According to the Academy of Nutrition and Dietetics, a Registered Dietitian (RD) is a food and nutrition expert with the ability to translate the science of nutrition into practical solutions that are essential for healthy living. RDs work in various settings throughout the community, including hospitals, school districts, public health clinics, skilled nursing facilities, food management, colleges and universities, sports teams, research facilities, and within private practice. In each of these settings, an RD uses nutrition expertise to help make individual changes for a positive lifestyle change. Ultimately, it is up to the RD to advocate for the nutrition status of clients, patients, and individuals throughout the United States, and around the world.1
Education of RDs
In order to become an RD, there are a number of credentials that an individual must meet. He or she first must earn a bachelor's degree and complete coursework through an Accreditation Council for Education in Nutrition and Dietetics (ACEND) accredited Didactic Program in Dietetics (DPD) or Coordinated Program in Dietetics (CP). Dietitians study a variety of subjects, including nutrition and food science, biochemistry, microbiology, anatomy, biology, chemistry, food service, counseling, business, psychology, and communication. Following this degree, they must complete a yearlong internship at an accredited, supervised practice program that includes time spent at a health care facility, a community agency, and a food service corporation.
After successful completion of the internship, an RD must pass a national examination administered by the Commission on Dietetic Registration (CDR) to become Board Certified. Most states require additional Licensure at a state level. Finally, continuing education geared towards specific career goals must be completed to maintain registration status. Over 50% of RDs hold an advanced degree, as well as advanced certifications. RDs may hold certifications in a variety of specialty categories, including nutrition support, diabetes education, renal health, sports nutrition, and pediatric nutrition. RDs are not only the food and nutrition experts, but they are leaders in the field of dietetics, constantly advancing their knowledge and skills to enhance their education.1
Opportunities for Employment
With such a diverse background, RDs have ample employment opportunities. RDs can be employed in hospitals and health care facilities, where they provide medical nutrition therapy as a part of the health care team. In wellness programs, RDs work to educate clients regarding the association among nutrition, fitness, and health. They work in food service by maintaining food safety standards, creating standard driven menu cycles, and continuing product development. In the community setting, RDs work with programs such as Women, Infants, and Children (WIC), the Food Bank, and Meals on Wheels. Finally, RDs can work at universities and colleges, as well as in research for food companies conducting experiments to answer critical questions in the field of nutrition.1
Dietitians work closely with Registered Nurses and Certified Nursing Assistants in a variety of settings. Whether it is the clinical setting, a long-term care facility, or even in a health clinic in a school district, RNs and RDs can greatly support one another in the work that they do. Because a RN is at the forefront of patient care, they are able to provide RDs with a wealth of information regarding a patient's nutrition status. Whether it is enteral or parenteral nutrition tolerance, food and supplement intake, family concern for appetite or weight loss prior to admission, or other clinical information, RNs play a vital role in helping the RD come up with a clinical plan of care for the patient.
In many health care settings, there is a screening tool completed by the nurse when a patient is admitted that indicates whether the patient has lost weight or had a poor appetite prior to admission, if they have any difficulties with eating, or if they have any past medical history of need for nutrition support, among other indicators. While this screening tool is different based on the facility, the purpose of the tool is universal: to help facilitate a conversation among the RDs, RNs, physicians, auxiliary staff, and family to help create the best plan of care for the patient's nutrition status.
RDs and RNs work together with open, honest communication to collaborate the best care for the patient. If nurses have questions regarding the appropriateness of a diet or supplement, enteral or parenteral tolerance, or diet consistencies, they should contact the RD available on staff. As the experts, RD's will be able to help streamline any problems and create the best nutrition plan for patients. Nurses' help is invaluable to the care registered dietitians provide. They could not do their jobs without nurses!
1 EatRightPRO. Career in Dietetics. 2016. http://www.eatrightpro.org. Accessed April 3, 2016.
Taylor Schellhardt is medical nutrition therapist at the Cleveland Clinic.