Dietetic Intern Wisdom: Knowing My Scope Of Practice

Talking About Nutrition As A Dietetic Intern

Registered Dietitians are the medical nutrition experts of the healthcare world. I am studying to become one, but I’m not there yet.

I am a dietetic intern, meaning I am completing 1200 supervised practice hours, including clinicals, projects, presentations, case studies, and more, all so that I can pass the exam and become an RD.

Nutrition is a HUGE field of study

As a first year grad student and dietetic intern, I’m amazed at the depth and breadth of knowledge I’ve gained through my classes and extracurriculars.

I’m also humbled at the amount of information available in my field of study that I’ve yet to come across.

There’s always more to learn, and even when I think I’m proficient in a topic, there is new research that is constantly coming out.

And I LOVE to talk about my field of study! Nutrition is one of my absolute favorite topics!

I love talking about articles I’ve read, research papers or assignments I’m working on, or experiences I’ve had at my jobs.

As I have mentioned before, I get hit up for nutrition advice EVERYWHERE.

I frequently find myself pressed for nutrition advice from friends, acquaintances, and even strangers.

And as much as I love answering questions, it’s taken me several years to figure out how to navigate this area of my education I’m in, where I know a decent amount, but I’m not an expert, nor am I a licensed professional.

Here are the top three guiding ideas that help me know when to speak and what to say when people approach me with questions about nutrition.

Idea #1: I do not know everything. Therefore, ‘I’m not sure’ is always an acceptable answer.

One of my professors in undergrad has a saying. Whenever my peers or I asked her questions in class, she responded, without fail, “Well, it depends,”

My professor (Hi Holly!), was one of the best role models I’ve ever had for the humility that must come with any healthcare profession.

Dietitians all go through a standardized educational curriculum via our profession’s requirements.

I’ve taken coursework in community nutrition, food service management, education and counseling, medical nutrition therapy, and more.

BUT…nutrition is a huge area of study. It is impossible to know all that there is to know, and impossible to remember all that you’ve ever learned.

If someone asks me a question, and I have no idea, or I don’t think I can answer the question in a way that will be positive and constructive, I have to swallow my pride and work on not being afraid to say “I’m not sure.”

Idea #2: I am not a licensed professional; I cannot prescribe, diagnose, or treat.

When people ask me “I’m tired all the time, what can I eat to fix that?” or “Whenever I eat milk, I feel sick,”, I need to remember that I am not a professional yet.

I am in the midst of my education, but I do not have any certifications that allow me to practice nutrition.

It takes a lot to swallow my pride when someone asks me a question about something, even something I feel I have a solid base of knowledge in, because I have to remember that I cannot provide medical nutrition advice.

Even though I’ve learned in classes and internships about how to provide medical nutrition therapy to patients with diabetes, allergies, cancer, etc., I am not licensed to provide this advice without being under the direct supervision of a licensed healthcare professional.

This link here does a good job of explaining the concept of what a non-licensed professional can say to clients or patients regarding nutrition care.

As an example: say someone asks me: “I’m tired all the time, what can I eat to fix that?”

“Well, it depends…” is usually my first response.

From there, I might reference basic information that is easily available and applicable to the general public.

“Eating plenty of fruits and vegetables, staying hydrated, getting enough exercise, managing stress, and working hard to get 8 hours of sleep can usually help with increasing energy levels,”

From there, depending on how well I know the person, I might add what they can do to seek additional resources if I haven’t answered their question or if they are concerned that something is wrong.

“Sometimes fatigue can be related to a nutritional deficiency or another health problem. If you’re concerned with how tired you are feeling, I’d recommend speaking to a doctor,”

Obviously, I know from my studies that fatigue can be related to anemia, B12 deficiency, or other issues not related to nutrition, like a thyroid problem or mental illness.

But that’s not my place to speculate.

Especially because I don’t want someone to think that my saying “iron deficiency anemia could cause fatigue” means that THEY are anemic, because anemia has to be diagnosed by a healthcare professional.

I love finding online resources and articles for people who ask me questions!

If someone asks me about eating a well-balanced diet with celiac disease, I’m happy to help find credible information online for the person while recommending that they speak to a professional if they have additional questions or they’re looking to make a change or receive a treatment or diagnosis for a problem.

Idea #3: I am a coworker, peer, friend, or family member FIRST, nutrition expert SECOND.

One of the most difficult areas to navigate when discussing nutrition is determining if the person I’m speaking to is looking for my advice about their situation, or if we’re just having a casual conversation.

Sometimes it’s obvious.

When someone asks “My mom just got diagnosed with type 2 diabetes. What can I cook for her when she comes over on Friday?” it’s fairly obvious that they’re looking for me to provide them with information.

But sometimes it’s less obvious.

Imagine chatting with a friend, and they bring up that they’ve never liked drinking milk, and they’re considering going vegan, and they’re hoping to start running because they’ve heard that’s good for them. And they tried tofu for the first time and they thought it was really gross, and nothing that tastes that bad can possibly be good for them.

If I’m engaged in the conversation and paying attention to what they’re saying, I realize quickly that they are NOT asking for my advice as a nutrition student, even though we’re talking about nutrition topics.

They are simply updating me on new developments in their life because I am an important person to them. No advice necessary.

I might have a lot of opinions and thoughts about veganism, tofu, or working out. I might even disagree with what they are saying.

But if they don’t want my advice (and they aren’t saying anything that could potentially cause them harm), I don’t need to put on my nutrition hat.

When In Doubt, Ask First.

It is so important to realize when people are asking for my advice and when they are not.

Even if I have good intentions, nothing is more off-putting than receiving unwanted advice.

By listening and paying attention to what people are saying when they are talking to me,  it’s much easier to not only engage in genuine conversation with them.

By staying active in the conversation, It’s also easier to determine whether they are talking to me as a friend and they just want a listening ear, or if they are wanting my thoughts as someone who knows nutrition better than they do.

If I am in doubt about whether or not someone is wanting my opinion or advice from a nutrition perspective, I will ask.

If a friend is talking about their concerns about how tired they’ve been lately, and I can’t tell if they’re wanting my advice or just wanting me to listen, I’ll ask.

“Do you want me to just listen, or do you want me to put my nutrition hat on for a minute?”

In my experience, this question is usually received pretty well, no matter what their answer is.

Hello! Welcome to Feed That Nation!

My name is Natalie Nation. I’m a graduate student, future registered dietitian, health educator, content creator, and mac and cheese expert.

Feed That Nation is a space to talk all about college and health issues. I want to help college student to be more successful, more confident, and more healthy during their student experience.

Follow me on Instagram, subscribe to my YouTube channel, and go listen to my podcast!