Communication Elicits Confidence

UM Baltimore Washington Medical Center (UM BWMC)

By: Anh Trinh.

Some jobs do not require communications. You perform your assigned task, submit your timesheet, and call it a day. With some jobs, you might spend most of your day watching the clock, waiting for it to hit the five o’clock mark so that you can leave. Clinical practice as a dietitian is not one of those types of jobs. Communication during my rotation helped grow my confidence.

When the clinical nutrition manager at UM Baltimore Washington Medical Center (UM BWMC) first introduced me to the dietetic team, my first impression was hospitality and friendliness. The dietitians were nice, eager, and passionate about their job. As I learned throughout this rotation experience, the dietitians consulted with each other frequently throughout the day.  They shared additional knowledge and experiences that they encountered to help better themselves and each other. There was excitement at every corner and everyday was unique at work.  We had no time to look at the clock.  Our time was spent talking to our patients, providing recommendations based on our analysis, and recording our data, conversations, and recommendations. 

An example of the dietitians working as a team was when a new patient with cerebral palsy was admitted for dislodgment of her tube feed. My preceptor and I communicated with other dietitians about her condition and worked on the best formula for her. By putting this information on the table, we discussed our experience, asked for their experiences, and validated the best course of action for the patient.  We also searched for historical records of the patient. We found a note from another dietitian with her recommendation for tube feeds and modified that to provide appropriate nutrition goals for the patient’s current needs. This is one of several examples when the team optimized communication to provide excellent nutrition recommendations and interventions to patients and their families. 

Medical Staff Seated In Circle Chatting At Case Meeting.

At UM BWMC, good communication extended beyond the dietetics team to the entire group of care providers. The dietitians attended patients’ rounds to receive updates. Whenever there were questions coming up about a patient, information was discussed between the team, including the physicians, the attending nurse, the case manager, and the dietitian. This process kept the healthcare teams on the same page and avoided miscommunications or loss of information that might result from communication through multiple channels.  I believe patients’ rounds were very helpful not only in expanding my knowledge base but also in boosting my confidence because I could ask questions or get validations from these highly trained health professionals. It was also a boost when I was able to contribute to the team. During one of the rounds, for example,  I suggested anti-diarrheal medications for a patient and the doctors and nurses agreed with my recommendation. The medication helped with the diarrhea and the patient’s condition improved.  

Reflecting on my rotation so far, I have learned the importance of teamwork and proper communication skills.  I have vastly improved my communication skill and built my confidence along with it. I have interacted effectively with my preceptors and others. Initially when I saw patients, I was nervous and worried. Sometimes, I forgot to ask questions that I needed to ask, such as nutrition history or usual body weight. This information is crucial to help make accurate assessment and recommendation.  Since then, to calm my nerves, I focused on the nutrition assessment process of talking slower, using eye contact, and listening to patients. Two-way communications are effective in gaining patients’ information and builds trust, which helps with nutrition recommendations and evaluations.  

UM BWMC has been a tremendous clinical rotation for me. I have gained valuable lessons and enhanced my dietetic knowledge. It was a practical site that allowed me to interact with different team members and patients. I learned that two-way communication is needed to gather more information from patients. It helps the team develop good treatment plans for patients during discussion rounds. I also learned that consistent communication throughout the healthcare team enables the best possible care for those patients. 

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