Long story short- I was hired as a renal dietitian right after I finished my program and passed the exam. I have personal renal experience but limited as a dietitian. The previous renal RD left years before I started so I had no one to train me. Fast forward a year and I’m now being reprimanded for things I didn’t even know were an issue. I have a few questions.

1. How does rounding work with the nephrologist and social worker? And what questions should I ask while rounding as a group?
   - I’ve rounded only a handful of times but the SW told me the doctor said I was taking too long with patients. I typically see them on my own for additional time either a week before or after.

2. What does a day to day look like for a typical renal RD?
   - I know every clinic is different but I would like an idea of what the flow is like.

3. How do you deal with being blamed for patient’s labs?
   - I try to meet patients where they are and celebrate small wins (even if labs have decreased but are still elevated). But to the care team I’m not “doing enough” when the lab data doesn’t meet our clinic goals. I’ve had family members on dialysis and I’ve heard first hand how pushing too hard can have the opposite effect and ruin rapport. I try to do my due diligence but people have their own life’s and stuff happens- I try to be empathetic and find a compromise with small changes in their diet and offer resources or alternatives.

4. How long do you typically spend with each patient?
   - I’ve got in trouble for not talking with patients long enough. When a patient doesn’t want to speak to me- I don’t push. I ask if they have any nutritional concerns and if I can do anything for them at this time. I also present their labs with my contact info and let them know I’m always available and will check in with them next month.

Hi wondering if anyone knows any programs the help new RDN grads with managing first clinical roles. I don't feel like I'm getting the mentorship I need in my first clinical role and I don't want my performance to suffer. I know this is usually an informal thing, but if you do know of any resources please let me know! Or if anyone may have interest in mentoring please let me know!!

What do people do with patients on medium-long term TPN who cannot have lipid due to allergies (tree nut and legume) and are only allowed water and meds orally?

I’ve seen reference to a couple of teaspoons of various oils e.g sunflower. The MD has agreed to the minimum amount required to avoid EFAD.

Do people also need to have a source of DHA/EPA if their intake of LA/ALA is the bare minimum? Since the conversion of ALA to DHA/EPA is not very efficient?

Curious on everyone’s experience and perspective in dietetics with “job killer” tattoos (such as the face, neck, hands, or fingers—that cannot be hidden easily by standard business attire).

My facility recently updated their dress code policy mandating all long hair be put up but uniquely allowing “job killer” tattooed and gauged piercings

I’m well-established in the field and have maintained the same acute care employer for over a decade. Not an intern or student. The RNs here are fully covered in tattoos; the ones working LTC especially.

Anyway, I recently got very simple (few dots) finger tattoos on one hand and my children’s birth years as a side palm tattoo on the other handand there has been no issue. This was before the updated policy.

My geographical area has a deficit of dietitians. Employers are vying for dietitians. However, I also noticed during jury duty the the local district attorney has a hand tattoo! I’m near the point where I’m planning a vegetable cornucopia neck tattoo (apropos for a dietitian-nutritionist).

The acceptance of job killer tattoos, I cannot tell if it is unique to this area or a generational change.

Curious to see everyone’s opinions.

I work in outpatient and lately have felt burnt out. I eventually want to get my CDCES.

I’ve been thinking of my long term plan and feel a little less certain about the dietitian path as a whole. Other than the CDCES, I’m not sure that there are opportunities that feel “worth” the effort. Money is a big part of it. I’ve had to work a job plus a side hustle longterm.

I’m curious for the RDs that really enjoy what they do, what have you found that really felt “worth it” to work towards as a RD?