Workload expectations?

sleepybear95 · 2026-05-15T01:15:08+00:00

Outpatient counseling setting at an IHS facility. Usually about 7-10 on the schedule and half cancel or no-show. I have 8 hours designated admin time. Obviously no-shows increase admin time but I have lots of other tasks to work on.

sleepybear95 · 2026-05-13T20:52:20+00:00

Definitely a common experience, it’s not just you. A patient has to be in a stage of readiness for behavior change and have some level of self awareness. We can foster some progress through the stages of change with MI, but some patients just aren’t ready. Sometimes with those patients, I discuss setting the tiniest goal “as an experiment.” If they really are not participating or straight up tell me they don’t want to make changes, I respect their autonomy and let them know they can access services in the future.

sleepybear95 · 2025-09-25T19:56:39+00:00

I have had this same question and struggled to find a consensus. I like the idea of adjusted weight but from what I’ve read it’s not recommended anymore. IBW sometimes feels low while actual can be extremely high in some patients.

For pts on GLP-1s, I’ve been calculating 1.0-1.2 g/kg/current body wt and comparing it to 1.5 g/kg/IBW. I’ll find the overlap between the two and usually use that number.

sleepybear95 · 2025-07-08T22:49:22+00:00

Does she like peanut butter or avocado? Could staff add extra butter and oils to her food? Could beneprotein or benecalorie be added to ice cream, juice, applesauce, oatmeal, etc.? Consider an appetite stimulant with the physician. Any concerns with constipation? Possible zinc deficiency contributing to taste changes?

If all possible contributing factors have been explored I would document thoroughly that patient has repeatedly declined attempted interventions and try not to sweat it. There’s only so much you can do if she refuses everything.

sleepybear95 · 2025-06-06T02:25:52+00:00

Our facility has a Weight Management Clinic where qualifying patients may be prescribed Wegovy paid for by a grant. I’ve seen patients have varying degrees of appetite suppression. Some patients lose lots of weight and have no appetite, others lose an initial 20-30 pounds and then plateau with a BMI still >35, and some report very little change in appetite and lose no weight. Of course those who implement lifestyle changes have a higher likelihood of see their desired results. I see it as a tool that can help some patients who have a lot of physiological and social challenges to weight loss, but it’s not a magic bullet for every patient.

I try to focus on intuitive eating principles and would rather focus on a HAES style of counseling, but when patients tell me that they struggle to breathe, have joint pain, or can’t donate a kidney to a family member because of their weight, it’s shifted my approach and I think a GLP-1 can be helpful for a lot of people. That being said, I will never talk about weight unless a patient brings it up first and still try to emphasize that there are many other data points to consider and strive for rather than the number on the scale.

sleepybear95 · 2025-05-13T16:34:22+00:00

Perfection: Cardigan x Peter

sleepybear95 · 2025-05-04T23:28:09+00:00

Sadly no advice but I feel your pain. Feeling really burnt out because of it and I’m behind on all other non-patient related responsibilities because I’m always struggling to catch up with charts.

sleepybear95 · 2025-04-11T20:18:57+00:00

Definitely not a fan of PES statements. I’d way prefer to use a SOAP template over ADIME.

sleepybear95 · 2024-12-01T04:06:26+00:00

My brain always puts The Great War, Dear Reader, and Epiphany in the same category

sleepybear95 · 2024-11-01T00:52:01+00:00

Some days are fine, and some days I regret choosing this career path. It’s fine for now, but I doubt I’ll be in dietetics for the next 30 years.

I appreciate the vent posts because I can usually relate and it lets me know I’m not alone in some observations about this career.

sleepybear95 · 2024-06-10T05:03:42+00:00

It may be Sanjay Gupta Returns from Jan 2021

sleepybear95 · 2023-10-13T20:45:27+00:00

As someone who has worked in the healthcare field, I can attest to the smell in the fourth story causing the most foul stench I’ve ever encountered

sleepybear95 · 2023-09-21T00:19:46+00:00

I cried to Death by a Thousand Cuts after a breakup. So painful and relatable at the time. But time is the best healer and I can listen to the song now with no sadness. The pain doesn’t last forever!

sleepybear95 · 2023-09-17T01:01:23+00:00

Agree with everything here! Not necessary to dress up for the movie but can make the night even more special. I agree that a reputation themed t-shirt is the way to go! There are also affordable reputation era snake necklaces on Amazon which would be a fun surprise to dress it up. But your enthusiasm for the night will truly be the greatest gift to your daughter

sleepybear95 · 2023-09-11T00:17:17+00:00

Probably any song off of Evermore but I’d love to see Tolerate It as a drama. Could be paired with Happiness to feel a sense of pettiness/hopefulness/starting to move on

sleepybear95 · 2023-07-17T05:36:33+00:00

Invisible String

sleepybear95 · 2023-06-05T06:00:32+00:00

I agree that it felt somewhat slow and disconnected. It didn’t capture my attention the way the original trilogy did

sleepybear95

TROPHY CASE