Assessment: 22 y/o female, 5'6", ???#, admitted c completion of first clinical rotation. Pmhx includes community rotations, management rotations, stress, homework, stress, commuting, anger at crazy drivers. Pt states she enjoyed the hospital at which she interned and will miss the dietitians who were "real characters." Pt. confirms feeling dumb at times secondary to a senior dietitian giving her "you're dumb" looks. Pt denies any problems chewing or swallowing the generous evaluation from the dietitians. Pt reports some mouth pain from talking to so many people in one day. Estimated energy needs approx. 1200-13chocoate calories based on adjusted BEE. Educated pt on next rotation which will be more complex due to the long-term acute care nature of the environment. Informed pt that Joint Commission may visit the next hospital, so she should be on her best behavior.
Diagnosis: Increased energy needs related to being overworked and underpaid as evidenced by stack of dishes in sink.
Intervention: Nutrition Rx: anything but hospital cafeteria food, po, TID. ADAT.
Recommend transferring pt to other hospital to assess aptitude for and enjoyment of clinical dietetics field.
Thank you for this consult,
MW, dietetic intern
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