What RDs Do: Caitlin Boudreau, RD, MPH

CAITLIN BOUDREAU 

PEDIATRICS & ONCOLOGY;

CHILD & FAMILY DIETITIAN

for something nutrishus

I knew Caitlin online as Wee Nourish before I knew her actual name, which reminds me of being introduced to other dietitians at conferences as Nutrishus RD or the something nutrishus dietitian. Career paths often intrigue me, as dietitians have various reasons for finding different roles and this applies to Caitlin as explained below. I also love learning unique new things about them, such as their second language or favourite food/meal.

Why did you become a RD? 

I think I was drawn to the practicality of nutrition. Coming from a psychology background, I’ve always been interested in food and people’s eating choices.

What area of dietetics do you work in? 

A bit of a mix really. Mostly pediatrics, with a side of oncology.

How would you explain what you do? 

I help support parents with feeding their little ones, and work to reduce anxieties and frustrations that come with that. My goal is to help parents build a positive feeding relationship, and to avoid and manage picky eating. I can relate to so many of the struggles my clients have as a mom of two little ones myself.

What are your ‘typical’ daily/weekly tasks? 

I’m on social media more than I would like to be, but this seems to be a key part of my work as a private practice dietitian. I write Facebook and blog posts, do live videos, and prepare for upcoming workshops both online and in-person. My practice is shifting to one that offers more support online and by phone, so I’m often on calls with parents throughout the day. And when I’m not doing that, I’m chasing my toddler and preschooler around as I’m home part-time with them.

What has been your career path? 

I started in addictions, as a clinical dietitian at the Centre for Addiction and Mental Health in Toronto. After my mat leave, I decided to switch gears and create my own job in an area I’ve become very passionate about, pediatrics. I’m still working in my private practice in this area. As someone who has always liked to try new things, I’ve recently started working casually as a clinical dietitian with the BC Cancer Agency, which has proved to be incredibly interesting and meaningful work.

What advanced education or special training do you have? 

I completed a Master of Public Health in Community Nutrition from the University of Toronto. I also speak Spanish fluently (does that count?).

In an ideal world, what does the industry look like 5 years from now? 

I wish there was a better understanding from the public and other health professionals about what RDs actually do and what we have to offer. And I’d love to see more collaboration between RDs. I often sense that RDs feel like they’re in competition with one another, instead of joining forces to create something bigger and better.

What would you like people to know about RDs? 

I would love for people to know that dietitians all have their own lenses and biases. I think this is true for all professions, but for some reason I find dietitians tend to get painted with the same brush. I think this is what makes us great. We each have something unique to offer, and what fits for one client may not work for another.

What makes RDs unique/different from other nutrition/wellness professionals? 

Being a great dietitian is definitely a craft. I think what sets us apart from other wellness professionals is that we have the knowledge base and skills to take evidence-based information and translate it in a way that is practical and useful.

What is your favourite meal? 

Sushi. So cliche as a west coaster, but I seriously think I could eat it just about every day.

What tip(s) would you give to our readers? 

I remember something an experienced dietitian (Carol Dombrow) once said during my practicum that stuck with me. Her advice was to stay open to all areas of nutrition and opportunities that arose and never close the door on anything. This has kind of been my motto ever since I finished school. Sometimes you think your path will lead you a certain way, but it doesn’t. It might lead you somewhere even better.

More about Caitlin:

Website: Wee Nourish
Facebook: Wee Nourish Nutrition
Email: caitlin@weenourish.ca

Thanks Caitlin! Find out more about What RDs Do.

If you're a dietitian that would like to be featured, email me for the details!

What RDs Do: Grace Wong, RD

GRACE WONG
MENTAL HEALTH & PEDIATRICS

for something nutrishus

I love that Grace connects food to each person's story. During October I helped with our Agriculture Month in Saskatchewan and the theme was 'Our Food Has A Story' and it truly does. Food plays a large role in our lives and I would enjoy sitting down to a bowl of soup with Grace, especially this time of year in Canada. She mentions the variety of skills dietitians and entrepreneurial dietitians require to succeed and support their patients/clients, we wear many hats and do lots of extra courses and trainings. 

Why did you become a RD?

I really did not know what to expect when I put in my application for dietetics. Fortunately, it felt right as I went through my training. I love stories, and I have always been curious about people's stories. Discovering the meaning of food to a person or a group (a family, a demographic group or patients who share the same health experience) is like reading a story. Every chapter and every detail matter. Being a dietitian allows me to connect with people through their day to day ritual - eating! And every client brings a new story!

What area of dietetics do you work in?

I primarily work in mental health and pediatric nutrition. Common diagnoses I work with include eating disorders, pediatric feeding disorders, mental health issues (addictions, mood and anxiety disorders), ADHD (Attention deficit hyperactivity disorder), autism spectrum and so on.

How would you explain what you do?

I work with many clients who do not fall into well-defined diagnostic categories. Many individuals and families start out saying "it doesn't make sense". Then we embark on a journey of making sense of their food/nutrition struggles, whatever they may be. Their situations may not have obvious nutrition implications; and often there aren't any standard practice guidelines, so I do a lot of detective work!

What are your ‘typical’ daily/weekly tasks?

I work in a hospital outpatient clinic as well as in private practice. My work days are mostly taken up by client appointments. Besides that, I am still learning the ropes of managing a private practice. Other typical tasks include talking to inquiring clients, booking appointments, accounting, managing resources etc.

What has been your career path?

My very first job was in public health/community development. I worked with various social service and mental health agencies on food security projects. That was how I started working in mental health nutrition. And life happens, I have since worked in 7 different positions in 3 provinces. While these jobs were all different, there were some peculiar connections. My clinical work eventually branched out to a diverse mix of mental health and pediatric nutrition.

My current aspiration is to be more creative in my work. Operating a small business is really out of my comfort zone, but it certainly has allowed a lot of freedom and creativity.

What advanced education or special training do you have?

I completed a master's degree in Health Promotion Studies at the University of Alberta. My graduate work focused on the determinants of health in vulnerable populations including families living in poverty, single parents, Aboriginal groups and people living with mental illnesses etc.

Additional training I had: nutrition therapy for disordered eating, various model-specific trainings in eating disorders, group therapy facilitation, motivational interviewing, allergy & food intolerances, feeding therapy, parent-child relationship and feeding relationship.

In an ideal world, what does the industry look like 5 years from now?

This is a big question, maybe I would just touch on what's most relevant in my clinical practice. Dietitians are only working in a small subset of health care settings. It would be great to see dietitians working in more primary care clinics and specialized services. Over and over again, I hear other health professionals say "We need a dietitian on our team!"

What misinformation about RDs would you like to clear up?

Dear clients, we may assess your nutrition health for your well-being, but we do not judge you as a person based on what you eat. I sincerely mean it!

What are challenges you encounter as a RD?

Letting go of what I think is best for my clients and being patient with the journey they choose. Walking along with people is what I love about what I do, but it can be very difficult some days.

What are you passionate about in dietetics?

Make time to eat! Eat and hang out with your loved ones, even better! I am a huge believer that how you eat matters just as much as what you eat. It is my passion to advocate that eating is a self-care experience, not a chore!

What is your favourite meal?

A hearty bowl of soup is my all time favourite! Soups convey comfort and warmth, and you can pack a lot of nutrition in one pot!

More about Grace:

Email: gracewongrd@gmail.com

Thanks Grace! Find out more about What RDsDo.

If you're a dietitian that would like to be featured, email me for the details!

What RDs Do: Julie Wallace, RDN, LD

JULIE WALLACE

PEDIATRIC NUTRITION:

HEART & LIVER FAILURE/TRANSPLANT
for something nutrishus

I can tell and I know (because she told me) that Julie loves what she does, and we need people like Julie as I think her job would be extremely challenging, although rewarding. We also have excellent timing as it's Julie's birthday tomorrow, so be sure to wish her well! 

Why did you become a RD? 

Nutrition has always been of interest to me. When I was a small child, I enjoyed learning how to grow food with my father and was already cooking advanced recipes in my teens. In high school, I took a class called “Science of Nutrition” taught by our Biology teacher and fell in love with the concepts that allowed me to teach my friends how to read nutrition labels when we would go to the local grocery store (in a small town there can be little to do).

What area of dietetics do you work in? 

I work in Pediatric Nutrition: Heart and Liver Failure/Transplant.

How would you explain what you do? 

When my patients, age 0 months – 21 years, are in heart failure, I provide nutrition assessment and interventions to help them maintain a healthy weight and get adequate nutrients, sometimes this is in preparation for a future heart transplant. In some situations, especially with children who have NALFD (Non Alcoholic Fatty Liver Disease), I actually help them to safely lose weight, particularly excess fat, in hopes of avoiding the need for a liver transplant or to ensure they are a better candidate if they do need a transplant. I also perform nutrition assessments in those who are being evaluated for a transplant and provide nutrition-related education for post-transplant needs. After transplant, I work with the patients and their caregivers to ensure adequate food safety due to immunosuppression, monitor labs, assist in avoiding nutrient-medication interactions, and help prepare the children for independence as they grow into adults.

I also have a private practice providing nutritional counseling to those seeking general well-being, weight management, vegetarian/vegan/plant-based diets, as well as a number of medical nutrition therapies such as diabetes, heart conditions, or kidney failure. I provide counseling in person, over the phone, over skype, or online. I will hopefully be accepting new clients again in January. Over time, I plan to implement more blog posts, newsletters, webinars, Facebook groups, and other resources for my clients who will have lifetime membership access to such resources. I am a Strong4Life Certified Nutritionist/Dietitian in the state of Georgia with a background of working with all age groups from infants to seniors. 

What are your ‘typical’ daily/weekly tasks? 

In a typical week, I participate in 3 outpatient clinics as part of a multidisciplinary team. Time not spent in those clinics is spent in team conferences or rounds to keep up to date on our patients for continuity of care, charting, participating in CEU (Continuing Education Unit) activities or conferences, and meeting with patients who are in cath lab for routine or annual biopsies (which check for rejection).

What has been your career path? 

After high school, I spent time working in a corporate finance office before returning to college for my BS in Dietetics. My first years as a RDN were spent working full-time hours, although I was PRN, in a 600 bed adult inpatient hospital. This opportunity allowed me to see patients on every unit, including heart failure and ICU, preparing me to work with such a special population.

What advanced education or special training do you have? 

Currently I have my BS in Dietetics. I am also preparing to sit for the CSP (Board Certification as a Specialist in Pediatric Nutrition) exam in the near future. Each year, I attend transplant nutrition focused CEUs and conferences (such as NATCO).

In an ideal world, what does the industry look like 5 years from now? 

I believe telemedicine will become more established allowing dietitians to sit in front of a computer screen, using programs like Skype, to follow up with patients with nutrition counseling between their physical clinic visits. Food diaries will be easier to obtain using apps. More dietitians will reach out using social media such as Facebook Groups to motivate their clients. Everything will be more technology focused and dietitians will be more accessible.

What misinformation about RDs would you like to clear up? 

We are not ‘owned’ by big food industries. RDs, in general, care about people first, want people to get in good, wholesome nutrition in ways that work best for the individual they are talking to which may or may not include brand name foods, but we recognize the place that certain types of foods or formulas have. We do our best to keep up to date with trends, the most recent science, and behavioral practices to help others make the most nutritious decisions. We are not walking text books but if we care about our patients and are passionate about our field, we’ll research your questions if we don’t already know the answer and base it on evidence-based science.

What are challenges you encounter as a RD? 

Dispelling common misinformation driven by the media, food companies, people calling themselves ‘nutritionists’, and sometimes even other health professionals. Many times when I first meet a new patient, they are not aware of my background that includes a pre-med degree and assume we will only talk about topics such as recipes or calories.

What do people think that you do for a living? 

In general, people probably think I’m like the food police telling people what they can or cannot eat. Others believe I probably write out meal plans telling people what exactly they can or cannot eat every single day which I do not.

What are you passionate about in dietetics? 

Helping others. It’s really simple but that’s all it comes down to; helping others to help themselves by educating them and providing them with tools, helping others stay healthy when very sick, and helping others live the healthiest life they can. I am very lucky that I get to work with children. Children are the best patients! The little ones are usually smiling through their hard times and give you hugs and kisses. It’s pretty amazing to be part of something in which we take children who are critically ill and give them a second chance at life. I can’t imagine doing anything else with my life.

What makes RDs unique/different from other nutrition/wellness professionals? 

We are held up to a set of standards including a minimum of a Bachelor’s of Science in nutrition (which includes many of the same undergraduate courses doctors end up taking) as well as Dietetic Internship (which includes various rotations in various settings) followed by an exam. We have to complete all of these as well as stay up to date on current research, policies, and trends whereas many people who have simply taken up an interest in nutrition by reading a lot of articles can call themselves a “Nutritionist”.

More about Julie:

Facebook Page: Planted in Nutrition: Counseling & Services
Website: Planted in Nutrition
LinkedIn: Julie Wallace, RD, LD
Instagram: @jwallacerd

*Currently, my business is on hold due to health issues. I am hoping to be up and running
again in January. I am active on social media, however, so please feel free to follow me.

Thanks Julie! Find out more about What RDsDo.

If you're a dietitian that would like to be featured, email me for the details!

What RDs Do: Lyndsay Hall, RD, CLC

LYNDSAY HALL

WIC, PUBLIC HEALTH

for something nutrishus

Working for a federal program, Lyndsay has a mix of hands-on counseling and management duties. Since obtaining her degree she has been moving up the ranks at the WIC Program and continues to pursue educational opportunities in her field. I too enjoy working with children/teens as we strive to support the development of lifelong healthy habits. 

Why did you become an RD?

I became an RD because I love food. I love the way it can create a sense of togetherness and happiness as well as the importance of it in every aspect of human life.

What area of dietetics do you work in?

Public Health

How would you explain what you do?

I help families grow stronger and healthier together. I supervise and practice as an RD and
lactation consultant in the WIC (Women, Infants, and Children) Program that focuses on educating low to middle income families on small changes they can make to help their children or themselves thrive. The WIC program is a supplemental food program that provides nutritious foods such as whole grains, milk, eggs, cheese, yogurt, and fresh fruits and vegetables to qualifying participants. We act as an expert resource in the community for both nutrition and lactation support.

What are your 'typical' daily/weekly tasks?

I work in clinic 2-3 days/wk providing high risk nutrition counseling to clients on various topics related to maternal, infant or child nutrition. In-between appointments and the remainder of the week, I manage staff scheduling, budget, ongoing QA/QI (quality assurance/quality improvement) projects, assign staff monthly duties (and monitor), practice as liaison between our clinic and the state WIC office, manage compliance investigations, outreach, and offer staff guidance as needed.

What has been your career path?

I graduated from Central Michigan University in 2011 with my BSc in Dietetics and was hired in as an hourly Community Nutrition Specialist at Public Health Muskegon County WIC in October of 2011. I was accepted to the part time WIC/Michigan State University Dietetic Internship where Public Health Muskegon County sponsored me to complete it while still able to work part time.

I completed the internship in Nov of 2013 and sat for my registration exam in Dec 2013. After passing, I was hired in full time as a Community Nutrition Specialist at the same employer. Nov 2014 I was promoted to WIC Quality Coordinator and most recently promoted in June 2016 as WIC Supervisor. I've been a practicing dietitian since Nov 2014 since the Community Nutrition Specialist title did not allow me to perform nutrition counseling at that time.

What advanced education or special training do you have?

I am a Certified Lactation Counselor and will be taking the registration examination to become certified in pediatric nutrition (CSP) in November 2016. I will also begin graduate school pursuing a Masters degree in Health Administration beginning August 2016.

In an ideal world, what does the industry look like 5 years from now?

Dietitians will be licensed as the nutrition expert in all 50 states. Their input will be highly valued as a part of every multidisciplinary team in any health setting. More dietitians will be employed by larger companies to help promote workplace wellness.

What misinformation about RDs would you like to clear up?

RDs do not believe that any specific diet is superior, it is very individualized based on situation. We are humans, too! We will not eat super healthy 100% of the time. We love food and want to help others enjoy it too. We are the nutrition experts - not 'nutritionists', not self proclaimed 'nutritionists', not doctor Oz.

What are you passionate about in dietetics?

Infant and child nutrition. Infants and children depend on the proper nutrition to grow and heal. It is crucial for their development and good habits start young.

What do people think you do for a living?

Make meal plans, eat healthy 100% of the time.

What makes RDs different from other nutrition/wellness professionals?

We know the science behind everything nutrition related. We know biochemistry, organic chemistry and are realistic when applying the knowledge. We won't make you partake in a restrictive diets and do not believe in short term fixes. WE LOVE WHAT WE DO!

What is your favorite meal?

Anything Mexican.

Thanks Lyndsay! Find out more about What RDsDo.

If you're a dietitian that would like to be featured, email me for the details!

What RDs Do: Casey Napper, RD

CASEY NAPPER

PEDIATRIC DIETITIAN

for something nutrishus 

I have had such a great response to the interview series, and am pleased that many local registered dietitians (RDs) have stepped forward. Today we feature Casey Napper. Like Casey, I too was intrigued by nutrition as a young athlete and wanted to work with sports, kids and adolescents (which I do). Casey has the tough job of tube feeding pediatric patients and seems to have found her dream job early on. She provided a great overview of her position, misconceptions of our profession, and being able to be a contributing team member.

Why did you become a RD? 

I knew I wanted to be in health care in some capacity, but wasn't sold on the hands on patient care of nursing (blood and needles are not my cup of tea, to say the least!) I was intrigued after a presentation by a sport dietitian as a young athlete, and after looking into the profession more, was interested in the variety of areas that a dietitian can work. I also love working with kids and adolescents, so I pursued nutrition hoping to one day specialize in either pediatrics, sports, or eating disorders.

What area of dietetics do you work in? 

I work as a clinical pediatric dietitian with the Saskatoon Health Region. Specifically, I cover the Pediatric ICU, and part of our Neonatal ICU.

How would you explain what you do?

In the PICU, children are admitted in critical condition, often needing the support of a ventilator to breathe, and often in a medically induced coma while they recover from their particular critical illness. Most are unable to eat orally during this time, and yet they are in need of optimal nutrition to support their recovery and meet the increased metabolic demands of their illness. My job is to ensure they receive optimal nutrition by way of tube feeding, and in some cases, total parenteral nutrition (TPN) or intravenous nutrition.

In the NICU, we deal primarily with preterm and low birthweight infants who need medical support to continue their growth and development in the outside world (that would have otherwise occurred in utero). I work in the less acute part of our NICU (another dietitian works full time in the more acute part), so my patient population is typically preterm babies who have been in NICU for a long period of time and are nearing their due date, and their discharge home. I also treat late preterm babies who need a bit of extra support for being born a tad early. Babies do not have the reflexes to suck, swallow and breathe with good coordination until they reach a certain gestation, so these babies need feeding tubes for nutrition until they are ready to start feeding my mouth, and to supplement their oral feeds while they are learning. As they get older and bigger, they start developing these reflexes and need tube feeds less and less. My job is making sure that these babies are getting the nutrients and calories necessary to grow and develop as if they were still in utero, so that they can go on to be happy, healthy children.

What are your ‘typical’ daily/weekly tasks? 

Each morning I attend rounds with the health care team. This includes the pediatric intensivist (PICU) or neonatalogist (NICU), medical residents, neonatal nurse practitioners, charge nurses, bedside nurses, and other important allied health professionals such as Respiratory Therapists, Social Workers, and Speech Language Pathologists. When daily reports are given and plans are made for the day, I contribute my recommendations for nutrition. I also do my part in educating medical residents and nurses on nutrition-related topics, as well as contribute to the larger clinical dietitian group at our hospital and within our health region.

What has been your career path? 

I realized after my internship, that my ultimate career goal was clinical pediatric nutrition. With a bit of good timing on my side, a temporary job opening in pediatrics happened to come about not long after my graduation, so I started my career on our inpatient pediatric ward. It was a wonderful place to learn and to really feel like a member of a team. Since then, I have also worked in pediatric outpatients, counselling babies discharged from NICU, general pediatric patients such as childhood allergies, failure to thrive, and new celiac diagnoses, and chronically tube fed children with gastrostomy feeding tubes. I also had the chance to briefly work on an adult Neurology ward, prior to my current position splitting my time between PICU and NICU.

What advanced education or special training do you have?

I was lucky enough to receive one-on-one training by an experienced pediatric dietitian for my first few months on the inpatient pediatric ward. Since then I have learned from other experienced colleagues, and from my own reading and studying on various pediatric topics. I have completed SOS (Sequential Oral Sensory) training, which is a program aimed at helping children overcome oral aversions and feeding difficulties. I hope to one day complete my Certified Nutrition Support Clinician (CNSC) designation through ASPEN (American Society of Parenteral and Enteral Nutrition).

In an ideal world, what does the industry look like 5 years from now?

Tough question! I can't seem to come up with a forward thinking, broad answer - I operate on a day-by-day basis in my job, I think I've become too comfortable with that process! But if I were to say something very specific to my area, I would say that using indirect calorimetry for measuring energy requirements in critically ill patients would be a goal.

What would you like people to know about RDs? 

One thing that often irks me in working in the clinical setting is being called 'dietary'. It seems it can't be shaken from the hospital lingo. It may be a simple request, but a dietitian is an educated individual with a 4 year degree, accredited internship, and specialized knowledge and experience under their belt. 'Dietary' is who fills the food trays in the kitchen, and delivers meals to the ward. There is a big difference!!! If you work with a dietitian, consider this before you refer to him or her as 'dietary'!

What do people think that you do for a living? 

When I tell people I'm a pediatric dietitian they often think that I counsel overweight or obese children on reaching a healthy weight. I find the public seems to equate 'dietitian' with 'weight loss.' This is most definitely not the case for my particular position, although there are certainly dietitians out there who are doing this important work. I think people are surprised at how much of my job entails non-oral feeding (tube feeds and TPN). These methods of providing nutrition are not something that an average person even knows exist. And it involves way more math than one would expect :)

What are you passionate about in dietetics?

Of course my number one priority is always the patient and helping them through their illness. It's so rewarding seeing a patient recover to a happy, healthy child after seeing them at their sickest. However if I were to answer in a different way, my favourite part about my job is the teamwork. I love being a valued member of a team, whether it is the medical team or the team of pediatric dietitians that I work with, or the team of allied health professionals we work so closely with. Collaborating and sharing ideas with my colleagues and patients' families, coming to a mutually agreed upon plan is one of the biggest reasons I am excited to come to work every day.

What makes RDs unique/different from other nutrition/wellness professionals?

Our degree and designation is not only measured in length of time spent (4 years), but also in the educational variety it encompasses. Not only do we learn in depth about all the various areas of nutrition (and related chemical, biochemical, and health sciences), but also are trained in how to interpret research, how to practice in an evidence- and science-based way, how to be a professional, how to practice ethically. We hold ourselves to very high standards, and are also held to high standards by our regulatory bodies.

What is your favourite meal? 

Greek Salad, no question!!

Thanks Casey! Find out more about What RDsDo.

If you're a dietitian that would like to be featured, email me for the details!