Preceptor Profile: Becoming Fearless

“Learn how to work with the whole picture of nutrition. Keep in mind that you are dealing with people with a lot of experiences.” This quote from Lorna Ehrisman, my preceptor at Bayside Care Center, perfectly sums up my time in long-term care. Long-term care often gets an unfortunate reputation due to a lack of regulation in the past. Many think that long-term care facilities are filled with awful smells, elderly people tied to their beds, and unappetizing mush for food. I can tell you that none of these things are true…well the smell part is true sometimes but welcome to health care! Long-term care is a beautiful aspect of our healthcare system. It’s a chance to take care of the people who have contributed to our work force and communities. The quote above says it all, the people in these facilities are someone’s loved ones who have experienced life and deserve to have the best care possible. I hope this post helps to shine light on the role of the Registered Dietitian (RD) in long-term care.

I had the privilege of working with Lorna, through Compass Health, for two weeks. Bayside Care Center is one of the many facilities that falls under Compass Health’s long-term care umbrella. During my time in this rotation I found that long-term care is very different from acute care, or the hospital setting. In acute care, the focus is on the immediate problem at hand. If someone has diabetes, their diet is restricted and they are given nutrition education to help prevent any further damage to their health. In long-term care, many of these people are at the end of their lives and the only pleasure that they have is eating. Patients' enjoyment and comfort is the number one priority to the RD. Giving residents autonomy and choice in how they want to eat outweighs the need to restrict and provide a specific therapeutic diet. The facility is their home and the RD’s job is to decide the best plan of care possible for this individual. The RD works with a standardized process and provides individualized care.

I spent a lot of time talking in Lorna’s office during the rotation. Throughout the two weeks I worked to soak up every last drop of Lorna’s wisdom and incredible stories. I was continually in awe of the amazing life that Lorna has lived. From surfing in Hawaii to working in a bikini factory in Southern California, she gave me continual hope that life can take you anywhere. Her dietetics career began after she took 2 years off from school. She was originally a nursing student who soon discovered that nutrition was an interest of hers. Lorna grew up in a family of vegetarians before being vegetarian was trendy, which fueled her interest in nutrition. After graduating from Loma Linda and sitting for her RD exam she landed her first job in clinical at a local hospital for four years. She took some time off after having a beautiful baby girl, and moved to Hawaii with her husband. While in Hawaii she was approached by a fellow professional about taking a part time job at a long-term care facility. Lorna had never considered a job in long-term care but decided to give it a try. She accepted the job and fell in love with the atmosphere. For Lorna, long-term care gave her the ability to really get to know the residents, utilize her clinical skills, and have a hand in food service. After spending some time consulting for different facilities, taking a job at a country hospital, moving to Colorado, New Mexico and back to California, she began her job with Compass Health – and the rest is history.

During my two weeks with Lorna, I witnessed firsthand her compassion for her residents. There were many mornings that we sat talking with residents in their rooms, discussing alternate meal choices in her office, and running to the kitchen to see if the chefs could change a lunch or dinner order. The residents ADORE Lorna! It was so inspiring to work with an RD who was still full of life after working in the field for many years. Lorna goes above and beyond for her residents but she also makes sure to have boundaries. Lorna continually advocates for her residents and works to make Bayside into a home for the people who live there. She would walk into rooms and help however she could. I never saw Lorna back down from a challenging resident or avoid entering a room with strange smell or agitated resident. It was evident that Lorna was fearless in pursuit of exceptional care for her residents. I realized that one of the most challenging aspects of the dietetic internship has been getting over the discomfort of having to invade people’s space both physically and emotionally. It can be so terrifying to walk into a room where someone is sick, grumpy and could very well be partially undressed. Not only do I have to cross over physical taboos but I then have to be the third or fourth medical professional to ask them personal questions about their eating habits, bowel movements, and food preferences. Watching Lorna genuinely care for her residents inspired me to let go of the fear of discomfort and provide the care that the people lying in these beds deserve. By the end of the rotation I determined the type of dietitian I want to be: fearless, like Lorna.