By Katie O’Brien
I would regard myself as being quite lucky in that, quite early in life, I recognised the area in which I wanted to work. I have always had what I thought was a somewhat strange interest in food and how it affects the human body. To this day I still find it fascinating how something so simple can impact our health in such a significant way. When applying to university it was clear to me that a course in nutritional science at University College Cork was perfect for me. I researched career opportunities from this course and the one that appealed to me most was that of a dietitian. Combining my love of food and nutrition with helping people seemed like a no-brainer.
Admittedly I picked the long way of going about this as following the four years studying nutritional science; I would then need to complete a two year postgraduate diploma in dietetics. However, I found the challenge of this exciting and felt this route would open up more opportunities in my future career. Through my undergraduate programme I would gain valuable food industry experience, while the postgraduate programme would provide me with essential clinical experience.
Fast forward six years and I have just now completed my final exam at the end of my postgraduate diploma in dietetics with Glasgow Caledonian University. A long journey but one I have thoroughly enjoyed. My undergraduate programme provided me with a strong foundation of the science and nutrition knowledge essential to work effectively as a dietitian. While the postgraduate diploma equipped me with all the skills necessary to use this knowledge to best help patients.
In the final year of my postgraduate diploma, I completed two twelve week (B and C) placements. This experience was by far the most enjoyable in my six years of study. Finally I was applying all the knowledge floating around my head in the best possible way. Most importantly I was seeing how this work made a significant difference to my patients. I have seen first-hand how dietetic input can significantly improve a patient’s health, quality of life and well-being. This service is vital for patients.
Although my placement experience was an extremely positive one, it has left me concerned that our profession is not as valued as it ought to be. I have met a large variety of other health professionals and patients over the course of my 24 weeks of placement and whilst many of them saw dietetic input as a priority, a worrying number seemed to dismiss it as unimportant.
On placement I have encountered patients with preconceived ideas that my input would not benefit them, making them reluctant to accept dietetic input. For instance a number of patients believed my main role was to provide weight management advice and encourage fruit and vegetable intake. While others believed my advice would be as simple as telling them to eat more which they felt they would not manage. I dealt with these situations by explaining to patients why they were referred for input, the ways in which I could support them and how this would benefit them overall. Following this some patients were more open to receiving advice however others still refused input.
I have also encountered other health professionals who have considered my role to be minor, thus making dietetic input more difficult. Examples of this include recommendations I made to medical and ward staff which were disregarded. For instance; requests for daily bloods on patients at high risk of re-feeding syndrome were ignored while supplements and snacks were not been given as requested. On occasion enteral feeding was commenced contrary to recommendations, while in other cases the need to consider enteral feeding was not taken on board. In these instances I flagged up my concerns through the medical and nursing notes, I spoke with staff personally and I highlighted my concerns to the supervising dietitian.
I am concerned that, if this continues, eventually our role will be de-valued to the point where our input is not being received where it is really needed. I know that the work of a dietitian is invaluable in community, acute, research, industry, legislative and public health roles among many others. However as a profession we need to promote our roles more, and highlight our worth to both the public and fellow health professionals. I can see that already great work is being done in this area, for instance through the British Dietetic Association’s “trust a dietitian” campaign, the greater presence of dietitians in the media, and the use of clinical outcomes in practice. Moving forward I hope this work will continue and greater discussion around this area will be generated.
So what’s next? Well I have just received news that I have passed the final year of my postgraduate diploma in dietetics! The next step from here will see me look to gain HCPC registration. After six long years of studying, I think a well earned break is in order, so I plan to spend a few months in Spain travelling. During this time I hope to improve on my Spanish and learn some more about the dietetic service in the country as I am keen to see how things are done across different countries. Hopefully I will return with a bit of a tan and look to find my first role as a dietitian. Down the line I hope to identify a specialty and would love to become involved in research, maybe even do a PhD at some point but I think I’m getting a bit ahead of myself now!