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Arthritis Diet and Exercises

Normandale Community College Dietetic Technician Testimonial – Carol

[MUSIC] Hi, my name is
Carol Tuttoilmondo, and I became a diet
tech back in 1994 when I graduated
from Normandale. I had been a high school
home economics teacher and lost my job due to budget
cuts, which is what a lot of people are suffering
right now and so picked up
the second career. I have always had a huge
interest in nutrition. Did very well in my
undergraduate work with that and my first husband had issues
with nutrition and hypoglycemia, so I had been studying
and reading all along. I had gotten laid off one year, heard about the diet tech
program and then got rehired for my position at North High
and then got laid off again when they closed
the department down and could not find another
teaching job and remembered about the diet tech
program that I had learned about the summer
before and inquired and within two weeks’
time I was in school. So it was a very good
learning experience for me. [SILENCE] I do a
variety of things. Primarily when someone is
new I interview them to find out their food preferences –
their likes and their dislikes, what kind of nutritional
needs – I take a look at their medications,
their diagnoses, what contributing factors
there may be to a risk factor – if they have a pressure ulcer
or if they have a poor appetite, and I look at all
of those pieces and develop a care
plan for them. So I meet with the
resident initially, we meet as an interdisciplinary
team several times, we have care conferences
with the families – and so, it is a big team effort
to produce the care plan that we have because
nursing has vital information such as heights and weights and
intake recordings and whether or not they have
teeth or dentures, so there is a lot of data. It is all part of our
nutrition assessment. So, much of my day is
meeting with people, working with my
interdisciplinary teams, I have 4 floors, so I have a
variety of meetings on a variety of day, so I don’t
have any two days that are exactly
the same depending on where my care
conferences are, and when my IDT meetings
are, etc. So, it’s busy crazy,
but it works out. [SILENCE] We are
nutrition professionals. We complete a 2 year
program culminating in an associate degree
in dietetic technology. We work with registered
dieticians and when we have complex cases,
such as dialysis, tube feeding, stage IV pressure ulcers, we refer to the registered
dietician as a consultant to come up with additional
opportunities for consultation, different supplements,
different methods of treatment. We also work closely with
the wound care nurses. Actually a dietician here
and myself, we alternate when we do wound rounds, and so we work together
that way as well. [SILENCE] Well, it gives
us an indication of what the nutritional
status is. If someone is only eating
25 percent of their food and has a poor appetite, maybe
has a diagnosis of cancer which is contributing to
their lack of appetite. Then we can develop some
nutritional interventions. Six small meals,
nutritional supplements. They might have an aversion to
sweets so then we have to come up with a different
type of supplement that will give them
some higher calories that don’t taste so sweet. We also have a nutrition
intervention program which is a high calorie,
cereal, double eggs, high calorie mashed potatoes
and gravy that we provide, as well as a supplement program
that is a medication pass where we do two ounces
of supplement. So they are getting more
calories throughout the day. [SILENCE] Most of my residents are the
very elderly, 85 and over. But I do have a few residents
that are younger, in their 50s and 60s, generally there is
some significant medical issues with those younger residents, but most of my residents
are elderly. Many have dementia, many
strokes, CVAs, heart disease, many people with diabetes. [SILENCE] Well, for the most part,
I work in long term care, and in long term care we want to liberalize the diet
as much as possible. So, as much as possible, I
have people on a regular diet. Now if there are stroke
issues, swallowing issues, then speech comes in and
we modify the texture of the diet either to mechanical
soft or puree and we have levels of thickened liquids, –
nectar thick, honey thick, and occasionally, in the last
year I have had two people that have been on pudding thick. Not very common, but
when we have to because of severe swallowing issues. We also have people
on tube feedings. We also have people with
pressure ulcers and probably one of the most exciting
parts of my job is when the nutrition interventions that we do help heal those
ulcers, which is pretty amazing. [SILENCE] It is fast-paced,
it is exciting, challenging, we work with a lot more people with mental health issues
these days than we did when I initially started. So it is not just the
cute little old ladies, it’s people with significant
mental health issues, addictions. So people are sicker. And we also work with hospice,
so hospice is a good adjunct to what we do here
at the nursing home. I work later in the day. My co-workers, the dieticians,
come in earlier, and they come in about 7:30 or 8:00. I come in at 9:00,
I work until 5:30 so that there is a
little continuum so that if they are gone, I can follow
up on things that happen. But I typically come in, I
check my e-mail, I see what kind of information, check my
messages, voices messages, and then I make my list of what
I am going to do for the day. And, as I get through with
each person, I cross it off. But I do assessments,
go to IDT meetings. Tuesdays, Wednesdays and Thursdays I have care
conferences and Tuesdays in the morning and the afternoon
for two different floors – Wednesdays and Thursdays
are afternoons for two different floors, and
occasionally I get overlap or spillovers into Wednesday
and Thursday mornings. Then we have staff meetings with the clinical
nutrition staff on Mondays. And IDT meetings every day for
different floors and on the days that we have care conferences
we don’t have the IDT meeting for that particular day
because we are spending time with each other talking
about the residents. [SILENCE] Every resident
is assessed by nursing as to whether they
can be a part of part of the feeding assistant
program. In order to be a part of the feeding assistant
program they need to have non-complicated
diet, so a regular diet or a diabetic diet or
something that is a whole food or no swallowing problems. If they have had a severe
swallowing risk then nursing has to feed them. We have to go through
an 8 hour training to get this feeding
training so that we talk about different diets, we
talk about different textures, we talk about aspiration,
what it is, how to prevent it,
we talk about CPR. Speech therapy comes
in and talks more about the different
textures and modifications and why we have to do it. So it is quite a
complex training program. And you have to pass a test in
order to get the certification. [SILENCE] Working
with the residents– getting to know them. When I have a little extra time,
coming out here on the patio and visiting with them. Finding out a little bit more
about their personal lives. We have had many, many
people who have been here that have very significant
history with the history of our country. Civil rights workers,
authors, speakers, professors, people that can play the
piano and sing hymns, pastors, pastors’ wives. It is fascinating to get to know
the person, not the diagnosis. [SILENCE] State survey – even
though they point out things that we are not doing as
good as we could have, it gives us the opportunity as a
learning tool to do a better job for our residents to help
them maintain their dignity and provide the highest
quality care. [SILENCE] Actually, I don’t think right now
my job is very stressful. As a new diet tech or
as a new employee, you are always striving to do
the best job or to be perfect, and I have grown enough in age that being perfect I know
is not an achievable goal, so I do the best I can, I
set goals and I make my lists in the morning and cross
things off as I get them done. [SILENCE] A registered dietician completes
a 4 or 5 year program plus completes an internship. As a diet tech we do the 2 year
program and we have 450 hours of clinical work
that is interspersed within our classwork as well. And I help as a preceptor
with students from Normandale which is an enjoyable
experience. I like working with the students
and giving them the perspective of what happens in
long term care.

One thought on “Normandale Community College Dietetic Technician Testimonial – Carol

  1. Thank you for this video! It sealed the deal for me. Very fascinating. I start prerequisites for a program here in Orange County, CA. this Fall. I am very excited.

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