Sunday, 18 July 2010

Renal week

Noticeboard and toys in the waiting room
This Dietetics department contains lovely people. Of course, there are things that might be improved, but on the whole, it works very well, and I am having a high quality experience on this placement. Last week was renal week, and unlike paediatric week, I've actually been almost exclusively working in renal situations.

I attended a 'Ward Round' which was remarkably similar to the one depicted in 'Doctor in the House' more than 50 years ago, with Sir Lancelot Spratt played by James Robertson Justice and Dirk Bogarde as Simon Sparrow. Except the doctor was probably in her 30's, female, and black, and she actually spoke to the patients. I thought she did a pretty good job at juggling the fairly obscure clinical jargon and the need to ensure that the patients understood what was going on. They were even offered choices, although I'm not sure what would have happened if they hadn't agreed with the option that was proposed for them.

A Dietitian on the acute hospital renal ward has fairly low status, and this is probably realistic - dialysis and controlling infection is definitely more important than a low potassium diet for these patients. Just getting them to eat enough is a challenge, because when there's something wrong with your kidneys it seems you generally feel pretty rubbish and not particularly interested in food.

I was looking forward to the outpatient clinic, where patients really rely on good dietary advice in order to avoid complications and put off the need for dialysis as long as possible. Unfortunately, outpatients were thin on the ground for some reason, and we only saw two in a morning, one needing advice on restricting potassium and the other on restricting phosphate. Obviously we were guaranteed to see patients at the Dialysis Centre, where I was able to practise my diet history taking technique, and then back on the ward for another Ward Round on Friday. Different doctor in charge, but same attention to communicating with the patients.

Renal week overall lesson for the future: if you like cheese, chocolate and tomatoes as much as I do, then try to look after your kidneys. This means keeping your blood pressure under control, and make sure you manage your blood sugar properly too if you have diabetes.

In between long days trying to hone my skills at writing concise dietetic notes in records, J and I went out after work for a pizza with some of the team. When the time came to split the bill, there was a little bit of cash left over - most of it went towards the department tea and coffee kitty, but they made J and me take a £1 refund. This was most thoughtful - after all, we're not being paid for our labours. J has been having a hard time with her shared accommodation as well, so an evening out in such good company was quite lovely.

Healthy Lunchbox poster detailThankfully the office has been cooler since the weather broke this week, although it's still hot enough to wear sleeveless vests. J and I finished our Healthy Lunchbox noticeboard, and it's now displayed in all its glory in the Children's Waiting Area. Click on the small image if you want a version that you can enlarge and read.

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