Spotlight on Registered Dietitians, Part I

Dietetics is the science of how food and nutrition affects human health. Dietetics has a strong focus on public health and a commitment to educating about the importance of making proper dietary choices. We recently spoke with registered dietitians Felicia Stewart and Alexandra Rae to learn more about this field, which is predicted to grow by 16 percent between 2014 and 2024

Felicia and Alexandra don’t just work in dietetics, they’ve also developed and currently run their website, Fully Nourished, a “resource for all things health and wellness.” In part one of this two part interview, these two health care professionals explain how they developed their career and professional experiences in the field. (EHC): Tell me a bit about being a registered dietitian. What inspired you to enter into this field?
Felicia Stewart (FS) and Alexandra Rae (AR): The decision to pursue a career as a Registered Dietitian (RD) is one of the best decisions we both have made! The field of dietetics is growing rapidly, providing a wide range of meaningful and exciting career possibilities.

As RDs, we’re fierce defenders of nutrition and wellbeing. Our skill set is applicable and beneficial in the clinical, managerial, food service, community and corporate wellness settings. This profession is so exciting because we’re impactful in a variety of areas, and no two days are the same! Being an RD means helping others develop a healthy and positive relationship with food. We work to empower people to make food choices in-line with their own personal health, wellbeing and life goals. As RDs, we also have the opportunity to be influential in creating healthy food environments through working with restaurants, brands, schools and food manufacturers.

We both agree that inspiration to enter this field stemmed first from a love of all food! Second, from a desire to provide people with evidence-based information that can be utilized to fully experience food and the benefits food has to fuel emotion, movement, culture and thought.

EHC: Please briefly describe your current position and where you’re located.
FS: I work as an inpatient clinical dietitian at Massachusetts General Hospital and I’m responsible for completing nutrition assessments and education in the acute care setting. Within this role, I create tailored nutrition plans centered around optimizing intake to aid in decreasing infection risk, promoting wound healing and reducing the length of hospital stay. Also, as an inpatient clinical dietitian, I’m often consulted to provide education about the relationship between nutrition and various disease states like heart failure, diabetes and inflammatory bowel disease.

AR: I’m an outpatient clinical dietitian at Massachusetts General Hospital. Patients are referred to me by their primary care provider for conditions such as diabetes, cardiovascular disease, food allergies and gastrointestinal issues. I work with patients one on one to address their medical nutrition concerns and develop a personalized eating plan tailored to their individual needs. It’s my absolute joy to help patients explore their relationship with food, navigate food with consideration for their health and learn to nourish themselves in ways that make them feel awesome!

What was your first job in this field? How did school prepare you for this job?
FS: My position at Massachusetts General Hospital is my first job as a licensed and registered dietitian. I completed my undergraduate studies at Wheaton College and Simmons College. Along with the 50-week long supervised-practiced internship I completed at Massachusetts General Hospital, this schooling prepared me for my current position in different ways. Theory, medical nutrition therapy and nutrient metabolism were learned in the classroom. This classwork helped me to truly understand how specific disease states can influence how our bodies digest and absorb food. I learned the application of the knowledge, motivational interviewing and efficient communication through the multiple rotations of my dietetic internship and the hands-on experience it provided.

AR: To gain experience in the field while studying nutrition, I began working as a research dietetic technician at MGH. In this role, I helped design meals and food challenges specific to clinical research studies and I collaborated with dietitians, nurses and doctors to carry out research protocols. This position offered invaluable experience in a clinical setting, exposed me to one of the many career paths a dietitian can take and richly complemented my dietetics education at Simmons College. I maintained this position throughout my dietetic internship at MGH, which was a fabulous test in honing my time management skills. Like Felicia, my current role as an outpatient clinical dietitian is my first job as a licensed and registered dietitian. The combination of my nutrition studies, working amongst health care professionals in a research center and gaining hands-on experience through my dietetic internship, provided me with a strong foundation for my current position where I provide compassionate and individually tailored medical nutrition therapy.

What do your day to day tasks look like?
FS: As an inpatient clinical dietitian, I’m the primary RD for two hospital floors and typically responsible for an additional one to two floors daily. As the primary RD for any particular floor, I begin my day assessing the number of consults that are ordered and the various follow-ups that are due. I also screen each floor I’m assigned to that day for any patients that may need to be seen due to a concern for malnutrition or a need for nutrition support like enteral feeding or parenteral nutrition. Each consult, follow-up and screen is then prioritized and I create a working schedule to see the most critical patients first. My day also includes attending multidisciplinary care team rounds where each patient on the floor is discussed to determine particular needs and plan for discharge. Consults are completed by performing a full nutrition assessment with the patient and follow-ups are completed by assessing nutritional changes made from the initial visit.

AR: Most of my days are spent one on one with patients providing nutrition education and counseling. Each new patient session is 60 minutes and each follow-up appointment is 30 minutes in duration. New sessions involve gathering a detailed medical and diet history, assessing and providing feedback on the nutritional adequacy of the patient’s diet, delivering nutrition education and collaborating with the patient to develop individualized and realistic nutrition-related goals. Follow-up appointments include reviewing previously set goals and discussing any challenges or triumphs that arose since the previous session. Often, I’ll provide additional education and together, we will set new goals for the patient to work on until the following appointment. Between patients, time is spent reviewing the scientific literature, developing education materials, preparing for upcoming patients and communicating with other members of patient’s care teams.

In part two of this interview, we’ll find out how these health care professional started their website Fully Nourished to provide information and guidance on health and wellness. Stay tuned!

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