Growing up, Becky Blake enjoyed cooking and was interested in healthy eating. So when her mom suggested that she become a dietitian, she heeded the advice.

"Good nutrition impacts healing and helps shorten a patient's hospital stay. I like knowing that I'm making a difference in people's lives," says Blake, a clinical dietitian at St. Joseph's Hospital, a member of the HealthEast Care System.

Nutritional Assessment

Every day, Blake sees 10 to 15 inpatients with nutritional risk factors that could compromise their care or lengthen their hospital stay. Such patients might include a leukemia patient who is undergoing chemotherapy, a frail elder who has been losing weight or an unconscious person who is unable to eat.

Blake's assessment takes into account the patient's current height and weight, recent weight gain or loss, allergies, use of herbal supplements, and ethnic or religious preferences. If she determines that the patient has difficulty chewing or swallowing, she makes a referral to a speech therapist. She also checks lab values such as cholesterol, blood sugar level and kidney function.

Care Plan And Follow-Up

After assessing the patient, Blake develops a nutritional care plan. For an undernourished patient, she recommends frequent snacks or nutritional drinks. For a leukemia patient, she plans a diet to offset the unpleasant side effects of chemotherapy. And for a patient who must be fed through a tube or an IV, she calculates the right amount of fluid, calories and protein.

Once the plan is put into action, Blake follows the patient's progress. She confers with physicians, nurses and other members of the care team to determine whether changes are needed. When the patient is ready to go home, Blake provides nutritional instruction and recommendations.

A Variety Of Work Settings

"This is a field with lots of opportunity," Blake says. She points out that clinical dietitians are needed in outpatient clinics to help patients with the nutritional management of a wide variety of chronic conditions. Dietitians can also choose to specialize in a particular area, such as nutrition for patients with cancer.

Although most dietitians work in healthcare settings, some are employed by food manufacturers and pharmaceutical companies, such as those that make products for tube feeding. Others work in food service and businesses, like health clubs, that promote wellness.

Self-employment as a consultant is also an option. Consulting dietitians contract with healthcare facilities and companies. They also provide dietary counseling to individuals.

Education And Outlook

To be licensed in Minnesota, dietitians must hold a bachelor's degree in dietetics or food science and nutrition. In addition, they must also complete a yearlong internship and pass a national certification examination.

According to the Bureau of Labor Statistics, rapid employment growth for dietitians is expected through 2014. This will occur because of increased emphasis on disease prevention through improved dietary habits.

If Medicare coverage is expanded to include medical nutrition therapy for patients with diabetes and kidney disease, dietitians with training in these specialties should experience good employment opportunities.

Nancy Giguere is a freelance writer from St. Paul who has written about healthcare since 1995.