Here’s a secret no one will tell you: asking good clinical nutrition questions makes you sound smarter.
Great questions show those you’re talking to that you know what information you need to do your job. And you’re not afraid to ask for it.
So let’s get you asking great clinical nutrition questions.
3 Steps to Asking Great Clinical Nutrition Questions for New RDs
As a dietetic intern, knowing what kinds of questions to ask can be really tricky. Feeling confident about asking those questions can be equally as hard.
It’s easy to feel like you’re out of your depth or you don’t belong around those super smart RDs who have it all figured out.
But being able to ask questions is one of the fastest ways to win brownie points with your preceptors, learn how to do clinical nutrition really well, and start to flex one of the most important skills you’ll be using for the rest of your nutrition career: critical thinking.
And while there’s no such thing as a dumb question.
There is such a thing as a good or even great questions.
So how are you supposed to ask something important when you think every question is just proof you don’t know enough and don’t belong?
What are the questions you should even be asking?
How do you come up with new ones?
And when should you look something up yourself?
See…you’re asking great questions already!
This post will give you an easy way to make sure you’re always asking those great clinical nutrition questions.
There’s 3 simple steps to it. Here they are:
- Do your research
- Get clear on what you need
- Ask follow-up questions
Don’t worry. You don’t have to figure it out on your own.
Keep reading for a full breakdown on how you can use each of these steps to ask great questions, every time.
What are good clinical nutrition questions?
Another great question.
Before we break down each step, you want to know why spending so much time coming up with a good question is important in the first place.
It’s because when you get good at asking great clinical nutrition questions, you’ll be able to do two very key things.
First, you give your preceptors (or anyone else you need information from like a doctor or nurse) something very specific to address — and why it needs addressing.
We all know dietitians are busy.
And this means your preceptors are even busier.
They aren’t just responsible for managing their patient load. They’re also responsible for managing you and your work as you’re learning to take on your own patient list.
Good questions are probably one of the biggest underrated things you can do to help your preceptors better help you.
Second, you get the exact answer you need today — and information that will help you find an answer faster, tomorrow.
Ask a good question and you save everyone involved time by making sure the person answering your question can give you specific answers to your specific questions.
They make sure you get more of what you need by giving those you’re speaking to a chance to elaborate on the parts they know more about.
Parts you might not even have thought to ask about.
And when that happens, you’ve suddenly been given a tool or a skill that you’ll take with you the next time this question comes up.
Which, without question, it will.
These questions show those you’re working with that you’re looking at all the angles and can be counted on to notice things others might have missed.
Everyone knows that you as a dietetic intern is learning and that there will be questions.
It’s the types of questions you ask that will demonstrate to others how savvy a clinical dietitian you are.
So, how do you do it?
The best kinds of questions are the ones you can’t answer on your own.
This might sound sort of obvious. Or strange.
But it’s not unusual for new dietitians or interns to get so caught up in the many things they’re supposed to be doing, that it ends up feeling easier to just ask someone for the answer.
The problem with this, is that everyone around you is equally as busy.
Maybe busier.
Which is why you’re going to want to stick with these 3 steps before asking anyone anything.
#1: Do your research first
Before you ask anything, you’ve got to try and find the answer on your own. Every time.
There’s not many things that can annoy a preceptor like being asked a question you could have spent 5 minutes finding the answer to yourself.
To be clear, this isn’t the same as looking for something and not being able to find the answer.
The act of looking in the first place counts as doing the research.
Read the medical chart. Google something. Phone a friend.
Collect as much as you can about what you need to know. And then have all that information in front of you when you sit down to ask your questions.
Here’s an example:
Let’s say you’re stuck on what certain altered lab values mean and what you’re supposed to do about them.
You could start by looking into past labs and seeing if they’re trending up or down.
- If the labs are trends tell you they’re improving, maybe you don’t have to do anything and now you have.
- If they’re getting worse, now you know something really isn’t going right and you’re on to a legit question.
You could also check their past medical history and list of diagnoses and correlate medical conditions with the labs you’re concerned about.
- If they have a medical condition that contributes to those altered lab values, you have a lot of context regarding why they might be out of wack.
- If your patient doesn’t have anything indicating that specific health issue, it’s reasonable that you might have questions about organ dysfunction or disease progression.
And finally, you’d probably want to check the rest of the medical chart for mentions of either the labs or the corresponding medical condition.
- If it’s a renal issue, is there a note from nephrology?
- If you’re looking at glucose levels, is there a note from the endocrinologist?
- If there’s a worry about anemia, is there a note from a GI doctor or maybe a surgeon?
When you’ve gone through all possible angles related to your question, it’s time to move on to step 2.
#2: Get clear on the answer you’re looking for
So you have a question and now you have all of this extra information. You know a lot more than you did before that first question popped into your head.
And that’s a great thing.
The next step is to refine that first question into something that’s more specific and more direct.
Something that reflects all the things you’ve just learned.
This might reframe the entire question. It might be a subtle difference in word choice. Or it might be the exact same question you originally had.
Changing the first question isn’t the point.
The point is making sure you have a great clinical nutrition question that will help you get exactly the information you need from the person you’re talking to.
The research you’ve just done should help you get very clear on this.
To refine your question, you’re going to do two things:
First, be clear on what you’re planning to do with the answer you get.
And second, frame your questions so you can actually do that thing when you get the answer.
Here’s an example:
You see elevated BUN and Cr labs.
The first question you’re thinking is: did I miss something? Does this patient really have kidney disease? Am I supposed to give them a renal diet?
Ok, that’s 3 questions. But they come fast.
After doing some research, you learn the labs were much higher a few days ago but they’ve stabilized at a continued elevated level. They’re better today, but not normal.
It also turns out you were right and you didn’t miss anything. Your patient has no history of renal disease.
But there is a note from the nephrologist.
It mentions improved acute renal injury with no more reason for nephrology to continue following the patient.
There’s also a recommendation for the doctor to continue providing IV fluids.
Now, you have more information:
- The labs are improving.
It’s not chronic kidney disease, it’s acute and it’s improving.
Even the nephrologist isn’t worried anymore.
Maybe it changes what you need to ask, maybe it doesn’t. But you do have a chance to ask a better question.
Maybe your question goes from “what am I supposed to do about these kidneys and what kind of renal diet do I need to give them?” to…
“Should I even be worried about their renal function?”.
Ask a doctor this question, and you’re going to get a very specific answer that you can insert directly into your assessment as justification for your final decision.
And suddenly, your note is writing itself.
#3: Be ok asking follow up questions
Sometimes the first answer you get doesn’t really fit what you needed.
This is when follow-up questions are crucial to getting what you need.
Don’t assume that just because you’re talking to a doctor they’ll know what you’re asking for.
Or they’ll understand the exact information you need to do your job.
It could be because of the actual words you used when you asked your question.
It could be because you asked someone who just doesn’t answer questions well.
The same goes for your patients.
Or conversations you have with a surgeon or a CNA or someone in the kitchen.
It’s easy for people to misunderstand a question or simply leave things out they don’t think you want or need to know.
Follow-up questions help you guide the conversation towards the answers you’re looking for.
…Instead of leaving you with an answer that leaves you confused or without a solution to your problem.
Here’s an example:
You want to give the patient a regular diet but you need to confirm the kidneys can handle it.
You’ve landed on the question “how’s this patient’s kidneys doing” and ask the attending MD for an answer.
The doctor tells you the patient has acute kidney injury and they’re still running the IV as the nephrologist recommended.
All things you already know. And it doesn’t actually answer your question.
A follow-up question would be great here.
And since you know that your goal is ultimately to decide between a regular diet and a renal diet, you’re armed with a very specific direction to guide this conversation.
It might be something like:
- Thanks. I saw the labs are improving and would like to get them a regular diet. Is there any reason you’re still concerned about their kidneys possibly getting worse?
- Ok, so would you say the kidneys are getting better with the IV treatment? I saw their labs are trending down.
- Got it. I’m going to recommend a renal diet until the renal labs have improved a bit more. Are there lab values you’re watching for that I can also monitor?
There are no wrong answers.
Your follow-up questions (or any question, actually) needs to get you to an answer and a clear justification or reason for making that decision, which you can then document in your assessment is the goal.
And That’s It!
The best clinical nutrition questions you can ask are the ones that will support you as you care for your patients.
They’re refined enough that there’s no confusion about what you’re asking and leave no confusion as to why you’re asking it.
Practice these three steps and you’ll come back to them again and again in your nutrition career.
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