NTEs Summer 2020 Newsletter

registered dietitians striking a pose admin

Sam Ousey, RDN/President
Hello Summer! And yes, it will looks like Summer and feels like summer but no so much the season of activities we expect. Here at NTE, we would like to help you be creative with your nutrition summer activities! I say let’s do the 360 and be positive on change. How to deliver meals with some fun, how to beat the heat and stay hydrated. Gain a bit of weight the last few months let us help you create a wellness team. Having weight loss in the community due to depression and infection we have suggestions for that too. You see if there is a problem there is always a solution.

I have asked our team members to contribute to this Summer edition of our Newsletter to provide interesting tips on the challenges we see as Registered Dietitians!

Make Meals Fun Decorate trays … have weekly events lemonade day! Lazy days of summer. Have Dog Day Heat Change up the menus … not is the time to really consider Computerized menus. We have also created alternate menu for emergency situation such as lack of labor and decrease us of utilities. Want to get better morale with your employees start a wellness program. Hydration programs … We just want to help and make it fun. Cause we all know if it is not fun it won’t get done! Let’s unite to make it fun! Isn’t that is what summer is all about!

Summer Activities to Bring Cheer and Joy to our Residents By Sukanya Singh MS, RDN

With everything changing we also have to change our tactics to help our residents eat. We can
no longer rely on family members and outside food establishments to help our residents eat.
In light of that we need to start thinking out of the box. Here are some ways to help our facilities:

Costume Ideas
  • Someone dressed in soda fountain person and serve floats
  • Someone can dress up in lemonade makers and serve lemonade make a variety (simple, Strawberry and lemonade with Tea)
  • How about a bar tender serving Nonalcoholic beverage like
  • Someone dressed as an Ice cream man handing out popsicles.
  • Making changes to the Menu by having Special events
  • Picnic in Bed: serve picnic
  • Barbeque day
  • Candle light or themed meals decorate the rooms and send food in a elegant setting.
  • This is the time to rethink about the menu these changes are simpler if we have Electronic

Nutrition Therapy essential are happy to help you. We have created a created alternate menu for emergency situation such as lack of labor and decrease us of utilities. This package is for sale. It comes with menu items, recipes, spreadsheets and nutritional analysis. This will be a great supplement especially if you have paper menus.

Another Thing to keep in mind is to look after our employees, have huddles, family meals or start a wellness program.

We just want to help and make it fun.

Because we all know if it is not fun it won’t get done! Let’s unite to make it fun! Isn’t that is what summer is all about!

The Cook’s Shoes By David Trask RDN

It’s an unusually hot afternoon, and there is no air conditioning in your kitchen. You have to turn your fans off during tray line so the tray tickets don’t blow away. You’re already behind because no one came in to put away the delivery this morning. To top it all off, you’re wear- ing a thick surgical mask and the dietitian is watching, clipboard in hand. Your first concern is probably not checking your temperatures.

Some of us have been food service workers, but many of us have not. Are you prepared to step in and work a shift as a cook, an aide, or a dishwasher? If we are to have any credibility in-servicing people in these positions, we not only need to be competent ourselves, but we need to be aware of their barriers to success. Put yourself in their position, literally.

A cook’s first priority should be to produce a satisfying meal. It is our job to teach them how to do it safely and according to their policies. We cannot lecture them periodically and expect any significant change to occur. New habits are formed with repetition, and only under suitable conditions. Is your time better spent watching them or helping them? Model the team approach you want to cultivate in your department.

It is much easier to teach your staff new concepts when you first ensure they have an understanding of the purpose behind them. Your cooks need to understand the dangers of foodborne illness in graphic detail. They also need to believe that following policies and procedures will improve the quality of the meal. Are cooling logs being used? If a cook can- not explain why they are supposed to complete a cooling log they have little reason to do so.

So try on the cook’s shoes. If you’re wearing scrubs anyway, you might as well get them dirty. You’ll learn that every meal differs in its complexity and time required to prepare it. You’ll realize why some supervisors allow extra preparation time for more complex meals, why some substitute meals they do not feel their cooks are capable of preparing appropriately, and others step in and help when needed.    Reexamine the workflow in your kitchens and take input from the staff. Your cooks will thank you.

 We are the Glue By Paul Ladewig RDN

Much like everyone else now, I have had a great deal of time to think and ponder and read over the last 5 months. I am left surprised how much time I used to spend out of the house previous to the current pandemic. In many ways this has been good and has helped to evolve my perspective on a few things. I’ve also had some enlightening conversations with others on a topic that I find are very important. The topic is, “What is an RD and what do they do?

This question, I feel, has become very important in light of our recent events. We, as dietitians, speak with everyone in a facility and are part of a selective few that see at least a small part of everything that goes on in a building. This happens because we need to speak with nurses to care for our patients. We speak with rehab to help our patients eat. We speak with staff development to help train staff and to make sure facility staff is properly trained to give us accurate information and so on. The list of people we work in concert with is endless. It gives us a unique perspective but it also gives us a unique responsibility.

As part of the IDT team we may find that our QAPI and the requests that it makes are at times in conflict with what the facility wants. It is often frustrating to us since we are trying to help everyone out. The problem is that we are, most of the time, looking at it in a vacuum. In other words, we aren’t taking into account the challenges the building is having outside the issues we have raised.

So here are some the challenges I have run across and some that you may as well.

  • Distraction– for good reason, the nursing staff of our buildings may take longer to put through our interventions. They are all trying to keep safe and are spending a lot more time and keeping everything going.
    • Budget Issues—We may find the facility is focusing on adjusting staffing and keeping a closer eye on water usage. Buying new equipment may be a challenge. Because of the need for ramped-up cleaning and the purchase of disposables in much larger amounts, the amount of money going out in facilities is greater than 3 months ago.
  • Lack of Admissions— During the last 3 months many facilities have not been receiving as many, and in some cases non at all, new admissions but their expenses have in- creased.

With the understanding of these issues we need to remember who we are as die- titians. We Are The Glue.

We are Clinical. We are Dietary. We aren’t Social Services but we become aware of the mindset of our residents to assist them in eating and improving their quality of life. Because of this we have to find other ways to achieve our goals set out in our QAPI. When suggesting solutions for issues that we see we need to act like the glue that we are and speak with our IDT team, including the Admin. By including them in the process we get a better idea of the challenges and can work together to find solutions that work.

Creating a Safe Haven for our Residents By Nikki Andries RDN

For those residing in skilled nursing, assisted living, group homes or other extended care facilities, the world has turned completely upside down even more than it has for us. Residents living in these types of facilities have been going through some trying times. The world has shut down, mainly in an attempt to preserve the health of those most vulnerable, the majority of which live or rehab in these types of facilities. But at what cost.

By closing dining rooms, ending communal activities, stopping all visitors and field trips, many of these residents are stuck in their rooms most of the day, watching TV and not interacting with others. The only people they may see from day-to-day are their nurses and CNAs. We are attempting to preserve their health, but what about their emotional health? This is the new challenge that we are facing now. And it does not help that the TV is filled with information that can cause fear as we hear the numbers of infections and deaths rise. How do we address this? We are potentially shielding them from a virus that can lead to death, however more and more residents are experiencing weight loss, malnutrition, depression and isolation.

Just like anything else that comes our way- we adapt!!! This is the time when it is important to cultivate new ways to engage and restore quality of life. This is the time to listen to our residents and become creative on how we can bring joy to their lives. They can- not come to the dining room or activities, so have the dining room or activities come to them.

Some ideas would be to incorporate a new snack or happy hour program to come door-to-door to each room offering fluids and snacks (yummmm, ice cream sundaes) to lift morale and provide essential fluids, calories and nutrients (yes, ice cream counts). Hold Bin- go or other communal activities in the hallway with residents 6 feet apart. Organize a scavenger hunt for residents to go on a search within the facility while safely wearing masks for protection. Stream fun, uplifting films on TV and pass out popcorn (or other movie treats that may be safer if swallowing concerns are present). Decorate for holidays other than traditional ones (why do we not celebrate National Donut Day every year!?!)

This is a time when they need us the most. This will not last forever as dining rooms will open back up and visitors will be allowed back, however, things will never go back exactly as they were so it is time to help establish new habits and new procedures, ones that are safer and provide an enhanced quality of life for our residents, and in turn, ourselves.

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