King's Daughters Medical Center: Community Rotation, Week 7

I have finally finished up my last week of my community rotation. I say “finally”, but it went by in the blink of an eye and I can honestly say it was a very bittersweet moment for me. Working with the staff there at KDMC was a true treat and it was in an area that I love learning about: weight loss counseling, diabetes counseling, and just connecting with individuals on a 1-on-1 level. I believe if you’re going to make a real difference on someone’s life, you need to spend extensive quality time with that person and listen to their struggles.

In the last week, I was lucky enough to finally sit in on a psychiatric evaluation and the key component of that type of evaluation is simply listening. Normally, I wouldn’t have been able to sit in on these encounters but the psychiatric specialist thought this person was “normal” enough for me to tag along. The person was definitely pretty “normal”, but it was a little interesting because they had a real phobia of snakes. The specialist explained to me that this wasn’t just a common fear for this person; they had all the symptoms that would qualify their fear as a true phobia. Working with specialists like this made me realize there is so many psychological issues I may not be able to identify with an initial meeting with a patient or a client, and so a competency I want to work on is CRDN 2.6 Refer clients and patients to other professionals and services when needs are beyond individual scope of practice.

The next activity I got to partake in was analyzing about a month’s worth of a person’s food log. They were a diabetic and my preceptor wanted me to look it over and point out things she thought the patient could improve on and then turn it back into her. Throughout my 7 weeks of working with diabetics, I have started to notice some trends. The main trend is these patients tend to think carbs are “bad” and that since they are diabetic they should avoid them completely. This usually results in them opting for higher fat foods, which are also higher calories. I made sure to point out this patient was not eating enough carbohydrates at their meals and was consuming way too much saturated fat and calories in general. This combination, along with them not eating at consistent meal times throughout the day, was not going to end well if they kept doing what they were doing.

Finally, the last activity I got to do was presenting my Nutrition Presentation to the dietitians and nurses on-staff. It was extra special for me because my mom works at the hospital and she got to come down and listen to me speak. The topic was on weight loss nutrition and I got to deep dive into subject that I was already familiar with and combine them with topics we had discussed during my time at this rotation. I believe those who came to my talk were pleased with my presentation and they told me they learned a few things, which is always great. One thing I brought to their attention was the emerging research on the benefits of a high protein diet for those trying to lose weight. Antonio et al. (2014) was the first interventional study to demonstrate that consuming a hypercaloric high protein diet does not result in an increase in body fat. It showed that consuming 5.5 times (4.4g/kg/d) the recommended daily allowance of protein has no effect on body composition in resistance-trained individuals who otherwise maintain the same training regimen. I then followed this up with a paper by Møller et al. (2018) that showed a high protein diet (more than 2g/kg/d) had no effect on kidney function in pre-diabetic older adults and is completely safe to consume higher amounts of protein. They were open-minded on the subject and this made me happy that I got to share the new data with them. This led me to believe I did well on CRDN 1.4 Evaluate emerging research for application in nutrition and dietetics practice.

 

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References:

Antonio J., et al. (2014). The effects of consuming a high protein diet (4.4 g/kg/d) on body composition in resistance-trained individuals. Journal of the International Society of Sports Nutrition. 1550-2783;11-19.

Møller, G., Rikardt Andersen, J., Ritz, C., P. Silvestre, M., Navas-Carretero, S., Jalo, E., … Raben, A. (2018). Higher Protein Intake Is Not Associated with Decreased Kidney Function in Pre-Diabetic Older Adults Following a One-Year Intervention—A Preview Sub-Study. Nutrients, 10(1), 54. http://doi.org/10.3390/nu10010054