It’s RDN Day! Celebrating registered dietitian nutritionists’ integral role at Michigan Medicine

March 9, 2022  //  FOUND IN: Our Employees,

At Michigan Medicine, multidisciplinary care teams develop comprehensive plans to help patients heal and thrive.

Among those teams are registered dietitian nutritionists, who work with individuals and families in both the inpatient and ambulatory care settings to ensure everyone gets the nutrition support they need for their specific diagnosis.

Though their numbers may be small — with approximately 100 spread across the organization — their impact is felt in almost every patient interaction.

To celebrate their work, RDNs shared what a typical day is like, what they love most about their job and what the biggest misconceptions are about the work that they do.

Here’s what they had to say:

What is your job like on a day-to-day basis?

Elizabeth Kosch, M.P.H., inpatient RDN: My job can vary greatly on a day-to-day basis, but ultimately, I’m spending time talking with patients and developing a plan to help address any nutrition-related concerns. When we talk with patients, we’re assessing their nutritional status and determining if there is a risk of — or the presence of — malnutrition, as this often relates to clinical outcomes. With that comes helping to educate patients on any specific diet they should be following due to a health condition, helping patients optimize their nutritional intake when they’re dealing with symptoms/side effects from illnesses or treatments, formulating nutrition support recommendations for things like tube feeding or parenteral nutrition when patients can’t eat by mouth, and collaborating with other providers to ensure nutrition-related issues are addressed.

Austin Michalski, CNSC, inpatient NICU RDN: Each day in the NICU is centered around making sure patients are receiving the nutrition support they need to grow. This often means monitoring weight gain and growth, planning nutritional intake through feeding tubes or IVs, troubleshooting difficult clinical scenarios and educating families on the home feeding plans and breast milk or formula recipes they need to keep their babies growing at home.

Ann Miros, ambulatory care RDN: My day-to-day routine involves caring for patients 20 years old or younger who have chronic kidney disease, a kidney transplant or any kidney-related condition. Some days are busy seeing patients in clinic, others are filled with phone calls and video visits to families. My expertise on the team is to make sure that the child’s complex nutrition care plan is safely understood and user friendly for family members and caregivers. My role is to adjust formula and milk regimens, provide nutrition education, and treat conditions and symptoms to optimize growth and meet goals.

Rebecca Thorwall, M.S., RDN; Samantha Choi, M.S., RDN, C.S.P.; Makenna Bogaard, RDN (inpatient ketogenic RDN team): We follow both inpatient and outpatient keto patients, so we split our time between the hospital and the pediatric neurology clinic. The days go very quickly because we work with many different patients either starting the ketogenic diet, making changes to their diet based on seizure activity, or troubleshooting whatever barriers might be making the diet challenging.

What do you like most about your job?

Katie Byrne, ambulatory care RDN: I really enjoy working with a large span of ages, from newborns to young adults! I also like working closely with a team of RDNs caring for patients and their families over many years that creates special relationships — we get to know our families very well!

Erin Zettell, M.P.H., inpatient RDN: I am proud to work for an institution where other providers respect the value in the dietitian’s contribution to patient care. I am also grateful for the collaborative and adaptive spaces that Patient Food & Nutrition Services, the health system at large, the university and the greater community supports.

Monica German, inpatient RDN: My favorite thing about my job is educating and guiding doctors on my interdisciplinary team rounds regarding nutrition and how to obtain optimal growth for patients at a multitude of ages who have certain diseases. 

Ketogenic RDNs: Being a ketogenic diet dietitian is very rewarding. We spend a lot of time with our patients and caregivers, so we get to build great relationships. There is no better feeling than getting a call from a caregiver to tell you that their child had their first day without seizures because of your help. We all feel very lucky to work with this population — and to use our knowledge and skills to have such an impact on the patients we get to work with.

What do you think is the biggest misperception about RDNs and the work that you do?

Kaitlin Thomas, CNSC, inpatient RDN: A common misconception is that patients often think I am the “food police” and wonder why they are being referred to a dietitian in the setting of a poor appetite during acute illness. In the hospital, any calorie is a good calorie and I am frequently educating about how to meet nutritional needs. Optimizing the nutrition status of patients throughout medical and surgical treatments can reduce hospital stays, decrease risk of infections and improve healing.

Jenna Beehler, M.P.H., inpatient RDN: I think that one misconception is that dietitians only provide education on healthy diets. The reality is that dietitians work in many settings, including providing complex and critical nutrition support for ICU patients, chronic diseases, patients with long-term parenteral/enteral nutrition and many other conditions that require thoughtful and thorough nutrition plans.

Michalski: While some RDNs do work in the kitchen to ensure we have the most nutritious options for patients in the hospital, clinical RDNs are vital members of the patients’ health care team. Growth and development are care elements to pediatric health care, especially in the NICU. As the tube feeding and IV nutrition experts, we are the ones who can step in to make sure patients get the best nutrition even if they are unable to eat food in a typical way.

Zettell: It is often overlooked that nutrition is a fundamental component in preventing, treating and reversing disease. In order to expand nutrition services to improve health outcomes and decrease health care costs, we must advocate for greater presence, autonomy and leverage of dietitians in medicine, public health and research.

Be sure to thank the RDNs in your area of the organization!