Wednesday, July 9, 2014

Pester makes Profession

So just to refresh your memory (and mine! It has truly been a whirlwind), I ended my employment in Los Angeles, moved cross country, idled in unemployment, started employment at a small hospital outside Atlanta, resigned, and now! have been working about 3 weeks in a new Atlanta inpatient dietitian position.
It was exactly the position I wanted when I left California. And really, there were only two positions of this kind: Academic hospital, inpatient, GI surgery.
Done&Done&Done.
I'll have a dietetic intern soon.
I'll start adjunct teaching at a state university soon! In a very cool department focused on culinary arts, hospitality, sustainability and exercise science.
It's like all my goals of inpatient GI surgery, teaching, hippy dippy culinary/sustainability and exercise science are blending. Who would have thought that could happen...? You really can get what you want. Exhale...
Pester, study, pester some more and there you have it! What you want. Or what you think you want anyways. This is America, I tell ya!

My dear friend/old coworker at the University of Southern California posted an article from the Hospitalist regarding Medicare/Medicaid decision to allow dietitians to order therapeutic diets for hospital patients.

Issued by the Centers for Medicare & Medicaid Services, the revised rule enables RDs to "operate at the top of their license," says hospitalist Melissa Parkhurst, MD, FHM, medical director of the Nutrition Support Service at the University of Kansas Hospital in Kansas City, who says she's in favor of the change.

Reentering this 100% inpatient clinical world, it feels good to be given a bit more control.
Or rather, not have to call a big time doctor when a 90#, 90 year old isn't eating much on fat and sodium restricted diet.
I mean really...Who would?
At 90 years old, give me a lobster roll, banana bread, froyo and wine. Let me be in the hospital as a happy woman.
Even if you have to blend it all up, shove a tube down my nose and bolus it into my belly. Just make me happy. Bowel obstruction or not.

It seems slow but even since I started this career just 5 years ago, I have already seen the advancement of paper to electronic charts. From not being able to order nutritional supplements to ordering them without permission from a doctor. From recommending tube feed to outright ordering them after a consult. Now the therapeutic diet is a hold up...and really so is a multivitamin...but things are coming along!
I just find it interesting that I had/will have less resistance compiling and initiating a solution to feed through someones vein that could render immediate harm if done incorrectly than liberalizing a diet order to regular. Wacky...

And I'm coming along too. It's been a wacky, wacky road. And I'm sure there is more wacky in store for me. But at least for now, I feel a tiny bit more stable. I said tiny.
And I'm ready to come along.
Or the pestering will continue! Good thing I have a good network of RDs running around this nation.