Kristen Vander WoudeIn February 2018, Kristen Vander Woude led the February Heart Healthy Event at Cura Hospitality. She graduated from IUP in May 2015 summa cum laude with a Bachelor of Science degree in Nutrition and Dietetics. She completed her dietetic internship at IUP in May 2016. In December 2017, she earned her Master of Science degree in Food and Nutrition at IUP.

I have been a long-term care dietitian since July 2016. I can honestly say that I had no idea that I would be in long-term care for this longalmost two years now, but it turns out that I really do enjoy it! The best part of my day is when I get to check-in with my residents. I love hearing their stories and their wisdomand of course, helping them through food and nutrition!

6:00 a.m.

I typically wake up two hours before getting to work and spend some time making breakfast and getting my day started. I usually eat an English muffin with peanut butter and milk; or, if time allows, I make a smoothie. My drive takes about 15 minutes to what most people would refer to as a job at a nursing home; however, I do not like referring to my job as solely working at a nursing homethere are many different levels of care, from rehab to skilled nursing. We also have independent living apartments and cottages, a memory care home, and assisted living apartments. Although I do play a role in all of these residents' care, my day mostly consists of being the dietitian for the skilled and rehab residents.

8:00-9:30 a.m.

My day starts with catching up on e-mails and checking my minimum data set (MDS) schedule. The MDS list serves as a guide of when I should complete my residents' assessments. Our assessments vary depending on residents' insurance, and how long they have been at our community. We first do an admission assessment, then a 14-day assessment (14 days after admission), a 30-day assessment, and a 60-day assessment. Assessments vary based upon how long the resident stays. For the long-term residents, my colleagues and I complete quarterly assessments and an annual assessment. We also do significant change assessments on an as-needed basis; this could be a "good" significant change or a "bad" significant change in the condition of the resident. My schedule is set and assigned by the Registered Nurse Assessment coordinators.

9:30-10:30 a.m.

Each morning I attend a morning meeting, which is also referred to as a morning stand-up. It is called a morning stand-up because we try to physically stand up for the entire meeting to stretch our legs; we are often sitting for most of the day! During a stand-up meeting, my team goes over 24-hour resident reports, including anything significant that happened such as any adverse resident effects or triggers. A trigger is a sign or a symptom that something unfavorable has happened with a resident such as a fall or unanticipated change.

10:30-11:30 a.m.

Once a week, I run a weight team meeting to discuss those who triggered for weight loss or weight gain and to discuss their care plan and interventions. Typically, when someone "triggers" for a significant weight loss or weight gain, they have lost or gained either 5 percent in 30 days, 7.5 percent in 90 days, or 10 percent in 180 days. I also use the meeting to discuss any residents that I am concerned about nutritionally. This is the biggest part of my jobtrying to combat weight loss before it happens. If my residents are not eating well or are losing weight, I typically try to add more calories and protein to their diets with a food-first policy before turning to a supplement.

11:30 a.m.-5:00 p.m.

Throughout the rest of my day, I fluctuate between checking my MDS schedule, participating in care conference meetings with families, conducting meal rounds, working on test trays in the kitchen, and conducting interviews with residents. My typical resident is in their 70s to 90s. The most common diagnoses are: Alzheimer's disease, congestive heart failure, diabetes, dementia, chronic kidney disease, and hypertension. For my rehab residents, they are typically recovering from knee or hip replacement surgery or have had a recent fall, and I sometimes get residents recovering from heart surgery or another type of surgery such as a recent amputation.

I host a monthly "Food for Thought" talk covering a variety of topics for the independent living residents. This past February, I held a special event celebrating Heart Health Month. Special event planning and coordination is not an unusual task that takes place under my job description to spread health and nutrition related awareness to not only residents, but also to their families and friends who come to visit. Organizing awareness events is something that I did many times during my studies at IUP and was able to transfer into the real world.

5:00-7:00 p.m.

I do not have a usual departure timeI leave depending on how the day is going. Then head home and do it all again the next day!

Written by Kristen Vander Woude, MS, RD, LDN and Marie Webb, graduate assistant
Edited by Sherita Jamison, graduate assistant