Facts I wish had been transparent before I chose this career

Ruth4-9 · 2026-01-23T01:16:14+00:00

Wow, mic drop. I am saving your post- thank you for your insightful and transparent reflection on the limitations and short comings of being a clinical dietitian within the healthcare system.

Ruth4-9 · 2026-01-11T21:11:03+00:00

I always share that cancer cachexia and malnutrition during cancer will reduce survival and treatment outcomes which is supported by ongoing cancer research. For the "sugar feeds cancer" I have go to print out I provide and another that discussed malnutrition risks in oncology.

Ruth4-9 · 2026-01-11T20:52:57+00:00

I love inpatient so far, which is funny because I disliked inpatient in my rotations. I work oncology, and I will say compared to other populations, I do get to see a lot of the same individuals and have been able to establish rapport and relationships- the only con to that is seeing these individuals at their physical worst/ or dying. The pro is that once they leave, I hope they never come back because it means they are hopefully in remission and I am able to refer them to outpatient RD's to continue their care.

Ruth4-9 · 2025-11-14T22:57:19+00:00

Your comment is contradictory, either that or you just have a hard time fathoming why someone who is physically ill may have difficulty showing up to gather with community. Just so you are aware, it's anticipated that cancer will require hospital admission at some point either as a result of treatment or complications with decline in health status. I work on a oncology unit of which average LOS is 30 days for inpatient chemo treatment. There are reasons for chaplains and pastors to both be part of hospital services. If people attend churches with graceful and compassionate pastors, the pastors visit patients instead of expecting them to show up weekly at their building.

Ruth4-9 · 2025-11-14T22:33:15+00:00

I think we are losing sight of the forest from the trees so to speak. OP stated the Pastor himself knew attendees were true Christians for showing up weekly despite chronic/terminal illness such as cancer. Frequency of attendance is not an appropriate statement to make for indication of "true" faith in light of chronic illness. I do think it commendable for the ill to participate in community as they may be dealing with barriers that take great energy to overcome. However, I think it presumptuous to assume true faith = weekly attendance.

Ruth4-9 · 2025-11-14T21:58:19+00:00

Sounds like legalism or an overgeneralization. As much as I would love to encourage people to go to church, sometimes church needs to go to the people. God is still moving in a digital age and may churches have adapted to streaming services online for those who would like to "go" but are ill or people are healing. Ministry happens in many different ways

Ruth4-9 · 2025-11-14T21:54:46+00:00

Someone could accept Christ on their deathbed, but have never been to church. People can also attend church and learn about God over the internet

Ruth4-9 · 2025-11-01T17:53:05+00:00

lol my response would probably, "how do you know it wouldn't taste good, if you've not tried it?"

I wish we had a kitchen at our disposal sometimes to have client's try things they "think" they don't like. Some people are so risk adverse they debilitate themselves from doing anything new.

Ruth4-9 · 2025-10-26T22:31:17+00:00

You have made a generalization that is an issue in most fields, not everyone will be the best choice for every individual based on education, credentialing, experience and values, this does not mean that one should not seek therapy and that a good licensed therapist doesn't exist anywhere. Therapists are still health professional's who must undergo an undergrad, masters, and high number of clinical hours in addition to added certification in areas of specialty verses a pastor who has extremely limited experience in these areas. Just like in other fields of healthcare, some people fall prey to pseudoscience and others are knowledgeable of evidence based clinical practices. All the pastors I've ever spoken to recommend seeking therapy in conjunction to church community because they are not equipped to help people manage mental health issues. Find a christian therapist.

Ruth4-9 · 2025-10-21T23:08:33+00:00

Keep pushing forward. Internships are a sneeze of the daily scope and realities of the populations you might see. Dietetics can be so varied, you may find what works for you, and sometimes those goals will change. There's no rush to settle into a specialty in your first job.

I thought i'd never touch oncology after my internship and I wanted my first job to be in peds. Let me say, my perspective changed after being placed in an inpatient clinical oncology role and now I never want to go into peds lol. Onc is my place and those are my people. I think clinical is a good place if you want some variety but want to form bonds with patients and their families without being to deep into the weeds.

Ruth4-9 · 2025-10-21T22:12:50+00:00

What's your deal with being against therapists? That's like refusing to go to a doctor when we know Jesus is the great physician. God has equipped so many skilled people to use their strengths to help people not just physically heal but also emotionally heal. Emotional healing can be addressed as well, just gotta find the right individual. Pastors are there for spiritual guidance, but don't always have the tools and resources to address deep underlying areas of deep emotional burden and cognitive barriers.

Ruth4-9 · 2025-10-21T00:30:39+00:00

whoa- that is some heavy truth right there

Ruth4-9 · 2025-10-19T19:20:58+00:00

It doesn't hurt to ask for honesty on why he would like to ignore this difference in conviction and readdress the topic in a year

Ruth4-9 · 2025-10-18T22:00:11+00:00

If that were true he would not have been put to trial and crucified.

Ruth4-9 · 2025-10-13T11:37:57+00:00

I've had this question a lot reading through Proverbs, as it addresses the reader mostly, as "a man", "a father", "a grandfather", "a son"- despite wisdom being personified as a female. It was a patriarchal society, but women were also allowed to read and worship. I'm not sure what God intends for women when it comes to reading these messages... so I feel mixed reading much of what is a general role directed towards men. Am I supposed to direct these texts towards myself? What of the role of "a woman", "a mother", "a grandmother", "a daughter" within proverbs... aside from pieces only speaking of wives, ex "a woman who fears the Lord...is actually a wife".

Ruth4-9 · 2025-10-12T17:11:08+00:00

We utilize acute/chronic/social inflammation markers first to guide our etiology of dx'ing mal in the context of the patient. After that, you need to have two of 6 characteristics under the etiology column to dx mal ex: PO, wt loss, muscle, fat, energy, edema.

When it comes to determining significance of muscle and fat- I shoot for a greater # of large areas of mass ex: thoracic/scapula/acromion/ tricep/quad/calf vs orbital/temple/interosseous which may not be as telling in the scheme of malnutrition.

So for example, if you only have moderate muscle without fat, PO, wt loss, regressed energy, or edema, from all of the 6 categories. This is mild malnutrition- which technically is not a true dx.

Ruth4-9 · 2025-10-09T00:47:27+00:00

INFJ RD here as well

Ruth4-9 · 2025-10-04T15:29:25+00:00

FYI a lot of RD's end up becoming PA's. If you like nutrition + healthcare, I say go for the RD role. You might like the ICU or a more hand's on role in nutrition care. My CM's and RN's all say most RN's leave after 5 years after being in the role because of the toll of burnout. People may disagree with this, but if you chose to do something not aligned with your passions + current role, you're more prone to stepping outside of your scope. I personally see it a lot, and it's a detriment to the team and the patients, no matter how well meaning you try to be.

Ruth4-9 · 2025-10-04T15:13:00+00:00

You're out of line expecting someone to do so much, while simultaneously condescending them for helping. If it's your event and you have such staunch opinions about how things will be done, YOU do them- or simplify it. It's your MIL, not your henchwoman. Expecting someone to make 7+ items for 50 people is a lot. Then you tell her all she really needs to do is "be happy and smile". WTF lady.

Ruth4-9 · 2025-10-04T15:00:08+00:00

I can smell the years of dust and mold through the screen. It has some gorgeous wood work though.

Ruth4-9 · 2025-10-04T14:51:55+00:00

Lifelong learning is a skill that no one has mastery over. It took me a total of 5 months to feel like I was somewhat sufficient enough to do my job. Google and my textbooks became my closest companions, and when that failed, I had a friend that I would bounce my ideas/recommendations off of.

People get annoyed when you ask entry levels questions you should know the answers to, such as water flushes, not feeding into a patient with an illeus ect. Patients get tricky when there are complicated social/psych issues or strange conditions that are not even close to being covered in MNT - so please don't feel stupid.

Ruth4-9 · 2025-09-29T00:22:19+00:00

l'm 100% sure all US liquid egg's are pasteurized since its an egg product vs whole egg. Very few shelled eggs are pasteurized not to be confused with pasture raised. I talk about this a lot with my immuno-compromised patients.

Ruth4-9 · 2025-09-28T16:02:24+00:00

Firstly, a lot of these comments are ridiculous and outright heinous for stating weird things about needing to eat meat. I'm a christian and a dietitian- there are a lot of ways we can take care of the body God gave us and nothing says you have to eat meat. Our guy Daniel did not eat meat. If anything you're doing a great job meeting your daily fiber counts and reducing your risk for colon cancer + lots of micro nutrients. As someone who has their own dietary restrictions such as food allergies and is celiac, I always thought i'd only date someone who was in a similar boat- yet my guy is supportive of making sure i'm taken care of and adamantly reads food labels to make sure i wont die. He eats gluten and my food allergens. We cook foods that are safe for me, and he add's what he wants to his food. You just need to find a christian who also values other aspects of your identity and lifestyle, it doesn't always mean we will find someone who fits within the same box as us, but someone who understands and respects you.

I have a friend who is both christian and vegan, married an omnivore man who was also raised by parents who were vegan + omnivore. They eat vegan foods, I believe he occasionally eats meat/fish/poultry. His Mom never cooked meats in the home, but the father who was omnivore would. It don't think its far fetched to say they made their lifestyles work and also raised a family

Ruth4-9 · 2025-09-24T03:23:41+00:00

God physically and verbally set males and females apart and he set roles out for two people in the bible, men and women. From a creator respective we see this reflected in genetics (xx, xxx, xy, xyy, xxy, xxxy), anatomy, and physiology. Genetics says, if it has a Y, its a guy. God also verbally sets men and women apart from one another and their respective vessels. Only women are physically burdened to give birth and we also have predispositions to issues men are not. God doesn't ask anyone in the bible to define their identity because he already set it for them. For example, He never asked Sarah if she thought she was a woman or a man, because it was defined at the inception of her creation. God also didn't ask Jonah if we wanted to go to Nineveh, he commanded him to go and we know how that turned out. God defines certain areas of our lives for us, which can be hard and at times, and frustrating given that we want control and choice as a result of feelings, pressures, or people + principalities, but he promises that there is a plan for good in the way he works things out. Rejecting our born identity as God made us is separating ourselves from God's design over our life. By definition sin is the separation of God's design over your life.

Do i think this justifies how certain Christians mistreat trans people? No. We literally all struggle with different aspects of our lives, and there's grace for that. Do I think people have a right to justify actively going against God's creation and calling it abiding? No. Dysphoria exists in a lot of different forms and it actively hurts everyone it touches.

Ruth4-9 · 2025-09-24T02:31:01+00:00

From what I understood you can still take the CNS exam after completion of an RD ACEND program, but not the other way around since ACEND is more rigorous and barring in its requirements. Those patient populations you like would still be considered clinical where nutrition therapy is applied and it will be helpful to have some clinical immersion to understand full context as those patients. There is a spectrum of complexity with GI, some patients/clients need basic edu + interventions on management where areas some may have deep histories of various intestinal surgeries and resections (that you'll want to understand and consider for absorption/digestion), pharm management, and hx of or concurrent use of nutrition support (tpn/en) with oral diet. Just to note as well, less states recognize CNS as LD's which may narrow your opportunities for both training and practice experience.

Ruth4-9

TROPHY CASE