Patient Education

By now I have been able to perform a number of diet educations to patients, with mixed results and responses. Last week, I counseled a man in his late 60s with a BMI over 40 about the "cardiac diet". To say he was resistant is an understatement. As we talked about lower-fat meat options, low-fat dairy, avoiding processed meats and snacks, and other aspects of the heart-healthy diet, he repeated "it's too late for me to change", and "I can't live without my spare ribs." I was with my preceptor who was observing my education session, and we were both feeling frustrated. At one point he even commented that both of us were "no small things", and we had to look the way we did from eating spare ribs once in a while... Needless to say it wasn't my favorite experience. He started to listen to us a little bit when we spoke about hypertension, but overall we left the room feeling like we wasted our time. Situations like this seem to be one of the frustrating sides of clinical dietetics. What I've enjoyed is utilizing my clinical skills (tube feeds, TPN formulas, and writing notes/evaluations). Some of the patient eds are hard to feel good about, especially (I imagine) for an experienced dietitian who's been doing this for a number of years.

On the other hand, Tuesday I counseled a patient (and his family) about the cardiac diet. This time, the family was concerned about the patient's health and interested in making changes in their lifestyles. They asked me questions, suggested food alternatives, and enthusastically listened to my advice and suggestions. When I left this room, I felt great- like I did actually help to make a difference in the health of that patient. And that my nutrition skills were being put to good use. I can see how many dietitians look forward to starting their own practices. To counsel patients or clients that actually want your advice and are interested in making the effort to improve their health seems like a rewarding experience.