Kursten Orr, DTR, shares her experience as a clinical dietetic technician working with the NICU at a teaching hospital.

As a freshly registered new grad I was struggling to find a job and beginning to feel defeated. I kept looking for that perfect position but I live in a somewhat isolated area so there is not a lot available that doesn’t require a horrible commute. Before becoming registered I had applied to a local hospital system for a diet tech position that did not require registration. They invited me in for an interview months later, after I was registered, and offered me the job. I never imagined I would find myself in clinical nutrition but it’s really growing on me. I enjoy the different daily challenges, the fast pace, and the varied experiences patients provide. So what does a day in the life of a clinical registered diet tech look like?

The clinical nutrition department at the hospital has 9 registered dietitians and 9 diet techs, with 3 of us being registered. We work on a strict timeline so our day is pretty regimented. Our main goal is to get all patient meal orders to the kitchen for breakfast, lunch, and dinner. We operate with a restaurant style menu so there is a large variety of food from which to choose. While this sounds kind of like working as glorified order takers, there is so much more to it. First, we have to ensure that what the patient orders is within the dietary guidelines set forth by their doctor, while at the same time helping them select meals they will enjoy and ultimately eat. This is not always easy when a patient on a renal diet really wants lots of meat and potatoes! Second, we have to interpret wild diet orders and we often call nursing to have them clarified. A 2,000 calorie carbohydrate modified clear liquid diet is impossible so we need to be able to explain the reasoning to nursing and get that corrected. We also have to understand food allergies and how some medications interact with food. We look at all patients multiple times a day to ensure we don’t miss an allergy. Finally, our office is the one patients and nursing call when the patient wants more food, is unhappy with their food, or nursing has a complaint about what we sent.

There are a few additional tasks the diet office is responsible for. Tray line for every meal has a diet tech as the final checker to ensure accuracy of the tray against the meal ticket, to verify the tray doesn’t have any allergens, to check that all food follows the patients diet order, and for a final quality control check before it’s loaded in the cart to be taken to patient rooms. Another function of our office is to manage the stock and distribution of tube feedings in the hospital.

The hospital has a small level 2 NICU and few of the diet techs are responsible for mixing breast milk in the milk room. As needed a diet tech will fortify breastmilk for babies who need more calories, per doctors orders. It is quite a process with sanitizing the work station and creating a sterile environment. The fortifying of breast milk requires precise measuring and calculating to ensure the babies receive exactly what they need.

My department has a new manager who is working to utilize staff more efficiently. Part of this process is utilizing NDTR’s to do no or low nutritional risk patient assessments and the associated charting. All other patients will be handed off to the dietitians. We haven’t began this new process but will be very soon.

Clinical nutrition is a fast paced and interesting environment. There is always so much information to learn and everyday is a new day!