Working Life

COVID-19’s Impact on Working Clinical RDs

As of late August, almost 6 million people will have been infected with the coronavirus and more than 175,000 will have died from it. The pandemic has caused unprecedented changes to our daily lives and is impacting how RDs do their jobs in every specialty and work environment and how our patients receive care. Over just a few months, many RDs have seen their roles vanish or expand with new responsibilities, have had to shift from face-to-face care to providing remote services, or have had to suit up into full personal protective equipment (PPE) to counsel a patient.

“Business as Usual”: A Distant Memory
On top of our career responsibilities, many of us have families and are juggling working from home and getting our kids back into remote schooling or homeschooling, and navigating our own health behaviors such as exercise and mindfulness.

COVID-19 also has taken a toll on the business sector, especially start-ups. At the end of 2019, I left my senior clinical role at the Dana-Farber Cancer Institute (DFCI) after 19 years to accept a full-time position as vice president for a California-based company making plant-based foods in a direct selling model. We found out abruptly in late April that the company was ceasing operations. Just like you, I’m taking a moment to reimagine my career and work/life balance, in part due to necessity and in part to embrace this opportunity for change and growth.

Let’s take a closer look at how clinical RDs are navigating this unprecedented time.

Long Term Care
Given the increased risk for residents due to age and comorbidities, long-term care centers have become epicenters for Covid-19 infections. Christine Burke (@vitamin_christine), a dietetics intern, graduate student at Simmons University, and nutritional services supervisor at a long term care facility in Massachusetts, says, “Luckily, we avoided the virus for the first month, but then it started going downhill fast. I had been having difficulty meeting school assignment deadlines due to the extreme challenges at work—like working extra hours due to staff quitting because of fear or sickness, a continuous increase of positive cases, precautions we must take, and the overall hectic changes in discharge holds, admissions, room changes, sickness status, and increase in deaths. Currently, dining rooms in the nursing home are closed, so residents have to eat in their rooms with no social interaction with diet aides.”

Outpatient/Private Practice
I’ve learned over the years to always keep my side hustle going in case I ever needed to pivot.  My private practice, Wellness Guides, LLC, is based out of a local primary care physician’s office.  In mid-March, they ceased all face-to-face visits for the wellness providers and consulting MDs. All my appointments are now via telehealth.

Cancer centers and others serving immunocompromised patients face significant challenges.  According to Hillary Wright, MEd, RD, LDN, a senior clinical nutritionist at DFCI, “Pretty much overnight I had to shift my job (and my private practice) to remote counseling. While I’d prefer to meet with patients face to face, I’m fortunate to be able to continue to work while keeping their and my exposure risk low. It’s worked out surprisingly well for myself and my oncology patients, in that I’ve found I’m still able to maintain a supportive, human connection from the safety of both our homes.”

Mae Reilly, MS, RD, CNSC, LDN, a senior clinical nutritionist at DFCI, says, “We’ve taken on more roles, like scheduling Zoom meetings and care coordination for our nutrition support patients. These are unprecedented times, but having a team that works together to provide the best patient care possible has made the transition to working remotely much easier.”

Inpatient Care
One example of rapid change for providing care, is the establishment of the Mass General Boston Hope Hospital, set up in April at the city’s convention and expo center. The thousand-bed hospital serves postacute COVID-19 patients and homeless patients with COVID-19 who don’t require hospitalization in an acute care facility.

Emilie Burgess, MS, RDN, CSSD, LDN (@emthedietitian, @homebaseprogram), a clinical nutrition specialist at Boston Children’s Hospital, is on the front lines and shares her experience.

“Each day at Boston Hope is different. We are all thinking on our feet, creating protocols, training staffing, and implementing change each day to support both patients and staff.

“As an RD, my role of providing direct patient care has shifted to a broader approach. I have joined the wellness team at Boston Hope, and we are tasked with creating a more supportive and brighter space within both patient units and staff spaces. Everyone working at Boston Hope wants to be there. The energy in there is so positive and everyone is working together to deliver the best patient care and support one another day in and day out.

“The wellness team and I are creating wellness initiatives wherever we can, from mindful eating tips and water stations to promote hydration to access to mental health counseling on site. I think everyone worries about becoming infected, but Partners Healthcare is committed to staff safety and the protocols in place make you feel safe whatever your role is at the facility.

“As the facility grows, and the census increases, the goal is to be able to provide nutrition consults on the patient floors. Dietitians that will be going onto the floors will be required to wear full PPE (N95 masks, gloves, face shields, and suits) to provide care. When off the patient floor, only a mask is required. I am most proud of this chance to give back and to be a part of history!”

How has COVID-19 affected your job?  What do you envision for the future of RDs?

— Stacy Kennedy, MPH, RD, CSO, LDN, is a board-certified specialist in nutrition with more than 20 years of experience. She holds a BS degree in Nutrition and Dietetics from Indiana University and a Master’s degree in Public Health from the University of North Carolina at Chapel Hill. She’s cofounder of Wellness Guides, LLC, and a professor of graduate studies at Simmons University. She’s an American College of Sports Medicine Certified Fitness Specialist and had served as senior clinical nutritionist for Dana-Farber Cancer Institute at Harvard Medical School Teaching Hospital in Boston for 19 years.

Stacy’s career highlights include collaborating with the industry’s top nutrition and technology talent to pioneer programs, platforms, and products from the ground up that reengineered healthful eating experiences and transformed how people approached their health. She has served on scientific advisory boards and held executive vice president- and chief-level positions in start-up companies. Stacy is regularly featured on TV, radio, podcasts, and in other media and is a sought-after international speaker.

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