What Do Registered Dietitians Do On A Daily Basis

Happy mid-March to all of you lot! Peter and I are in the midst of enjoying some skiing at an "undisclosed location" … but if you're clever (and/or a longtime reader), you tin discover out where we are. Let the chase begin!

I call back that in my last post I promised you all a twenty-four hour period in the life of a clinical registered dietitian/RD. Jessie promises, Jessie delivers! Outset, however, a little about what dietitians DO in general. In my experiences talking to the random (wo)man-on-the-street, I have discovered that most people think RDs do ane of the following: (A) Tell people what they CAN'T eat (i.e. "yummy" foods), (B) Tell people what they CAN eat (i.eastward. "good for you rabbit food" ), or (C) A combination of the above. C'mon, enhance you hand if you recollect the above is true. Yeah, you! 😉

As y'all can probably approximate from my rather subjective circumlocution, (A) (B) and (C) does Non embrace the scope of what an RD tin can do. The title "registered dietitian" is protected because of the science-heavy education, supervised practice, and ongoing training that a registered dietitian must complete and maintain. The title "registered dietitian" distinguishes a trained and certified RD from a "nutritionist" or "nutritional expert" or one of the other many permutations of "nutrition" that require lilliputian or no formal training. Yous can read more almost what an RD does on ADA'south website hither.

So, where Practice registered dietitians piece of work? Just for you lot, my honey readers, I made up this handy little pie nautical chart based on the American Dietetic Clan'due south well-nigh recent survey of where its members work:

Snazzy, eh?

As you can run into, more than a third (34%) of RDs work in hospitals, in inpatient and acute care. I'll be sharing my experience in inpatient care below. A meaning percentage of RDs work in clinics (12%) and customs and public health programs (eleven%) – I wrote virtually my feel in community nutrition hither. xi% work in extended care facilities (which was one of my kickoff clinical dietetic experiences). RDs tin can work as consultants to health-care facilities (6%) or other organizations (2%). RDs can work in individual practice (iv%) – in which I'll be working for my next supervised do rotation. And, of course, RDs tin work in school foodservice (3% – I wrote most my experience in school foodservice here), or in education (5%). RDs work in very diverse areas!

Still, the piechart is vague. What exactly do those 34% of RDs who work inpatient actually DO? For the past six weeks, I have worked as an inpatient dietitian at a VA infirmary (this feel is function of the 1200 hours of supervised do that I need to consummate before I tin can accept the registration test to get a registered dietitian). On a day when one of the dietitians was out and I sat on her floor, I wrote down everything I did that solar day (with the exception of the TPN order, which another RD put in and I observed). Besides, I moved the timing of some events around to aid with flow.

vii:45 am: Arrival at the infirmary. The parking lot is already crammed full of cars.

The VA hospital is that tall, rather imposing grayness building in the back. That'south only one of the buildings.

eight am: Go far on the flooring, check computer to see how many patients have been admitted and how many nutrition consults take come in. Prioritize patients based on time of inflow (all new inpatient admissions to the floors must be seen within 72 hours and all consults must be seen within 48 hours – yeah, RDs practice work weekends!).

8:fifteen am: Walk around the flooring and check on patients' breakfasts. Note errors and patient concerns with their trays. Correct errors if needed. On this item twenty-four hour period, I too asked each patient if they wanted a not-meat pick for dejeuner, as information technology was Ash Wednesday.

8:25 am: Reported which patients wanted a not-meat lunch to the kitchen in fourth dimension for them to brand changes to the lunch service.

8:45 am: A nurse stops me in the hall and says that a patient wants to talk to me most his trays. I quickly review patient'due south chart on the VA'southward accolade winning computerized medical records. Note the patient has severe ascites and is therefore on a sodium and fluid restriction. Visit pt and discuss the rationale of why he cannot have extra salt and h2o. Later on some conversation, the patient is calmer. I write down the patient's food preferences and have i of the RDs enter his preferences into the computer system (I can't alter diets or preferences myself because I'one thousand still a student).

9:30 am: Hop on the computer to finally first charting on my patients for the day, only to be interrupted …

9:45 am: … by a dietetic technician, registered (DTR – an essential part of the dietetics team!) calling from the kitchen about a patient whose diet order keeps irresolute back and forth. Review patient's chart and recommend the correct diet for this patient. Have RD modify nutrition.

10 am: Finally! Some time to chart on patients. I review their current diagnoses and prior medical history, besides as summit, weight, claret pressure level, labs, and subjective information such as ambition and nausea/diarrhea/constipation/chewing or swallowing problems. I talk to the patient to discover out this subjective information, too equally make a notation of how they appear (malnourished, nourished, etc., and how likely the patient volition comply with diet recommendations). All this information, plus other information non mentioned, must be recorded in a professional way in the calculator charting system. The RD will make diet recommendations based on all this information. The nutrition may exist unproblematic if the patient has no nutritional bug, only most patients at the VA hospital must take some kind of special diet. For example, sodium-restricted diets are common due to high blood pressure or liver disease, and renal affliction and failure without dialysis may require a protein restriction. There are disease-related needs for low fat diets, low poly peptide diets, high protein diets, fluid-restricted diets, consistent carbohydrate diets, and on and on. Those diets don't even count the tube feeds and parenteral diet needed for some patients.

10:45 am: As I walk to my next patient, I break to be inspired by the posters on the wall (distressing for the glare – at least I'm still getting inspired!):

12:15 pm: Walk effectually the floor checking on patients' lunch trays. A patient is irate because she received the incorrect lunch tray. Talk with patient for a few minutes, and so have RD call downwardly to kitchen for late tray.

one pm: Time for lunch! Admire roses on clinical RD managing director'south desk for RD Day.

Jumping ahead a few days … at lunch, we were able to enjoy some chocolate brownies baked past ane of the dietitians, Laurie, for our last day at the hospital ("our" meaning me and Brianna, some other University of Connecticut student who was working in outpatient counseling at the same infirmary). Here we are:

I only adore Brianna! We've done a lot of our supervised exercise in dietetics together, and let me tell you: this girl is going to be an awesome registered dietitian!

Closeup of the goods:

Yeah, information technology definitely tasted as practiced as information technology looks. Thanks, Laurie!

i:30 pm: Back to work! Need to make sure we get run into all the patients before the twenty-four hour period is over.

2:thirty pm: Check on a TPN patient. I won't get into all the technicalities of nutrition back up, but I volition say that RDs have an important function in making certain someone who can't consume (enough or at all) gets the nutrition he or she needs. For example, an advanced head and neck cancer patient who can no longer safely eat and therefore get enough oral diet may get a PEG placed (actually got to see one of those procedures!) – this person will get nourishment directly into the breadbasket. Or, a person may develop a postsurgical ileus and somewhen need TPN – this person will receive nutrition intravenously. Dietetics is cool, folks.

3 pm: Keep at information technology! Gotta run into all those patients!

Hither I am with Elizabeth, ane of the dietitians at the VA, who I coerced into taking a movie with me:

Thank you, Elizabeth! 😀

4:xxx pm: Done for the day! … every bit long equally I've seen all my patients, of grade …

So, what do yous think? I hope you'll agree that a registered dietitian does more (A) (B) and (C). 🙂 I will miss my fourth dimension at the VA infirmary, but I am excited to start my next rotation with a private do dietitian!

Please feel gratis to ask me whatever questions yous accept almost dietetics, nutrition, whatever, and I will be happy to answer! 'Til side by side time, honey reader …

Q: Have you lot ever met a registered dietitian? What was your experience like?