 2013
Wakulla County Cooperative Extension Service, University of Florida
I was at Wakulla Cooperative Extension Office for two weeks.
Check out their website: http://wakulla.ifas.ufl.edu/
The Cooperative Extension Service is nationwide and was established by the Smith-Lever Act of 1914. It is a partnership between state land grant universities, the United States Department of Agriculture (USDA) and the county governments throughout the nation. All of these groups share in the planning, financing, and operation of extension programs. In Florida, the Cooperative Extension Service is administered by the University of Florida.
Wakulla County Commissioners provide support for local faculty, staff and facilities. The Wakulla County Cooperative Extension Service conducts research-based educational programs in Agriculture, Horticulture, Family & Consumer Sciences, marine interest, and 4-H Youth Development. Locally based advisory committees assure that programs are designed to meet community needs. Volunteer training is strongly emphasized in our programs to enable us to reach more of the county’s population.
These two weeks have been jammed packed with different events. The first day I attended a canning class to learn how to pressure can foods.
The next day I went to EFNEP nutrition lesson in a school. Later that day I went to an after school program where there was a guest speaker talking about electricity.
Wednesday I was not in the office as I had a makeup day for my renal rotation.
Thursday was a work from home day because my preceptor was out of the office.
Friday I attended a School Advisory Committee meeting. I found out that the extension services are now going to be promoting the USDA HealthierUS School Challenge program so we discussed this with the principle for a few minutes http://www.fns.usda.gov/tn/healthierus/.
The second week I worked on my article for a local news paper and also worked on my lesson plan that I would be giving later that week. Shelley and I then met with a farm to school coordinator and spoke about what needs to be done to get some schools into the HealthierUS School Challenge. Tuesday I was at the Tallahassee Children's Day at the Capital (separate post).
Wednesday April 10th, I went to see an EFNEP nutrition lesson in a kindergarten classroom. It was really cute how involved and excited the students were for the nutrition lesson. They learned about vegetables.
The rest of the day I prepped the food for my nutrition lesson. My lesson was given later that afternoon. I taught the nutrition lesson to elementary school students about protein and Florida Agriculture. We made salsa- a bean, tomato, and corn salsa, then a mango salsa.
Thursday I was with Shelley helping her in the kitchen. We prepared different foods for an herb workshop that evening.
Friday morning I finished my newspaper article about dehydration. I then attended an EFNEP quarterly discussion.
I really enjoyed this rotation so I managed to go back for a couple extra days. This might have been my favorite rotation.
Check out their website: http://wakulla.ifas.ufl.edu/
The Cooperative Extension Service is nationwide and was established by the Smith-Lever Act of 1914. It is a partnership between state land grant universities, the United States Department of Agriculture (USDA) and the county governments throughout the nation. All of these groups share in the planning, financing, and operation of extension programs. In Florida, the Cooperative Extension Service is administered by the University of Florida.
Wakulla County Commissioners provide support for local faculty, staff and facilities. The Wakulla County Cooperative Extension Service conducts research-based educational programs in Agriculture, Horticulture, Family & Consumer Sciences, marine interest, and 4-H Youth Development. Locally based advisory committees assure that programs are designed to meet community needs. Volunteer training is strongly emphasized in our programs to enable us to reach more of the county’s population.
These two weeks have been jammed packed with different events. The first day I attended a canning class to learn how to pressure can foods.
The next day I went to EFNEP nutrition lesson in a school. Later that day I went to an after school program where there was a guest speaker talking about electricity.
Wednesday I was not in the office as I had a makeup day for my renal rotation.
Thursday was a work from home day because my preceptor was out of the office.
Friday I attended a School Advisory Committee meeting. I found out that the extension services are now going to be promoting the USDA HealthierUS School Challenge program so we discussed this with the principle for a few minutes http://www.fns.usda.gov/tn/healthierus/.
The second week I worked on my article for a local news paper and also worked on my lesson plan that I would be giving later that week. Shelley and I then met with a farm to school coordinator and spoke about what needs to be done to get some schools into the HealthierUS School Challenge. Tuesday I was at the Tallahassee Children's Day at the Capital (separate post).
Wednesday April 10th, I went to see an EFNEP nutrition lesson in a kindergarten classroom. It was really cute how involved and excited the students were for the nutrition lesson. They learned about vegetables.
The rest of the day I prepped the food for my nutrition lesson. My lesson was given later that afternoon. I taught the nutrition lesson to elementary school students about protein and Florida Agriculture. We made salsa- a bean, tomato, and corn salsa, then a mango salsa.
Thursday I was with Shelley helping her in the kitchen. We prepared different foods for an herb workshop that evening.
Friday morning I finished my newspaper article about dehydration. I then attended an EFNEP quarterly discussion.
I really enjoyed this rotation so I managed to go back for a couple extra days. This might have been my favorite rotation.
Tallahassee Children's Day with the Florida Dairy Council
On Tuesday April 9th I worked with the Florida Dairy Council along with the Florida Dairy Farmers at the Tallahassee Children's Day at the Capital as part of Tallahassee's children's week http://www.childrensweek.org/
I arrived at 7:30 am to meet all new faces and just jump in and start serving breakfast bags. These breakfast bags were reusable 'breakfast bag' with a yoplait yogurt, a yogurt covered granola bar, a tangerine, and a chocolate milk. Breakfast was suppose to be 8-10 am, however, most children did not come until after 10 am. We gave out over 1500 bags!!! Most of the bags were pre-made the day before and held in the dairy truck, but there were bags that needed to be made during the event. There was almost nothing left at the end of the event!
At 9 am, there were some students who came and sang, then we had a milk toast. The dairy council had been told the toast was going to be 4 people and six cups were brought, but there ended up being a few more without cups. There was the President of the Florida Dairy Farmers as well as some Legislators present for this milk toast.
After we gave out all of the breakfast bags we gave out pencils. We all received free lunch- a sandwich from Nuke's. I was able to sit down with the Dairy Council employees and talk to them about working for the Dairy Council. There seems to be a lot of opportunities with them.
I worked mostly with Alyssa Greenstein, RD, LD/N, Senior Manager, Nutrition Affairs for DAIRY COUNCIL OF FLORIDA, a division of Florida Dairy Farmers.
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Wednesday, April 3, 2013
Renal Rotation
Renal rotation was at DaVita, a world wide dialysis center (http://www.davita.com/) This rotation was only Monday, Wednesday, and Friday due to those being the days clinic is open.
The Tallahassee center offers dialysis in three shifts, 6 am, 11 am, and 5 pm. They are the only one around that offers 5 pm dialysis which is great for those persons still working and cannot come during the middle of the day. This center has 24 chairs total.
The first day I met with the RD and learned about the dialysis machine and the 'fake kidney'.
The second day of this rotation I was in Perry, Florida (about an hour drive) at another DaVita dialysis location. It was a much smaller clinic with only 12 chairs and two shifts.
The dietitian talked about the effects of cancer and dialysis and she showed me their charting program. We charted on some patients together. They use a point of care note, not nutrition care process so there's no PES (problem, etiology, signs/symptoms) statements. Their charting covers why the patient was seen, what education was given and what was spoken, as well as if goals were set, met, or not met. It's mostly a lot of box clicking with minimal writing. The RD does suggest putting in comments that will make you remember the patient at a later point in time if needed.
At dialysis, the lab values of concern are Albumin, PO4, K, Ca.
The first Friday was very interesting. I was back at the Tallahassee DaVita clinic, and saw some of the same patients from Monday. I was able to sit down with two of the patients and hear their story about dialysis and how they live with it and what it's like to be in kidney failure. These patients shared their stories and experiences.
It was interesting to know that if any DaVita patients travel, DaVita's are world wide- they can set up appointments while traveling and DaVita sets the appointments. DaVita can even schedule dialysis appointments around the world even if it's not a DaVita clinic.
The following Monday I was back in Perry, FL . It was kind of a crazy morning, the doctor was there for rounds on the patients. The interaction between the patients and the doctor was pretty neat. He checked almost every patient for fluid retention in their legs/abdomen. After rounds we met with the doctor to discuss bone mineral disease and see if the medications are enough or too much for the patients related to their calcium levels.
Wednesday I was not at the rotation, I was at RD Legislature Day. (I have a separate post about this)
Friday I was back in Tallahassee and gave the patients reminders that 'big labs' were on Monday. Big Labs are when monthly labs are taken. I had to remind them to watch what they ate on Easter and to take extra binders if needed.
I went back to DaVita for my final day on Wednesday April 3rd as a make up day because I missed a day due to the Legislature Day. I went around to the patients and gave them their 'report card' for their monthly labs. Many people had high phosphorus lab values so I had to educate them on proper foods and to take binders.
The Tallahassee center offers dialysis in three shifts, 6 am, 11 am, and 5 pm. They are the only one around that offers 5 pm dialysis which is great for those persons still working and cannot come during the middle of the day. This center has 24 chairs total.
The first day I met with the RD and learned about the dialysis machine and the 'fake kidney'.
The second day of this rotation I was in Perry, Florida (about an hour drive) at another DaVita dialysis location. It was a much smaller clinic with only 12 chairs and two shifts.
The dietitian talked about the effects of cancer and dialysis and she showed me their charting program. We charted on some patients together. They use a point of care note, not nutrition care process so there's no PES (problem, etiology, signs/symptoms) statements. Their charting covers why the patient was seen, what education was given and what was spoken, as well as if goals were set, met, or not met. It's mostly a lot of box clicking with minimal writing. The RD does suggest putting in comments that will make you remember the patient at a later point in time if needed.
At dialysis, the lab values of concern are Albumin, PO4, K, Ca.
The first Friday was very interesting. I was back at the Tallahassee DaVita clinic, and saw some of the same patients from Monday. I was able to sit down with two of the patients and hear their story about dialysis and how they live with it and what it's like to be in kidney failure. These patients shared their stories and experiences.
It was interesting to know that if any DaVita patients travel, DaVita's are world wide- they can set up appointments while traveling and DaVita sets the appointments. DaVita can even schedule dialysis appointments around the world even if it's not a DaVita clinic.
The following Monday I was back in Perry, FL . It was kind of a crazy morning, the doctor was there for rounds on the patients. The interaction between the patients and the doctor was pretty neat. He checked almost every patient for fluid retention in their legs/abdomen. After rounds we met with the doctor to discuss bone mineral disease and see if the medications are enough or too much for the patients related to their calcium levels.
In Perry I made this lovely bulletin board (below)
Wednesday I was not at the rotation, I was at RD Legislature Day. (I have a separate post about this)
Friday I was back in Tallahassee and gave the patients reminders that 'big labs' were on Monday. Big Labs are when monthly labs are taken. I had to remind them to watch what they ate on Easter and to take extra binders if needed.
I went back to DaVita for my final day on Wednesday April 3rd as a make up day because I missed a day due to the Legislature Day. I went around to the patients and gave them their 'report card' for their monthly labs. Many people had high phosphorus lab values so I had to educate them on proper foods and to take binders.
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