The Nutrition Focused Physical Exam (NFPE) is a tool inside every registered dietitian’s pocket and is an essential part of the Nutrition care process (NCP). Therefore, it is crucial as a dietetic intern to be competent and confident when applying such tool to assess the nutritional needs of others. My name is Natasha “Tasha” Rumsey, and I am a Sodexo intern from region 11 located in Denver Colorado. I had the pleasure of completing my long-term care rotation and clinical nutrition management rotations in Seattle Washington at a continued care retirement community with a former Sodexo intern Emily Haymond. While working under my preceptor in Washington, I learned firsthand invaluable skills. One of which was how to perform the NFPE with confidence.
To refresh everyone’s mind, the NFPE is a piece of the NCP in which dietitians collect, interpret, and analyze findings from the NFPE, interview, and the health record including: muscle and subcutaneous fat, oral health, suck/swallow/breathe ability, appetite, and affect. The NFPE requires hands-on contact with individuals to perform our jobs effectively and accurately as nutrition professionals. The Covid 19 pandemic, my lack of experience, and my low confidence to perform such a task in general, let alone on the older population (whom I admire and respect greatly), presented a challenge. I knew that this was something I needed more experience with. After such realization, I apprehensively communicated this with Emily. She then assured me that this was a tool she would gladly help me improve upon.
From that moment on I knew I was in great hands. Emily guided me step-by-step through one NFPE and from there I soared. Every resident I assessed and evaluated supplied my practical experience. I applied skills and knowledge with confidence and my abilities supported that. I remembered my mission: to help those in nutritional need the best I could. My preceptor shared a few tips that I would like to share with you. While performing the NFPE, get to know your resident. This is an opportunity to learn more about whether they have had any changes in weight, appetite, or bowel movements (amongst others). In addition to the physical findings, it allows you to investigate where you can be further effective. She helped me see that I could utilize the time to be efficient. I could physically assess the resident while determining if there were other areas that needed addressed. Once I understood this, I was no longer afraid or intimidated of performing the NFPE. My newly acquired skill took the attention off myself and directed it toward the resident. I will forever be grateful for Emily’s patience and kindness for showing me how to perform the NFPE.
Before I go, I want to encourage others to speak up regarding areas of the internship or about any part of the NCP that is challenging or seems intimidating because of lack of confidence. Ask for help; a little bit of direction, guidance, and encouragement can do wonders for a person. Confidence requires maintenance, and I believe my experience will (and already has) translate to other areas of my life.
To refresh everyone’s mind, the NFPE is a piece of the NCP in which dietitians collect, interpret, and analyze findings from the NFPE, interview, and the health record including: muscle and subcutaneous fat, oral health, suck/swallow/breathe ability, appetite, and affect. The NFPE requires hands-on contact with individuals to perform our jobs effectively and accurately as nutrition professionals. The Covid 19 pandemic, my lack of experience, and my low confidence to perform such a task in general, let alone on the older population (whom I admire and respect greatly), presented a challenge. I knew that this was something I needed more experience with. After such realization, I apprehensively communicated this with Emily. She then assured me that this was a tool she would gladly help me improve upon.
From that moment on I knew I was in great hands. Emily guided me step-by-step through one NFPE and from there I soared. Every resident I assessed and evaluated supplied my practical experience. I applied skills and knowledge with confidence and my abilities supported that. I remembered my mission: to help those in nutritional need the best I could. My preceptor shared a few tips that I would like to share with you. While performing the NFPE, get to know your resident. This is an opportunity to learn more about whether they have had any changes in weight, appetite, or bowel movements (amongst others). In addition to the physical findings, it allows you to investigate where you can be further effective. She helped me see that I could utilize the time to be efficient. I could physically assess the resident while determining if there were other areas that needed addressed. Once I understood this, I was no longer afraid or intimidated of performing the NFPE. My newly acquired skill took the attention off myself and directed it toward the resident. I will forever be grateful for Emily’s patience and kindness for showing me how to perform the NFPE.
Before I go, I want to encourage others to speak up regarding areas of the internship or about any part of the NCP that is challenging or seems intimidating because of lack of confidence. Ask for help; a little bit of direction, guidance, and encouragement can do wonders for a person. Confidence requires maintenance, and I believe my experience will (and already has) translate to other areas of my life.
