Being a NICU RD

Being a NICU Registered Dietitian is a very unique job. Lots of people don't fully understand what this job entails. Other RDs often have no idea what all goes into working in a NICU with preterm infants. As of 2013 there were 983 NICUs in the United States (reference). Out of those NICUs not all of them have Registered Dietitians. All Level IV NICUs are required to have a RD involved to help provide nutrition care for those infants. I wasn't able to find a number of Level IV NICUs in the United States, but there are not that many (maybe ~100). I spoken with multiple RDs across the country who are working in NICUs and not sure how to provide the best nutrition care to their units. Often, RDs are asked to step into this role with limited experience.  

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I just wanted to highlight what NICU RDs do and what they offer to the Multi-Disciplinary Team in the NICU. There is a misconception out there that just because babies in the NICU can't talk that somehow the care we provide as a RD is not as valuable or doesn't require communication skills?! Well that is just not the case. We work very closely with the neonatologists, the bedside nurses, the case managers, the social worker, the pharmacist, the therapists and the parents. Being able to communicate with everyone who is in involved in patient care is extremely important.

Job Tasks

  • Attend Multi-Disciplinary Rounds on a weekly basis to provide recommendations on nutrition changes for each patient. 
  • Sit up in the physician work room to serve as a resource for the MDs and the other NICU staff for nutrition recommendations. 
  • Weekly see all the NICU patients and assess growth and if nutrition plan is best meeting assessed nutrition needs. 
  • Keep track of complex GI patients to spreadsheets to monitor ostomy outputs and to micromanage those complicated patients. 
  • Put together discharge feedings plans for tube feeding and TPN home discharges. 
  • Fill out WIC scripts for families being discharged. 
  • Help to oversee and run the Formula Mixing room. Provide education staffing for those formula mixing technicians. We are working hard this year to start using a breastmilk scanning system called Timeless in our unit. Help with hiring staff and making sure they have the tools they need to do their job well. 
  • Sit on several committees and run a neonatal nutrition committee with various leaders of the multi-disciplinary team in the NICU.
  • Serve as a resource for other NICU RDs to help provide support and answer questions, because it can be a tough job and something you just need to run something past another RD. 

This is a great job because you get to work with such small patients who grow and change so quickly. I think that is one of my favorite parts of the NICU. When you make a change or adjust feedings you see changes right away.  It is a fast paced environment and things are always changing. There is nothing more satisfying than seeing a little 24 week infant who is < 1000g grow, reach full term age and then get to be discharged home. That is an amazing journey to get to be a part of!