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Career Story: Registered Dietician In A Nursing Home

Registered Dietician In A Nursing Home

Job Title: Registered Dietitian

Type of Company: I work in a nursing home and rehabilitation center who care for resident's and patients who cannot care for themselves and/or who need physical therapy or temporary nursing care.

Education: BS in in Nutrition and Dietetics •• Master's degree in Nutrition Education

Previous Experience: I worked at a major hospital on the cardiac unit and the oncology unit. For the past 13 years I have worked as a nutrition consultant in nursing homes and rehabs.

Job Tasks: I am a consultant dietitian (registered dietitian) working in two nursing home and rehabilitation centers in Massachusetts (suburbs) outside of Boston. I have been a dietitian for more than fifteen years and have worked in consulting for more than 13 years.

A typical day includes interviewing new patient's that come into the rehab. The interview includes asking their height, weight, if they have gained or lost any weight recently. I ask if they have difficulty chewing or swallowing in case they need a diet which would consist of soft foods. I always ask how their appetite is and how much of the meals they are eating.

After my interview, I take their chart and sit at the nursing station. I fill in the nutrition assessment including their medical history, lab work, percent they are eating/drinking at meals. I take notes as to whether they have skin breakdown, because if they do, they would need more nutritional intake and supplemental vitamins and protein. I write out my assessment and make any recommendations for items like liquid supplements (e.g., Ensure drinks), vitamin supplements, modified diet texture, or to check labs, etc.

For the long-term residents, I assess each of them quarterly - every 90 days. The health care team has care plan meeting every Tuesday and Wednesday morning for each new resident (after they have been there two weeks and if they didn't already go home) as well as each long term resident every 90 days. The family members are invited to the care plan meeting which consists of the health care team (nurse manager, speech therapist if needed, activities director, dietitian, physical and/or occupational therapists and the social worker) We all go around the table and talk about each patient's progress and current status. In addition we are required to write out a quarterly assessment in the chart. In addition to these tasks, I review the weight book on each floor every week to monitor for significant weight losses or large weight gains in a short period of time.

I attend a weekly wound and weight meeting to discuss any new wounds and weight losses.

I work as a consultant for 20 hours per week at one facility and 8 hours per week at another (hours depend on how large the facility is)

Best and Worst Parts of the Job: The best part of being a consultant in long-term care and in rehab facilities is I have a large amount of flexibility with regard to my schedule. I can even go in on the weekend or evenings if I choose. They basically want me to be present at the care plan meeting and wound and weights meeting, other than that I can make up my own schedule. I do try to stick with the same schedule weekly, so the nurses etc. know when I will be in the building. I love to work with people and in particular the elderly, therefore it is very enjoyable to me to work in long-term care. I also love to educate individuals on good nutrition and help make people feel better. I feel I can do this daily.

Working as a consultant, however has its downfall in that I do not get benefits or vacation time. The good part is, as a consultant I get a very good hourly rate.

Job Tips:
1. To be sure you work hard in school and keep your grade point average up as the internships are fairly competitive. You have to apply for an internship and get accepted into one.

2. You will take many chemistry classes.

3. You will take many science classes like microbiology and anatomy physiology.

Additional Thoughts: If I could change one thing about being a consultant, I would definitely say having vacation time. I have no coverage, so If I take a week off, there is much work to be caught up on upon my return. I usually do more hours the week prior to a vacation and when I get back. Also, if I don't work my given hours, I don't get paid.

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