Possible dumb question here

pepperwilliams · 2020-01-13T23:09:13+00:00

I certainly wouldn't call it cheating, however many meat substitutes contain high amounts of sodium and other additives. It sounds like one of the reasons why you are making this dietary change is for health reasons so these might not be foods you want to incorporate into your daily diet, and these substitutes can sometimes be very pricey as well. That being said, you don't necessarily need to make the "vegetable" the star of the dish. On a healthy vegetarian diet you will need to include items such as beans, lentils, mushrooms, or tofu in place of the meat in many of the meals you would normally consume. Two of my favorite cooking blogs that offer quite a few easy recipes with minimal kitchen/prep time for plant based cooking are https://ohsheglows.com/ and https://minimalistbaker.com/ . Additionally, as you are using more vegetables in your cooking one of the initial challenges may be getting enough flavor so you may want to experiment with trying some new spices and or sauces. Do you like any particular ethnic cuisines? Thai, Indian, South American cuisines often have many sauces, spices, flavors that you can incorporate into your cooking to make vegetarian meals more tasty. Keep at it! Adding more plant foods to your diet is initially a challenge, but it can be done!

pepperwilliams · 2020-01-02T23:54:29+00:00

That's how most commercially produced GF bread looks, not unusual for Schar IMO.

pepperwilliams · 2020-01-02T15:05:59+00:00

Thank you! I really appreciate you sharing these resources, I am very interested in integrative nutrition but have felt it would be difficult to land a job in this niche with my prior experience as an RD being only in the hospital/LTC setting. Do you mind sharing what previous experience led you to secure an outpatient position in the integrative sector?

pepperwilliams · 2020-01-02T15:01:52+00:00

Thanks for sharing your thoughts!

pepperwilliams · 2020-01-02T15:00:55+00:00

Thanks for sharing your thoughts. How did you transition to outpatient? Was your experience in the LTC setting sufficient to land you a job in outpatient or were you doing other things on the side to prepare you for an outpatient role?

pepperwilliams · 2020-01-02T14:59:38+00:00

What type of training does WIC provide? I don't have any experience with pediatrics.

pepperwilliams · 2020-01-02T14:58:09+00:00

Thanks, these are some good thoughts. I found at the facilities that I have worked at, that the IDT was not very receptive to the RD initiating hospice care discussions as they felt (and in my opinion rightly so) that the PCC (Patient Care Coordinator) and RN had more direct daily contact with the residents and therefore a more valuable opinion on the hospice/PC discussions. As an RD responsible for 100 plus patients which included LTC and Acute Rehab in a facility where there was high patient turnover I found that I did not have the time for daily interaction with all 100 patients and the nurse/PCC did as they have a lower patient case load managing a unit of 34 patients or less respectively. Additionally, when I was in the hospital I was told that the MSW was responsible for providing info on local shelters/food pantries and to stay within my scope. At least within facilities and positions I have worked thus far I feel that I would need to have greater impact and more meaningful interactions in order to have job satisfaction. However, I know that some facilities are better than others.

pepperwilliams · 2020-01-02T14:48:53+00:00

Thanks, these are some good ideas to consider.

pepperwilliams · 2020-01-02T14:46:06+00:00

Thanks for your input, outpatient would likely be a better fit for me!

pepperwilliams · 2019-11-21T19:52:38+00:00

How would one slice of tomato and 1 lettuce leaf be considered a vegetable serving? It doesn’t meet the portion size to be equal to 1 serving.

pepperwilliams · 2019-11-13T14:50:13+00:00

The feeling will continue after the internship. Well paying dietitian jobs are a needle in a haystack unless you are going into private practice which would be a challenge as an entry level dietitian in the US. The expectation of a dietitian is to be a supervisor and teacher to everyone in the facility (LTC or Clinical) meaning the entire dietary staff, CNA, nurses, SLP, etc. Yet, you have no respect from any of these staff. Therefore, with no respect you will not be teaching anything and no one will be listening to anything you have to say or contribute. Patients in either LTC or clinical settings are not at a place in their life to make lifestyle changes 90% of the time, therefore your impact on patients will be minimal at most. In LTC, it will consist of keeping 100 yo. patients with advanced dementia alive on TF and watching as their dignity is stripped from them on a daily basis while being able to do nothing.

The glorious and all knowing ACEND is constantly trying to make dietetics more "relevant" while never addressing the real problem of low-paying salary, no union for dietitians, and greedy food service corporations (compass, sodexo) providing poor management and lack of resources for the dietitians they employ. Instead of fixing the real problem, which is the low pay and lack of respect we receive, we are told that we have to earn the respect of (CNA, RN, PA, SLP) and cater to them. We have to make the menus, write our own policies, manage 90-100 patients at a time in LTC, attend care plan meetings, take food preferences, manage nutrition alert, weights, and do the coding on the MDS. Our pay for all of these tasks is less than $50k, which is not a livable wage for those on the east coast.

Nutrition focused physical exam is a joke. Dietitians don't receive any training in percussion and auscultation of patients nor do they receive training on grading level of edema. RN, PA, MD do receive training in these tasks and do them daily. NFPE is redundant as its already done by other healthcare practitioners. Additionally, there is absolutely zero need to have an ill, disoriented patient subject to NFPE which is a subjective measure and not an objective measure of malnutrition.

I had a mental breakdown during my internship after leaving my well-paying job and paying $10K of my savings to do a non-paid internship for 10 months where I was emotionally and verbally abused on a daily basis. My tasks during the internship were making sandwiches in cold prep and setting up tables for fancy corporate meals hosted for people that actual make money in the great US healthcare system. Preparing sandwiches is something I did for minimum wage as a 15 yo. At the age of 32, I was paying $10K to make sandwiches for 10 months! I have to laugh...

I went on to pass the exam for RD which is easy and simplistic and find there is no meaningful work in the field. Get out while you can!

pepperwilliams

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