#rdn

Hi everyone!

It’s been quiiiiiiite a while since I’ve posted on here, and I’m really sorry about that! One perk of quarantine is that I’ve had a whole lot of extra free time, so here we are.

In my last post (done almost 2 years ago....how?!), I shared my thoughts on the lack of jobs for dietitians. Well, shortly after posting that, I was fortunate to land a job in the world of inpatient dietetics. It was in my dream area and I was thrilled to a) have a full time job and b) have it be in the area I have my degrees in. In today’s rather pathetic millennial society, I recognize how lucky I am to have a job that fits both of those categories. But anyways, as you can tell by the title of this post, I will (hopefully) be leaving this job, and this field, soon.

I’ll try to keep this post short and sweet, but I have to admit that I never thought I would actually be writing this. I was a young, spry 18 year old when I decided on this career. I was slightly obnoxious over how proud I was for never changing my major and I always knew what I wanted to be when I grew up. Maybe this is payback? I truly thought this was the career for me and I didn’t let anything get in the way of that. There were many times during both undergrad and grad school that I wanted to quit, but I did not let anything get in my way. I was so beyond determined to hurry up and graduate and start my dream career, and I was ecstatic to land the job that I did.

Now that I’m looking back, I realized this career wasn’t for me during my internship. On my second day of my clinical rotations, I cried on my whole drive home. After a whole two days at my rotation site, I knew didn’t chose the right career. I’ve never told ANYONE this because I was so embarrassed that it took me years of schooling to realize that; and here I am, in a coveted and competitive internship, realizing that this wasn’t what I wanted. So, I sucked it up and just told myself I was overreacting, and that there was no way in hell I would quit the internship because I was lucky to be there. It took me quite a while to grapple that idea. 

Now, to get to the why am I leaving the field? I’ve been at my job for a while now. Again, I realize, especially now, how fortunate I am to even have a job, let alone contemplate a career change. But, if this helps anyone thinking of becoming a dietitian, then I’m glad I put this out here. Here are the reasons why I am leaving the field:

-We have to get permission for EVERYTHING. This is possibly what bothers me the most. Everyone I work with has advanced degrees, tons of experience, and credentials, yet we have to ask permission to do the very things that we’ve been trained to do. Want to order a vitamin level? Call the doctor. Want to change tube feeds because the patient is off the ventilator? Call the doctor. Want to correct your patient’s diet order? Call the doctor. At my hospital, we are the only group of providers that has to get permission to do anything. I see MDs order speech evals, or PT/OT evals, and they just say “evaluate and treat”. No physical therapist is calling the doctor to see if it’s ok to do this certain exercise on a patient. Even if we get an order for tube feeds, we have to call the doctor (who ordered the consult) to see if, yes, they truly want tube feeds. Doctors don’t have a clue what exercises should be done, just like they don’t know what tube feeds a patient should be on. I’m not slamming doctors at all; that’s why different specialties and careers exist. But why can’t dietitians be treated like other professions? It’s ridiculous to call to get permission to DO OUR JOBS.

-The pay. I knew I wouldn’t be a millionaire as a dietitian, but I didn’t think the pay would be that dismal. Sitting in the office everyday, at least one person complains about not having enough money. Our raises are very small and are automatic; we get them each year whether we are good at our job or not. There are no incentives to perform better. I’m a strong believer in working hard because that’s what you should do, but it gets pretty dang annoying to see people in other careers who get lucrative bonuses for simply doing things required for their jobs. At my workplace, you don’t get extra pay if you get your CNSC/CDE/etc, see extra patients, come in early, or anything else. Your pay doesn’t change except for your yearly raise. Hearing my coworkers complain about money on the daily really starts to get to me, especially after working so hard to get here. A few of my coworkers have worked at my workplace for 30+ years and don’t even come close to making $70k. Hearing that they can’t afford to do needed house repairs, or fix their cars, or even go on vacation with their kids gets really depressing. I even have a coworker who has to give up her shift if her mom can’t watch her kids because she can’t afford to pay for childcare. You wouldn’t think any of those things would be a concern working in healthcare! Dietitians work insanely hard to even become a dietitian, and our jobs are demanding. Our pay needs to reflect that. See my previous post for salary comparisons in healthcare careers. I had a professor in undergrad who said dietitians will only be successful financially if their spouses are the breadwinners. I brushed her comment off at first, but after working in the field, SHE WAS RIGHT. I have a lot of coworkers, and the ones who are truly happy in this field are the ones that have spouses who are breadwinners. Because money DOES matter. I want to be able to take care of myself, buy things I need, fix things that break, and yes, go on vacation. I don’t even have kids yet, but the number of times I’ve already thought about not being able to afford things for them freaks me out. I’ve known dietitians who work for WIC who are on WIC themselves.That is not even slightly ok. I am not shaming those who use WIC; but to be a dietitian and meet the salary requirements for WIC is mind-boggling. Your education is an investment; you want a solid return on that investment. If you’ve ever paid for a dietetic internship, you know exactly what I’m talking about.

-Lack of leadership. Sorry, but I can’t stand the Academy. Using my example of physical therapists again, their “academy” fought for them to raise their pay and to improve the field, and they did. The only advancement in our field is the new “RDN” credential, which, frankly, just brings more confusion on who we are and tacks on the word “nutritionist”, something that 99.9% of dietitians hate being called. The Academy is also requiring all RD’s to have Masters degrees by 2024. I interviewed for quite a few jobs, and having a Masters does nothing for your duties/responsibilities, and results in a very minimal salary adjustment. We can do better. Making it even harder to enter into this field or slightly changing our name won’t help anyone.

-Lack of support for the field. Excluding FNCE, have you ever been to a dietitian conference? They’re usually in a random hall at hospital. Have you ever seen a conference for other health professions? They’re usually at a gorgeous resort on an island. Because of our poor pay, very few dietitians are actually able to support their profession financially. This results in lackadaisical events that are frankly depressing to be at. It’s not about the glitz and glamour; its about supporting the profession and being enthusiastic about it. These events that are held should make people want to join our profession, not run the other way. 

-Job outlook. As a clinical inpatient dietitian, I don’t see my exact position being around for much longer. Especially with losses in revenue amongst hospitals due to COVID, I truly (and unfortunately) think this position will eventually be phased out. In my city, a lot of hospitals have already started cutting their clinical inpatient diet techs, and I think dietitians are next. And it kills me to say that, because our job is needed. But since nurses can (and have) been doing our educations, pharmacy can order TPNs, and residents can stumble through ordering tube feeds, I think our job has shifted into the “not really necessary but nice to have” category. Which really, really sucks. But even in the few years I’ve been a dietitian, I’ve seen the shift. I think outpatient and community RD jobs will always be there, but I think inpatient dietitians are going to be a thing of the past very soon. Starting your own business has become more popular. If you can make it work, go for it. There is a dietitian “business coach” who started her own Instagram business after realizing clinical just isn’t where it’s at, and that new clinical jobs are becoming few and far between. And honestly, she’s right. Post-pandemic, look at the number of job opportunities in your area. It’s a shrinking number.

So that’s that. I’m sure this came off as negative, but someone needs to be telling others this. As much as I love nutrition and am passionate about helping those improve their health with nutrition, this career just isn’t worth it. I hope to always use my RD roots in my next career and I don’t regret the years of schooling I’ve done. But if you’re considering this route, I want you to recognize that this career isn’t even close to what your professors have chalked it up to be. If anything, if you are in college right now, GO SHADOW. Shadow inpatient, shadow outpatient, go see what the job is like. See how happy they are in their jobs, learn their salaries, learn what they love, what they don’t love, and truly see if you can see yourself in this job. That’s what I would tell my 18 year old self, and it’s what I’m telling you as well. 

xoxo,

“you never got me down, ray.”

raging bull (1980) ;

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