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motivated by money

I talked a little bit about what I’ll be doing as a renal dietitian, but I didn’t mention that I am responsible for improving very poor lab values in my patients. In dialysis, dietitians most closely monitor albumin, potassium, phosphorus, calcium, and parathyroid hormone (PTH). And most importantly, low albumin levels correlate with increased risk of mortality and morbidity. Not good. I walked into a rather bleak situation and it’s 100% on me to turn this around. Pressssure!!

Because everyone loves “free” money and winning, I created a little competition for our patients. Every month, after labs are drawn, patients can earn chances to win Kroger gift cards that they can use on medications, food, or gas. Patients get 1 entry for every criteria they meet: albumin within range, potassium within range, phosphorus within range, and NO missed treatments. If they are able to meet all 4 criteria, they get 2 extra entries.

And in order to increase long-term compliance with medications and diet, this competition will be on going each month, with 4 winners each month. I hope it works! Or at least helps 🙂

I’ve also requested the clinic to purchase protein supplements for our patients who need the added nutrition. Most of the malnourished patients find protein supplements to either be too expensive or not palatable. And because of strict potassium, phosphorus, and fluid restrictions, not just any protein supplement is appropriate. After doing some research and speaking with drug reps, I chose LiquaCel for my patients. This is a product previously unfamiliar to me, but it is gaining popularity quickly among the protein malnourished populations. After tasting samples I can confirm that this stuff is DELICIOUS! And just 1 ounce provides 16 grams of protein — perfect!

Quesiton: What’s the last challenging situation you were in at school, work, or otherwise? Do you like to be challenged or does it push you out of your comfort zone?

I have to admit, I’m a bit out of my comfort zone on this one. Especially since I have to stand before a committee next Wednesday and give evidence as to what steps I’m taking in order to remedy our patient’s poor nutrition statuses. 🙁

Or on a lighter note…anything fun planned for the weekend?? 😀

I am meeting Gina tonight for dinner and drinks! We got together back in June, and I’ve been anxious to hangout again! And now that we’re in Columbus for good, that will be much more doable 😉 We both have new jobs and I’m sure we’ll gab on and on about dietetics…especially since we’re leaving the guys at home! 😉


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  1. August 13, 2010 / 6:22 am

    Love that idea! I bet it will motivate quite a few people.

  2. August 13, 2010 / 7:51 am

    What a great idea Nicole! I mean you would think that the fact that they would feel better and look better if they took care of themselves, would be enough motivation, but many times it isn’t. I think your challenge sounds fabulous! Although I am a Giant Eagle gal, I love KRoger too ๐Ÿ˜‰ I need to come up with some good challenges for the GE employees! Many of them are not very healthy and they need some motivation and support.

    I’m excited for tonight!! And, if we have time, we can get gelato after dinner! If not, we’ll have to get it another time because it’s AMAZING, and right down the street from where we are eating dinner.

  3. August 13, 2010 / 7:51 am

    Wow, that’s a tough situation since much of your performance is assessed on patient compliance. That’s why I always wonder about talk of Pay For Performance for doctors and the like. I can’t imagine getting paid based off of whether my patients actually listen to what I tell them. I hope you have good luck with yours!

  4. August 13, 2010 / 8:10 am

    Thank you very much for the comment about my Blog’s name…I’m still very conflicted…I feel like it’s so expected and people think I chose it just because of the book or a knock-off of Jenna’s…bah…

    I used to work with Dieticians in the hospital – busy busy busy!!

    Good luck!

  5. August 13, 2010 / 9:06 am

    Have fun with Gina!! I wish I could sit in on y’all’s nutrition chatting ๐Ÿ™‚

  6. August 13, 2010 / 9:29 am

    Hooray for improving labs! I think renal RD= report card time! Lots of smiley face stickers and gold stars too. I love, love, love the idea of entries to win gift cards that have very practical uses, like meds.

    Glad you found a great product out there for your patients and I will talk your word it tastes good. Hard to believe, but if you say so ๐Ÿ™‚

    I am so jealous that you not only get to hang out with Gina, but you can talk about dietetics, because I have not one single person to relate to here about my job/profession. Reading your posts makes me miss clinical.

    My biggest challenging situation was mostly weight loss clients who were forced by doctors or loved ones and were really not ready for change. I love challenges. I will be working 4 part time jobs, and taking 1 grad class in September, so my fall will be crazy and a juggling act, but I like that kind of challenge. writing and following daily lists and planning my time is like a hobby for me and for some strange OCD reason, I find this fun.

  7. August 13, 2010 / 9:30 am

    That’s an awesome idea! This weekend, I’m taking birthing classes with my hubby. Should be interesting!

  8. August 13, 2010 / 9:39 am

    What a great motivation too! I am sure the patients love it!

    So neat that you get to meet up with Gina. I love blogger meet ups!

  9. August 13, 2010 / 9:42 am

    Gosh girl, sounds like you have your hands full. Sorry to hear about the pressure. Hopefully your weekend will bring relaxation & fun!! I LOVE breaking out of my comfort zone.

  10. August 13, 2010 / 9:56 am

    I think that’s a great idea, Nicole! It’s actually a good thing that you are forced out of your comfort zone…it’s uncomfortable at first, but you’re just widening your comfort zone limits!

    So cool that you are meeting up with Gina. My two favorite RDs together!

  11. August 13, 2010 / 9:58 am

    Your incentive game is such a cool idea! Look at you being innovative within your first week on the job! You’ll do great I’m sure!!!

  12. Veronica
    August 13, 2010 / 10:04 am

    Going before a commitee sounds like a tense situation, and I hate being put under pressure. What you did with the incentive program sounds awesome. Was it difficult to attain the gift cards? I don’t remember the last stressul situation I was put under, but this year I’ll be presenting (as a student) at a dietetic association meeting (kinda nervous about that). Good Luck with the new job!

  13. August 13, 2010 / 10:41 am

    I think people are more motivated not to lose than to win. But there’s probably no way you can make your patients pay you money if they don’t have their numbers in check, eh?

  14. August 13, 2010 / 10:49 am

    I love being challenged. Life is all about overcoming your challenges and proving to yourself what you can achieve. Accomplishing challenges can be so rewarding, and it also really makes you appreciate those days where you do get to stay inside your comfort zone.

  15. August 13, 2010 / 11:04 am

    It sounds like your new job is really interesting! I think the monthly challenge is a great idea too… especially considering the prize is a gift card they can really use.

    My biggest challenge at work recently has been figuring out how to best navigate the political aspects of my job. I’m a very small fish in a very big pond with rather vicious big fish in it, but my ideas and opinions are anything but small. I’m trying to figure out how to present them without stepping on toes and making problems for myself.

  16. August 13, 2010 / 11:20 am

    Wow – that is a great idea! Thats a lot of pressure, good for you for being able to come up with something like this. I definitely think it will make a difference. ๐Ÿ™‚

  17. August 13, 2010 / 11:28 am

    Your job sounds very exciting, Nicole!
    I love challeges but I don’t like to be pressurized. When I was in high school… the whole class voted me to go for debating competition. I hated public speaking and I totally embarassed myself that day!

  18. August 13, 2010 / 11:40 am

    You are so creative!! Your incentive sounds awesome…I mean I would be all about it. Tomorrow I’m headed to the opening ceremony of the first ever Youth Olympic Games :). Hopefully I’ll grab some good pics to share. Have a good one!

  19. August 13, 2010 / 2:07 pm

    WOW! What a great idea. You are one great dietician. I bet all your patients are going to really get in gear with their diets now. . . I know I would ๐Ÿ™‚
    I love love love challenges. Right now it’s gearing up for graduate nursing school and take the Boards in 4 months!

  20. August 13, 2010 / 2:23 pm

    I think having incentives for keeping within range is a great way to motivate your patients! It’s so important for them to stay as healthy as possible, and I’m sure many of them appreciate the efforts your making to make them healthier (although they may not say so out loud!). I find it difficult to be pushed out of my comfort zone, but an incentive definitely helps, and I almost always feel better afterward ๐Ÿ™‚

    Good luck on your committee meeting next Wed! I know you’ll do great!!! Also, I think you and Gina should come visit CT. Just sayin’ ๐Ÿ˜‰

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