So You Know

My job is really simple. Every day I worry that I don’t have the knowledge to help my patients, but for the most part, I think it’s not the knowledge that takes priority, but the interpersonal skills. I’m a dietitian and for the past couple months, I now work in an outpatient clinic. My day no longer consists of visiting hospitalized patients for 10-15 minutes to give them the Sparknotes version of why they should consider eating healthier. Now I get a full hour to get to know someone and start to figure out what that really looks like.

It can be difficult in its own way, but what keeps it interesting is that even if it is the same education over and over again, every person is different. Sometimes this can be frustrating. Sometimes it is surprising in the best of ways. Most of the time I find myself rooting for people.

Let’s take weight loss appointments for example. The advice is simple, be mindful of portion sizes and added unnecessary calories. How do you do that though? Depends on the person. Some people just cutting out soda is a huge difference. Others it’s more about healthier snacks consisting of whole foods like fruits or other fiber containing carbohydrates and protein containing foods to replace ultraprocessed products such as chips or candy that add little nutritional value. Or for the people who eat fast food every day multiple times per day, just choosing restaurants that serve more vegetables than what goes on a burger would be an improvement.

What I’m saying is that the ultimate goal may be the same, but the steps to get there are different from person to person. It really is about admitting if you have a problem and what it is first then making small gradual changes for the better. I’ve talked about my personal issues regarding food for years on this blog. It’s been a thing that nagged at me even as a student, before working as a dietitian. When I started working as an inpatient dietitian, everything was so fast paced and at times critical- such as when I worked in an ICU. I hardly even had time to stress about how I wasn’t following my own advice between trying to see 12-15 people per day to talk to them and give them nutrition guidance. Now as an outpatient dietitian with more time to talk about the details with people, I find myself following my own advice more.

I’m recommending people eat more vegetables, fruit, and whole grains typically using the plate method (learn more at the website: myplate.gov). Quick explanation: for a healthy balanced meal, aim to fill half of a 9 inch plate with vegetables (2 cups of raw vegetables or 1 cup of cooked vegetables), about a quarter of the plate with a healthy carbohydrate such as whole grain bread, whole grain tortilla, brown rice, beans, lentils, starchy vegetables like potatoes, corn, or green peas (about 1/2 cup serving) and the last quarter with a lean protein such as skinless chicken, turkey, fish, lean beef or plant based protein like nuts, nut butters, or tofu (3oz portion, generally about the size of a deck of cards).

When I go to the cafeteria at work, I find myself trying to follow this method too. Something that I did not attempt to do before. Before it was all about getting food into me, any food, quickly before getting back to seeing patients or write notes or go to meetings. Now I feel like I can breathe again. Currently I feel comfortable seeing 4-5 patients per day (1 hour sessions each). That alone has made an immense difference in my days. On this side of being a dietitian, my job has allowed me to increase the number of patients I see as I feel comfortable. On the impatient side, there were quotas and expectations that did not take into account how I or any other inpatient dietitian I worked with felt, or how tired or overworked we were.

My life has involved a lot of change recently, mainly in regards to social dynamics. It’s been hectic and more than a little stressful. I won’t say that the job change hasn’t contributed stress to my life, but overall, I find myself partaking in the hope I attempt to instill in my patients. I am beginning to believe that I also can make the small, simple, but truly difficult changes to slowly improve my own nutrition and thus my life.

I get so many different viewpoints about my profession. Some people have told me that my job is unnecessary and that everyone knows how to eat healthy generally while others are so grateful after a visit it makes me feel like all of the struggle to get to where I am professionally was worth it. It renews my convictions of why I went into this profession. I truly believe it matters; what you eat affects your entire life from how you feel, how much energy you have, to how quickly a disease progresses (or is prevented).

Yet, believing this, wanting this, knowing what to do, has not been enough for me. Remember, it is so simple. But even having all of the tools and intentions has not been enough. Maybe this will be another in a long line of attempts instead of the time I actually stick to what I preach. I know I am not in the ideal environment for many of the changes I would like to make, but I am ready to do what I can, as small as those changes may be.

I used to think, like many of my patients express in their initial appointments, that the changes had to be major to mean anything. But as I have experienced, the years will pass anyway, and those big changes can be unsustainable if they are drastically different from a person’s baseline behavior (what you do when you’re tired or stressed or are just not feeling it). If I had accepted making tiny, easy changes even in the past three years as a dietitian I would be much healthier than I am now. I’m done waiting for the perfect conditions to fix everything in order to start doing anything.

I think I’m ready and if I’m not, then here we go, let’s learn another life lesson in what not to do. I accept whatever happens.

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Note: This post is long enough, I will post a follow up of the tiny things I want to focus on in the next post. I encourage you to attempt the same with whatever goals you have. Take the big things and break them down into smaller more manageable pieces. Come back for examples!