Dietitian skills are more than just clinical knowledge. Here are 3 surprising skills to help you start feeling more like the professional you are.
Worried about your clinical nutrition skills? Start here.
Being a new clinical dietitian is like being in a whole new world.
The Clinical Nutrition 101 course we took suddenly feels like a primer in the 5 food groups. And walking into your patient’s rooms feels like you’re center stage in a play where you don’t know your lines.
The real world requires different clinical nutrition skills than being able to do a 10 minute presentation on the latest cholesterol research.
The fear and overwhelm can be palpable.
What you DON'T need in clinical nutrition
Here’s a secret about starting out in clinical nutrition you never learned in school: You don’t have to memorize anything.
Almost everything you’re worried about forgetting, can be posted on the wall in your office for quick reference.
Those pesky lab values and nutrient-medication interactions that you forgot and figured you never really needed to remember anyway. Even the therapeutic diets you could never quite remember come in easy to use patient handouts to guide your conversation.
In truth, most of the things we were quizzed on in school come in the form of helpful cheat sheets and handouts that make sure you never have to memorize anything.
It’s the things you’re NOT thinking about, that will mold you into a great RD. That’s what we’re going to talk about today.
3 dietitian skills you NEED to have
There are some clinical nutrition skills that can really make an impact as you navigate your way around the medical units. These are a few of the ones that ultimately really matter.
Unfortunately, these aren’t things we usually learn in school. They aren’t even the skills a lot of preceptors talk to us about. But the more comfortable you can get with each of these, the more comfortable you’ll feel in acute and critical care.
These 3 dietitian skills are:
- Become an excellent listener
- Think like a dietitian
- Always be asking questions
Each of these are sort of assumed to be things we’ll know how to do. Or even, things we’ll know that we SHOULD do.
But just because we have the education, and maybe even the RD title, doesn’t mean we’ve somehow suddenly absorbed the skills of a seasoned dietitian along the way.
Growing into a really good clinical dietitian does take time. But these 3 skills will get you there a bit faster.
Skill #1: Become an excellent listener
Being able to listen well is one of those things we can take for granted. But it comes in at number 1, for a good reason.
We can follow directions. We understand instructions. We’re great at checking boxes and getting things executed. After all, that’s what we’ve been taught to be good at.
But when we’re dealing with people who are struggling to feel better, being heard can be as important as their medication. For this reason, listening is the first secret skill dietitians who are great at clinical nutrition do every day.
When you begin to do this well, the way you start treating your patients will change. You’ll learn what they really need from you and what they’re ready to work on. You might even learn why they ended up in your care in the first place. And there’s a really good chance it’s not the reason you think it is.
Stuck on the conversation part of listening to your patients? The free Nutrition Quick Chats Quick Course get you through any clinical conversation.
What else happens when you listen well?
As you become a better listener, you’ll start to pick up on a lot of other little things as well. Things that might change the course of how you do your work, or those you go to for support.
You might start paying closer attention to the side conversations 2 doctors are having about a new admission who happens to be a really complex patient. After hearing them talk, maybe you make a mental note to always check a specific lab the next time you see someone with that particular condition.
Or maybe you’re sitting next to a couple of nurses talking about their patients. There’s a good chance you’ll quickly figure out who’s got more patience and is more receptive to answering your questions about how the tube feed hang works (or doesn’t work).
If you don’t remember anything else, remember this. Being an excellent listener will be one of your greatest skills as a dietitian.
Skill #2: Think like a dietitian
This one’s a bit harder to get a good handle on. Not because it’s particularly complicated, but because it takes a little more practice.
Thinking like a dietitian is all about being able to justify every decision you make in your nutrition care plan. You should be able to defend all our recommendations in your nutrition note, to another dietitian, and to any doctor who asks.
Remember that everything in clinical is documented for a reason. There has to be an ongoing record of everything everyone has decided to do.
For this reason, you want the nutrition note and diet order you write to be exceptionally clear. Every part of the chart you’ve review, everyone you speak to, everything you attempt to do, should be documented in that note.
What happens when you document well
First, you will start to have a very clear idea of why you’re making the decisions you’re making.
If you’re giving someone an extra Ensure with their meals, there should be a reason why. If you’re NOT giving someone an Ensure, there should be a reason why.
Second, you’ll be able to explain yourself to whoever asks.
In most clinical settings, you’re likely not going to be the only dietitian on staff. This means someone else might be reviewing the same patient you just saw last month. And when that RD goes back in that patient’s chart to get a better understanding of their history, the reasons for the decisions you made should be very clearly laid out.
Third, you should be able to advocate for your patient to a doctor or the nurse, or anyone else who asks.
Doctors are only human and make mistakes all the time. They overlook key information, they forget to put in orders, they drop the ball when a diet order needs to be changed. If you can’t clearly explain to them why something needs to happen, it’s your patient who pays the price.
Skill #3: Ask as many questions as you can
It’s easy to worry about looking dumb when we ask questions. Especially to our patients when we’re supposed to “know” everything.
But the truth is, great nutritionists don’t get anywhere without constantly learning and seeking out information. And the best way to do that is by asking people who have the answers and experience you need.
Luckily, when you work in a clinical setting, you’re surrounded by experience.
- Nurses who’ve been on the job for decades.
- Doctors who can’t stop talking about their war stories.
- Other dietitians who want you to be better and see you shine.
These are the people who are going to help hone your dietitian skills. They’ll help you go from having a basic understanding of something, to having a much deeper understanding of that thing.
What Else Happens When You Ask Questions
Quality health care doesn’t happen in a vacuum. It’s never just one person who fixes a patient, it’s quite literally a team effort.
It’s called an interdisciplinary team (IDT) for a reason.
So, volunteer to sit in on IDT rounds. Listen to what the others in the room are talking about. Pay close attention when you hear your patient’s name come up, or a new condition you haven’t yet worked with. Figure out who knows the most. And when you find them alone one day, ask them a question.
Ask them anything:
- Ask them why they looked at that lab instead of the other one.
- Ask them if they’re worried about the patient’s weight status.
- Ask them when that patient will be able to transition off their NPO status and start eating solid foods again.
And if they recommend you do something differently than what you were thinking, ask them to clarify. I promise, most people who have the time are going to love knowing how interested the dietitian is in the bigger picture.
Here’s one caveat to the “ask anyone” rule: brand new medical residents.
If you’re working in a teaching hospital, one that supports new doctors just going through their medical rotations, remember that they are learning in the same way you are. They don’t have the hands-on experience that their attending physician will have. They probably won’t even know half of what a really good nurse will know.
Aim to chat up more experienced doctors, nurse practitioners (NP) and physician assistants (PA) who can share the benefit of their time on the job.
And That’s It!
Those are the 3 skills all new clinical dietitians can learn. Each one will help you succeed in acute care and get you closer to feeling like the professional you are.
Want even more to help in clinical?
Check out The Nutrition Cheat Sheets Shop for all the nutrition education and clinical resources that will make your life easier.
