Environment is Everything

The VA hosts many medical students, interns, and residents.  Because of this educational environment, this site is little different than other non-teaching hospitals.  Being a medical student is surely overwhelming at times; in the hospital environment there is so much pressure to know everything about everything.  These students/interns/residents as a result are very open to suggestions from other medical concentrations, such as nursing staff or dietitians.  I have observed a few instances where a VA dietitian has a recommendation and simply goes to seek out whatever “team” is responsible for that patient, communicating their point of view.  The team members (who are the doctors-in-training) are often very receptive and immediately respond to that advice.  Going on rounds utilized a lot of interdisciplinary input as well.  Even as an intern, I felt really connected to the patients plan of care and what was going on.

Just the overall “feel” of the VA is great too.  It may not be the most extravagant or fancy building in Baltimore, but the friendliness of the staff is hard to beat.  Everyone says hi in the hallways, asking “how are you doing?” and actually wanting to know.  Like I said previously, I was not sure what to expect, and the patient population is a lot different than at my original hospital, but I really like it here.  A job in the government sounds like a great option for me, personally.  Also, I have a large appreciation for the armed forces because of my personal family background, so working for the veteran population would be very rewarding.

Yesterday was another inpatient day.  It went very well for the most part.  One of my tasks was to give a diabetes education to a newly diagnosed veteran.  I have given tons of educations before so I wasn’t too worried, but this particular patient proved to be a little difficult. I could tell he was not taking his diagnosis well and he didn’t know much about diet or have any desire to change his, so he was not very receptive to anything I was saying.  As a result, I choked a little, and the dietitian that was with me had to step in and help me out.  As terrible as it made me feel afterwards, I’m glad I had that experience.  This is my 10th week in a hospital and for the most part, everything has gone pretty smoothly with only a few bumps in the road.  However, I AM just an intern and I still have a lot to learn.  Interacting with all kinds of patients and adapting to different personalities/situations is good exposure for me to be prepared in the future.  Because of this individual experience, I will be better equipped for other difficult patient interactions.

This morning I will be with a dietitian who works in outpatient oncology, meeting with patients who are undergoing cancer treatment.  These patients often have special needs, such as coping with the side effects of chemotherapy or radiation (nausea, vomiting, mouth sores, weight loss, etc).  After that, I will get to sit in on a few more classes.  I can’t believe tomorrow is my last day at the VA!


2 responses to “Environment is Everything

  1. Pingback: Mi Futuro en Nutrición | Mission: Dietitian

  2. There is certainly a lot to learn about this topic.
    I love all of the points you have made.

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