Meal Rounds for Two, Headaches for All

Every clinical dietitian knows that meal rounds and test trays are a part of the job. The normal expectation may vary but I’ve typically been asked to complete 1 test tray a month and 10 meal rounds. If you’re also a clinical dietitian, you know how rarely those tasks are completed. Usually you start off with good intentions but hospital work stays busy and it falls by the wayside. Case in point, I’ve completed approximately four test trays in four years of work before my current position.

I’ve never minded doing either task although I don’t have a passion for them either. They’re simply part of being in a hospital. Honestly, I often let them fall by the wayside as well.

Until I changed jobs.

When we had the inevitable talk about needing to do both test trays and meal rounds, I asked about the expectation only to be told that our department of two people would be doing 200 meal rounds and 12 test trays.

Sure. And, while I’m doing that, I’ll also move into the office and never leave work. Okay, maybe I’m exaggerating but this workload is still a lot, especially given that we’re understaffed in general.

All of this leads to the question of why we’ve been tasked with 100% of the meal rounds and test trays. In a typical foodservice department, the food service supervisors also take on some of this work. The answer we were given is that when the supervisors did these tasks, our scores were great (>90%). When the dietitians do them, our scores are <80% on average. It doesn’t take a genius to determine what’s happening here.

Fast Forward

As always, time is a rare commodity and I’m simply not going to put in a few extra hours a day to do these. I’ve found that I’m able to do one test tray a week so our department can do at least 8 a month. I will do meal rounds with patients I’m already assessing but that averages out to ~100 a month between the two of us.

If asked why we’re not meeting our goals, I do have a realistic response ready: “I have 8 hours of the workday and I can usually see ~10 patients, attend hour-long rounds, and do tasks x, y, z. Which one of these would you like me to skip in order to do meal rounds?”* I also have several questions about whether the food service supervisors will be taking over the parts of my job where I don’t excel. I’ve always been bad about calorie counts but I don’t think the supervisors are taking on that job for me.

While it would be nice to have some closure in this area, it’s an ongoing task. We’re still not doing adequate test trays or meal rounds. I’m comfortable with the work we’re doing and can defend our productivity.