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SITE SUMMARY for: Concord Hospital

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Post to your portfolio within 7 days of completing work at the site. For Community sites, team
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time.


Intern name: Claudia Gumina Date: 06/19/2014
Rotation: Clinical Preceptor: Jan Greer-Carney
Rotation dates from: March 18
th
, 2014 to: June 13
th
, 2014 Total hours: 444


1. Describe the projects and activities you completed during this experience.
During my clinical rotation, I got to screen and assess patients, design nutrition interventions for
them and follow up with the high care level ones. I also got to present for a heart wellness class on a
regular basis and design presentations and hand outs for the psychiatric unit and the patients with
diabetes. I got to observe the dietitian in different units like oncology and ICU and learn from their
techniques and interventions. Lastly, for my last 2 weeks I got to be on staff relief and be in charge of
my own floor.

2. What new knowledge was gained or new skills practiced?
I got to work with actual patients as opposed to case studies for the first time which was very
exciting and definitely a skill I had never practiced before. I think one of the skills that I gained that is
the most valuable is that I learned to communicate with the entire care team and work together
towards a patient's recovery. I got to interact with so many different people, and observe first hand
how all of their cases developed.

3. Identify the roll of the nutrition professional at this site and discuss your interactions with the
professionals and audience members at the site.
At this site, the dietetitians are the nutrition professionals and our role was to provide nutrition care
to every patient admitted that was screened as a high nutrition risk. All the dietitians at the site are
so used to having interns they are amazing at teaching and will stop to answer any of the questions
you have (which in my case, were plenty) . They let you ease into it slowly and then you get to see all
the patients you can on your own, which was great. I have to say "the audience," in this case the
patients, were hard to work with because for the most part, they were to ill to even talk about
nutrition. There were many older women who simply did not have an appetite and no matter how
much you insisted, would not eat more. When our intervention worked, it made a great difference
and it was very gratifying.

4. Were there regulations or rules at this site that were related to the Scope of Practice for Nutrition
and Dietetics, or the Code of Ethics?
Because of the setting in which we were, we had to follow all HIPPA privacy rules which concur with
the protection of cofidentiality clause in the Nutrition Code of Ethics. Similarly, we saw a wide variety
of individuals from different origins and cultures and it was relevant to treat them all objectively.

5. What did you learn about the audience / population group? What did you learn about yourself?
I learned that malnutrition is present where you least expect it. Just because a patient is obsese, does
not mean they do not have undelying nutritional problems (besides the obvious excessive fat). About
myself, I confirmed that I love getting to know my patients and now know that I would enjoy working
in other setting better.

6. Describe how you were effective with this topic or with this group. What would you do differently
in the future?
I was effective because I made sure to have a clear picture of who my patient was before I went in to
see this and this significantly helped me figure out where to direct our conversation and how to help
them best.

7. Summarize the ways that you applied wellness concepts and messages in this rotation. Discuss
whether there were any opportunities to promote sustainable food choices or address sustainability
from a food systems perspective.
I applied wellness concepts through the education that I gave patients regurlarly on different topics
like heart healthy, and consistent carbohydrate diets and the heart wellness presentations. We had a
chance to be sustainable with the amount of supplements we sent, because we could check in with
the patients and make sure the supplements were being consumed in order for them not to go to
waste like so much of the other food at the hospital.

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