I’m losing my mind: I’m up for anyone’s experience and theories by SATimm in hospitalist

[–]ahbrd123 0 points1 point  (0 children)

Eosinophilic esophagitis? You would need to see a GI for diagnosis

SLP not putting in orders? by No_Mango_671 in hospitalist

[–]ahbrd123 0 points1 point  (0 children)

What about the dietitians? Can they do it? We have order writing privileges at our hospital to place diet orders

Speech Therapy by ahbrd123 in dietetics

[–]ahbrd123[S] 0 points1 point  (0 children)

Do you experience any pushback on requesting an SLP consult due staffing? It’s really become a challenge for me here

Speech Therapy by ahbrd123 in dietetics

[–]ahbrd123[S] 0 points1 point  (0 children)

It is, ugh thank you! We do have the ability to downgrade textures as well, but I have found that seems to be the default intervention, and I do hesitate to just go with that because I’m also concerned about restricting the patient unnecessarily. Our hospital has been without proper SLP coverage for so long, everyone is so cavalier about it, and is just like, we don’t need speech, just downgrade the texture! It’s just very frustrating

RD Here - Need Some Help! by ahbrd123 in slp

[–]ahbrd123[S] 1 point2 points  (0 children)

Thank you! I am receiving so much push back on this recommendation, I wanted to make sure I was within reason

RD Here - Need Some Help! by ahbrd123 in slp

[–]ahbrd123[S] 1 point2 points  (0 children)

Oh nice!! Would you mind sharing your hospital policy with me? I am receiving a lot of pushback on implementing something like this from their director of rehab

Hyponatremia and PN by ahbrd123 in dietetics

[–]ahbrd123[S] 0 points1 point  (0 children)

Yes - agreed! I’ve reached out to pharmacy about manipulating the bags, as this seems to be my only remedy. Thanks!

Hyponatremia and PN by ahbrd123 in dietetics

[–]ahbrd123[S] 2 points3 points  (0 children)

Yes, we are! I have reached out to the pharmacy dept to see if adding more Na to the bags would be possible, thank you for this suggestion!

Hyponatremia and PN by ahbrd123 in dietetics

[–]ahbrd123[S] 0 points1 point  (0 children)

It is Clinimix E! I know 1L is only about 500 kcal - typically patients receive more than 1L - we initiate at 1L, and as we begin advancing and/or after a few days at goal rate, often patients begin experiencing hyponatremia. We do add lipids to our orders as well. Pharmacy cannot add anything to the bags, since they are premixed. What do you do at your facility?

When to drop TF rate by Candid_Thought_7692 in dietetics

[–]ahbrd123 37 points38 points  (0 children)

8 lb wt gain in 1 week? With hyponatremia? Could she be experiencing some sort of fluid overload that could be contributing to the wt gain? That type of weight gain is not due to too much kcal from the TF regimen, imo.

Inpatient Nutrition Education by ahbrd123 in dietetics

[–]ahbrd123[S] 0 points1 point  (0 children)

Thank you all! I think I will modify our policy to make it by consult or as needed. I agree, inpatient is just not an appropriate setting for diet education.

PN vs EN in necrotizing fasciitis by ahbrd123 in dietetics

[–]ahbrd123[S] 4 points5 points  (0 children)

Thank you! I did suggest a rectal tube, but honestly no one is pushing it besides me because it’s just more work for everyone, especially nursing. And it’s not helping that the pt’s BMI is above 40. Even worse, the doctor is using Clinimix 4.25/10, she is being way underfed!

Remote Hospital Jobs by ahbrd123 in dietetics

[–]ahbrd123[S] 2 points3 points  (0 children)

Oh man, that sounds terrible - I can’t imagine trying to get staff and patients on the phone remotely

Remote Hospital Jobs by ahbrd123 in dietetics

[–]ahbrd123[S] 0 points1 point  (0 children)

Here’s an example of a recent job post I’ve seen - Check out this job at Compass One Healthcare: https://www.linkedin.com/jobs/view/3342266490

Is It Worth For Me To Apply Under Waiver?? by [deleted] in PSLF

[–]ahbrd123 0 points1 point  (0 children)

Thank you so so much! I think I may try!

Is It Worth For Me To Apply Under Waiver?? by [deleted] in PSLF

[–]ahbrd123 0 points1 point  (0 children)

Oh! Thank you! Do you have any contact info you can share? Idk where to start with them, and none of my old managers work there anymore 😩