The Power in Being Present

“I know I don’t have much time left to live, but I want you to remember while you are young to try and be present. Take each moment as it comes and focus on what is most important. You never know when conditions, like the ones I have, may take all of the enjoyment you once had out of your life.”

This was shared with me by an 89-year old woman, admitted for respiratory failure with a previous medical history of breast cancer, currently still fighting lung cancer for a third year and undergoing immunotherapy and chemotherapy.

It was my second follow-up visit with this patient, but never before did she open up to me like this. I spent well over 30 minutes in her room. As I stood beside her, she told me about her past, her family, and how although she had no appetite, she expressed to me she would love a strawberry banana smoothie as it would remind her of her daughters and her home.

As the dietitian, in times like this, we have to stop and ask ourselves: What is the priority nutrition problem at this moment and how can we intervene while the patient is in the hospital?

I wrestled with her request all day, uncertain if my compassion for her was clouding my judgement. I gave myself permission to choose the simple (and nutritious) comfort food instead of something more complex and less palatable and requested the smoothie for her. I realized that I’m learning from every patient I encounter and the learning is usually about the importance of relationship and trust we’ve established more than medical nutrition therapy. It’s only been three weeks and there are still so many opportunities to come.

Each day will be similar, but also has the potential to be different, and sometimes challenging.

• Similar: every day involves coming into the office, screening for patients, looking through the electronic medical records, visiting patients, and completing charting.

Screening done, notes compiled, temp checked, mask on, ready to head to the patient rooms!

• Different: Every patient has a unique story that includes medical history, admitting diagnoses, and social/environmental circumstances. Some days the dietitian will just be consulted for the purpose of providing brief education, but other days there will be an alert for a malnutrition consult or tube feeding order.

• Challenging: You can prepare with notes and questions to ask a patient in an interview, but you can never really predict the environment once you step inside their room. As the dietitian, we must learn to be flexible, and understand how to use our resources to work around any challenges that may arise each day.

All prepared with some initial patient assessment information before going to their rooms.

Back in the office determining diagnoses statements, energy needs, and final recommendations to finish up my notes for the day.

Throughout my first few weeks of clinical rotations, I have identified what I think are 10 of the most important qualities of an effective clinical dietitian.

1) Organized

2) Time-efficient

3) Precise

4) Flexible

5) Active listener

6) Knowledgeable

7) Compassionate

8) Good social perception

9) Good communicator

10) Resourceful

I wake up every morning excited for rotations, knowing every day is another opportunity for me to expand my knowledge in clinical dietetics. More than anything, I come to the hospital with the hope that in the brief time I spend with a patient, I may have the potential to positively impact their health, not only at that present moment but hopefully far beyond their time in the hospital.

By getting experience working in the field, I now have a new appreciation, insight, and understanding of why dietitians are so passionate about what they do.

Dietetics goes well beyond the numbers, calculations, and diet prescriptions. It is a profession that provides gratification in so many ways. Knowing that our knowledge can translate into improving the overall health and wellness of individuals around us is what makes me so passionate about pursuing this career path.

This is just the beginning of my journey, but I am beyond thankful for this opportunity and cannot wait to see how all of these experiences I have now will help to shape my future as a dietitian.