House Staff Manual - Winthrop University Hospital

88. NUTRITION SUPPORT SERVICESThe Nutrition Support Team is available to aid in the diagnosis and treatment of inpatient nutrition-relatedproblems. This multidisciplinary team consists of a nutrition support physician, gastroenterology fellow,nutrition support dietitian, nutrition support nurse and pharmacist.For the routine nutritional assessment of patients, selection of p.o. diet or for tube feeding, a staff dietitianfrom the Hospital's dietary department should be consulted. The Nutrition Support Team, an entirelyseparate entity from the Hospital's dietary department, should be called for difficult tube feeding cases,problems with peripheral parenteral nutrition (PPN), diagnostic dilemmas, or if the patient is beingconsidered for Total Parenteral Nutrition (TPN).If TPN is desired for a patient, it is mandatory that the Nutrition Support Team be consulted to evaluate thispatient. The Team must be consulted before a surgical consult is submitted to place the central venouscatheter for TPN access. Once TPN is initiated, the Nutrition Support Team will continue to follow thepatient and provide medical record documentation as necessary to guide the housestaff in managing thepatient’s ongoing nutrition support.89. PASTORAL CAREThe Department of Pastoral Care and Education offers pastoral care and spiritual support to all patients,family members and staff members. Pastoral care ranges from celebrating the birth of a newborn tosupporting a patient and family to find strength, comfort and guidance in their spiritual tradition during thedying process. The basic goal is to offer patients, families and staff a trustworthy, spiritually andemotionally knowledgeable and well-educated companion, with whom the pain and concerns connectedwith the hospital stay can be shared. This sharing usually leads to a deeper acceptance of reality, healthiercoping and supports the healing process, even when there is no cure. This sharing helps the patientcelebrate life up to the last minute and end it in dignity, in tune with the best wisdom of his or her spiritualtradition.Indicators to involve pastoral care: patient in the dying process; after receiving a severe diagnosis; patientor family depressed, upset, worried, alone, has little support; specific religious or cultural concerns.How to reach pastoral care: write a request in the chart; call the Pastoral Care Department at ext. 4749; inan emergency call the operator (24-hour on call service available).90. PAIN MANAGEMENTThe Winthrop Pain Management Center offers a multidisciplinary approach to diagnosis, evaluation andtreatment of pain in an inpatient and outpatient setting. Under the direction a Board-certifiedAnesthesiologist and Pain Management Specialist, the Center is staffed with a physician and a painmanagement clinical nurse specialist, who employ the most advanced techniques to ensure optimaltreatment.Pain Management is a responsibility of all clinicians. If, after initial intervention, a patients’ conditionwarrants insight from a specialist or the patient is a complex situation, the Pain Management Service shouldbe contacted at (516) 739-9771, ext. 11.The institution also offers a Palliative Care Service, available to all patients in need. This Service isavailable every regular business day by calling the operator and requesting a Palliative Care consult.91. PATHOLOGYThe following describes essential policies and procedures of the Department of Pathology. House Staffshould take the time to familiarize themselves with the complete procedures, as contained in the LaboratoryRev. 1/08