Before I began my clinical rotation, I had this idea in my head that you couldn’t connect with patients in the hospital: either they’re too sick to talk to or they’re discharged before you have a chance to make an impact. I had never seen a dietitian in action in an in-patient setting before so I had no clue what to expect. But as someone who likes to form relationships and bond with people, I had assumed that being a clinical RD was not for me.
During my first week at Harbor Hospital, I quickly learned how wrong I was. Yes, sometimes the patient leaves before we have a chance to see them and yes, some people are not very receptive to what you have to say but for many patients and family members, speaking with a dietitian can make a huge difference. Some people have received mixed messages in the past or never received a diet education before—and they are really grateful that you stopped by.
I realized that knowing kcal/protein needs in different disease states, nutrition support calculations, and how to provide diet educations are not the only skills a clinical dietitian needs. They also need to have empathy, or the ability to understand the feelings of another person. Here are some phrases I found myself saying over and over to patients, and it really helped them feel at ease:
“What are your concerns about making healthier choices after you leave?” It’s easy to blame the patient for their poor decisions or to become frustrated when you’ve seen someone several times in a month for the same admitting diagnosis. But we have no clue what that person has been through, and although nutrition is our top priority, it may not be theirs. Maybe the person can’t control their diabetes because they are homeless without consistent access to food, let alone healthy, carb-consistent meals. Maybe the person needs to deal with their alcohol or drug dependencies before their diet becomes a priority. It is crucial to learn more about the patient as a whole, and not just the signs and symptoms brought them in.
“Tell me more about it”. Or something along those lines. This can be difficult because you may have patients who aren’t very forthcoming. It may be their personality, it may be that they are overwhelmed with everything that’s happening to them, or it may be that they are afraid of being judged. Be patient—if no one has asked them food- and nutrition-related questions before, they will need some time to reflect. Tell them that you’re there to support them and to discuss their needs, not just to tell them what they should/shouldn’t eat.
“That reminds me of a time when…so I realize how frustrating that is”. It’s totally okay to share your experiences with patients. Being relatable will put them at ease and hopefully encourage them to open up to you. It may be helpful for them to hear that dietitians are human beings too—we struggle with weight loss, being short on time, limited budgets, enjoying junk foods, etc. just like everyone else. But remember to maintain a professional relationship! Only share relevant stories and make sure you don’t reveal any private information.
“Would you like me to come back later?” For some people, the hospital setting is shocking and depressing. They have had a lot of time to come to terms with their health problems and what led them there. I’ve had some patients who cried during my visits—some wanted me to stay, some asked me to come back later. Let them be open with you if they want to share. Sometimes they will answer your questions so they can rest and not have you return. If they aren’t willing to talk to you, take a hint and leave.
“I’ll stop by later/tomorrow to see how you’re doing, if that’s okay with you”. Each hospital will have follow-up protocols depending on the risk level of the patient. But if your schedule allows it, you can try to visit patients that are having a particularly hard time or are not eating well more often. Or follow up with patients who received a diet education since they may need time to read over handouts and could come up with questions after you leave. People appreciate you checking in on them and enjoy seeing a familiar face.
Even though the time you have with a patient is limited, being empathetic can show that you care about their wellbeing, making a big difference during a difficult period in their life. My rotation at Harbor Hospital was very rewarding and taught me two important things: it’s definitely possible to bond with patients in an in-patient setting, and I would actually love to be a clinical RD!