Dietetics is a large field of opportunity, and therefore people work as dietitians in many many different roles. From scientific research, lecturing, NHS/private hospitals, sports, food and drink companies, media and freelancing. Therefore I obviously cannot cover all of these, mainly because I do not have the experience of all of these disciplines! I can comment however on what I do know, and that is working as a dietitian within the NHS. So here is a general day that can be expected (obviously things may differ depending on speciality and/or hospital).
8.20am: Arrive at the hospital and try to find a car parking space (as it is usually busy already!)
8.30am: Sit at your desk, turn on the computer and make a drink
8.40am: Check the answering machine/fax or however you receive referrals to see how many new patients you have
8.50: Check the computer to see how many of your patients on the list have left, add on the new ones and prioritise which patients need to be seen and when (all new inpatient admissions are generally seen within 24 hours, depending on hospital policy and severity of patient’s condition, and follow-ups within 3-5 days, again dependent on condition)
9.00am: Check the computer for any new blood results out for your patients and make notes of anything which may be useful for your care plan (this can take a while depending on how many patients you have! Typically a case load is 35-40 patients, but not all may need blood results)
9.30am: If you are running a clinic that day it is a good idea to have a look at the referrals for the outpatients, familiarise yourself with their reason for coming in and gather any information/diet sheets that may be needed for these patients
9.50am: Head onto the wards, based on your patient prioritisation from earlier. Usually on the wards you receive referrals/questions/requests from nurses and doctors which may cause you to change your plan and have you running off to sort out another patient you did not know about until then! This may also involve liaising with the catering department as a patient has a special request/allergy/religious request or running back to the department to get a diet sheet for a patient about to go home.
10.15am: So with a typical patient on the ward you will check their medical notes first for any changes in their condition and to see what the doctor has written about today’s ward round and what their care plan is. Sometimes the doctor will request the dietitian to change something, such as a fluid restriction or enteral nutrition feeding plan, but only sometimes! Then you check the ‘bed end notes’, these contain information on the patient’s weight, height, BMI, stool chart, fluid chart, food chart and temperature from which you can adjust your care plan if needed. This is all before actually talking to the patient and can take a while as there is usually a few people wanting to use the same notes as you at any one time! So then once you are up to date with information you can go and chat with the patient, ask of how they’re feeling, have they eaten well, do they feel nausea etc. Then, it’s time to make your care plan, which can be really simple or much more intricate dependent on overall goal, disease state and treatment needed. Patients may need a plan to: gain weight, low protein/sodium/potassium diet, fluid restriction, control blood sugars, or they may need tube feeding or parenteral nutrition.
11am: A typical new patient can take up to 45 mins to assess, talk to and construct a care plan, a follow-up patient anywhere from 15-30 mins. Then of course once the care plan is written in the medical notes you need to talk to the appropriate care staff of anything that needs doing, this could be nurses/doctors/physios/speech and language therapists.
12.30pm: So you try and get as many patients seen in the morning as possible, as there are probably more new referrals to see to once you head back to the office for lunch! Lunch is 30 mins.
1pm: Back to work! Hopefully the list of prioritised patients is working out well and you can get the rest seen this afternoon.
But lets say instead you have a clinic to run. If there are any patients unseen that need to be, someone in the team will be able to cover them for you, if not then well done!
1pm: A general clinic, which is what a band 5 (newbie) dietitian will run, can consist of many different patient types. Such as: type 2 diabetes, weight gain, weight loss, kidney problems, low sodium, reflux, fussy eaters and IBS to name a few, therefore a good grasp of general knowledge is essential, as is a good supply of diet sheets with you to give out! New patient appointments are typically 45 minutes with follow ups 20-30 minutes. I love clinics, they are a great way to not only advise on dietary matters but to also counsel people, as a lot of difficulty comes from psychological issues and past experience. We get taught at uni about psychology of health, and this really comes into useful.
4.30pm: Home time! As long as all patients are seen and/or clinic didn’t overrun (which it has a tendancy of doing!)
I hope you found this interesting! And hopefully this explains a bit about what we do 🙂 please let me know!
I have also just written a page about iodine and pregnancy, take a look 🙂
(Image courtesy of stock images / FreeDigitalPhotos.net)