Thursday, December 10, 2009

"You know you could kill someone, right?"

That is what my husband said to me over the dinner table last night.

At my job (wish I gushingly adore, yes!), dietitians can change insulin dosing. This our policy and a great one, if I do say so myself! As most of you know, I work with diabetics the vast majority of my days and I am working towards obtaining my Certified Diabetes Educator (CDE) credential (as of yesterday I have 25% of the hours I need!).

Over dinner last night, husband was asking me about my job and my span of care -- i.e. can I change insulin regimens. When I explained our policy he said, "You know you could kill someone, right?". Awesome, husband...thanks for your vote of confidence! (Side note: this is a very, very, very slim possibility at the rate at which insulin dosing is increased).

My co-worker, very much so unlike myself, would rather leave all dosing changes to the provider. Whaaaa? Aren't dietitians working towards autonomy in the medical world? We are important! We are well-educated! We are RESOURCES that ought not to be underutilized! 

Disclaimer: The above in red sounds narcissistic, but for those out there who are RD's or know the history of the battle for Medical Nutrition Therapy reimbursement, it hits very close to home. 

Don't get me wrong, I very much so know my place on the totem pole and would never abuse or over-use the "power" I have in my role. However, I think that our policy is a huge pat on the back and vote of confidence in the corner of RD's!

For those of you who are familiar with prescriptions and span of practice policies -- how do you feel about this? You can be honest, it won't hurt my feelings : )


  1. I am not a clinical dietitian, but I know exactly what you are saying. When I did my internship I got the feeling that many of the RDs who proctored me felt like they were not treated properly and not treated like they had the medical background to make serious, and important decisions. I hate how people don't consider RDs anything but "food Nazis" or "hairnet wearing kitchen workers!". This needs to change, and the only way to change it is by making your voice heard. So, good for you Nicole!

  2. I honestly don't know too much about this (I wish I knew more!)...but I think that dieticians know as much, if not more than the provider, because they are the ones working with the patients on a day to day basis.

    I just saw on your "about the dietitian"that you've ran 2 marathons! Wow, I would love to hear about this.

  3. If you are experienced and know what you are doing; I do not see anything wrong with it.

    Off topic: Since you deal Diabetes, Insulin, etc. do you know much about PCOS?

  4. I always worry about that too! Like really, the job can be so POWERFUL! But I think as long as your are experienced and not afraid to ask questions, you should be ok. :)