As we celebrate Dietitians Week, it’s time we shine a spotlight on the remarkable work of these often-overlooked professionals within the realm of healthcare. Before delving into our interviews with the dedicated dietitians at POWH, we found ourselves pondering: What exactly do dietitians do in a hospital setting? Is their role solely confined to crafting meal plans and addressing weight loss concerns? Curiosity led us to five passionate individuals at the Nutrition and Dietetics Unit at POWH, and we discovered that we couldn’t be more wrong! Here’s what they had to say:
- Vicky – OACCP
- Jemma – Gastrointestinal Medicine
- Keats – Intensive Care Unit
- Emma – Community Assessment Unit
- Jacqui – Radiotherapy
Vicky– Osteoarthritis Chronic Care Program
POWHF: Can you please introduce yourself and your role title at POWH?
Vicky: I’m Vicky. I am a clinical dietitian here at Prince of Wales Hospital. I work on the cardiology and hemodialysis wards, and I’m also the Dietitian for an outpatient clinic called the Osteoarthritis Chronic Care Program (OACCP).
POWHF: What initially motivated you to get into the role you’re in now?
Vicky: So, I think in high school I always knew I wanted to do something science based. I wasn’t specifically thinking about working in allied health, but when I was looking through university courses, I thought a nutrition and dietetics degree sounded interesting. As part of the degree, one of the clinical placements I completed was in Dubbo Hospital, and I really enjoyed that environment. I enjoyed working with patients in hospital and seeing their progress and being able to feel like I was making a difference in their recovery. So that’s what really motivated me to start working in a hospital as a dietitian, and luckily since I’ve been here [at POWH], I’ve had a lot of opportunities to work in different clinical areas and it’s been a really rewarding experience.
POWHF: What do you enjoy about working in the unit you’re in now at POWH?
Vicky: I think what’s really enjoyable about that unit [Osteoarthritis Chronic Care] is it’s more of a multi-disciplinary team. We’ve got myself, a physio, and a clinical nurse consultant (CNC). Since she’s an orthopedics CNC, she’s able to talk with patients about their medications and pain management. The physio will talk about exercise and helping improve function. I’ll talk about diet and weight management. It’s a very team-based approach and I feel like the patients really benefit from having that varied input. We also manage our patients from a very holistic point of view, and it really helps with making those behavior changes and increasing motivation. We also follow up with patients every three months, so we get to see that progress over time as well.
POWHF: It sounds like you have an opportunity to work on your own and sometimes also work in a team.
Vicky: Yeah, we get to have our one-on-one consults with patients, and after we’ve completed our individual assessments, we’ll have a case conference and discuss any issues as a team. The physio, who’s our clinic coordinator, will also give feedback to the GP and pass on any recommendations, so you get to feel like you’re part of a bigger team.
POWHF: Do you have a favourite patient memory?
Vicky: There is a patient that comes to mind who I saw in the osteoarthritis clinic. Usually in this clinic, we see a lot of patients who, because of their pain, are very limited in how much physical activity they do. It causes them to gain weight, which then causes more pain and unfortunately, they often get stuck in this vicious cycle.
With this patient, she was someone who was very aware of the messages around osteoarthritis and that you should be concerned about managing your weight. But she was within the healthy weight range and had started restricting a lot of her foods because she thought she should be trying to avoid weight gain. We worked together on making healthy improvements to her eating habits, so we were aiming to maintain her weight but I was encouraging her to have more protein-rich foods and giving her that education that this was important to maintain her muscle mass and her function. I could see this reduced a lot of her anxiety because she was previously quite stressed about managing the pain, so I think I was able to increase her confidence by allowing her to have more food that she enjoyed and reducing a bit of the stress and anxiety around that.
POWHF: It sounds like the work you do is not just about helping with their nutrition but also helping them feel empowered, increase their self-esteem, and manage their physical pain. My last question for you is what is a misconception people have about dietitians who work at the hospital or in general?
Vicky: I think a very big misconception people have when I say I’m a dietitian is they assume we’re only focused on healthy eating and weight loss. While this is something that is often a focus of my sessions in the OACCP clinic, when I’m working with patients who are admitted in hospital, our role is often centered around helping patients who are malnourished, who aren’t getting enough nutrition, and who need that extra support to help them have more calorie-dense, protein-rich foods to help with their recovery and general health outcomes
Even in the osteoarthritis chronic care program when talking about weight management, we’re not just focused on weight loss and measurements and what the number on the scale is. I think we try to give a much more holistic approach in terms of how eating fits into their daily routines, making achievable goals around diet quality, and considering their overall relationship with food, rather than just focusing on numbers on the scale.
Jemma –Gastrointestinal Medicine
POWHF: Can you please introduce yourself and your role title at POWH?
Jemma: My name is Jemma and I’m the Gastro Medical Dietitian.
POWHF: What initially motivated you to get into the role you’re in now?
Jemma: I always knew I wanted to get into health care, and I have always been interested in nutrition, so Nutrition and Dietetics felt like the perfect mix of the two.
Growing up, I had some friends who had struggled with their weight. I was always interested in their weight loss journeys, their progress and what they were doing to achieve their goals. Whereas a lot of other people weren’t that interested. I think this really sparked an interest in me. At the moment I’m working predominantly on the gastro medical wards. I see patients with chronic liver disease, inflammatory bowel disease and other conditions that affect the gastrointestinal tract. I have always had a personal interest in gastroenterology. When I was working in the UK, I was working as a Liver Specialist Dietitian. However, I also had previously personal experiences with my gut health and irritable bowel syndrome, so I have always been interested in how you can heal your gut and how specific foods can trigger your symptoms. Now at the Prince of Wales, I find it rewarding working with patients who have similar issues and helping them to navigate their condition and manage their symptoms and nutrition.
POWHF: You have lived experience which gives you more of an advantage with those patients. What do you enjoy about working in the Gastro Medical team?
Jemma: I really enjoy the team aspect. I get on really well with the doctors and nurses who look after the gastro patients. They value my opinion as the dietitian and nutrition expert and this makes a massive difference when caring for patients; there’s a mutual respect. I’m also quite lucky in my role that I have a mixture of inpatient and outpatient work. I have a gastro-medical outpatient clinic where I have the opportunity to follow up my patients once they have been discharged from hospital. I love that aspect of my job, where I can provide specialised input whilst they are more unwell in hospital, however also in the community when they are better, I get to see the journey from start to end.
POWHF: Do you have a favourite patient memory that you can share?
Jemma: It’s difficult to pinpoint one specific memory from the Prince of Wales, as I have only been working as a dietitian in Australia since November. I think one of the most rewarding aspects is seeing patients again once they are feeling better and no longer in hospital. It’s wonderful to see the cases where patients have come so far with their health conditions, and nutrition. To follow up these patients in the community and see how grateful they are for the care they received in hospital is really rewarding. These patient stories are probably some of my favourite memories.
POWHF: That’s so nice to hear! Picking your favourite patient memory can be hard. My last question Jemma is, what is a misconception people have about dietitians who work in the hospital?
Jemma: I’d say there’s quite a few, but one that comes to mind would probably be the idea that dietitians in a hospital setting mainly deal with weight management, whereas this is the complete opposite of what we do!
In the acute setting as dietitians, we mainly help patients with maintaining their weight and preventing unintentional weight loss. Weight management is something that’s dealt with more in the community setting.
When patients are more unwell in hospital, we focus predominantly on nutrition support, diagnosing and preventing malnutrition and trying to provide as much nutrition to patients as possible through things like oral nutritional supplements and tube feeding, including enteral and parenteral nutrition.
But yes, in summary, we mainly work with patients to maintain their weight rather than to lose weight.
Keats– Intensive Care Unit
POWHF: Can you please introduce yourself and your role title at POWH?
Keats: I’m Keats. I’m currently the Acting Deputy Department Head and Clinical Lead, and the Intensive Care Dietitian.
POWHF: And if we scale it back in the past, what initially motivated you to get into the role you’re in now? What motivated you to study this area of medicine?
Keats: I did a lot of sailing when I was younger and there were dietitians within the team which is where I first heard of the job and thought it was pretty cool. I started the degree and loved it, a part of placement was in the hospital, and I knew that’s where I wanted to work. Working in the intensive care unit, I see a variety of patients, with various medical backgrounds, multi-organ involvement and multiple factors impacting their nutrition, so what motivates me for this role is the desire to help a wide variety of patients and to use these experiences to be able to help other dietitians do so as well.
POWHF: What do you enjoy about working in the ICU at POWH?
Keats: Working in the ICU team, I think it’s really amazing that everyone is doing everything they can as a team to help the patients. Dietitians play an important role in helping support patients nutrition when they are unable to eat or tolerate food in a way they previously could due to multiple medical issues and factors impacting their nutrition. In the ICU setting this could be due to multi-organ failure, post major gastrointestinal surgery, trauma or stroke etc. I really enjoy the troubleshooting side of the role and trying to work out how we can overcome some of the challenges that our patients face to provide them adequate nutrition. Whether it’s working with the team to feed through a tube beyond the area of concern or completely bypassing the gastrointestinal system and feeding via a vein using parenteral nutrition (PN). There are different forms of and strategies to provide nutrition support to help our patients and I really enjoy that part of it.
POWHF: I’ve asked this question numerous times with different clinicians, and I feel like for them it’s always a challenging one to pick. But do you have a favourite patient?
Keats: That is a hard one. A lot of patients stick with you for various reasons, some positive, good news stories and some that might not have been a positive outcome, especially in the ICU setting however part of their personality or the challenges of the case sticks. We see them when they’re so sick so when they get out of ICU it’s such a win. My favorite part though is when I hear from the ward dietitians that a patient I supported in ICU is going home, It’s pretty amazing.
POWHF: So the last thing I’d like to hear from you is, what are the common misconceptions that people generally have about dietitians?
Keats: People think that we’re involved with the physical food that’s provided, or diabetes education and weight loss advice and not really much more than that. These are areas dietitians are involved in; however, we also do a lot more. We are involved in providing essential and complex nutrition support across most areas of the hospital to manage a wide range of medical conditions
I think the second misconception is that we (dietitians) love snacks and desserts just as much as everyone else. If you come to the department, we’ve got heaps of tasty treats and a lot of people don’t realise that either.
Emma– Community Assessment Unit
POWHF: Can you please introduce yourself and your role title at POWH?
Emma: I’m Emma, and I am a Senior Dietitian. I work primarily in the Community Assessment Unit, which is a newly opened ward at the hospital. I’m also acting at the moment as our Student Coordinator part time.
POWHF: Going back a few years in the past, what initially motivated you to get into the role you’re in now? What initiated your study?
Emma: So back in high school, I can’t say I ever thought, “Hey, I want to be a dietitian!”. To be honest, I didn’t really know they even existed. I had a big interest in food, and I loved science. So, I applied for a science degree majoring in nutrition to start off with at uni, and through doing that course I then realised my love for nutrition and the pathway of what dietetics could be as well. I then applied for the Masters of Nutrition and Dietetics at Wollongong Uni.
But it was what was happening in my family life when I was going through during uni as well. My dad had motor neurone disease and when he was unwell towards the end of his life we met a dietitian, and they supported Dad with his nutrition, and I think that was probably one of the first moments for me of finding out what a dietitian could do for people. So in a way, I think that kind of shaped or paved, my journey into dietetics too.
I was lucky enough to have one of my clinical placements at Prince of Wales Hospital, which then led me to applying and successfully starting in a locum position here for my first clinical job. 7 years later, and I am still loving working here!
POWHF: Thanks so much for sharing. What do you enjoy about working in the Community Assessment Uni?
Emma : I guess I didn’t know what to expect because it was a new service that I was putting my hand up to work in. But having worked in it, the MDT is just a really lovely team to work with! All the allied health team members, the medical team members, the nurses, admin, I find we’re quite collaborative and aim to be really patient centered, and we’ve all got that goal to support patients that are coming into our unit to help them manage the chronic conditions that they are experiencing, and to support them.
It’s the team collaboration and teamwork I really enjoy. I’ve been lucky to work on a few wards at Prince of Wales since I’ve worked here, and in saying that I’ll put them equally at the top (as one of my favourite teams).
POWHF: My next question has been quite a challenging one amongst the team, so it may be hard to pick, but do you have a patient memory that you can share?
Emma: There’s a lot that stand out for me. When I first started working at Prince of Wales on the Respiratory Ward, there was a patient that stands out. She had a chronic respiratory condition and she ended up coming into the hospital quite frequently. I remember she was someone I saw at the start of my career, and she was just so grateful and lovely and took on all my advice, but also wanted to work with me in trying to put strategies forward to help her nutrition. She’s someone that’s really stuck in my mind over the years.
POWHF: My last question is, what’s a misconception you feel people have about dietitians who work in a hospital setting?
Emma: I’m thinking of this from varying perspectives. People I meet socially, a lot of the time they’re surprised that a dietitian even works in a hospital and their first thought often goes to “So you’re supporting people to lose weight because they are too heavy or they need to improve their eating?”. And that’s a huge misconception. Because a big part of our business working in a hospital is not supporting people that are trying to lose weight, it’s trying to support people that need to eat more or can’t eat more. So, we’re often using other routes of nutrition too.
In the hospital, I think patients are often shocked at how helpful we can be. I often receive feedback that they’re shocked that I’m not just telling them what they can’t eat. I’ve had great feedback that they’re appreciative that I am listening to them and that I want to know about their thoughts and feelings when we discuss changes to their eating.
From doctors and nurses’ perspectives, I think they’ve come a long way the years, even before I started working in a hospital. I think most tend to know what we do. But there can still be small amounts of misconception I guess. Some might think all that we do is walk around with nutrition supplements or enteral feeds, or request food charts. There is a lot of education and counselling that we do for patients, and we use that as method to support patients’ nutrition, which often might surprise people. I always have nurses laugh at me too when I pull out my old school pink calculator to estimate patients nutrition requirements and their intake, we do quite a bit of maths!
Jacqui–Radiotherapy
POWHF: Can you please introduce yourself and your role title at POWH?
Jacqui: I’m Jacqui. I’m one of the Dietitians at Prince of Wales, and I work in the Radiation Oncology Outpatient Department.
POWHF: Stepping back in time, what initially motivated you to get into the role you’re in now?
Jacqui: Yeah, I always really liked food and cooking. My mom was a chef, so cooking and food has been a big part of my life, but I also really like science. So, it was the perfect combination of both of them. And you get to help people every day.
POWHF: That’s so nice. And what do you enjoy about working in the unit you’re in now?
Jacqui: So obviously in the Radiation Oncology Department, the patients that we see are going through a really tough journey in their life. So, I think it’s a real privilege to be able to help them and to support them through that. And we know that good nutrition for these patients does lead to better outcomes, including better survival outcomes. It’s definitely fulfilling work to be able to help these patients, help get them through treatment, and to support them to have better outcomes. And if not, if they’re not going to have good outcomes to support them in their final stages of life.
POWHF: This may be a challenging question, but do you have a favourite patient memory you can share with us?
Jacqui: There are many individual patients that you really connect with. So, it’s really satisfying to see them recover from their treatment, have good outcomes, to have good news with their follow up scans and see them to be able to return to normal life after they’ve had that treatment.
POWHF: And my last question Jacki, what is a misconception that people have about dietitians?
Jacqui: I think there’s a very common misconception that as dietitians working in hospital that we’ll be restricting patients diets and removing lots of discretionary or junk foods from their diet, where in fact often we’re recommending or encouraging those foods to increase patient’s nutritional intake to support their recovery. And I think that there’s also a bit of a misunderstanding about other things that we can do for patients, like tube feeding or providing nutrition directly into patients’ blood streams.
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As we conclude Dietitians Week and reflect on the invaluable contributions of these unsung heroes in healthcare, we’re reminded of the transformative impact they have on patient well-being at Prince of Wales Hospital. Their dedication to providing the highest standard of patient-centric care underscores the importance of supporting initiatives that enhance healthcare delivery.
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