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Wednesday, October 04, 2006

Patient Interviews

Part of being a dietitian is doing patient interviews. During the initial assessment the interview allows us to find out about eating habits, appetite and special diets of the patient before they were admitted to the hospital. We also find out about food allergies, weight changes, and problems with chewing or swallowing. In the follow-up assessments we focus on the patients tolerance of their diet in the hospital, i.e. whether they are experiencing nausea, vomiting, diarrhea or abdominal pain. We also are responsible for nutrition education, whether it is explaining what they are getting in the hospital or preparing them for when they leave. Interviews are my favorite part of the job because each patient is a different story. Some interviews are frustrating, some are very rewarding. Below are some examples of the characters that I meet during my interviews:

  1. After a patient education session on a low sodium diet, I asked the patient whether she had any questions. To which she responded, "When they lower me into the ground, I am going to lift the lid and ask, 'Can I have some salt now?'"
  2. Often times when entering a patient room, you find that that patient is sleeping. Sometimes we let them rest, sometimes we wake them up. Last week I interviewed a patient who was determined to sleep through the interview. After "waking him up" by calling his name, he answered my question and then would return to his snoring/sleeping state. After calling his name again, he would answer the next question and then return to sleep. It made me wonder whether he was just talking in his sleep or actually answering my questions.
  3. When you do get patients awake and alert and ready to talk, it is important to not take their answers for truth. For example, today I asked a patient whether they followed any special type of diet at home to which they responded, "Yes a low sodium diet." I then asked, "What types of foods do you eat at home?" To which I was informed the patients low sodium diet consisted of cup of noodle for lunch and TV dinners.
  4. Today I also learned that heavy exercise isn't necessarily defined the same for every person. The cardiac patient I was educating about a low sodium diet informed me that he didn't watch his sodium as he exercised and therefore lost a lot of sweat. For clarification I asked him how often he exercised to which he responded, "Right now, about once a week." I then asked, "What does your normal exercise routine consist of?" To which he responded, "I play golf." Hmmm.

The rewarding part of interviewing is when you get a patient who is really interested in what you have to tell them. They ask loads of questions, give examples of what they eat and suggestions for making their diet healthier. They want the handouts you provide, they read them with you and they ask questions to increase their understanding. It's when you get these patients that you feel like your education interventions might actually make a difference. As long as I keep getting one of these patients a week, I will be happy.

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