In Defense of Registered Dietitians

During this pandemic, there are a lot of people we need to thank. Of course, the doctors and nurses providing hands-on care to those who need it most. We have our grocery store employees, mail carriers, baristas, first responders, and a bunch of other professions. But one I never hear about are registered dietitians. Maybe it’s because I am one and I’m looking for the validation, or maybe because people don’t think we actually do much. Never before have I ever felt more disrespected in my profession as when I work in inpatient health care. But day in and day out, RDs are the unsung heroes of healthcare.

Before I became an RD, I thought nutrition was telling people what macros to eat. After taking all the premed science courses, I thought differently. I didn’t understand how much there was to the job when I decided to become one. RDs don’t just help with “weight loss’ as so many people think we do. We don’t just put together meal plans or yell at people to eat some vegetables (which you should btw). RDs help you plan out grocery shopping for the week around a budget that most people spend in a single meal at a restaurant. RDs work with people who have severe allergies or intolerances and help them navigate through life easier. RDs help to make sure your baby is growing properly and getting enough nutrition. But that doesn’t even include what we do in a hospital.

In an inpatient setting, RDs assess labs to find nutrient deficiencies that can uncover whether or not someone has been eating before they came in unconscious. RDs advocate for patients who cannot eat for whatever reason and get their team to start feeding them another way because they need nutrition now. RDs advocate to stop feeding patients when they are too unstable to feed. RDs calculate how to feed people intravenously and choose what additions should go into the mix based on their labs. Are we holding someone’s copper because their Tbili lab shot up? Are their triglycerides too high to receive lipids today? Did they just get sepsis or a pressure ulcer and now we need to completely recalculate their needs with higher protein? We assess malnutrition, which is rampant in hospitals. We work with pharmacists to make sure there won’t be any food-drug interactions with the medications the patients are taking. We find ways to help people get nutrition when they have no appetite. We know which tube feeding formula to use depending on where a tube is placed, you can’t have intact macros if it starts further down in the GI tract. We are in the hospital making sure everyone is getting exactly what they need to be as stable as they can. We read and understand nutrition research, which is much different than other health care research because you cannot account for confounding factors nor just have someone not eat for months as a control.

We are not just a consult service. We are not “dietary.” We do not bring food to the floors. RDs are so much more and absolutely Vital AF (RD joke) to the function of hospitals. If we weren’t, we wouldn’t need to work on the weekends. But no one thinks about RDs when we’re talking about professions essential to a hospital. Hell, I get mistaken as a social worker every day just because I’m not in scrubs; RDs just aren’t the people you think are going to truly take care of patients. But we’re there. Making sure your labs say you are able to eat. Making sure you aren’t going to have a reaction to a medication with your food. Making sure that you are getting the best care from your team and collaborating with them. So, if you know an RD, please thank them because I can almost guarantee they don’t get enough of it at work.

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