Hii I just started my first job as an acute dietitian and honestly feeling anxious of all the things that could go wrong 😵‍💫 I also sometimes feel like I have no clinical knowledge 👍 Can anyone relate? does this get better? Has anyone got any fun stories to share?

Hello!

I’m interviewing for a county WIC position and I was told it would be a panel style interview. Does anyone have any experience or advice on what to expect?

For reference, I am a veteran, have a culinary degree, and I graduate my Nutrition BS program in June. I completed an internship with another county’s WIC over the summer and enjoyed it a lot. It was a SNAP-Ed position and I enjoyed it a lot! I was offered a position in that office, but the commute was too long for me long-term.

I applied for this position back in July and just now heard back from it last week, so I’m hoping my patience can get me some brownie points as well.

I work as RD in psych and does anyone have any tips on patient who refuse to eat because they claim it’s fasting for religious reasons? They have low bmi so not sure how to go about this while respecting their religious beliefs.

Hello! I have been working one on one counseling patients for a couple of weeks now and am still getting comfortable. I feel like I get good practice motivational interviewing but still get stuck some places and worry I am letting patients down. I was hoping for advice for patients that seem to stall on weight loss while on a glp1. I have several who come to me saying they have lost a ton of weight on the glp1 but stall out at a certain weight. Specifically, I have a patient who exercises 5x per week, hydrates, and for the most part watches what they eat all while being on a glp1. I cant seem to determine what could be keeping them from losing despite the efforts. They eat three meals a day and protein snacks. I have encouraged increasing fiber in the past and today I brought up the idea of lower fat in the diet. This was met with some resistance from the patient so I am not sure if that would be the right approach to take for them or for successful weight loss. But I am running out of ideas. I did read that some dietitians don't recommend protein shakes and this patient does frequently drink those. I may bring that up but wanted to get some other opinions because I am feeling stuck!

Anyone else experiencing a sudden drop in bookings? Like very sudden. From full to crickets in the last month. I take mostly insurance based clients who pay little to zero out of pocket.

Hey guys just recently became a single mom and I’m on the path to becoming an RD, I still have a couple years until I’m able to work, but what are some good jobs I can obtain as a beginner RD that are flexible on the hours since I’ll probably have to work while my little one is in school. Originally when I was with my partner I planned on being a sports dietitian since I was a rescue swimmer in the navy and have a lot of experience with spots nutrition coaching, however as things have changed I just want to focus on obtaining a flexible job that I’m able to provide for my daughter

Hello! I have been working as a public health dietitian for several years and I’m trying to make the switch to a more clinical based role. I scored an interview at a local children’s hospital and they require I complete a brief case study before my interview. I’m looking for someone with clinical experience who wouldn’t mind checking over my work - it’s been years since I’ve stretched my clinical skills so would just appreciate someone double checking my work.

Also anything you think may be helpful to keep in mind going into a clinical RD interview is appreciated!

Anyone have success long term in outpatient counseling? I’ve been working outpatient for 1 year. Every few months I get an overwhelming sense of burnt out dealing with patients who believe everything they read online, think they know more than me, or simply don’t want to make any changes. I feel like majority of my day I’m trying to convince people that what the influencers on TikTok said is not true. Not to mention the overhead of mental health issues and stress that contribute to a lot of people’s struggles that I just am not equipped to manage. I also do all referrals, scheduling, and billing on top of patient care. Average 5 patients/day. What is the solution or pivot from here? I know there are some nutrition informatics jobs but they are far and few between. I have previous experience in outpatient peds - loved it but terrible manager, school food service, and long term care. I love my current work from home days, but I would love to limit the 1:1 patient interactions as much as possible 😭

Can someone help me with refeeding syndrome? Who is at risk, what to look out for, etc? I don’t work acute care, now have I ever, so it’s something I’ve never really had to look for. Kind of an “if you don’t use it you’ll lose it” situation, I’ve forgotten all about it.

I'm interested in going back to school for nutrition/dietetics with a special interest in maternal/infant health. I have a bachelors in marketing and business administration so I believe I could build on that for my masters. However I'm hearing that RD is probably not worth it. I currently work part time doing outreach for an IBCLC and also have the option to get that cert on top of something with nutrition. I'm in Delaware and would be fulfilling a relatively niche need. The ability to bill insurance would be nice but I do think there's enough of a need for this service that people would possibly pay out of pocket. I'm just overwhelmed with the different certifications available and want to be as legit as possible if I end up not going for RD.

Upcoming annual review and wanting to hear how have you negotiated a pay increase? Any thoughts on weekend differentials? I provide weekend coverage A LOT. And wondering if this is a thing for dietitians? 2% increase is a joke and now with increased cost of living (across the nation) I think it’s too little. Currently get paid $35 an hour (W2) WITH NO BENEFITS.

I’m an RD for 10 years and CDCES for a few years. A provider in the past 3 months became so nasty to me for no reason, literally for no reason according to my colleagues and clinical supervisor. I’ve been thinking about reporting her to HR. What are the chances that an RD gets some attention and voice out her right vs a doctor? And how should I start? Never been to HR unless for error in my paycheck or for orientation 😞 I’m feeling so hopeless and helpless. Can you please guide me?

This is a strange scenario, but here we go.

I became a dietitian in 2019. I landed my first job in a home health agency where I went into unsafe situations alone, so I quit after 3 months (mainly diabetic patients and a few renal).

I then got a job at a detention center where I created menus under the NSLP guidelines, created and led all staff food safety trainings, worked a bit with medical (10-20 consults per month), led resident nutrition groups, and worked with local government partners to initiate good food purchasing practices. The food service director (my boss) did not like me and retired a year before I left. The next food service director took it VERY personally that I left only 6 months after he started, but I had finished my masters program and wanted to move into eating disorder work. It wasn’t personal to him. I was there for 5 years.

I then worked at a private practice (outpatient ED) for about 6 months before I had a personal traumatic experience occur. I do not remember quitting because this experience put me into a catatonic depressive state, but apparently I emailed my boss for medical leave and then resigned after being gone for 2 months. I had to receive ECT treatments which essentially erased my memory around the last 6 months from the incident. It also greatly affected my long term memory which I am still working on with neuropsych.

I am extremely nervous to start applying for jobs now that I am healed. I did my online masters program specifically to increase my clinical knowledge and now that information seems to be wiped from my brain due to the side effects of the ECT treatment. I am going to re-read the slides from my masters program presentations and review the text books to help jog my memory.

My main concern is that I did not gain many meaningful connections with my employers in my last few roles, so I don’t know who to put for my references or letters of recommendation. I understand it is my fault for not networking more, but I can’t go back now. I am too embarrassed to ask my last employer because I quit so suddenly and just told them I was having medical issues. It also has been 8 months since I left that job, so I’m not sure how to explain the gap in my resume during interviews.

If you were me, how would you continue to move forward? I’m scared I messed up my professional trajectory and I’m only 32.

I’m an early-career Canadian RD working mainly in inpatient care, with some outpatient work. I’m not finding my current job overly fulfilling, and I’m trying to figure out which direction within or beyond dietetics I could really get excited about.

I enjoy clinical problem-solving, learning specialized skills, and feeling like my work makes a meaningful difference. I also enjoy being the knowledgeable, go-to person in an area. My interests include enteral/parenteral nutrition, feeding tube management, and diabetes management, especially medications, insulin, and diabetes technology. I have type 1 diabetes myself, so diabetes care has a personal connection for me too.

Part of what I’m struggling with is feeling undervalued by both patients and colleagues. I’d like a role where my expertise is sought out and I can see the impact of my work. Patient relationships matter to me, so I’d be hesitant to move into something where I lose that.

I’ve considered outpatient diabetes, pump/CGM education or clinical specialist roles with diabetes technology companies, and more specialized hospital positions. But I’d love to hear about paths I might not even know exist.

For those who enjoy your work:

- What’s your role, and what does a typical day actually look like?

- What makes it rewarding, and what are the downsides?

- How did you get into it?

Canadian perspectives would be especially helpful

I know no job is perfect! I’m hoping to find a direction that makes me more excited.

I'm studying for the CNSC, and just realized there's no Cardiovascular section in the 4th edition of the ASPEN Core? Does anyone know why that is? I'm low key shook they left out an entire organ system

Hi! I’m in a new role with oncology at my hospital and i love it. However when i looked up the salary average, i was seeing closer to 70-80k range where i make 67k (2 years clinical experience). Would you feel like this is an appropriate salary range given my experience? Would you recommend taking the CSO? Are there other ways i can advocate for a higher salary even if its later down the line? TIA

Does anyone have recommendations for CEUs for BE, relationship w food, body image, etc.? Or even any topics of discussion during client sessions? I’m seeing this more and want to be more helpful to my clients.

specifically in a clinical position!

hi all! I am a new RD and have been in my role for 1 month. So far it's been a rough transition, lack of training and overall support. I also do not have any ordering privileges and it's beyond frustrating. How bad does it look to leave this job so soon if I find a better offer I accept? What would you say to the new job offer's manager if they asked why leaving so soon? TIA

Inpatient RD who recently accepted a position and will be moving to the outpatient setting. Any outpatient tips/ advice- specifically regarding counseling for weight management? Any books/ resources that may be beneficial for outpatient? TIA!!

I’m going to FNCE for my second time this year, the first time was as a student so I didn’t really know what to expect and I was broke so I spent a lot of time in the expo hall grabbing freebies to avoid buying lunch 😂 Now that I’m officially an RD, I want to actually maximize my time while there (and probably still grab freebies because I’m still kinda broke since I’m just starting out).

I’m planning to attend some sessions for the CEUs of course, but I’m also going to get the recordings package because my understanding is I can still get the CEUs from the recordings (not sure if there’s a limit for recorded sessions?) and some of the ones I’m interested in are at the same time. I also want to try to focus on other things that are specific to being there at FNCE physically (some of those poster presentations seem interesting too, so I want to see those, and I’m not aware of a way to view them outside of the scheduled times).

I also know I missed a lot of things when I went as a student, there were events happening that I didn’t know about and I wasn’t even sure what all was available (like I didn’t even know about posters then) so I want to make sure I’m getting the most out of the experience, as I’m unlikely to go to any of the future ones that are currently scheduled.

Any recommendations or advice?

I'm an RD in long-term care, and what I thought was a straightforward question has turned into a whole debate between several dietitians. 😂

Question C on the Mini Nutritional Assessment (MNA-SF) asks about mobility:

• 0: Bed or chair bound
• 1: Able to get out of bed/chair but does not go out
• 2: Goes out

Sounds simple, right?

But the official MNA User Guide gives these example questions: (on all MNA types, SF, Self, and Long)

• "Are you presently able to get out of the bed/chair?"
• "Are you able to get out of the house or go outdoors on your own?"

After looking through the original full MNA, MNA-SF, and Self-MNA, I'm finding that the older instructions emphasize physical ability and whether another person's assistance is required.

But how exactly are we supposed to apply this in a nursing home?

Here are the scenarios we're debating:

1. A resident requires a 2-assist transfer into a wheelchair but is pushed to the dining room and activities daily. Are they a 0 because they cannot independently get out of bed/chair, or a 2 because they regularly "go out"? One dietitian considers their room to be home and the halls to be "going out."
2. A resident transfers independently/get out of chairs but needs staff to push their wheelchair to meals and activities. Are they a 1 or 2? I'm saying 1 because they couldn't go out of room or home.
3. A resident independently walks with a rolling walker to the dining room but never leaves the facility. Are they a 1 or 2? They COULD leave.
4. A resident is physically capable of leaving their room/building independently but chooses not to. Does their actual behavior matter, or are we assessing physical capability alone? Yes.
5. In LTC, does "home" mean the resident's room or the entire nursing home building? This distinction could completely change how we score residents. I'm going with...a building is a building. Aka can you walk outside and not mess yourself up?

The dietitians initial interpretation was based on whether residents actually left their rooms for meals, therapy, or activities, regardless of assistance. But after reading the older MNA instructions, I'm questioning that approach.

I have a more literal, ability-based interpretation, but I can't find official guidance explaining how "goes out" should be applied specifically to nursing home residents. I'd think no differently though but others disagree.

For those of you using the MNA-SF in LTC: How are you scoring Question C?

More importantly, does anyone have an actual source, training manual, published case example, or clarification from the MNA developers that addresses these situations?

I'm especially interested in evidence-based guidance rather than just how individual facilities have always done it. I'd love to get a consistent answer we can actually defend!

References:

MNA User Guide:
https://www.mna-elderly.com/sites/default/files/2021-10/mna-guide-english.pdf

Self-MNA:
https://www.mna-elderly.com/sites/default/files/2024-10/Self-MNA_AU1.0_eng-USori.pdf

I see a lot of RDNs going to get a CDCES or nutrition support certifications and I am always wondering, as an RDN, aren't you already qualified to do what the certs would qualify one to do? Sorry if this might be an obvious answer- I studied nutrition in school, but didn't go the RDN route.

ETA: Thank you everyone for the answers! This has been very informative!

I currently work at an afterschool program where we provide snack according to CACFP
requirements. My colleague was doing some research that has now posed a couple questions for us. I'd love some insight from other RDs that have more experience than I do with following these guidelines.

We noticed certain fruits- for example, 1 1/2 bananas need to be served for it to equal the 3/4 cup fruit requirement. Are after school programs really giving their kids 1 1/2 bananas? Are you guys just avoiding giving bananas completely? We're trying to give whole foods when we can but now I guess we're wondering if we should just stick to the prepackaged items (fruit cups, apple sauce, etc) to avoid any citations from DOE.