Clinical dietitians play important role in meeting nutritional needs for critically ill patients

Carole Thompson, clinical dietitian and dietitian team lead at the Halifax Infirmary site of QEII Health Sciences Centre; Ashley Manuel, clinical dietitian at Colchester East Hants Health Centre; and Terri MacDonald, clinical dietitian at Cape Breton Regional Hospital.

Carole Thompson, clinical dietitian and dietitian team lead at the Halifax Infirmary site of QEII Health Sciences Centre in Halifax; Ashley Manuel, clinical dietitian at Colchester East Hants Health Centre in Truro; and Terri MacDonald, clinical dietitian at Cape Breton Regional Hospital in Sydney, understand the important role that nutrition can play in health and well-being. 

“I would like every Nova Scotian to recognize the power of a varied and nutrient-packed way of eating,” said Thompson. “I wish for everyone to have both the knowledge and the opportunity to optimize their nutrition.”

“Healthy eating looks different for everyone,” said Manuel. “Our job as dietitians is to help people reach their nutritional goals and meet their needs, whether they are recovering from serious illness, surgery, or just living their daily lives.”

Thompson, Manuel and MacDonald acknowledge that their role as critical care dietitians is different than what most people would expect.

“The majority of patients I work with are critically ill; therefore, they usually require specialized nutrition consults and plans,” said MacDonald. 

“As a critical care dietitian in the intensive care unit (ICU), I often see patients who require mechanical ventilation and cannot eat in the traditional way,” said Thompson. 

In these cases, Manuel, MacDonald and Thompson work with patients and health care teams to ensure the nutrition needs of these patients are being met in other ways, such as tube feeding, intravenous nutrition (called TPN) and micronutrient supplementation as needed.

“I typically start my day by attending ICU rounds with other health care professionals,” said MacDonald. “This allows me to assess each patient’s individual needs and work with the health care team to ensure these patients have adequate nutrition to support their recovery.”

For patients at risk for swallowing problems, Thompson and Manuel often work with speech language pathologists to assess swallow safety and prescribe safe diets, or alternate nutrition support such as tube feeds when patients are not able to swallow safely at all. 

“I enjoy working as part of a larger health care team to optimize patient care and experiences,” said Thompson.

“Our work as critical care dietitians is very collaborative. We get to work with physicians and multidisciplinary teams on a daily basis to help patients optimize their health and recovery, and I am very fortunate to have a fantastic team that I work with in Truro” said Manuel.

This year’s Nutrition Month Theme was Good for you! Dieticians help you find your healthy. Accompanying this theme are four pillars intended to support good nutrition: culture, food traditions, personal circumstances and nutritional needs. 

For Manuel, Thompson and MacDonald, meeting nutritional needs is the pillar that most strongly informs their work in critical care, but ensuring this is often quite challenging, since the needs of critically-ill patients can change daily. 

“The nutrition needs of critically-ill patients are so specific,” said MacDonald. “It is extremely important for me to be up-to-date on the latest nutrition research in order to provide optimal nutrition to this specific patient population.” 

“Building a clinical nutrition culture that provides and celebrates the continuous provision of optimal, safe, and evidence-informed clinical nutrition care to patients is one of my top priorities,” noted Thompson.

Manuel, MacDonald and Thompson are fully committed to enhancing patient care and improving health outcomes for those they serve.

“I see new patients with unique challenges every day,” said Manuel. “I’m always learning something new that will help me deliver the best care to patients in critical and surgical care.”

“I find it very fulfilling to know that my efforts are contributing to someone’s health and recovery,” said MacDonald. 

When it comes to promoting good nutrition and well-being within the general public, Thompson, Manuel and MacDonald encourage Nova Scotians to think local. 

“There is such a wide variety and nutritional richness of foods produced in locally in Nova Scotia,” said Thompson. 

“With nice weather right around the corner, I think it’s important to remind everyone that by getting outside and being active, you are taking steps to improve your overall health and nutrition,” said MacDonald. 

To read more about this year’s Nutrition Month theme and pillars.