Registered dietitians account for more than a third of the leadership team at Morrison Healthcare, a division of Compass Group in the US, which is bringing huge benefits to patients.
Mara Whitesell is the division president at Morrison and became a registered dietitian (RD) once she’d graduated from university, because she’d always enjoyed learning about wellness and nutrition but doesn’t enjoy the blood and guts side of medicine.
“Having dietitians at the bedside as part of the medical team is incredibly important. And the skill sets that RDs have is a great opportunity to put them in leadership roles,” she says.
Being a registered dietitian also brings a lot of credibility to the catering department, she points out. “The foodservice department isn’t just serving meals, they are part of the healing process for the patients. Having RDs engaged helps connect food and clinical which is a key part of the healthcare process.”
The registered dietitians have many roles in the healthcare setting — from budgets, to managing staff, ensuring food is up to standards and is safe.
They really straddle the divide between the clinical side of healthcare – taking care of the patients – and the catering side, says Whitesell.
The RDs spend time at the bedside, with the medical team; they work with other clinical partners within the hospital such as nursing, therapists, doctors, and other medical professionals ‘so our impact is better’, she says.
“And, because they’re so involved they can perfectly craft the best diet and menu on a patient-by-patient basis. Many dietitians are very detail-oriented and know how to work through processes,” she adds.
Adjusting diets
Most diets at Morrison Healthcare accounts are fairly standard, but the registered dietitians are there to make any adjustments, Whitesell points out.
“They look at the diets [and determine whether] they need additional supplementation, are they on an IV or a tube feed. They create a tailored plan, which is such an important part of the healing piece. The ‘food is medicine’ saying is not just a buzz word. Our RDs have an expertise that no one else in the hospital has.”
The dietitians are also trained to be on the lookout for dietary deficiencies, she says. For example, malnutrition is under-diagnosed.
“But when we have dietitians engaged as part of the diagnostic process we know a lot more people get treated for malnutrition.” This has been highlighted through the RDs and Morrison has invested in a malnutrition programme.
One of Morrison’s registered dietitians is Dominique Dortch, RDN, who’s senior director of food and nutrition with at Children’s Hospital in Oakland, California.
In her role, and in that of most Morrison registered dietitians, she straddles the clinical side of healthcare (the non-food side of caring for patients) and the food side.
On the food side, Dortch works closely with the catering department to ensure the patients are being fed the best food for their recovery.
She also works on the retail side, ensuring a variety of foods are available that appeal to the local demographic. For Oakland, this means clam chowder has to be available every day, and there needs to be a selection of Hispanic and Asian foods. She also aims to give back to the community and partners with local coffee roasters to buy beans for the hospital’s coffee shop.
Helping people one-on-one
She really enjoys her job. “I like that it’s always challenging, always something new, and dealing with different people and all the different personalities and how to help them. And the psychology of management – me adjusting my personal skills to each person – how I talk to one employee, I won’t talk in the same way to another,” she points out.
The reason Dortch wanted to become a registered dietitian and work closely on patients’ diets is personal. She was born two months premature, which led to her developing anaemia.
“If someone had put a vitamin E supplement in my mouth when I was born I wouldn’t have had anaemia. Such a simple thing can make a change,” she says. Later in her life, seeing her mum battle fibromyalgia and rheumatoid arthritis and taking lots of pills, she started think about dietary changes that could bring her mother some relief. Medicine and diet should work hand-in-hand, she says.
Dortch has been a registered dietitian for a year and it took her six months to gain the qualification, which meant doing work experience at another hospital, concurrent with her work at Children’s.
Becoming a registered dietitian has helped give her the confidence to do her job, to create diet plans for patients with different needs and has enabled her to quickly think on her feet in this fast-paced job. For example, supply shortages require her to think quickly to substitute nutritionally comparable foods if needed.
“It’s very rewarding; I’m coming up with a new solution to make things better,” she says.
Currently, her department is partnering with speech therapy to revamp patient menus.
“Giving patients [the right] food helps nourish their bodies and helps them heal from whatever reason they’re in the hospital. If someone has burns they need enough protein to regain their strength. And this is just as important as having their medication.”
A challenge that has occurred recently, says Whitesell, is the Commission on Dietetic Registration has mandated that anyone becoming a registered dietitian needs to have a Masters degree, ‘which is going to lead to fewer people going into that role’, she says.
On the flip side, encouraging Morrison employees to become registered dietitians is drawing more applicants to jobs at Morrison, says Whitesell, and it helps them envision a career trajectory.
It’s a very fulfilling job to have, she says. “I’m glad to be part of an organisation that values dietitians and what they do. It’s helped me grow my career.”