The Yearly Dietitian Shuffle

Whenever a dietitian turns in her notice, there’s always a “mad scramble” to change your floors. During the time between a dietitian leaving and a new one coming in to fill that role, floors and duties get shuffled around a fair amount.

Maybe you’re tired of a med-surg floor and want the challenge of the ICU step-down unit. Or maybe you just can’t take cardiac anymore and would like to pass that floor onto the incoming dietitian. No matter what the reason, a dietitian leaving your team has its pros and cons.

Advantages

Doing the same floors isn’t a bad thing, but we all enjoy variety in the workplace. In my initial job as an inpatient dietitian, I took the advantage of a dietitian leaving to spend more time in critical care. Not only was this personally rewarding, it also a great change to my daily work and made me a more versatile employee. For any dietitian who may be tired of a certain floor or wanting to make a change, open spaces offer opportunities.

Most dietitian jobs also have a certain hierarchy. For example, the ICU dietitian is generally a specialized position. You may cover this area but you’re probably not going to take it over completely unless that dietitian decides to step down (rare) or ends up leaving the job entirely. When people leave, you have the advantage of being able to step into more complicated and specialized roles.

A related advantage is that you'll see the rewards of longevity. Most jobs have benefits for seniority and dietitian positions have that to a certain extent. Being able to choose your floors or coverage is an advantage and you also usually get first pick for more specialized positions. Of course, you need to be qualified but I agree that being loyal to your hospital should give you an advantage.

Disadvantages

Of course the primary disadvantage of a person leaving is that you’re one dietitian short. Ideally, you’d fill the position quickly but, in my experience, it can take months to bring in dietitians. When I was working in Tennessee, our hospital was in a rural area. Most of the new dietitians were from the nutrition program at a local college which only had graduates every May. This meant that two open spots that were vacated in October and January stayed open until May. When this happens, there’s a negative effect on quality of care and workplace morale.

Another disadvantage would be a loss in productivity. Even if the position is filled quickly, that person has to be trained and, even an experienced dietitian, needs time to learn how the hospital works. Each hospital has specific policies and workflow procedures that it just takes time to learn. In my new position, I think it really took about six months before I was functioning as a competent dietitian in that role.

Finally, as a new employee, you start off your job with the "worst" floors. At my first job, I had the cardiac and GI floors which I loved but everyone else on our team hated them. Granted, they were challenging and sometimes frustrating but I didn't mind them. That's not always the case though. When a new dietitian moved from our SNF to inpatient as I was leaving, she wasn't happy about being stuck with the leftover floors. Although not a huge disadvantage, the person filling the open role may not be happy with their assignment.

Filling Positions

The best scenario in these situations would be to move through the hiring process quickly but that’s where you get the joys of human resources. They move at turtle-like speeds and don’t seem to understand that being short a dietitian could negatively affect patient care. I’m a fairly level headed person but bureaucracy and slow-moving people send me from zero to rage in <5 seconds.

Sure. You want to hire the right person for the job but we don’t always have that luxury. If you don’t have a dedicated PRN dietitian, then you need to get moving filling that position. I guarantee that your team of dietitians is going to appreciate having that position filled. This will allow them to take the vacation time that they’ve earned, maintain good relationships and care on their assigned units, and just create a better work environment.

My first job had horrible employee morale. We all, myself included, complained about our job. Our clinical manager always seemed bewildered but the solution wasn’t that ground breaking at all. We wanted to be fairly compensated and fully staffed. That’s all. And, if a dietitian leaves, fill that position asap.