A Day in the Life of a Registered Dietitian

Hey friends! I’m excited to be posting this today about a day in the life of a registered dietitian! Back in January when I did my blog poll, this was my #1 requested post. I’m sorry it has taken me so long to get to writing it!

I published a previous post back in October. A few things haven’t changed…. I still give Lily a belly rub every morning, wearing scrubs to work is still the most awesome thing ever and I will always hate traffic in Charlotte But lots has changed in life since then so here’s an update of my daily routine!

Good Morning

6:30am- My alarm goes off and I start to wake up. I am actually incredibly happy this morning because my next door neighbors, who have a beagle that starts barking at 6am, have recently moved. Hallelujah!

My morning routine is pretty simple- walk Lily / hair / makeup / grab stuff / leave. I have wisened up this summer and made an effort to pack my breakfast and lunch the night before.

I used to have good intentions with this but now it’s always part of my nightly routine. I make not-so-great food choices in the cafeteria when I don’t pack my lunch. I can’t help it. They have rice crispy treats!

7:30- Arrive at work, do office stuff, fill up water bottle and eat breakfast while looking up patients. My summertime breakfast staple has been cottage cheese with fruit. I like it because it has dairy, protein and fruit all in one.

Work

8:30- The day really gets going because I go to physician rounding and then see patients. I have realized in my year of clinical work that most people don’t realize what an inpatient clinical dietitian does. They think I either work in the food service department making menus or that I talk to people about losing weight. I actually don’t do either of those. Here’s a brief run down of what I do these days:

What a Clinical RD does

(I decided to go into detail here because I get so many emails from RD students. Feel free to skip over this section if you’re not into the details of clinical dietetics )

Nutrition assessments- determine if people are at nutritional risk and provide an appropriate nutrition intervention. Some examples of this could be a patient who is not feeling well and has poor oral intake, someone admitted with substantial weight loss, or someone with a wound or injury that has increased nutrient needs. Whatever is going on, my job is to get them back on track with their oral intake so that their nutritional status is not preventing them from getting better in the hospital.

Educations- These account for ~25% of my patient load. The educations I do are about dietary recommendations related to chronic diseases, such as diabetes and congestive heart failure. Educations are hard because when a patient is sick in the hospital, they are getting a lot of information about their health at one time. It can be overwhelming, and absorbing advice about their home diet is usually not their top concern. It’s also hard for me because I could talk to someone about their diet all day long, and I have to manage my time wisely.

I hear clinical RDs talk all the time about how educations get pushed down the priority list when you are dealing with urgent nutritional issues. One time I read some very prudent advice from a fellow RD blogger about doing nutrition educations. She said to always devote time and effort with educations because they are so rewarding and can truly help a patient in the long run. After a year of working in the hospital, I completely agree. I would like to think that all of the work I do is important, but I really feel like I have made a difference in someone’s life if they tell me they took my education to heart and made some dietary changes that changed their health for the better. I find this the most with patients who have diabetes, because it is a lot easier for them to see results in their blood sugar control.

Nutrition Support- before I did my dietetic internship, I did not know a thing about nutrition support. There are two types of nutrition that can be provided to a patient when they can’t eat.

• Enteral nutrition (tube feeding)- This is the optimal way to feed a patient because your GI system has a lot of important immunological functions. A patient might need tube feeding temporarily if they are unconscious or permanently if they have any type of condition that affects their ability to eat/swallow. My job is to estimate the patient’s nutrient needs and select the tube feeding formula and rate that best meets those needs.
• Parenteral nutrition (TPN / PPN)– I had never even heard of this until I become an RD. PN is artificial nutrition through the vein. This is used when a patient’s GI tract cannot be used or the patient cannot receive tube feeding for whatever reason. My job is to estimate the patients nutrient needs and select the appropriate amount of dextrose (carbs), aminosyn (protein), intralipids (fats) and electrolytes (sodium, phosphorous, magnesium, potassium) that will hang in the IV bag.

In terms of my overall job responsibilities, I have the strongest interest in nutrition support. There is always something new to learn!

Lunch

12:00- Lunch time. I typically pack my lunch 4/5 days per week. Today happened to be a salad because I’m trying to use up a bunch of stuff I got at the farmer’s market. I’ve got romaine, tomato, cucumber and I topped it with some leftover london broil.

Other lunches typically include either leftovers or a sandwich and I try to fit in some fruits and vegetables.

Back to work

12:30-4pm- I spent the rest of my day seeing patients and charting. What I really love about my job is that my overall job responsibilities are very routine, but I see new patients each day. Things never get old!

Home

4pm- I’m only a few minutes from work now (yay!) so no more lengthy commute for this girl. The first thing I do when I get home is walk Lily and play with her. I find that she has continued with her newest hobby today, which is finding a box of tissues and tearing them up.

She doesn’t think there’s anything wrong with this.

I spend my afternoon like most: reading/commenting on blogs and unwinding from work. I even take a 45-minute nap. Then I have a snack of raisin bran (not pictured).

Gym

6:30pm– I’m still resting my foot so a lot of my normal workouts are on the backburner. Today is a gym day to work on my legs in the weight room. I start off every leg day with 10 minutes on the recumbent bike to warm up my knee.

I stretch after that and then, like any normal person, I take pictures of myself.

I spend about an hour in the weight room rotating on all of the leg machines. I have to modify the leg press because it irritates my foot, but I’m otherwise okay on all of the other machines. I have really been working hard at making strength-training the foundation of my knee recovery… it has worked out well so far!

Dinner

8pm- After I’m finished at the gym, I head home to make dinner. I purposely wait until after my evening exercise to eat dinner because I don’t like working out on a full stomach and I like to get some protein intake afterwards.

Tonight’s dinner was scrambled eggs with a sliced pear on the side. I made my scrambled eggs with 2 whole eggs + 2 egg whites + fresh basil + spinach + shredded cheese + cracked pepper. In case you didn’t notice, eggs are a single girl’s staple when it comes to meal planning…. quick, easy and perfect for 1

Evening Routine

8:30pm- My nightly routine is always the same:

walk lily

take bubble bath or shower

write blog post

do a few household chores (laundry, dishes, etc.)

and then hit the hay. Lights are usually out by 11pm!!