Clinical Nutrition Rotations
The total length of clinical rotations is approximately 20 weeks. Some of the rotations are completed at Geisinger Medical Center and some at Geisinger Wyoming Valley Medical Center.
This introductory rotation provides theory and practice in nutritional care for patients with cancer. Interns work with members of the Bone Marrow Transplant team, and spend time in the radiation oncology and hematology/oncology clinics to observe patients undergoing therapy. In the free-standing rehabilitation hospital on the Danville campus, interns will work with patients physically compromised by disease or surgery who require nutritional monitoring.
Interns help provide medical nutrition therapy for patients with insulin-dependent, non-insulin dependent and gestational diabetes. Interns also observe the diabetes nurse specialist as she provides care and teaches patients disease management techniques.
Interns develop skills in educating patients with hyperlipidemias and in nutrition assessment and care of patients with a variety of cardiac diseases or who have undergone open heart surgery. They also observe various cardiac diagnostic procedures and rehabilitation activities for patients with cardiac disease.
Interns participate as team members providing care to patients undergoing hemodialysis, peritoneal dialysis, or kidney transplantation. They also have the opportunity to work with children with renal disease in the pediatric renal clinic. This rotation provides practical experience in both hospital-based and free-standing dialysis units.
Interns will become familiar with gastroenterology (GI) disorders and surgical procedures and their nutritional implications. They will have opportunities to go on rounds with an enterostomal nurse specialist and observe procedures such as an endoscopy. Interns will also gain experience working with trauma patients in this rotation. Part of this rotation also includes working with patients going through bariatric surgery.
The key experiences of this rotation are providing nutritional care for patients with failure to thrive disorders, chronic conditions such as diabetes, obesity, cystic fibrosis, and those born with cardiac disease or defects. Interns gain competence in selecting infant formulas, tube feedings, and parenteral nutrition. They also have opportunities to work with the multidisciplinary feeding team, and provide outpatient counseling for children and their families.
Critical Care/Nutrition Support
In the adult intensive care unit (ICU), interns gain competence in formulating and monitoring nutritional therapy for critically ill patients, many of whom require mechanical ventilation. Interns also gain experience with tube feeding and parenteral nutrition selection, volume and rate prescription, tolerance assessment and feeding adjustment. Interns participate in multidisciplinary ICU team rounds. This rotation also includes working with the Nutrition Support team to provide care for patients on total parenteral nutrition (TPN).
Ambulatory Nutrition Services
On the Danville and Wilkes-Barre campuses, as well as at outlying medical clinics, interns have the opportunity to develop nutrition counseling and behavior modification skills in the following areas: obesity, pregnancy, diabetes, and hyperlipidemia. Interns will also work with a multidisciplinary team in a high risk obesity clinic. Patients in this clinic may be managed with medications or choose to have bariatric surgery.
To gain staff experience, each intern completes a rotation as the clinical dietitian on assigned hospital-based inpatient units.