Tim's ND Blog

I admit that I'm starting to reminisce already about my time here at NUHS. Here are just a few of my thoughts this week as things start to wind down and rev up for the next part of this adventure!

As each of the 10th trimester Interns complete their patient numbers and competencies, transition their patients to the Interns advancing from observation to the main clinic, and prepare for the next step beyond graduation (whether joining or opening a practice, continuing with another license or starting a family), I believe each one has taken the first step on a journey of helping others with minimally invasive therapies to become healthier.

Spring 2014 will see 11 new doctors of naturopathic medicine graduate from NUHS. These doctors will be prepared to help those with chronic illness determine the underlying cause of their disease, and where possible with the therapies that we are taught to utilize and our rigorous training on the human body and its functions, work together as teammates to return our patients to their basis for health.

This is a bittersweet time for many of us. Those of us who have developed close friendships over the past 4-5 years and fostered a sense of teamwork, cooperation, learning, teaching and accomplishment will be stepping out on our own. We will be making our way in the world as healer, educator, family, friend and human being. While we will be making our singular way, we know that we will have the support of our colleagues, loved ones and our patients.

Ultimately, the support of our patients is the driving force that allows us (motivates us) to take the next leap as we begin our journey in a profession with a scope that currently exists in only 18 states and territories along with the District of Columbia in the United States. This is both an exciting and scary time for many, especially the younger new docs who are stepping out into the working world for the first time. I continue to encourage my colleagues with the notion that they are very well educated, well trained new naturopathic doctors who are going to make a positive, healing impact upon their patients' lives. As long as that is their motivation and they manage their practice wisely, they will be rewarded with a full practice as word of their expertise spreads.

Until next week, most likely with a bit more reminiscing, enjoy the spring season and renewal of the sun's warmth!

Well, here we 10th Trimester Interns sit working on our final 'check-offs', competency skill evaluations, and patient numbers.

Between the patient visits, acting as mentors for our rising classmates, completing outreach hours for the clinic, sitting and discussing conditions with our clinicians, preparing our grand rounds presentations, and double checking charting and paperwork, we don't have much time for anything else.

For some reason, I thought this part of the internship experience would be a time to sit back, relax and enjoy the clinical experience. I suppose I was pretty far off target on this notion. I am thoroughly enjoying myself however. The clinicians have given the 10th Trimester Interns a bit more autonomy with the diagnoses, treatment plans and conversations with our patients. We are now expected to train our underclassmen in clinic protocol, procedures and patient interaction. This is an exciting time!

The clinic is hopping today and is chock full of naturopathic patients! What a great problem to have in our little clinic! The word seems to be getting out about the services, therapies and treatments available at the NUHS Whole Health Center.

As the weather changes, the temps rise and spring arrives here in Chicagoland, the NUHS Whole Health Center, the naturopathic medical school and our students are rising to the occasion, growing and sharing our knowledge, skills and healing therapies with our neighbors in greater numbers!

Winter continues here at NUHS in the Chicago suburbs. While not a normal winter for the Chicagoland area, the snow has been beautiful in its ubiquitous falling, blanketing and build-up!

Clinic has chugged along through the weather, low temps and snow squalls. Our interns and clinicians have battled through the snarled traffic, snowdrifts and partially successful attempts to start their vehicles to maintain the excellent level of care that the NUHS naturopathic clinic provides!

On days that are not as busy because of the weather, those of us who are in tenth trimester clinic are going through our portfolios and check-off sheets to ensure that we have met our requirements for graduation. When possible, we sit with a clinician and speak of various ailments, maladies and injuries followed by the appropriate triage, treatment and healing strategies for a patient with that illness.

The portfolio includes everything from prenatal care to geriatrics and all stages of life, health and illness in between. Combined with our patient variety, over 450 or more total unique visits and rotations with the Salvation Army clinic in Chicago, the Naperville clinic and homeopathic rotations, we are well prepared as we sit down to discuss these patient conditions and how we would treat them.

So, even though winter is keeping most of us indoors for the next few days, we are quite busy with our clinic duties and fulfilling clinic requirements...well, except for the occasional midnight stroll through a nice little snowstorm! 

Until next week, keep warm and talk to you then!

One of the many skills that we develop while here at NUHS, and perhaps one of the more important, is taking an assessment of a patient's typical diet. Once we have a good diet recall or diary from a patient, we can determine the benefits and drawbacks of the patient's diet, the impact (for better or worse) upon the patient's health, and then we can make modifications as necessary to help the patient return to a basis for health.

Intern Heather Bautista taking a dietary assessment from Intern Jerrica Sweetnich.

We start by getting a log of a patient's typical weekday and weekend diets as many people eat differently on the weekends than they do during the workweek. After a review of the diet with the patient, we consult with our clinicians regarding the patient's chief complaint, review of systems, health stressors, and treatment plan. Part of the treatment plan involves modifications in a patient's diet and may include the following:

• Water Intake or hydration
• Meats (unless vegetarian/vegan)
• Vegetarian/vegan sources of protein
• Vegetables
• Fruits
• Avoidance of grains (if necessary)
• Healthy fat (Omega 3 Fatty Acid) sources
• Dairy sensitivities
• Estrogenic food intake and impact upon estrogen levels
• Sugar intake
• Fiber intake

...just to name a few.

Dietary modifications are a key tool to help our patients return to a basis for health. Our health begins with the nutrients we provide our bodies for building strong muscle, bone, nervous tissue, and preventing or fighting infection.

With that said, I'll grab a healthy bite to eat and make my way to clinic for the afternoon shift. This evening its time to carve pumpkins by the fire pit and make ready for Halloween!

Time to settle into the weekly routine again, albeit things are a bit different this trimester. With class and clinic rotations 5 days each week, along with work on the side during some mornings and each weekend, time is a precious commodity.

This is what a typical clinic schedule looks like for a 9th/10th trimester ND Intern.

During clinic, we sit down for "preview" each day to discuss upcoming patient cases and strategies for best helping our patients in a roundtable discussion. This is a "safe zone" to bounce ideas, debate the best strategy amongst peers and under the guidance of our clinicians. The idea is to share knowledge through discussion in a practical manner without judgment. This approach allows us to discuss all treatment modalities, their benefits, drawbacks and limitations, then move forward with the best overall treatment for our patients.

After preview, we see our patients, chart, research, develop and bring our suggested treatment plans to our clinicians, who vet the plans and approve or amend as required for the benefit of our patients. We must complete all of these tasks during our shifts as HIPPA regulations dictate that no patient records leave the premises. We learn quickly to be accurate, concise and have all work completed by the end of the day out of necessity.

Even though this seems like a lot of work, clinic is a fun, nurturing environment that I look forward to every day. The smiles on patients' faces when they begin to feel better, heal and share is priceless! The patience, knowledge, skill and care that our clinicians share with each intern on a daily basis set an excellent example for all of us as future doctors.

Me with Carrie (left) and Juanita (right), both 6th trimester ND students

The photo I'm sharing this week is of two friends and me. I was printing something at the library the other day and ran into them after having not seen either for about two months! This made me realize that I was separated from the rest of campus now that I'm in clinic and needed to visit my old friends still in their clinical courses. Challenge accepted...