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Job Report - Dietitians and Nutritionists
Published 1996
Mascor Publishing Co.
P.O. Box 8308
Silver Spring, MD 20907
Nature of the Work
Nutrition is the science of food and its effect on the body. It is concerned with the
nutrients in food, their use in body chemistry, and--in the final analysis--the
relationship
between diet and health. Nutritionists counsel individuals and groups; set up and
supervise food service systems for institutions such as hospitals, hotels, prisons, and
schools; and promote sound eating habits through education and research. The term
"nutritionist' applies to a number of different professionals involved with food
science
and human nutrition. Among these are dietitians, food technologists, and home
economists.
Among dietitians, major areas of specialization include administration, education,
research, and clinical and community dietetics.
Administrative dietitians apply the principles of nutrition and sound management
to large-scale meal planning and preparation, such as that done in company cafeterias,
schools, and other institutions. They supervise the planning, preparation, and service of
meals; select, train, and direct food service supervisors and workers; budget for and
purchase food, equipment, and supplies; enforce sanitary and safety regulations; and
prepare records and reports. Increasingly, dieticians utilize computer programs to plan
meals that satisfy nutritional requirements and are economical at the same time.
Dietitians who are directors of dietetic departments also decide on departmental policy;
coordinate dietetic services with the activities of other departments; and are responsible
for the dietetic department budget, which in large organizations may amount to millions
of dollars annually.
Clinical dietitians, sometimes called therapeutic dietitians, generally work in
hospitals, nursing homes, or clinics. They assess patients' nutritional needs, develop
and implement nutrition care plans, and evaluate and report the results. Clinical
dietitians confer with doctors and other members of the health care team about patients'
nutritional care, instruct patients and their families on the requirements and importance
of their diets, and suggest ways to maintain these diets at home. Computer programs
enable dietitians to provide patients and their physicians with a complete nutritional
analysis of food intake.
Technological advances in nutritional support for the critically ill have enhanced
the clinical dietitian's role. In the hospital, dietitians oversee the preparation of
custom-
mixed high-nutrition formulas for patients who are critically or terminally ill. In the
home
health field, they help develop and oversee sophisticated nutritional therapies for
homebound patients who, because of surgery or illness, are unable to eat regular foods.
Community dietitians or nutritionists may counsel individuals and groups on
sound nutrition practices to prevent disease, maintain health, and rehabilitate persons
recovering from illness. They may engage in teaching and research with a community
health focus. This work covers areas such as special diets, meal planning and
preparation, and food budgeting and purchasing. Dietitians or nutritionists in this field
usually are associated with community health programs; they may be responsible for
planning, developing, coordinating, and administering a nutrition program or a nutrition
component within the community health program. They work mainly for public and
private health and social service agencies, including "meals-on-wheels"
programs,
congregate meals for older Americans, and nutritional programs for women with infants
and young children.
Research dietitians seek ways to improve the nutrition of both healthy and sick
people. They may study nutrition science and education, food management, food
service systems and equipment, or how the body uses food. Other research projects
may investigate the nutritional needs of the aging, persons who have chronic diseases,
or space travelers. Research dietitians need advanced training in this field and usually
are employed in medical centers or educational facilities, or they may work in community
health programs.
Working Conditions
Although most work 40 hours a week, dietitians and nutritionists in hospitals may
sometimes work on weekends, and those in commercial food services have somewhat
irregular hours. Dietitians and nutritionists spend much of their time in clean, well-
lighted, and well-ventilated areas, such as research laboratories, classrooms, or offices
near food preparation areas. However, they do spend time in kitchens and serving
areas that often are hot and steamy. Dietitians and nutritionists in clinical settings may
be on their feet a lot; those involved in consulting spend a significant amount of time
traveling.
Employment
Dietitians and nutritionists held about 42,000 jobs in 1990. Hospitals and nursing
homes are a major source of employment in this field, accounting for just over half of all
jobs in 1990. Firms that provide food services for hospital patients on a contract basis
employ a small but growing number of dietitians and nutritionists.
State and local health departments, schools, and colleges, provide over 20
percent of dietitian jobs. Other jobs are found in a variety of settings, including prison
systems, hotel and restaurant chains, and business firms that provide food service for
their employees.
Many dietitians work as consultants, either full time or part time. In addition to
serving on the staff of a hospital, for example, a dietitian may be a consultant for
another
health care facility. Nursing homes use consultants to provide much of their dietetic
supervision.
Training, Other Qualifications, and Advancement
A bachelor's degree with a major in foods and nutrition or institution management
is the basic educational requirement for this field. This degree can be earned in about
270 colleges and universities, usually in departments of home economics and food and
nutrition sciences. Required college courses include food and nutrition, institution
management, chemistry, bacteriology, and physiology. Other important courses are
mathematics, statistics, computer science, psychology, sociology, and economics. It is
also possible to prepare for this profession by receiving an advanced degree in nutrition,
food service management, or related sciences and providing evidence of qualifying work
experience.
To qualify for professional credentials as a Registered Dietitian (R.D.), the
American Dietetic Association (ADA) recommends completion of a coordinated
undergraduate program which includes an internship; completion of a bachelor's degree,
plus an approved dietetic internship or 3 years of approved qualified experience; or 6
months of approved qualified experience plus an advanced degree. The internship lasts
6 to 12 months and combines clinical experience under a qualified dietitian with some
classroom work. In 1984, 104 internship programs were accredited by the ADA.
Coordinated undergraduate programs enable students to complete their clinical
experience requirement while obtaining their bachelor's degree. In 1984, 67 such
programs were offered by medical schools and by departments of allied health and
home economics in colleges and universities. These programs are accredited by the
ADA.
Experienced dietitians may advance to assistant or associate directors or director
of a dietetic department. Advancement to higher level positions in teaching and
research requires graduate education; public health nutritionists usually must earn a
graduate degree. Graduate study in institutional or business administration is valuable
to those interested in administrative dietetics.
Clinical specialization offers another path to career advancement. As a result of
scientific advances that have increased our understanding of the role of nutrition in
treating disease, clinical specialization is on the rise. Specialty areas for clinical
dietitians include cancer, heart disease, and diabetes.
Persons who plan to become dietitians or nutritionists should have organizational
and administrative ability as well as scientific aptitude, and should be able to work well
with people. Among the courses recommended for high school students interested in
careers as dietitians are home economics, business administration, biology, health,
mathematics, and chemistry.
Job Outlook
Employment of dietitians is expected to grow faster than the average for all
occupations through the year 2000 to meet the expanding needs for individual and
group meals in nursing homes, hospitals, retirement and life care communities, and
social service programs of various kinds. Most job openings, however, will result from
the need to replace experienced workers who stop working or transfer to other
occupations. A number of experienced dietitians and nutritionists are moving into
management positions in private industry, for example.
The factors that underlie future growth in demand for health services--population
growth and aging, emphasis on health education and promotion of prudent lifestyles,
and widespread ability to pay for care through public and private health insurance--will
spur demand for dietitians and nutritionists. Demand is also expected to grow in
commercial settings, including catering firms, restaurant chains, and medical supply
firms. In addition, dietitians and nutritionists will be needed to staff community health
programs, to provide nutritional counseling for employer-sponsored wellness and fitness
programs, and to conduct research in food and nutrition.
Opportunities for part-time employment should remain favorable. This will be
especially true in nursing homes and home health care, where dietetic services are
frequently provided for only a few hours each week. Hospitals, too, use a substantial
number of part-time dietitians in order to maintain staffing flexibility, raising or
lowering
the number of hours worked with fluctuations in the number of patients.
Earnings
Entry level salaries of hospital dietitians averaged about $23,100 a year in 1990,
according to a national survey conducted by the University of Texas Medical Branch.
Many experienced hospital dietitians earned more than $31,275 a year. Salaries may
vary by region.
Dietitians employed by others usually receive benefits such as paid vacations,
sick leave, holidays, health insurance, and retirement benefits. Self-employed dietitians
must provide their own benefits.
Related Occupations
Dietitians and nutritionists apply the principles of nutrition in a variety of
situations. Other workers with similar duties include food and home economists,
executive chefs, and food service managers.
Sources of Additional Information
For information on accredited dietetic internships and coordinated undergraduate
programs, scholarships, registration, and a list of colleges providing training for a
professional career in dietetics, contact:
The American Dietetic Association, 430 North Michigan Ave., Chicago, Ill.
60611.
The U.S. Office of Personnel Management, Washington, D.C. 20415, has
information on hiring requirements for dietitians in Federal hospitals and for public
health
nutritionists and dietitians in the U.S. Public Health Service.
The Veterans Administration employs dietitians and maintains a list of eligible
applicants. Graduates interested in VA positions may obtain application forms by
calling, toll free, 800-368-6008. Residents of Virginia should call 800-552-3045. Those
interested in a VA career as a dietitian are encouraged to visit the personnel office of
any VA medical center.
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