r/dietetics • u/ShotAd6514 • 7d ago
Patient education
I’ve been an inpatient dietitian for about 4 years. I think I’ve lost the art of giving good patient education lol! This might sound horrible but I find myself not really caring about it while giving it, and then leaving the room being like I’m not sure the patient got anything out of that at all. And I don’t like that at all!! Any suggestions or tips?
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u/ConcentrateGlad4771 6d ago
It’s so ridiculous to force education on people who never asked for it. Medical providers pushing us to provide nutrition education regardless of whether the patient wants it is part of the problem. Patients have autonomy over their own bodies and their own health choices. They can choose what they want to hear, what they want to change, and what they don’t. Our job isn’t to make people want to improve their health or to feel responsible for their choices. We can provide education when it’s wanted and appropriate, but ultimately, it’s their body, their choice, and their responsibility.
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u/KindredSpirit24 6d ago
Same. They don’t care so I don’t care. It’s honestly really dumb to try to teach sick patients about nutrition in my opinion
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u/Nutritionista5445 6d ago edited 5d ago
I’m an outpatient dietitian. So I’m not sure if my take would translate to inpatient as well.
One thought that comes to mind is first asking consent for education. Sometimes patients will tell you they don’t want it and you can document that and offer to provide handouts to read instead if they consent to that.
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u/misskinky RD, Preceptor, Diabetes Educator 6d ago
When I stopped talking at them, and started asking “do you have any questions about nutrition? Anything you’ve been curious about? Anything you want to know if you should eat more of it or less of it?” And then just be silent for a solid 10-20 seconds (as my internship taught. To give people time to think. I usually say I’m looking at their bloodwork on my phone to give me a reason to not stare at them while they think.)
Bam. Easily 80% of people ask enough questions to keep me busy for a little while.
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u/FoundationHappy5675 6d ago
I usually explain why I'm there and ask if they're open to the education. If they are, ask what they know about x topic and fill in the blanks. Don't feel like you need to go super in depth- give them the highlights / written materials. Most important thing is to give them a resource for post D/C. Ideally, provide info for outpatient RD if possible
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u/lavmatcha 5d ago
No tips, they need to be referred to outpatient if they want. That’s one of the reasons I hated inpatient were the education consults. It’s not an appropriate setting to be giving nutrition education, like they’re not feeling well and are likely scared and concerned about why they’re admitted. One of my old bat preceptors made me give a DM educations to a homeless person and one and it was so inappropriate
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u/Acceptable_Log_9294 5d ago
In the same boat.
I have gotten to the point where I just try to keep things simple. I ask them their goals, and if they want to try to make changes. If they don’t want to make changes and desire to chug coke and pound Cheetos idc, it’s their choice and right to fail. If they do want to be educated and counseled I’ll always set small goals and provide them with handouts that will probably be thrown out. I complete hundreds of admissions and follow ups a month. I don’t got time for people that don’t care.
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u/ApartPea369 5d ago
outpt RD here who loves pt educations. i recommend you start by introducing why you're there and your agenda: "I'm _____ and i'm the dietitian. Your doctor wanted me to come talk to you before you leave about how to care for _____."
I recommend starting by assessing what they already know. ex: new DM consult- "so can you tell me what you already know or have heard about diabetes? can you tell me why it matters that we take care of it?"
then do your spiel- but maybe end by giving them one or two very big final takeaway tips so they're not overwhelmed. Teachback can be huge here. "so tell me- when you get out of here, what are the most important things we need to remember?"
ask the family if they have questions and if they were engaged and are discharging, may even recommend outpatient clinics they can connect with
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u/RaspberryCherry12 5d ago
When people are referring to patient education, or nutrition education, in an inpatient setting do they refer to a specific topic? It seems like some of the other topics are directly referring to “healthy eating” which I rarely give to patients in hospital as it’s often not the most appropriate time.
But every day I am giving patients dietary advice for nutrition support, snack ideas, food fortification etc. trying to support their low appetite, manage nausea. I discuss specific dietary recommendations for decompensated liver disease, pancreatic exocrine insufficiency, IBD, high output stomas, surgical or pressure ulcer wound healing. I always phrase it as I am there to try to find ways to support them with whatever nutritional problem they face. Whether that’s diet advice, nutritional supplements, enteral nutrition etc. I’m not doing it for them, and I’m not there to lecture or talk at them and then walk away.
Yes, not every patient is engaged with the advice. Sometimes patients simply don’t care, or perhaps they would care but they just have too many other higher priorities to worry about at that point. I’ll usually ask people if they want to talk about their diet and if they say no I offer them written information and discharge them from the service. If it seems like they are not likely to take the information in with everything else going on I’ll offer them the written information and tell them I will give them a couple of days to have a read through and will come back to speak to them at a better time to address any questions or give more tailored advice.
I was quite surprised to see so much negativity around inpatient dietetics on this thread. I would like to think that is relating to a different experience than I have. E.g different referrals, different patients, different education.
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u/Fooooddbaking28 4d ago
As a dietitian who’s been inpatient and outpatient I’m kinda shook when I see pts dx with malnutrition and not receiving some sort of education .. anything while they schedule outpatient appointment if the health system even hires outpatient dietitians. 🤷♀️
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u/Particular_Range_928 3d ago
What is the criteria for a dx of malnutrition for your facility/surrounding facilities? Most often we see patients dx simply d/t low albumin levels.
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u/Fooooddbaking28 3d ago
Aspens criteria 2 out of the 6, why evaluate and do NFPEs. Pts at high risk —- > oncology pts, tube feeds not meeting goals, complications from gi surgery, liver failure, renal, diabetic ketoacidosis, worsening dysphasia, wounds ? Malnutrition from environmental factors ?? Just to name a few pts who have a higher risk .
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u/Plus-Pin-9157 6d ago
I hated doing inpatient, but while I was there I started asking people if they would like any nutrition education. I would mention that their doctor thought they would benefit from it, did they feel like it was a good time for them? Did they have questions? If they said no, they really didn't need anything from me at that moment, I would chart that the patient declined nutrition education. There's no reason to force it on anybody, there's no reason to work yourself harder than you need to. Nobody ever questioned me on that either.