Since July 2015, I have earned the right to put fancy initials behind my name: RDN (or RD, practitioner’s choice). I am known as a Registered Dietitian Nutritionist, currently licensed to practice in Texas and certified for Washington state. For the last few years I worked as a clinical dietitian but recently moved to Seattle to begin a new adventure. While I continue to hunt for a new job outside of the inpatient setting, I want to start to share about my experiences but also to answer the question, what does a dietitian do?
For the last 2 years I worked for Aramark as a clinical dietitian at Baylor Scott & White Medical Center in Waxahachie, Texas. Often I am asked, “do you just put sick people on diets?” Well, yes and not exactly. The primary goal of a clinical dietitian is to help patients maintain adequate nutrition status while admitted to the hospital. When you are sick, you often do not feel like eating but require more nutrition than normal to recover. It was my duty to make sure patients were getting enough calories, protein, and fluid and educate them. “Putting people on diets” is important when a person with diabetes has uncontrolled blood glucose levels that affect the ability of their wounds to heal. Or when someone with congestive heart failure has gained 15 pounds of fluid and needs to limit their sodium intake. And it is rather important when a patient with kidney failure needs to restrict potassium to avoid fatally high blood levels. Still, other patients with missing teeth may need a softer, easier to chew diet order. And people who cannot swallow or whose intestines are not functioning properly need an especially particular “diet” of nutrition support.
Some patients who come to the hospital are required to be on breathing machines, or ventilators. They must be fed through feeding tubes since they are not alert enough to eat with their mouths. Other people who may require these tubes are those with severe dysphagia such as from stroke, cancer, or dementia. A clinical dietitian may be responsible for what type of feeding tube is placed, but primarily for the formula and water that runs through the tubes each day to meet a patient’s calorie, protein, and fluid needs.
Another aspect of nutrition support is parenteral nutrition. This is a form of intravenous nutrition for those who have recently undergone intestinal surgery, or whose intestines are not properly functioning for an extended period of time. Rather than ingesting carbohydrates, fats, and proteins through the gastrointestinal tract, dextrose, lipids, and amino acids are run through the line directly into the bloodstream.
Nutrition support is only one aspect of what a clinical dietitian does, and I wore many hats while working in Waxahachie. But the more I learned about nutrition support, the more I realized that is not why I personally entered into the world of dietetics. While it plays a vital role for many patients, nutrition support is usually a synthetic way to maintain good nutrition status (although I am learning more about naturally blended tube feeding formulas). Nowadays we can find quick fixes for everything, including our health. And while there is a time and place for such fixes, I want to learn from my time in the hospital to help others avoid winding up there.
“Let food be thy medicine and medicine be thy food”
We are seeing more and more registered dietitians working in supermarkets, corporate wellness, athletics, and private practice. Anyone can benefit from a consultation with a dietitian to learn more about healthy eating, but many are trained to help people manage chronic diseases, gastrointestinal disorders, or food allergies. Looking for help with your fitness goals or becoming a vegetarian? Dietitians can help with that too! The goal is to help people maintain good health through food and physical activity. I have been trained to tailor a plan unique for each person, and I hope to help you learn something new!
Stay tuned to learn more about the world of dietetics, diseases, and delicious recipes! Feel free to comment your thoughts below or topics that you would like to see addressed in future posts.
Nicole Lyon, RDN, LD, CD