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Notes from the Intern: Nutrition Support + Pediatrics

So I’m only about FIVE months behind on my “Notes from the Intern” posts. Whoops. This internship has certainly kept me busy, so bear that in mind if you’re a dietetics student looking to apply to a DI in the near future…

Anyway, let’s pick up where we left off, shall we?

Nutrition Support

When I first started this internship, I had little to no experience with nutrition support–my graduate program really included just a few lectures on the topic. Fortunately, I took an entire class devoted to nutrition support in the fall, so I was adequately prepared to be set loose in the hospital setting. I used to think calculating tubefeedings and TPN would be so complex and scary, but it’s really quite straight-forward. Easy multiplication, really. So by the time I started the nutrition support rotation, I had the skills and confidence I needed. I completed this rotation at a local VA Hospital, so the setting was a little different than my previous clinical rotations.

What I did: As you might imagine, I calculated a lot of tubefeedings and a few TPN solutions during my two weeks at the VA. The preceptor was very trusting, so she pretty much just assigned me half of her patients every morning and said, “Go at it!” So I did. I love it when my supervisors give me a little autonomy. Really, the two things that were difficult about this rotation were 1) learning a new electronic charting system, and 2) writing PES statements for every patient. (PES=problem, etiology, signs/symptoms, part of the Nutrition Care Process).

My favorite aspect: I really liked working with veterans. The nutrition support dietitian doesn’t get as much patient contact (their patients are much more likely to be on sedatives or a ventilator), but I still got the chance to do several diet educations. I’ve never laughed so much as I did in this rotation–the veterans I worked with were all so good-natured and liked to joke around. I can see myself working with this population again.

Pediatrics

I had been looking forward to my pediatrics rotation for quite some time. The children’s hospital in this area is quite well-known for its superior level of care, so I was really excited to get to be a part of the healthcare team in the facility. I spent three weeks with the pediatric renal dietitian.

What I did: The dietitian and I primarily saw patients on dialysis and those who had received a renal transplant. Unlike my other rotations, I didn’t have the ability to chart on patients on my own; I didn’t have a computer log-in for the hospital’s system. So, I didn’t really have as much independence as I did in other facilities. I did assist in the diet educations, primarily focusing on either the renal diet or on the post-transplant diet (which includes SO MUCH FLUID).

I also spent a few days in the cardiovascular intensive care unit, the eating disorder clinic, and the weight management clinic. The CVICU was an interesting experience in that I got to see several patients with rare heart defects and learn about their specific nutritional needs. It was also heart-breaking, as I witnessed parents making decisions about withdrawing life-support. Visiting the eating disorder clinic was also emotional, as it was the same clinic I visited in high school for my anorexia treatment. It was pretty surreal to be sitting in the same exam room but on the “other side;” that is, to be sitting in as part of the healthcare team rather than as a patient. The experience definitely confirmed my desire to work with the eating disorder population at some point in my career. As for the weight management clinic, I definitely got to see the opposite end of the spectrum. Childhood obesity is a very real problem and affects a lot of kids in this part of the country.

My favorite aspect: Unlike older adults, kids and their parents are a lot more interested in what the dietitian has to say–at least in my limited experience. It’s nice to feel like the patients you’re spending time with actually care that you care, if that makes any sense.

Grocery Haul of the Week

It’s been a hot minute since the last time I published a “grocery haul” post, and considering my recent enthusiasm for Aldi, today seemed like a good day to re-establish that Broccoli Hut tradition. Here’s a look at the pretty sizable haul from today:

produce

DSC_0890 

  • bananas x 14
  • pineapple
  • bell peppers x 6
  • Fuji apples x 8 (3-lb. bag)
  • broccoli crowns
  • tomatoes x 5
  • cantaloupe
  • cucumber
  • asparagus
  • organic spring mix
  • organic spinach
  • blackberries
  • mushrooms
  • cole slaw mix
  • organic baby carrots
  • avocados x 3

frozen foods + dairy + deli

DSC_0892

  • frozen wild-caught flounder filets
  • frozen strawberries
  • frozen blueberries
  • plain Greek yogurt
  • low-fat cottage cheese
  • reduced-fat shredded cheddar
  • roasted garlic hummus
  • roasted red pepper hummus
  • natural turkey
  • lactose-free milk
  • almond milk
  • reduced-sugar orange juice
  • flavored non-fat yogurts x 4 (for Seth’s lunch box)

grocery items

DSC_0894

  • whole wheat bread
  • reduced-fat wheat thins
  • roasted cashews
  • natural almonds
  • coffee
  • stevia
  • canned pumpkin puree
  • canned organic black beans
  • low-sodium canned tuna x 2
  • fruit preserves
  • creamy natural peanut butter
  • corn tortillas

That seems like an awful lot of food, but somehow Seth and I manage to eat 99% of the food I buy. Lately, I’ve been minimizing waste even more by taking any produce that’s left in the fridge on Sundays and either cooking it into a pasta sauce/soup (and freezing for future use) or cleaning and chopping it to encourage consumption ASAP.

What did you buy this week?

An Aldi Convert

This is not a promotional or sponsored post. I am genuinely so excited about my savings at Aldi that I just needed to share with my fellow health-minded foodies.

Within the past few weeks I’ve read promotional posts from a few of my favorite healthy living bloggers (e.g., Caitlin and Meghann) about the wonders of Aldi. I was impressed by the cost savings that both bloggers discussed—I’m always looking for ways to trim my grocery bill! There happens to be an Aldi very close to my house, yet I had never set foot inside. So I took the time to explore a few weeks ago.

In case the title of this post didn’t give it away: I love this store. It has a lot of the items that I shop for on a weekly basis for much, much less. I am an Aldi convert for sure. I’ve been so excited by my trips for the last two weeks that I haven’t stopped to take pictures, but I did take note of a few products that I can see myself buying on a routine basis. Here’s a sampling:

32 oz plain non-fat Greek yogurt: $3.98 at Aldi vs. $5.99 at Publix.

Friendly Farms Plain Nonfat Greek Yogurt

I go through quite a bit of Greek yogurt on a weekly basis—I snack on it, use it in smoothies, and add it as a topping for a lot of my soups. I’m glad to find a tasty version for $2 less than what I normally pay!

8 oz hummus: $1.99 at Aldi vs. $2.99 at Publix.

I also eat quite a bit of hummus. I pack it in my lunchbox pretty much daily, so I typically buy two 8 oz containers. By buying at Aldi, I save $2 each week!

64 fluid oz unsweetened almond milk: $2.49 at Aldi vs. $3.59 at Publix.

Again, I buy these in twos. Seth makes fun of me for how much almond milk I chug down in a week, but I don’t care—it’s magically delicious (in a non-Lucky Charms kind of way). The ingredients in this Aldi version are pretty much identical to my usual Silk, although the kcalories are a little higher (40 vs. 30 per cup). Buying at Aldi saves me $2.20 per week.

7 oz natural sandwich meat: $2.99 at Aldi vs. $3.99 at Publix.

SimplyNature All Natural Oven Roasted Turkey Breast

Remember when I said I would start eating poultry again? Well, that lasted about a week and a half. I’ll still eat it if that is all that is offered, but I try to avoid it. I just didn’t like the effect it had on my skin and the way I felt. I much prefer using beans and fish and my main protein sources. Anyway, I still buy turkey every week for Seth. I try to buy organic when Applegate Farms stuff goes on sale, but this is a good sub. Very few ingredients (I think I counted four: turkey, salt, honey, and water), so I feel comfortable feeding it to my husband (and sometimes the dogs…). I save $1 each week buying this at Aldi.

25 oz organic tomato sauce: $1.99 at Aldi vs. $2.99+ at Publix.

SimplyNature Organic Tomato Basil Pasta Sauce

As much as I would like to be like Ina Garten and make all my pasta sauce from scratch, it just doesn’t happen. So I buy minimally processed versions at the grocery store. Typically, I’ll stock up on Newman’s Own or Muir Glen when they go on sale at Publix, but I am quite satisfied with this organic version from Aldi. I save at least $1 each time I buy this at Aldi.

16 oz frozen wild-caught salmon: $3.99 at Aldi vs. $9.99+ at Publix.

I must admit that I buy a lot of frozen fish. It’s really convenient to have it waiting in the freezer whenever I feel like making a seafood feast. I received an e-mail from Aldi today explaining their commitment to making all their seafood sustainable (<—click for the full details on their sustainable seafood policy). Hazaa! I bought their wild-caught salmon fillets this week and made them for dinner last night. I save at least $6 each time I buy this at Aldi.

12 oz fair trade coffee: $3.99 at Aldi vs. $5.29 at Publix.

Speaking of responsible buying and selling practices, I was also impressed to see that Aldi sells fair trade coffee. Taste-wise the Publix version is probably better, but it’s hard to argue with $1.30 savings each week.

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Clearly, I could go on all day about this subject, but I’ll stop the list there. Shopping at Aldi has enabled me to go back to my pre-Birmingham grocery budget. You see, in Durham, the tax on food was a measly 2%, whereas in Birmingham it’s a whopping 10%. That difference in sales tax had an impact on our grocery budget. I tried my best to shop sales and use coupons, but I eventually just had to raise our grocery budget by about 20% (ouch!). Now that I’ve been shopping at Aldi, I’ve been able to stay within our old budget, which thrills me.

Have you ever shopped at Aldi? Where do you like to shop to get the best bargains?

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