Essence Behind the Scenes – Part I

It’s not all glamor and instagrammable overnight oats in mason jars as dietitians in private practice. We wanted to expose you to the gals behind the giant orange butterfly logo.

  • We all came from clinical backgrounds – that means we worked as inpatient hospital dietitians for years before going private. Many clinical dietitians think the wheatgrass is greener on the other side, that is, if they quit their hospital job. Here’s what’s great about clinical work:
  • You’re part of a multidisciplinary team of residents, nurses, pharmacists, physical and occupational therapists, speech therapists, psychologists, and attendings talking in real time about real patients. It’s, like, REAL, Grey’s Anatomy-esque. You can scrub into surgeries and learn about very complicated medical patients. A learned surgeon will ask YOUR advice in rounds, and you’re expected to answer, intelligently, in front of a team of these scholarly people, how many grams of protein and which formula you’d select to feed someone with a multivisceral organ transplant who happens to also have cancer and a rare tropical disease (academic hospitals are full of excitement!)You see helicopters landing with live organs in them. It’s super badass.
  • In pediatrics, you get to see REALLY REALLY cute kids, their therapy dogs, their playrooms, and you get your heartwarmed when they draw you things.
  • Health insurance: through a hospital is AMAZING. It’s cheaper than ClassPass and you get access to world class doctors and treatments. Paid vacations, some maternity leave – when you’re working for ‘the man’ – there are laws that protect you.
  • You get to constantly bounce ideas, and fun, off of your team of registered dietitians. You cover for each other when you’re sick, you eat together, you text each other inside jokes about certain doctors, you gossip, you go to happy hour – it’s a beautiful camaraderie.
  • You often get reduced fees for lunch in the hospital cafeteria. Personally, we had free access to soda, which fed our Diet Coke addictions (confessions!)
  • You feel really needed, vital, and appreciated when your team of residents/doctors values your work, input, and feedback on patients.
  • You do have to work some weekends, but you know about them in advance.
  • For the most part, when you leave (which can be as early as 3:30 PM) work, you leave work. Some texts/calls may trickle in, but you can have a very fulfilling, dense life outside of work.
  • If you’re single, the hospital is essentially a meat market for dating.

…and here’s what is NOT great about clinical work:

  • The pay. Think your Master’s degree, award-winning thesis, educational pedigree and ability to write TPN orders in 3 minutes flat are worth anything? Nope. Since dietitians don’t use ICD10 code, they can’t bill / reimburse, and so, the average salary is about 23-27 dollars per hour, before taxes. We made more per hour as nannies.
  • You see death and suffering. Those cute little kids? Sometimes, they don’t make it. You see (and smell) pain from all angles. You see families lose parents, siblings, wives, husbands, grandparents, and everything in between. You see financial struggle. You see homelessness and people using the hospital as room and board. You experience grief when your favorite patients die.
  • You then become jaded to death and suffering. You roll your eyes when someone is moaning in agony after a cholecystectomy – can someone just give them some morphine so they can be quiet? Sheesh.
  • You work holidays. There ALWAYS has to be a dietitian in the hospital during business hours, so, hello, we are your holiday food fairies, padding around on Christmas Day, Thanksgiving day, New Year’s Day, and all the holidays you usually take a three day weekend trip for.
  • Though usually not arduous, there ARE some late night calls, texts, and pages from rookie residents not knowing how to start enteral and parenteral feeding regimens.
  • You sit through lifetimes of hospital-mandated trainings on pressure ulcers, insurance, CPR, patient safety, medical errors, and for some reason, they’re always in a freezing cold room.
  • There can be some cattiness amongst the dietitian staff
  • Attendings can call you out in front of many people and embarrass you
  • You have a boss. There are policies and protocols. You have to request vacation. You have to clock in and out. You have to get 14 forms signed to take a day off to go to the dentist or to change a lock on your office door. You suffer inane bureaucratic things.
  • Lab coats are gross. They don’t get washed daily. You get sick every month your first six months working as your immune system adapts to the germ environment. Your hands crack from eczema from washing them / using antibacterial solution all day. You are exposed to ALL sorts of bizarre communicable diseases.
  • You live in fear of violating HIPPAA. To this day, we leave all papers on our desk facedown.
  • You become frustrated with the droves of people ill and dying from COMPLETELY preventable diseases and conditions, many of which are indirectly or directly caused by poor diet and lifestyle.
  • These people often reject your help.
  • You cannot be creative enough to help, sometimes. Though you’d love to give lectures to residents about nutrition, create handouts for patients, and run a cooking demo, your ideas often fall flat at the behest of bureaucracy.
  • You think about going into private practice to fulfill your noble cause of teaching people about the healing power of food…

Stay tuned for Part II!

Essentially Yours,
The Dietitian Team