The science of diet
Published at: 02 Nov 2018
Acute dietetics is the use of a dietitian’s knowledge in a range of workplaces, from client-facing roles in clinics and hospitals, to food service roles in which the practitioner impacts the nutrition of residents and inpatients, to roles where we can influence the health of the population by guiding food policy and the food supply such as in government public health roles and food companies.
“We get involved when people are struggling nutritionally,” said Wendy Swan, GV Health’s Manager of Nutrition and Dietetics. “That might mean their appetite is poor because they’re unwell, or they may have a wound and their appetites are increased to help heal.”
Dietitians at GV Health are employed in the acute and subacute area, and also in ambulatory programs such as Transition Care, HARP DMT, Diabetes Centre, Rural Allied Health Team and Community Health. In total there are 12 dietitians employed at GV Health including 5 within the acute Nutrition & Dietetics team located at the Graham St Campus.
“A clinical setting for dietitians is very different to what people would expect,” said Ms Swan. “In the community you might be referred for an issue like excess weight, diabetes or something meaning you need to modify your diet to improve your health, whereas in the hospital it’s more about people not eating enough.”
Dietitians in the hospital setting are responsible for assessing the nutritional needs of patients, planning appropriate diets and educating patients and their families. The focus is on recovery from an acute illness, prevention from nutritional decline and reducing the risk of malnutrition.
Dietitian Sarah Lawless has been working with GV Health for six months. She is presently involved in a range of settings including dialysis, senior care and the medical ward.
“Working in a regional hospital is such a great opportunity to evolve,” she said. “The exposure you get in the country is amazing – day to day we deal with such a wide range of conditions with unique requirements.”
Ms Lawless’ fellow dietitian Hannah Vass came to GV Health as a graduate this year. She is thrilled with the opportunity to join a supportive, collaborative team in her first professional role.
“Everyone’s really approachable,” she said. “That really helps because we can’t work in isolation - diet is just one part of a patient’s care.”
Ms Lawless and Ms Vass may see up to six patients a day, depending on the level of assessment or prior history involved.
A large part of the dietitians’ roles revolves around communicating with patients and providing advice on how best to cater to their nutritional needs. Outpatients in particular rely on the tangible advice provided through consultations, which help generate ideas about what can be achieved outside the hospital setting.
“I like talking about food, recipes, getting an idea of what people eat at home,” said Ms Vass. “When people can bring home cooked meals to family in hospital, that’s also great – it really helps pick patients up.”
Dietetics is focused on people being unable to meet their dietary requirements, which in turn impacts their recovery time.
“We use a range of strategies to help people feel more like eating,” said Ms Swan. “We can give people small meals or familiar things to eat, or giving them assistance to eat, which could potentially be via a range of concentrated drinks designed to give them more protein and nutrients.”
In the event that a patient is unable to ingest their meals, dietitians may employ feeding tubes or deliver nutrients to patients intravenously.
Dietitians aim to ensure that patients do not experience weight loss, which predominantly takes the form of muscle loss, which leads to increased frailty and an increasing likelihood of injury.
For example, a stroke patient who comes in may not be able to eat owing to inability to swallow or a breathing problem. As part of recovery, a gastric tube may be employed in order to maintain their weight. Patients with a cancer or obstructive mass, meaning their stomach cannot tolerate food, may require direct feeding to the bloodstream.
“Deconditioning can lead to falls and wounds not healing,” said Ms Swan. “This can lead to longer hospital stays and a lack of independence when going home.”
The overall goal for patients is to return them to as close to their pre-ailment condition as possible.
Often, however, interventions can be ongoing or lifelong, as is the case with diabetes.
While some conditions are more likely to affect the elderly, dietitians can treat patients from across the age spectrum. Paediatric nutrition can be concerned with premature babies, or helping fussy eating newborns get more calories to help with their development.
“The job is about assessment, devising a plan and educating parents or carers,” said Ms Vass. “That could be around food allergies, juvenile diabetes or general diet for children who aren’t progressing well.”
Dietitians are qualified to provide a range of evidence-based nutrition services, but also have the expertise to provide individual dietary counselling, medical nutrition therapy, group dietary therapy and food service management.
“Dietetics is a ‘helping science’,” said Ms Swan. “People with an interest in chemistry, biology and maybe a bit of math are ideal – with an interest in food, obviously!”
As part of the GV Health Allied Health Therapy Services team, dietetics and nutrition works with clients and other health professional to achieve the best possible health outcomes for patients. Other Allied Health services include Occupational Therapy, Physiotherapy, Podiatry, Social Work and Speech Pathology.
“We can’t see hospital as the sole point for treatment,” said Ms Lawless. “It’s about linking patients to other programs on their care journey. We really want to raise awareness around referrals, ensure people know which services are available to them locally.”
These services are available across the continuum of care, and involve referrals to
other programs and sites.
“Everyone has to eat,” said Ms Vass. “In hospitals it takes very different forms. Patients are keen to talk about it, they understand it and have input into it. It’s every day life - we’re able to use our knowledge to help people improve their health through their diet.”
Call 1800 222 582 to request a referral.