Friday, January 29, 2010

Health Care Trends

Many of the health care trends that will affect me are easy for me to identify currently because we are building a new facility. The thought of moving to a brand new facility with state-of-the-art equipment and space is so exciting! Part of this transition is our move to electronic medical documentation and charting. Currently, many supplements and nutrition orders that are ordered "slip through the cracks" and disappear off of the MAR because the processes in place with paper charting create challenges for Nursing when administering supplements. This is only one example of how the electronic medical documentation will affect my job and benefit our facility and our patients.

Building a new hospital in such a poor economy sounds unnecessary to some, especially in such an economy. Our CEO explained our need for a new facility in a way that made a lot of sense. She talks about the importance of physician recruitment and how small, rural hospitals struggle to recruit and retain physicians because of lack of attractions to the area, among other reasons. Rural hospitals with outdated equipment and facilities really struggle in this area. We have had success in this area recently, but this was mainly because of the plans in place to build a new hospital. She went on to explain if you can't recruit physicians then you cannot provide health care and therefore, there is no hospital and no hospital jobs. This made me realize how much this new facility will impact not only our patients or Wright Memorial employees, but our community. If we want to stay alive as a hospital, we have to be competitive with hospitals from surrounding counties. A new hospital, we hope, will give us an advantage in competition with surrounding hospitals, which means more revenue. More revenue means we can add more services to serve our patients, such as a Diabetes Center in the future, among other things.

Because health care costs will continue to rise, the number of people who are under-insured or uninsured will increase and therefore we will have more patients who will not be able to pay their bills. As a Director, when census is low, I am to flex my staff accordingly. This means that I cut the hours of my staff by a small amount in order to cut expenses.

Currently, many patients refuse my service as an outpatient because their insurance does not reimburse for nutrition counseling unless the patient is diagnosed with diabetes or renal disease. I hope that the health care reform will provide more coverage for preventative heathcare measures, which would include nutrition counseling. The new health care reform will no doubt affect us all. We will have to wait and see what all those changes will mean to us.

I was unsuccessful posting pictures and will hopefully learn to do this better in the near future.

Thursday, January 28, 2010

I am not a lunch lady!

I am the Director of Nutrition Services at Wright Memorial Hospital in my hometown of Trenton, Missouri. I have worked at WMH for about 8 months and was recently promoted to Director. WMH is a 25 bed, critical-access hospital, and I feel very fortunate to have come on board when I did because we are currently building a brand new facility and it is a great time of growth. I began my position last June as a part-time (32 hours per week) inpatient/outpatient RD. My job then grew to 40 hours per week and I became Director shortly thereafter. I never thought that I would work in the clinical setting, but it has proven to be a great fit for me. I work very well with the aging and elderly population and in our hospital, a large percentage of our patients are elderly.

I graduated from the University of Missouri in May 2008. My first job was as a Nutrition Counselor at a YMCA. This was a very challenging job, especially in a struggling economy. My second position was at a WIC clinic in the tiny town of Tuscumbia, Missouri. I loved my work there and especially love the promotion and education of breastfeeding. I only worked this position a short time because I was offered a position at my current facility.

Change is something that I have underwent a lot of recently. Change is having to adapt or implement a different attitude or process for some reason, whether it be because you chose to change or because you were forced. Fortunately, most of the changes in my recent life have been by choice and were for the better. :) I graduated in May 2008, moved into the home that I would soon share with my husband, got married in June, and passed my RD exam in August. Almost a year after graduation (after changes jobs a few times) my husband and I moved back to our hometown of Trenton, Missouri, bought a house and a puppy. Since our move, my job description has also changed a few times and I have began pursuit of my Master's Degree. In a few months, my husband and my life will change again when we become a first time aunt and uncle. My brother and his wife are expecting 1 baby, and Jordan's brother and his wife, are expecting twin girls...all to come in April. We are so excited!

A fad is a passing fashion-something that will not remain popular forever. A trend is the direction of where a concept or process tends to go over a period of time...a "where the river flows" concept. An example of a trend in my life is the direction that my husband and I are headed with our future family. We fell in love, got married and the next step in this situation tends to be kids. Someday, we hope to have children (God willing). A fad in our life right now is drinking red wine every night. We probably will not continue this fad because we are spending almost $20 extra dollars on this weekly. Someday in the future when money is more tight, we will probably give up this fad. Another fad of ours is playing Mario Brothers 3 on the Wii. :) We will eventually lose interest in this.

Being that I have only been a Dietitian for a short time, I have not yet seen a lot of change within the profession. One reputation Dietitians have had in the past is "lunch ladies" or glorified cooks. In school and in my previous 2 jobs, I was able to escape this reputation because the environments that I was in were relatively modern in their thinking. However, after moving back to a rural community and accepting a newly created position at a small hospital, I have had a lot of trouble escaping this reputation. Many of the hospital employees came up to me my first week of work and asked if I was going to miraculously improve the cafeteria menus. (I wanted to say, "Yes, by eliminating the fried foods that you so love," but I bit my tongue. ) Upon introducing myself to patients, I was referred to, "as the lady that cooks your meals." :( This was a very maddening experience for me. I did not go to school and work so hard for 4 years to be viewed in this light. I became interested in Nutrition because of my participation in athletics and competitive sports, not because I wanted to work in food service. Oh well...slowly, I have been able to change how those around me view a "Dietician." And I hope to continue to do so.

I have not underwent many changes within my profession, however there are several changes that I look forward to within my position. One being the construction of our new facility. This is a huge asset to our community and it will be amazing to have brand new, state of the art equipment and space. I also look forward to hopefully beginning a Diabetes Program in our community, which is very much a dire need.

Dietetics is an ever-changing field and I am prepared to change and adapt along with it. I hope most of these changes will be fun, but I imagine some of them will just be "part of the job." That is ok. I am determined and ready for them when they come!