As part of Dietitians Week, the annual celebration of the profession, Caroline Bovey BEM RD, Chair of the British Dietetic Association, has written a few words about all the things dietetic services have done to support patients and public health during the coronavirus pandemic.
Dietitians are the clinical nutrition experts – the only professionals specifically trained to support the nutrition and hydration needs of acutely and chronically ill people with a wide range of conditions. Many people may not have realised the important role we have been playing in response to COVID-19, and will continue to play to support people to recover and rehabilitate, so I’m delighted to be able to highlight just some of the roles our NHS colleagues have been playing over the last few months.
Many COVID-19 patients have unfortunately required intensive care, where they will be sedated, ventilated and will have nutrition and hydration delivered through feeding tubes, or in some cases into their vein.
Dietitians assess the nutritional demands of each individual patient, taking into account their age, gender and other underlying medical conditions, and reviewing that daily. Getting this right can mean a shorter length of stay in ICU, and stronger recovery and rehabilitation. Our critical care dietitians have therefore been a key part of ICU teams, and have also helped to upskill and train non-critical care dietitians, to assist in managing the large number of critically ill patients we have seen and are likely to see over the coming months.
Dietitians also have an important role to play in rehabilitation, reducing risk of complications and shortening recovery times. Patients who have suffered COVID-19 and been hospitalised will be at increased risk of malnutrition and will likely have suffered deconditioning during their stay. Dietitians can prescribe fortified diets and specialist nutrition supplements to help people regain health and to build muscle strength that may have been lost, working closely with other allied health professionals such as physiotherapists and speech and language therapists.
Of course, the effects of the pandemic have been felt far wider than those who have caught and suffered complications from the virus. Acute and community dietitians normally support some of the largest and more vulnerable population groups in the UK, including patients with malnutrition, cancer, obesity, diabetes, food allergy and eating disorders to name but a few. These patients still need our help, and dietitians have used technology to great effect, including video consultations and specialist apps to provide clinics to patients who need them.
People’s mental health has also been affected by increased isolation and worry, and for those with conditions such as eating disorders, support from specialist mental health dietitians will be vital, especially as many of their support networks may not be available.
These groups will no doubt need additional support as the COVID-19 pandemic abates. Many will have been struggling to maintain their health and wellbeing, but may have held off on accessing health services either because of fear of infection or a desire to reduce pressure on NHS and care staff. Our message to those patients is that dietitians are still here and ready to support your health, so please help us help you, and come forward for care as you usually would.
And while frontline NHS staff have rightly been lauded by the public, it’s important to remember that many dietitians who work outside and alongside the health service are also playing their part
Dietitians in private practice and working freelance are making their services available to support clinical colleagues. Those working in academia have been faced with unheard of challenges in ensuring that they support students through their end of year exams and for those due to graduate this year, their final qualifying exams and viva – and many have also joined the temporary register to boost the frontline too.
Many of our research dietitians have diverted their expertise into the COVID-19 arena and are producing evidence reviews and gathering and synthesising data to inform clinical decisions and rehabilitation pathways – making sure their colleagues are able to deliver the best, evidence-based care.
And last but not least, public health dietitians are providing expert advice and guidance to help the whole population eat and stay well during lockdown, including working with local authorities and the third sector to ensure that direct support that is delivered, such as food parcels, and advice provided focuses on optimising nutrition, and also working with supermarkets to ensure that people with health conditions can access the good quality food they need.
In short, COVID-19 has shone a spotlight on the breadth of vital roles that dietitians can play and why a career in the profession is so rewarding. To find out more, including what it takes to join us, head to: www.bda.uk.com