The simple art of fitting in fast as a contract dietitian

The biggest hurdle is behind you: you completed the hiring process and secured your role as a contract dietitian. Now it’s time to focus on what comes next: starting strong. Use the blog below as a guide to walk in prepared, ask the right questions, and set yourself up for success from day one.

Be prepared for a variety of scenarios

As a board certified registered dietitian, you are intimately familiar with the Nutrition Care Process. That said, each facility tends to do things a little differently. From how they screen patients, how often they see high risk patients, to the communication platform/protocol with the interdisciplinary team – there’s always a process that looks slightly different than the others.

To set yourself up for success, control as much as you can to arrive confident on the first day. First up, make sure that your resources are in order to hit the ground running, then you can adjust as needed within the facility’s policies and procedures.

Real-world contract dietitian experience

About two years into being a dietitian, I secured my first contract dietitian role in rural Texas. I didn’t know much about the facility, except that it was a very small hospital and I’d be covering for the one dietitian who’d be out for a couple weeks. Not knowing what to expect, all I brought was my calculator and clinical assessment template.

When the staff dietitian walked me through charting and it included writing a PES statement (which I hadn’t had to do for a couple years at this point), my imposter system started creeping in. The second day I brought along more of my clinical resources to make sure I could see patients with full ease and confidence.

Through this and other assignments, I’ve learned that every charting system and process is a little different, so it’s always a good idea to walk through the doors ready for anything.

Below is a list of go-to clinical resources to bring on the first day and, many times, throughout the duration of an assignment.

Tried and true clinical resources:

• Clipboard (bonus points if you have one that your materials fit inside of, too!)
• Standards of Care/Evidence-based guidelines (each facility tends to have their own version of this, but if you have either one you made or one you’ve adopted from another facility, you can’t go wrong so long as they’re up to date)
• NFPE Pocket Guide
• Calculator
• Clinical assessment sheets (here is a reference to get started)
• The Essential Pocket Guide for Clinical Nutrition
• Abbott/Nestle Nutrition Product Reference booklet (Note there are other manufacturers of nutrition supplement products or tube feeding formulas, but these are the big two.)

Outside of this, some things to consider bringing on your first day include a reusable water bottle, lunch and lunchbox, snacks, pens/pencils, highlighters, a notebook/scratch paper and anything else to keep you hydrated, energized and prepared on your first day. (This annual gift guide for dietitian has some great suggestions.)

Stay flexible: Bring past experience and know when to ask for help

Each facility will have a different onboarding/training protocol ranging anywhere from hitting the ground running and learning as you go, to a couple of days of onboarding and shadowing other dietitians.

Regardless, it’s always helpful to have an idea of what you need to know to do your job well and what questions to ask to get this information. Once you’re exposed to different facilities and protocols, it makes it easier to understand and adapt to how things are done differently.

You may end up finding similarities among stark differences. But, all in all, as long as you’re going through the Nutrition Care Process, you’re going to serve your patient well.

Real-world contract dietitian experience

A couple years ago, I signed on for a 4-month assignment in southern California that turned into nearly two years working with an amazing team of dietitians. California is known for its tight healthcare regulations and oversight and, being my first clinical experience in the state, I had a pretty steep learning curve. When I first started screening units for the team, I made several mistakes but was able to learn each time and eventually was trusted to screen units and make patient assignments for the day.

Even though it was overwhelming, through asking clarifying questions and not being afraid to admit that I wasn’t sure what to do, I was able to learn an incredible amount and take this knowledge with me to other assignments.

Questions to ask in your first week as a contract dietitian:

• EMR: Take thorough notes; ask clarifying questions during training.
• How are patients screened daily? How is the consult list created?
• What’s the consult/referral timeline and follow-up schedule? Is there a written policy?
• Tour the formulary; keep a printed copy for calculations.
• Do we have order-writing privileges? For what, and how are orders entered?
• How does the IDT prefer to communicate? Ensure access.
• Which printer is used for patient education?
• Do we have access to the Nutrition Care Manual?
• Tour the facility: units, navigation, patient food/beverage, bathrooms.
• What foodservice model is used (room service, trayline, select menu)? Get a menu copy.
• How do I contact the speech therapist(s)?

Asking questions helps you understand the process and shows the team you’re eager to learn, adapt, and hit the ground running. Leaning on your team when you’re unsure builds trust and ensures you know how to do your job properly.

Many dietitians enjoy sharing their knowledge and are happy to help. In situations were a contract dietitian is brought in, teams are often short-staffed, which makes them especially grateful when you step in and help.

How to build relationships as a contract dietitian

It can be intimidating walking into a new hospital, but we’ve all been new somewhere before. Don’t be afraid to make the first move and introduce yourself to the staff on the units. This helps to build rapport and make it easier to navigate the units.

A great way to immerse yourself with the team is to attend rounds, if appropriate and able. Interdisciplinary Team (IDT) rounds get you in front of the physicians and nurses, and oftentimes the pharmacists, physical/speech/occupational therapy and case managers, too.

Regardless of if you can attend rounds, be sure to introduce yourself when you’re on the unit to the nurses and other members of the team who are caring for the patient. You may even end up running into fellow consultants and making a friend!

As we know, the IDT plays an important role in treating the patient and we can provide better care for patients by working closely together in a timely manner. Nurses and speech therapists provide valuable insight into the patient’s current condition and how our role as dietitians can further impact healing.

Real-world contract dietitian experience

Early in my career as a consultant dietitian, I tackled an intimidating role at a 1,000+ bed hospital in Miami, FL. It was nearly impossible to get to know all the nurses and the hospital was so large I got lost several times. I was assigned to cover one specific unit but in reality, I ended up covering seven. In the end, I ended up meeting some incredibly kind people and expanded my clinical skills more than I’d ever imagined during that assignment.

A final reminder: You got this!

Starting with a new team and facility can feel a little intimidating at first, but that stretch outside your comfort zone is part of what makes consultant work so rewarding. It’s a new challenge, sometimes a new way of thinking, and always a learning experience.

And at the end of the day, you will always be doing the impactful work of serving patients, no matter the setting, to improve their lives through the power of nutrition.

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Dietitians On Demand is the nationwide leader in staffing registered dietitians, specializing in short-term, temporary and permanent-hire positions in acute care, long term care and food service positions. Our dietitians cover a vacancy, maternity leave, vacations, FMLA or increases in census. Check out our job openings, or request your coverage today!