What is a Registered Dietitian?
A registered dietitian (RD) is a regulated health professional licensed or certified to treat nutritional problems. They’re known as food and nutrition experts, professionally trained to provide science-based nutrition information to patients and the public.
RDs help translate complicated nutrition science into simple, every day life recommendations for healthy living. They’re qualified to provide nutrition education and medical nutrition therapy to individuals and groups.
Services and recommendations provided by RDS are based on research, professional experience, and patient values.
RDs undergo rigorous academic requirements to obtains their credentials, including a bachelor’s or master’s degree, supervised practice, and the passing of a national board examination.
According to the U.S. Bureau of Labor Statistics, the median annual wage for RDs was $59,410 in 2017. The lowest 10% earned less than $36,910 and the highest 10% earned more than $83,070.
The top paying state for RDs is California, in which the annual mean wage was $74,060 in 2018. Other high paying states for RDs include Alaska, Connecticut, Hawaii and New Jersey.
On the other hand, Idaho, Montana, Arizona, New Mexico, Iowa, Missouri, Tennessee, Mississippi, Georgia, South Carolina, and North Carolina have the lowest average salaries for RDs in the country.
RDs who work in outpatient care centers had the highest median annual wage at $65,650, compared to RDs in other industries in 2017.
The median annual wages for similar professions are listed below:
Rehabilitation Counselors: $34,860
Health Educators & Community Health Workers: $45,360
Registered Nurses: $70,000
Physical Therapists: $88,080
Salaries for RDs depend on experience, location, and the specific industry they work in.
Employment of RDs is projected to grow 15 percent from the year 2016 to 2026, which is much faster than average for all occupations. There are approximately 5,400 job openings for RDs each year, and the amount of RDs employed is expected to increase by 9,900 over the next several years.
RDs are in high demand all throughout the country. According to the US Department of Labor – Employment and Training Administration, the states with the highest employment level for RDs include California, Texas, New York, Pennsylvania, and Florida.
There are many reasons for the fast growth of the dietetics field. In recent years, the role that food and nutrition have in promoting overall health, as well as preventing and treating illnesses has become more well-known. RDs have joined more preventative healthcare settings for this reason.
Additionally, community and corporate organizations, such as grocery stores, have begun to add RDs to their staff to increase awareness of good nutrition amongst employees and the public.
As the U.S. population changes, RDs are also in more demand for the baby-boomer generation. These individuals are interested in nutrition services to improve health and increase longevity as they age.
Further, the prevalence of obesity and chronic illnesses such as diabetes, heart disease, and cancer continues to grow in the U.S., and the RD profession is essential to provide care for people with these conditions.
What Does a Registered Dietitian Do?
RDs use their food and nutrition expertise to promote health and manage disease through education and influencing behavior change.
One of their primary duties is to counsel people on what to eat based on personal and clinical factors such as health history, food preferences, lifestyle, and lab values.
Below is a list of typical RD responsibilities:
- Assess the nutritional needs of patients and clients to diagnose nutrition-related conditions.
- Recommend and implement nutrition interventions for disease management.
- Monitor, evaluate, and document patient progress.
- Plan menus or meal plans for individuals, groups, and institutions.
- Provide nutrition education to individuals and groups to promote better health through eating habits and lifestyle change.
- Participate in patient care as part of an interdisciplinary team by attending rounds and patient meetings.
- Develop educational materials, such as handouts and brochures, on nutrition topics.
- Stay up to date with current nutrition research to ensure accurate information is relayed to patients and the public.
- Precept and mentor dietetic interns.
The job duties of RDs are highly variable depending on their work setting. A job description for a clinical RD will differ from one for a community RD, but they all have the same common goal to promote proper nutrition within a particular population.
Common Jobs in the Field
As the dietetics field continues to grow, there are many settings that RDs can work in. The three most common types of RD jobs are explained below:
Clinical Dietitian: According to the Bureau of Labor Statistics, approximately 30% of RDs are employed in a clinical setting, such as a hospital, outpatient clinic, long-term care facility, or private practice. They provide care for a variety of patients who range in illness severity, from those who need general support with healthy eating to individuals with traumatic brain injuries who require a tube feeding. Clinical RDs establish interventions for patients through education, medical nutrition therapy, and goal setting. They spend a significant amount of time charting, as well as monitoring and evaluating patient progress. As clinical RDs become more experienced, they may specialize in working with specific conditions such as diabetes, kidney disease, or cancer by obtaining a certification.
Community Dietitian: There are several community settings that employ RDs, such as schools, community health clinics, hunger relief organizations, government and nonprofit agencies, and health maintenance organizations. Community RDs provide nutrition education to the public and develop programs to promote health through proper nutrition. Some community RDs work with individuals across the lifespan, while others are focused on a specific population such as children or the elderly.
Foodservice Management Dietitian: Cafeterias, hospitals, prisons, and schools employ RDs to help manage their menus and food programs. Planning menus, budgeting, and food purchasing are among the primary responsibilities of foodservice management RDs. Depending on the specific position, they may also oversee staff such as kitchen employees or other RDs.
RDs must obtain a minimum of a bachelor’s degree from an accredited university or college, with coursework approved by the Accreditation Council for Education in Nutrition and Dietetics (ACEND). Most aspiring RDs major in nutrition or dietetics to meet these requirements.
Coursework in dietetics programs ranges from science-based courses to advanced nutrition and statistics. The goal is to obtain the ability to translate complicated nutritional science into simple, every day life recommendations for clients and patients.
Approximately 50% of RDs currently hold master’s degrees. By the year 2024, a master’s degree will be required to obtain the RD credential.
Upon completion of education requirements, the next step to become a RD is obtaining a dietetic internship (DI), otherwise known as an ACEND-accredited supervised practice program.
The DI involves 1200 hours of supervised practice at a health care facility, community agency, or foodservice corporation running six to 12 months in length. Dietetic interns spend 32 to 50 hours a week at various clinical, community, and foodservice rotation sites, switching locations every 1 to 3 weeks.
Each DI experience is different, but the common goal is to train students into entry level RDs through hands-on patient care and projects that meet core competencies.
DI programs are typically completed after graduation from college. However, some schools offer coordinated programs in dietetics that allow students to complete coursework and the DI simultaneously.
Credentials and Licensing
Once education and supervised practice requirements are fulfilled, students become eligible to take the CDR registration exam. The passing of this exam earns them the RD credential.
Additionally, several states require licensure for RDs to practice. Others only require registration or certification, and there are a few states that have no regulations for practicing RDs.
To maintain credentials and licensure, RDs are required to obtain 75 continuing education credits every 5 years. These can be obtained in a variety of ways, from attending webinars and conferences to reading books and journals.
There are many skills that help RDs succeed in their careers, from those that involve working with people to analytical abilities. Listed below are common skills that RD positions seek:
- Ability to accurately interpret and analyze nutrition research.
- Counseling skills, such as active listening and motivational interviewing.
- Critical thinking and problem-solving.
- Effective communication through speaking and in writing.
- Familiarity with education principles, including learning strategies and instructing.
- Organizational and project management skills.
- Professional judgement and decision making.
- Compassion and ability to empathize.
- Service orientation and social perceptiveness.
- Monitoring and evaluating.
- Capable of detail acuity while maintaining a big picture perspective.
- Adaptability; capable of tailoring communication style to a diverse set of patients.
Skill requirements for RDs will vary depending on the job. Employers pursue those who have an array of skills and competency that will have a positive impact on the population they’re serving.
Although RDs aren’t required to have a specialty, many pursue certifications to further their professional development. Listed below are some examples of special certifications offered through Commission for Dietetic Registration (CDR) and the Academy of and Dietetics (AND):
- Certified Specialist in Gerontological Nutrition (CSG)
- Certified Specialist in Pediatric Nutrition (CSP)
- Certified Specialist in Renal Nutrition (CSR)
- Certified Specialist in Oncology Nutrition (CSO)
- Certified Specialist in Obesity and Weight Management (CSOWM)
- Certified Specialist in Sports Dietetics (CSSD)
- Certified Diabetes Educator (CDE)
- Certified Nutrition Support Clinician (CNSC)
- Certified Lactation Counselor (CLC)
There are also certificates of training available for RDs to obtain through AND on topics such as food allergies, vegetarian nutrition, and leadership. RDs can also tailor their continuing education credits to an area of interest or join a Dietetic Practice Group (DPG) to further establish their specialty.
Day in The Life
RD job responsibilities can vary significantly, and there really is no typical day to describe for this career. Since clinical is a popular work setting for RDs, this section will describe a day in the life of a RD who works in a hospital.
There are three major components of daily tasks for clinical RDs: chart review, collaboration with healthcare teams, and patient meetings. These are described in detail below:
Chart Review: The first task on clinical RDs to-do list is patient chart review. They’ll assess if they have any consults from doctors or nurses and will focus on these patients first. RDs thoroughly review the charts of the patients who they plan to see each day. They’ll assess diet and weight changes, as well as updates in the patient’s overall health status. Based on this information, RDs prepare questions or educational materials they plan to discuss with the patients and/or their families.
Collaborate with Healthcare Teams: Before going to see patients, RDs typically meet with other members of the healthcare team, such as doctors, nurses, and speech therapists. This may take place in a group setting during patient rounds or individually. Communicating with other disciplines provides more insight about patients’ medical status and may influence the RDs recommendations and interventions.
Meet with Patients: RDs will meet with patients who require immediate attention, such as those who are malnourished, earlier in the day. During these meetings, they’ll gather information about the patient’s nutritional status, such as typical diet, weight history, and symptoms. In some situations, RDs may perform physical assessments to determine degrees of malnutrition. Additionally, they may provide nutrition education for patients who require it, such as those newly diagnosed with diabetes. Lower priority patients, such as those who need follow-ups after an initial assessment, are typically saved for later on in the day.
Another daily task for some clinical RDs includes mealtime observation, in which they’ll check on patients’ trays and assess their satisfaction with the meals provided. This helps determine if patients require a diet change or further intervention to make sure their nutritional needs are being met.
Clinical RDs also spend a significant amount of time charting on patients, which involves writing a thorough overview of their nutrition care plan for communication and billing purposes. Additionally, clinical RDs are responsible for attending to any high-priority patient needs or requests throughout the day, such as tube-feeding consults.