I'm Sure of Ensure

The last time I was in a hospital for longer than one single day was when I had an appendectomy in the seventh grade. I missed my 11-year-old Halloween and I always blamed my appendix for the loss of treats I received that year, but I surprisingly still found comfort in that hospital and in the PEDS room I was placed in.

I have always found hospitals to be comfortable for some odd reason, and I am extremely glad that that feeling still stays. On my first day at TJ Samson Community Hospital here in Glasgow, I walked in with thoughts of "I am not ready for this at all" and "Will my preceptor think I'm ill-prepared?"

My day was immediately turned around when a small and energetic woman came to retrieve me from the employee entrance. Carrie Dean, my preceptor, is a rockstar in all the ways a dietitian can be given that title. If I could find research on how great of a dietitian and person she is I would cite every single one of those reliable sources, but for now, I'll just leave it by stating that she is the absolute best.

From having practically no clinical experience in my undergraduate career (I know that is not exactly ideal), I have learned much more in these past two weeks than I anticipated. Patient charting, reading and understanding real lab values, and dealing hands-on with the hospital's supplements/nourishments are some of the main things we have focused on these past several days.

A dietitian's best friend: Ensure. (All Ensure products, all the time!)

Juven just happens to be Carrie's favorite, so I'm including it in the picture gallery as well.

When I get to the hospital in the mornings, I grab the patient census from Carrie's office and head to the computer where I start gathering patient information and data. In the instances when we use supplements like Ensure Enlive and Juven, it's usually evident from only a few pieces of information on a patient's chart that he or she needs more specific nourishment in their diet. Some reasons why patients are given supplements are if they have a low BMI, have wound sites that are not healing, are malnourished, or if they haven't been eating the hospital's food and show low reported intakes. According to Ensure.com, each bottle of Ensure Enlive provides advanced nutrition with 20 grams of high-quality protein, 26 essential vitamins and minerals, 3 grams of fiber, and 350 calories. The shakes help maintain muscle mass and bone strength while supporting the heart, immune system, and digestion. Enlive is perfect for an elderly patient who isn't eating well and has severe malnutrition, which we see quite a lot of at TJ Samson.

Juven, from the makers of Ensure, is different than the Ensure shakes because it is a nutrition powder. It can be mixed with food, juices, or other beverages. According to Juven.com, it has been clinically shown to support wound healing in as little as 2 weeks, as it contains a blend of HMB (an amino acid metabolite), arginine, glutamine, collagen protein, antioxidants (vitamins C and E), vitamin B12, and zinc. These ingredients are key for the wound healing process. For one of our patients with a diabetic foot ulcer, we provided him with Juven three times daily with meals.

The food service branch of the hospital is who prepares the actual supplements for the patients after Carrie orders them through the computer system. All the supplements we provide are Ensure Clear, Ensure Enlive, Glucerna, Juven, Suplena, Nepro, Pulmocare, and Ensure Plus/Pre-Surgery/ and Surgery. One of these options is put on a patient's tray during meal times when ordered. It's really interesting how each of these supplements nourish the body in a different way.

I'm already able to name plenty of competencies that I can check off my list now, but an insanely important and overarching one would have to be: CRDN 1.6: Incorporate critical-thinking skills in overall practice.

There is not a day that goes by where an RD does not incorporate critical-thinking skills into everyday practice. Choosing which supplement is best suited for the patients and will provide them with the nutrition they need to heal and survive revolves around critical thinking. The picture to the right is an example of one of my patient charts with Glucerna chosen as the provided supplement.

Another competency, CRDN 2.11: Show cultural competence/sensitivity in interactions with clients, colleagues and staff, is an absolute necessity when dealing with any person in the hospital. You must learn to show sensitivity with your patients, to trust your interprofessional partners, and provide culturally appropriate healthcare and guidance to all those you treat. When going into patient rooms, there is an upmost importance to culturally and professionally educate them on nutritional issues in a way they can fully understand.

These past two weeks in my MNT rotation have been eye-opening and pivotal for me; I am endlessly appreciative of Carrie for all the time she's taken to teach me so much already.

Fortunately, this hospital stay didn't end in an appendectomy.

(Thumbs up to eight more weeks of learning here at TJ Samson!)

Reference List:

Home. (n.d.). Retrieved January 31, 2021, from https://ensure.com/nutrition-products

Juven®: Why Juven. (n.d.). Retrieved January 31, 2021, from https://juven.com/why-juven