Wednesday, March 30, 2011
Week 2 Wednesday
This week has primarily been spent in the office preparing for the programs and I've gotten a chance to ask her more about her role. She usually schedules the programs that she visits places to do, but she schedules about a year in advance. The other county agents go into eachother's counties to do a program once a month. Today, another county came to our office to teach a Homemakers lesson on cleaning. It was very informative and we had about 3 participants. Yesterday we went to headstart again, but this time Marisa taught mothers about couponing. It was a great course, but still only 3 people attended. If people new what great free information was being given, they would come!
Monday, March 28, 2011
Week 1 Sunday
This week had a lot of variety! Every stage of life was reached through Extension; Headstart, Matter of Balance program for a retired community, and high school students. On Thursday we went to a retirement community- basically an Extended Care Facility- where Marisa and another county's extension agent wrapped up an 8 week program about exercise and safety around the home. Everyone loved the fiber information that I shared and many had great questions about lab values and specific sources of fiber.
On Friday we went to the Jessamine County HS Technical School and spoke in their child development class to 2 different groups. Marisa taught them about Facebook etiquette, online bullying, having a positive self image, and being assertive. I helped with some role playing and asked students to participate and spoke to the class. It seems like a great program to bring to high school students.
Most of the day at the office is spent doing paper work and Marisa shows me what she does to prepare for these programs and she gives me some time to work on projects.
On Friday we went to the Jessamine County HS Technical School and spoke in their child development class to 2 different groups. Marisa taught them about Facebook etiquette, online bullying, having a positive self image, and being assertive. I helped with some role playing and asked students to participate and spoke to the class. It seems like a great program to bring to high school students.
Most of the day at the office is spent doing paper work and Marisa shows me what she does to prepare for these programs and she gives me some time to work on projects.
Wednesday, March 23, 2011
Week 1 Wednesday
Cooperative Extension
I have been working with Marissa on various things like stuffing bags for the 10 year Cancer Free Cancer Coalition and planning programs that will happen in the next two weeks. Yesterday we went to Head Start for the "Leap" program and Marissa read a book to a group of kids about fruits and vegetables. The kids all loved it and learned about a lot of fruit and veggies through the alphabet. Tomorrow we are doing "Matter of Balance" with the elderly population. They usually do physical activity and give lessons. They partner with other extension agents in the area, like Anderson County. I wanted to help with it so I'm talking to them about fiber. I will be writing an article for the Jessamine paper on Kids Health next week. I'm learning that I like the variety.
I have been working with Marissa on various things like stuffing bags for the 10 year Cancer Free Cancer Coalition and planning programs that will happen in the next two weeks. Yesterday we went to Head Start for the "Leap" program and Marissa read a book to a group of kids about fruits and vegetables. The kids all loved it and learned about a lot of fruit and veggies through the alphabet. Tomorrow we are doing "Matter of Balance" with the elderly population. They usually do physical activity and give lessons. They partner with other extension agents in the area, like Anderson County. I wanted to help with it so I'm talking to them about fiber. I will be writing an article for the Jessamine paper on Kids Health next week. I'm learning that I like the variety.
Sunday, March 20, 2011
Week 5 Sunday
This has been a good rotation with the health department. Its completely different than clinical work, yet sometimes MNT and educations are needed. I struggled with telling a few mothers about their weight and child's weights this past week and I know that being comfortable with that comes with time. But its challenging to tell someone that their baby is off the growth chart. Thursday I stayed in Boyle County while Julie went to Mercer so I could help with the Womens Health Fair. I helped with registration but also talked with other health professionals from the area, including a representative of USDA that works for PACS (Pennyrile Allied Community Services). It was great to learn of more job opportunities for community nutrition that are out there.
Wednesday, March 16, 2011
Week 5-Wednesday
I'm glad you, Dr. Eliassen, were able to visit on Tuesday. I showed the bulletin board to the nurses and clerks that were able to listen in today. I went over the 2010 Dietary Guidelines and explained the handouts I put up as my inservice. Today to thank everyone for their hard work with WIC and the new changes, the director and head nurse planned a special candle lit lunch for us. We had to sing the "On top of Spaghetti" meatball song! It was great to see how the staff gets rewarded for their hard work.
Today we had another FTT, but she was already 4 years old and didn't seem that small. She did have other issues that may have been with mental development. It was The doctor had prescribed her Pediasure 2 cans/day d/t dx of FTT. I don't know the cause but she has always been very small. We ensured that she was getting the proper nutrients and said a vitamin would be beneficial also. The mother was also very slow so it became difficult to get things through to her. I'm sure the more I knew the pt and mother, the easier the communication would be.
Today we had another FTT, but she was already 4 years old and didn't seem that small. She did have other issues that may have been with mental development. It was The doctor had prescribed her Pediasure 2 cans/day d/t dx of FTT. I don't know the cause but she has always been very small. We ensured that she was getting the proper nutrients and said a vitamin would be beneficial also. The mother was also very slow so it became difficult to get things through to her. I'm sure the more I knew the pt and mother, the easier the communication would be.
Sunday, March 13, 2011
Week 4 Sunday
I officially sent in my first job application and resume to Central Baptist for a PRN position! I figure why not if thats all that becomes available. There is a position with Fayette Co HD but i'm not certain I want to jump to that yet. I'm realizing there is a lot more to the WIC position. With reports and program planning and implimentation, I want to be sure I am really interested in it first.
On Friday, we went to Frankfort for Kentucky Diabetes Network. The topic of interest was electronic medical records and being able to transform to them. The speaker mentioned there are more patients bringing their jump drives with them to appointments to have their records saved on them. I think its a great idea, but it could back up the offices until it becomes the new norm.
We started our WIC EBT card system last week, so we are getting to witness it first hand. Behind our desk, we are able to change the pts food packages if they want (minor changes) and the computer system is somewhat different so it had many people nervous.
On Friday, we went to Frankfort for Kentucky Diabetes Network. The topic of interest was electronic medical records and being able to transform to them. The speaker mentioned there are more patients bringing their jump drives with them to appointments to have their records saved on them. I think its a great idea, but it could back up the offices until it becomes the new norm.
We started our WIC EBT card system last week, so we are getting to witness it first hand. Behind our desk, we are able to change the pts food packages if they want (minor changes) and the computer system is somewhat different so it had many people nervous.
Wednesday, March 9, 2011
Week 4 Wednesday
Julie has been teaching me about the other side of her job; paperwork. We are hearing a lot about budget cuts and whether or not WIC will lose funding eventually. Many of the nurses are nervous and unsure about it. I think that nothing will happen overnight and it won't happen soon. Julie explained to me how she must keep record of all that she does here at the health department, with diabetes or with MNT. She is working on her record system right now where she must note how many people come to her classes and support groups. The program, CATALYST, is what will ensure that she can keep her funding.
On Monday, we attended a meeting for the Coordinated School Health Coalition that Julie is a part of. We discussed the epidemic of obesity/OW with children and a program to increase awareness, data collection, and education. The part that was most significant in the meeting was the budget. In order to receive the 200,000 grant they desire to put the nurses in every school, they must match it first then maintain the money after. Everyone pulled together ideas for raising the money; side small grants, fundraisors.
Yesterday evening the County Extension agent taught a Diabetes Support Group lesson on vitamins.
On Monday, we attended a meeting for the Coordinated School Health Coalition that Julie is a part of. We discussed the epidemic of obesity/OW with children and a program to increase awareness, data collection, and education. The part that was most significant in the meeting was the budget. In order to receive the 200,000 grant they desire to put the nurses in every school, they must match it first then maintain the money after. Everyone pulled together ideas for raising the money; side small grants, fundraisors.
Yesterday evening the County Extension agent taught a Diabetes Support Group lesson on vitamins.
Sunday, March 6, 2011
Week 3 Sunday
I am learning a lot about how the counseling tools we learned at BG can really be used. I've tried to listen more and soak up the patients life before I even say anything. I hope to really be able to use it in a counseling setting one day. On Thursday I gave the Sweeteners talk at a diabetes support group in Stanford. We had about 5 individuals and they came from all different prospectives. Some weren't familiar with most sweeteners, while a few used them on a regular basis.
I like this aspect of community nutrition, although Julie has stressed to me the limited time she has for it. She is fully devoted to the health department 37.5 hours a week, yet still suggested to run weight loss programs and classes. Some can be done during hours, but she is likely to still be scheduled to see patients.
I am getting really excited about my program for the project and I hope nothing falls through where I need to change it. Its focused on upcoming college students.
I like this aspect of community nutrition, although Julie has stressed to me the limited time she has for it. She is fully devoted to the health department 37.5 hours a week, yet still suggested to run weight loss programs and classes. Some can be done during hours, but she is likely to still be scheduled to see patients.
I am getting really excited about my program for the project and I hope nothing falls through where I need to change it. Its focused on upcoming college students.
Wednesday, March 2, 2011
Week 3- Wednesday
On Monday, I put up a trifold bulletin board on a table with handouts I printed from the Dairy Council of CA. The board had specific information from the new Dietary Guidelines, healthy weight loss tips that aren't "Fad diets", and healthy snacking ideas for kids, and the importance of family meals. I will be discussing the board to the staff for my inservice, hopefully next week. I am preparing for a talk I'll give tomorrow at a diabetes support group on sweeteners. Julie made the ppt a while back and I made a few edits.
As far as the project goes, there are some good statistics I retrieved from a Boyle County Assessment booklet for 2010 that the director of the health department had. Most of it is for the general population, but some had data on adolescents.
As far as the project goes, there are some good statistics I retrieved from a Boyle County Assessment booklet for 2010 that the director of the health department had. Most of it is for the general population, but some had data on adolescents.
Sunday, February 27, 2011
Week 2- Sunday
On Thursday, we had an MNT patient in for weight loss. I asked her what her weight loss goals were and she said she doesn't care about the number on the scale and just wants to be healthy for a change. It gave us a new turn on the session and thinking of the BGDDA talks, I realize the session couldve been a lot different. I really loved the topics because counseling is a passion of mine which I hope to do some day soon. With that young woman, we could have listened to her more and not given so much advice, but rather let her see her own issues in a different light enough to change them.
This upcoming week will be pretty full and assignments that I'll have this week are to put up a bulletin board Monday or Tuesday for National Nutrition Month which will have the new Dietary Guidelines on them, a article for friday for the commodities day, and a talk about sweeteners that I will give on Thursday to a group of diabetics.
This upcoming week will be pretty full and assignments that I'll have this week are to put up a bulletin board Monday or Tuesday for National Nutrition Month which will have the new Dietary Guidelines on them, a article for friday for the commodities day, and a talk about sweeteners that I will give on Thursday to a group of diabetics.
Thursday, February 24, 2011
Week 2-Wednesday
I was hesitant at first about how my WIC sessions were going, but now I feel very comfortable and I don't think I'm too behind. I completed the Commodities article that we will send out next friday for people to receive with their food. I wrote it on the new Dietary Guidelines and gave sodium levels for the general population as well as those at risk because older adults are the most common people receiving these commodities.
We have had some interesting patients including one 3 month old who was FTT. We had to refer him to Danville Peds for a quick appointment. It was really sad how small this baby was. I've learned the importance of regular and adequate sized feedings for infants through this situation. I do like the variety of patients in this rotation, it keeps things interesting.
The counselor forgot about our interview and she contacted me at the health department. So we wouldn't have to worry about that again, she decided that itd be best if I emailed her the questions. She was somewhat helpful along with the district nurse I met with Tuesday, but I'm looking forward to my other one with an Extension Agent.
We have had some interesting patients including one 3 month old who was FTT. We had to refer him to Danville Peds for a quick appointment. It was really sad how small this baby was. I've learned the importance of regular and adequate sized feedings for infants through this situation. I do like the variety of patients in this rotation, it keeps things interesting.
The counselor forgot about our interview and she contacted me at the health department. So we wouldn't have to worry about that again, she decided that itd be best if I emailed her the questions. She was somewhat helpful along with the district nurse I met with Tuesday, but I'm looking forward to my other one with an Extension Agent.
Sunday, February 20, 2011
Week 1- Sunday
On Thursday, we travelled to Mercer County Health Department and worked there for the day. Our first patient was an MNT and there are very few of them at the Boyle County Health Department. We had two total this week and the form was very extensive, including diet recall, medical history, meds, readiness to change, and labs if available. I wish I had more information to go by, but Julie said we can ask the pt all the questions if necessary. Its interesting to see some patients who don't want any education, they just want the food. Some of the patients mothers have needed the education but when asked if they'll do MNT, they usually refuse.
On friday, I did my hands experience with the coordinator who does most the follow-ups. It was a familiar client who hadn't yet had her baby. We discussed the feelings she may have post-partum and ways to combat them.
I plan to meet with the Boyle County HS Counselor tomorrow as scheduled for an interview. Hopefully she has some information on the community.
On friday, I did my hands experience with the coordinator who does most the follow-ups. It was a familiar client who hadn't yet had her baby. We discussed the feelings she may have post-partum and ways to combat them.
I plan to meet with the Boyle County HS Counselor tomorrow as scheduled for an interview. Hopefully she has some information on the community.
Wednesday, February 16, 2011
Week 1 Wednesday
We have been getting a variety of patients in for WIC certs, recerts, or follow ups for nutrition educations. The RD doesn't do many MNTs here but she suggests it with those at nutritional risk. The problem is it is more money out of the patients pocket and many of those at nutrition risk don't want to be counseled.
On my first day, Brittany and I both got our Environmental facility inspection done. We went into two city elementary schools and assessed their cafeterias and their school environment. The health department has 2 Environmental Specialists and both went along.
For WIC consults I have been calling in a few patients and asking various questions for their recertifications. The certs are more conversational that I thought they would be. I'm pretty comfortable talking with the patients, but I'm still learning what all should be asked along with the codes.
On my first day, Brittany and I both got our Environmental facility inspection done. We went into two city elementary schools and assessed their cafeterias and their school environment. The health department has 2 Environmental Specialists and both went along.
For WIC consults I have been calling in a few patients and asking various questions for their recertifications. The certs are more conversational that I thought they would be. I'm pretty comfortable talking with the patients, but I'm still learning what all should be asked along with the codes.
Sunday, February 13, 2011
Week 2
I didn't realize that I didn't post this week, I hope its okay! Everything wrapped up well at Kroger and I liked the variety. Friday we worked in the office in the morning. I had researched the ginkgo supplement for them and typed up a summary to be able to share with interested customers. So I shared that with them that morning. I found that in a very large, long term (6 year) study, they found no difference in cognitive decline in the group taking the supplement than with those taking the placebo. They get interesting questions about products or ingredients and want to be able to help them.
We also went back to the stores in the afternoon for the Grand Opening. One of the two stores had the grand prize and much advertising was used. Whereas they didnt put much emphasis on the other store. I got a chance to tell people about NuVal in both stores. Our booth was available at both. I made the display for one of the stores comparing the different products NuVal scores.
I'm glad to be getting into the health department tomorrow.
We also went back to the stores in the afternoon for the Grand Opening. One of the two stores had the grand prize and much advertising was used. Whereas they didnt put much emphasis on the other store. I got a chance to tell people about NuVal in both stores. Our booth was available at both. I made the display for one of the stores comparing the different products NuVal scores.
I'm glad to be getting into the health department tomorrow.
Sunday, February 6, 2011
Week 1- Sunday
I am looking forward to this week. We are putting up a booth at two separate Kroger stores in Lexington where we will educate customers about Nuval and any nutritional questions they may have. Amey was hoping to have some materials to give out, so I am creating one for Nuval that will be personalized for Kroger as well as easy to understand. Right now they only have a general brochure from NuVal and many of the services in the brochure are not yet at Kroger. I am also about finished completing a Gluten Free Shopping Tool as the RDs get many questions like "what CAN I eat?". Many times, those questions are left incomplete because there are many options. My tool will show the customer the ingredients to stay away from and other tips like calling the manufacturer. I'm hoping to have a lot of interaction with customers at the Grand Openings Wednesday and Thursday.
Wednesday, February 2, 2011
Week 1- Wednesday
Kroger really is a new experience all its own. I have been helping Amey plan for upcoming events and yesterday she led two grocery tours at Richmond Kroger which I attended. She introduced me to the head chef of one of the Lexington stores and many of the managers. The tour talks about the NuVal score for most food categories and how specific nutrients in those categories influence the score.
She and Leigh, the other RD covering the area have their own office in a smaller store. Tomorrow they are going to be on WKYT news at noon. They will air live around 12:30 and Amey plans to present economical nutrition tips and options at kroger along with a recipe I manipulated. We worked together on what they would talk about and the recipe. I think this line of work is really interesting because of all the variety. Looking forward to the other things coming next week.
She and Leigh, the other RD covering the area have their own office in a smaller store. Tomorrow they are going to be on WKYT news at noon. They will air live around 12:30 and Amey plans to present economical nutrition tips and options at kroger along with a recipe I manipulated. We worked together on what they would talk about and the recipe. I think this line of work is really interesting because of all the variety. Looking forward to the other things coming next week.
Friday, January 28, 2011
Week 3- Friday
This has been a good rotation and I think her schedule for me was organized and had a good amount of assignments for a supplemental rotation. I heard many comments Thursday on the bulletin board I just put up wednesday. We were paged for an education because a patient saw the bulletin board and wanted take-home information about their diet.
I can put the information for this rotation including the assignments that I did, inside the smaller rotation binder. Let me know if you would like something different.
I can put the information for this rotation including the assignments that I did, inside the smaller rotation binder. Let me know if you would like something different.
Wednesday, January 26, 2011
Week 3- Wednesday
This week has been good but I'm also sad I'll be leaving! I gave an education on Consistent Carb Diet and it was strange to see that kind of need here at the clinic. I enjoyed talking to the patient and his mother though as they were very receptive! While also dealing with his cancer it was extra important for him to be eating. I explained to him how the treatment may affect him and how it will affect his blood sugar if his eating habits aren't consistent.
Today I put up my bulletin board on Nutrition and Cancer and it looks good! Picture will be up at the end of the week.
Tomorrow I will be attending another meeting about documenting the nutrition assessment. Its neat to see how this process is beginning. More and more staff are paging Karina for consults and I'm able to do them just as she is so it's been a great experience.
The documentation process is the Nutrition Care Process yet it is a more thorough assessment because of the cancer center. It will allow her to document cancer types, treatment types, supplements... It is from ADA and diagnostic, intervention, and monitoring terms will all be listed. It would be neat to see the final product-which will be electronic.
Today I put up my bulletin board on Nutrition and Cancer and it looks good! Picture will be up at the end of the week.
Tomorrow I will be attending another meeting about documenting the nutrition assessment. Its neat to see how this process is beginning. More and more staff are paging Karina for consults and I'm able to do them just as she is so it's been a great experience.
The documentation process is the Nutrition Care Process yet it is a more thorough assessment because of the cancer center. It will allow her to document cancer types, treatment types, supplements... It is from ADA and diagnostic, intervention, and monitoring terms will all be listed. It would be neat to see the final product-which will be electronic.
Sunday, January 23, 2011
Week 2- Sunday

I have just completed an assignment for Karina and it is an education material for 2 cancer drugs. One can decrease bone mineral density (Aromasin) and the other is Taxotere, a chemotherapy with general side effects. This is for patients to see the effects of the drugs on their nutrition and ways to combat the problems. I have also enjoyed putting up a bulletin board for Nausea (see picture)and look forward to the larger bulletin board I will design this week on healthy snacks and tips during treatment. On Thursday we also gave out nutrition information and samples of supplements at a booth in the clinic.
I sat in with Karina at 2 different continuing educations. One was for research that her and colleagues attended. The other was for RD CEUs about cancer patients and the effects of treatment. It was a conference call but had many disciplines represented explaining how it can effect nutrition, dentition, skin, and overall health.
Wednesday, January 19, 2011
Week 2- Wednesday
This week has had a slow start with it being Martin Luther King Jr day on Monday, but I've gotten a chance to give some interesting educations. Today I spoke with a patient any who has lost 30 lb since April and she denied any eating problems. Her daughter was there and very helpful as she explained how her mother won't eat very much at all. I gave her education material on high calorie/protein foods and tried to explain to her the importance of eating during her cancer treatment.
Yesterday Karina and I posted a blog for the Markey Cancer Center that she regularly posts for. I know there is much concern about people getting enough Calcium and the problems that may occur during some medicinal treatments. Also I have heard about the possible cancer risk affiliated with a high casein intake. So in research I found no hard evidence on casein and blogged about the importance of calcium for strong healthy bones.
Yesterday, I also watched a paracentesis. Well, the beginning of one. I was interested in seeing how it is done and got too weak and almost passed out. This patient had a belly large enough and hard enough for triplets in the third trimester. He had a few large abdomenal tumors also so a large portion of the abdomen was tumor mass and only 2/5 liters was taken off when they thought maybe 10 would be pulled out.
Yesterday Karina and I posted a blog for the Markey Cancer Center that she regularly posts for. I know there is much concern about people getting enough Calcium and the problems that may occur during some medicinal treatments. Also I have heard about the possible cancer risk affiliated with a high casein intake. So in research I found no hard evidence on casein and blogged about the importance of calcium for strong healthy bones.
Yesterday, I also watched a paracentesis. Well, the beginning of one. I was interested in seeing how it is done and got too weak and almost passed out. This patient had a belly large enough and hard enough for triplets in the third trimester. He had a few large abdomenal tumors also so a large portion of the abdomen was tumor mass and only 2/5 liters was taken off when they thought maybe 10 would be pulled out.
Sunday, January 16, 2011
Week 1- Sunday
This has been a great experience and I'm glad a few other interns are going to be able to work here a few weeks. I'm learning about the different things Karina is doing outside of her research. The assignments she has for me are to design a small and large bulletin board in two areas of the clinic, define cancer terms/drugs and their nutritional affects, and give various educations. I enjoyed talking to a variety of patients this week about weight gain, weight loss, and nausea. I will be making education material for 2 cancer drugs and their nutritional affects to help patients deal with the problems.
Another neat aspect of this facility is I get to learn more about testing for cancer and how to read PET and CT scans. It gives me a better understanding of cancer and the affected areas in the body.
Another neat aspect of this facility is I get to learn more about testing for cancer and how to read PET and CT scans. It gives me a better understanding of cancer and the affected areas in the body.
Wednesday, January 12, 2011
First Week- Wednesday
It has been a great, new experience for me at Markey. I'm really enjoying the outpatient setting and the close relationship the RD has with the nurses and the doctors. Everyone communicates about each individual patient. The referrals for patient education by an RD are solely by way of communication. The nurses or doctors will tell the RD that they are in need of nutritional help or the RD checks the chart for nutritional risks. It is an informal system which has great potential with the clinicians in the facility.
I have been giving educations about weight gain and increasing intake as well has weight loss. There is some research that shows how fresh fruits and vegetables are protective against cancers, especially GI cancers. What we have been telling the patients is that the important thing they do is eat. Obviously with cancer patients there is concern with GI problems but also loss of appetite and taste changes. I've been discussing these with patients and giving tips on how to increase their caloric intake.
During the week I have been to 2 meetings. One was about ititiating a pilot study that wil determine the need for a nutrition team. Currently, since there is only one dietitian, they cannot adequately see all patients. The goal is to show that patients have a desire to learn about nutrition and benefit from it after the intervention educations/programs.
I have been giving educations about weight gain and increasing intake as well has weight loss. There is some research that shows how fresh fruits and vegetables are protective against cancers, especially GI cancers. What we have been telling the patients is that the important thing they do is eat. Obviously with cancer patients there is concern with GI problems but also loss of appetite and taste changes. I've been discussing these with patients and giving tips on how to increase their caloric intake.
During the week I have been to 2 meetings. One was about ititiating a pilot study that wil determine the need for a nutrition team. Currently, since there is only one dietitian, they cannot adequately see all patients. The goal is to show that patients have a desire to learn about nutrition and benefit from it after the intervention educations/programs.
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