I recieved a lovely email from a reader this week who wanted me to write up a little something on a “Day in the Life of an RD”…so, I did! I get a lot of emails about people pursuing a career in dietetics, or a career change to dietetics, and various questions about the educational and career paths for dietitians…and I am always happy to help! I am passionate about what I do and truly, whole-heartedly LOVE my work. It’s not work if you love what you do, right? 😉
As a little background, I work as a dietitian in an out-patient clinic in a rural community outside of Tulsa. For patient safety and to remain compliant with HIPPA laws, I cannot disclose identifiable information on patients or my place of work. We do have several physicians on staff as well as 8 nurses, 4 pharmacists and pharmacy technicians, 2 dietitians, ultrasound technician, radiology technician, physiologists, ophthalmologists and optometrists, phlebotomists (and a laboratory), as well as per diem podiatrists, endocrinologists, pediatricians, etc. Basically, we are one-stop shop for health care and accept all major medical coverage and insurance.
I work Monday through Thursday, 7am to 5:30pm and for the most part schedule my own patients. If a referral is made for the dietitian, a receptionist books a patient in for a 1-hour appointment. I see primarily diabetic and bariatric patients, as well as those needing diet assistance to manage other conditions such as hyperlipidemia, hypertension, anemia, non-alcoholic fatty liver, metabolic syndrome, gout, renal insufficiency, pre-natal nutrition, and digestive health (i.e. Crohn’s, Celiac disease, etc.). But it is fair to say 80% or more of my time is spent on diabetes and bariatrics. I work on 30-minute slots and bill for medical nutrition therapy in 15-minute increments.
Let me set the scene…
Currently, I am pursuing the Certified Diabetes Educator (CDE) credential. I currently have 445 hours and need 1,000 to sit for the exam. Logging my hours:
This is (part of) the form RD’s use to chart in my clinic. We are making the switch the Electronic Health Records (EHR) in the coming months.
Here is how insulin pens work:
Breakfast at my desk:
My work station:
Lunch at my desk:
Employee Taste Test Sign-Up!
Tuesday went something like this…
7-8am: Check my schedule (no 7:30am appointment – woo!), catch up on emails, eat breakfast at my desk, and finish any charting left from the previous day
8am: New onset type 2 diabetic wanting to control blood glucose through diet and exercise. Full diabetes diet and glucometer education completed. Discussed the role of oral agents to help control diabetes (45 minutes)
9am: Weight management follow-up – patient is trying to lose 40 lbs for her 50th birthday in 5 months – down 9 lbs in 3 months so far (60 minutes)
10:30am: Uncontrolled diabetic on insulin – discussed recommitting after “falling off the wagon” (45 minutes)
11:20am: Uncontrolled type 1 diabetic following up regarding carbohydrate to insulin ratio. Food journals and insulin regimens reviewed, glucometer downloaded to analyze. Recommended no changes in insulin dosing as fasting and post-prandial blood glucose goals were being met (45 minutes)
12:30pm: Surprise appointment! I went out to my car to get my water bottle and a patient asked me in the street to download his glucometer and give him more testing strips. The patient is a controlled type 2 diabetic who I have worked closely with over the course of 9 months to get his blood glucose levels within normal limits. He now journals all of his intake and checks his blood glucose up to 6x a day (45 minutes)
1:15pm: QUICK 5 minute lunch at my desk
1:20pm: Weight management follow-up. Patient lost 4.3 lbs in 2 weeks on a 1,800 calorie diet. Patient is considering bariatric surgery through our clinic (30 minutes)
2pm: Weight management follow-up. Patient lost 3.5 lbs in 2 weeks. Young, disruptive child present at session. Patient goals include meal planning and making food stamps last longer throughout the month (45 minutes)
2:45pm: Patient was rescheduled – he did not bring his glucometer or food journals/pattern management to meeting and therefore no insulin adjustments could be made.
3pm: Follow-up with uncontrolled type 2 diabetic on insulin and strict pattern management. Called patient’s physician and recommended a change in Levemir (long-acting insulin) – verbal order given over the phone (30 minutes)
3:45pm: Follow-up weight management and uncontrolled hypertension; 0.8 lb weight gain in 2 weeks. Patient was seeking advice on diet pills and how to manage “dieting” with unsupportive friends, co-workers, and husband (45 minutes)
4:30pm: Weight management follow-up – I have been seeing this patient for 9 months without significant weight loss, yet she attends all of our appointments and wants to continue coming to RD meetings (30 minutes)
5-5:30pm: Catch-up on charting, returns urgent emails and phone calls, and head home!
There were 14 appointments scheduled on this day – 2 called to cancel, 2 no-showed, and I had 1 walk-in patient.
Likes and Dislikes
I love the critical thinking and intense patient-provider interaction involved in diabetes care. Plus, I do have some of the best patients :). And most of you know I am passionate about diabetes, I love working in diabetes. I hate the early hours…mornings are rough…and the fact that most blogs are blocked at work 🙁 And…I can always want more money, right? 😉
There you have it…a Day in the Life of an RD!
Question: What is your current profession? What do you love and hate most about YOUR current role?
Work hard 😉 ,