Nova Scotia Dietitians adapt to help fight COVID-19

July 6, 2020

By: Lauchlin Ewald, BPR Student, MSVU

Like all health professionals, dietitians have had to adapt to the pandemic environment after the COVID-19 outbreak. The Dietitians’ Network of Nova Scotia wanted to find out how our local dietitians are handling the changes in many different sectors.
 
After a survey, we heard back from over 35 dietitians working in different areas of healthcare, academia, and the retail industry. They answered questions regarding how their roles have changed, how they adapted, what was difficult, and how they see their roles in the future.

 
On the front lines

 

Clinical dietitians working in hospitals and long-term care have been on the front lines during the pandemic. They reported changes in their day-to-day responsibilities, and some have experienced a temporary relocation to different areas of their hospitals or long-term care homes. Many of them have been on a steep learning curve to upgrade their skills and knowledge in providing nutrition care for the potential of a surge in critically ill patients.

 

“I have been re-allocated to backup ICU coverage and have spent over a month upgrading critical care knowledge and COVID-19 care specifically for ICU patients,” says Christina Palao. “I’m doing a lot of resource and education development for upskilling dietitians to work in critical care in addition to my regular job.”

 

With COVID-19 remaining a concern for hospitals, there are plans in place to re-structure how they run in case of a sudden increase in cases. For the dietitians, this means they could be moved to the ICU to assess and provide nutrition and hydration through tube feeding.

 

These face-to-face assessments create a need for additional PPE (personal protective equipment) to prevent further spread of the disease.

 

 

 

“I’ve been more mindful about the risk of infectious disease transmission since the pandemic began,” says another dietitian working in acute care. “Moving forward, I will continue to assess this risk before any patient interactions.”

 

Some outpatient dietitians have been working more on the hospital inpatient units because they are currently not seeing outpatients in person. They are offering counseling to outpatients virtually but are reporting some resistance.

 

“Many of my clients are unable or unwilling to participate in virtual sessions.”

 

Dietitians in long term care settings have found working during the pandemic to be challenging and rewarding. Across the country, long term care homes have been struggling to contain the virus due to the vulnerability of their residents. Here in Nova Scotia, Northwood Halifax’s long-term care facility has been one of the most affected communities.

 

“Restrictions on family visits have been very challenging for our residents and having them restricted to their rooms has been very hard for them,” says Michele Keeling. “It has impacted their nutritional health with noted decline in appetites and nutritional intake.”

 

Dietitians have noted that with the lack of social interaction, there is difficulty in ensuring that patients and residents are cued to eat and monitored. This is a real concern because nutritional status of long-term care residents can be particularly fragile.

“I have really missed the volunteers and patients' families and visitors during this time,” says Pam Soley-Wheatley. “These folks help with meals and feeding and assist in many ways that improve patient care.”

 

The pandemic has led to an emotionally charged atmosphere in these long-term care facilities.

“This has been particularly difficult for residents who have not been able to see their families for so long, not been able to give them a hug for comfort,” says Cathy Lockerbie-Forrester. “It has been heartbreaking.”

 

Dietitians have experienced a shift in perspective towards the nutritional care of residents.

 

 

“Reducing the diet mentality in our facility has been important,” says

Katelyn Bourgeois. “There's no need to restrict comfort foods for someone in our

care, especially frail elders, unless medically indicated.”

Meeting with clients

 

Dietitians working in retail, community services, private practice, or other sectors have reported different changes to their work lives.

 

Like other specialists who must meet with clients, many Nova Scotian dietitians are meeting with clients online now, which has given them new opportunities to help. Of course, this change comes with challenges.

 

 

 

Edie Shaw-Ewald noted that “The online webinars are attracting customers from all over the province-not just my own local community as all of the NS Superstore RDs are promoting each other online.”

While some clients are very grateful to meet with their dietitian online, there are some who are reluctant to do so. One Nova Scotian dietitian who continues to meet with clients outlines the need for foresight regarding new health and safety requirements.

 

“While this new form of communication is being embraced by many, of course there needs to be a common desire from everyone to embrace how our society will work in the future.”

 

Not only has the process of meeting with clients changed, but the COVID-19 outbreak and the state of emergency that followed has influenced clients’ eating habits.

“Our patients seem to have higher blood sugars due to emotional eating, stress, less physical activity, etc.,” says Tara Jones. “We have a greater emphasis on how to manage their diabetes if they get sick and strongly encourage our patients to call us if they need support with high or low blood sugars vs waiting and it becoming an emergency situation.”

 

‘The new normal’ and what that means for the Nova Scotia Dietitians

 

Speculation of what ‘the new normal’ will look like in the years to come has been rampant online and in social circles. How will it affect how we work, travel, socialize, and more? Dietitians are looking to answer many of those questions and adapt with the world as it changes, hopefully for the better.

 

There is nothing as effective as strong adversity to encourage a strong response, and the community of dietitians want to exhibit the strong response required. Reports of increased collaboration could be one of the many positives gained from our society’s struggle in modern times.

 

“As provincial NS Health Authority acute care dietitians we have learned from each other and now feel like a team!” says Pam Soley-Wheatley.

 

While the future is uncertain, the Dietitians’ Network of Nova Scotia and its members are committed to supporting their patients, clients, and communities health by providing nutrition education, guidance and support no matter what the future brings.

Thank you to all Nova Scotia Dietitians for being an essential part of the COVID-19 response!

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© 2018 by The Dietitians Network of Nova Scotia.