Graduating from college with a nutrition degree in my hand and a full-time job scheduled into my planner, I really thought I could change the world. Okay, maybe not the world, but at least some lives. Walking into a nursing home my first day as a diet tech, in my navy work pants and ironed button down, I was ready to make a difference in a place that seemed full of sadness.
I had studied all the lab values and memorized formulas to estimate energy needs, and even studied the best approaches to healing pressure ulcers among the elderly. I quickly learned that to succeed in this healthcare setting I would need more than a B+ in Organic Chemistry and an A in Human Disease.
One of my main responsibilities is to complete initial nutrition assessments on the sub-acute rehab unit. This unit has primarily alert patients who can answer my questions about food preferences and remember how much they weigh. But, as Forrest Gump says, “You never know what you’re gonna get.” I entered the day room on the unit and found Mr. Chance* snuggled up in a white sheet sitting in his wheelchair. I had noted from his chart that he came from the hospital s/p (status-post) a hip fracture.
“Hello, sir, I’m Elizabeth, the diet tech here… I work with the food,” I yelled loudly, as the chart also noted he was HOH (hard of hearing). He looked at me and smiled and said, “I like food.” I asked him what kind of food he likes. Typically, I get complaints about how awful the dinner was or that breakfast was cold. But, instead, this patient frowned and said, “You know, you live your whole life knowing what you like to eat and drink and then one day a pretty girl like you asks me what I like… and I don’t know. I can’t remember.” I smiled and realized that this particular chocolate in the box was missing a couple nuts.
I wrote an assessment note for the admission, estimated his needs, calculated his BMI, and recommended a multivitamin and an Ensure shake. This is far from changing lives, I thought. Every afternoon I would walk down to the unit and see Mr. Chance in his wheelchair and I would bring him a cup of juice. For Ms. Homes, I would give two saltine crackers; make Ms. Orkin a cup of tea with milk and three sugars, and Ms. Green would get a chocolate ice cream. For me this is such a simple gesture. My job was to make sure the residents stayed hydrated and prevent them from losing weight. But for them, the residents who forget what their daughter looks like, are wheelchair bound, or just want to go home, a 2:00 p.m. snack was a big deal. Not just because of the food itself, but because among all the nurses running back and forth, chair alarms beeping, and residents with dementia screaming out, someone stopped and noticed them and showed that they cared.
I may not be changing the world by curing childhood obesity, prescribing life-saving tube feeding orders, or counting carbohydrates for newly diagnosed diabetics, but my first real job has taught me to realize that I can make a difference in someone’s last days with a smile and a cup of ice cream.
*Names have been changed to follow HIPPA regulations
Elizabeth is a recent college graduate. She’s getting ready to move to Long Island, where she’ll start grad school and clinical rotations at Stony Brook University Hospital. She plans to become a dietitian. Her hobbies include taking naps, practicing yoga, and reading with a hot cup of tea in hand.