For most of history, little information has been available on how to prepare nutritionally sound meals. Families planned their meals on the basis of what they could afford and the need to introduce some variety in the diet occasionally. In the last fifty years, however, scientists have learned more about nutrition and its influence on health. Nutritional information has been disseminated widely, and food planning has become important in the home and in institutional life. Hospitals, schools, industrial plants, and other institutions have turned to the new dietician profession for aid.
In the late nineteenth century, hospital workers were employed to teach ways of preparing food for patients, and the field of dieticians actually came into existence as an outgrowth of this early hospital work. Although the medical profession had been aware of the value of nutrition in developing and maintaining good health, the dietitian’s profession was slow to develop. The professional status of the dietitian has risen considerably during this century. The modern dietitian is trained to function in a number of specialized areas - hospital dietetics, research, teaching, writing, commercial food service, and school and college food service. In many ways, the dietitian helps to promote health through nutrition.
The dietitian’s health and safety job may vary according to the chosen area of specialization. The dietitian, in general, is trained in the science of foods and nutrition and in food service management. Various careers branch out from this basic foundation. One of the best known is the field of hospital dietetics. Here the dietitian works as part of the hospital’s professional staff, dedicated to promoting the health of the patients. In large hospitals there are opportunities for further specialization: food administration, therapeutics, outpatient clinic work, teaching, and research.
Meanwhile, the administrative dietitian, specifically trained in food administration or management, is responsible for the training and work of food service supervisors and other assistants as they prepare meals. This person, also known as the chief dietitian, helps to formulate policies of the department, enforces sanitary and safety regulations, prepares departmental budgets, and is in charge of buying food, equipment, and other supplies. This requires a sound understanding of purchasing techniques. Menus must be planned on a large scale and with a view toward the economy. The administrative dietitian tries to coordinate the work of the dietician department with that of the other departments in the hospital so that they may function effectively for the patient’s welfare.
On the other hand, the clinical dietitian, sometimes called a therapeutic dietitian, plans and supervises the preparation of diets to meet the individual needs of patients for whom physicians have prescribed a dietary requirement. This dietitian discusses each patient’s needs not only with the physician and other members of the health-care team, but also with the patient and other family members, explaining the purpose of the diet, discussing likes and dislikes, and preparing the patient for carrying on the diet at home. The therapeutic dietitian works with the hospital administration concerning policies in planning diets.
The community dietitian is usually associated with a community health program sponsored by a public or private health or social service agency. The dietitian counsels individuals and groups on proper nutrition to maintain health and prevent diseases. Special diets are planned for expectant mothers, diabetics, persons who are overweight or recovering from an illness, the elderly, and others with special nutritional problems. Families are taught how to plan and prepare meals and how to shop for food wisely and economically with the same goal of imposing health and safety jobs for everyone.
Most dietitians do some teaching to explain their particular area of work to dietician interns, nurses, and medical and dental students. Others teach on a full-time basis, usually in hospitals affiliated with medical centers. The teaching dietitian plans and teachers courses for the department of dietetics and supervises dietetic interns. The dietitian in a small hospital may well function in all of the above-mentioned areas. Each may have one professional assistant, but must delegate much responsibility to food service supervisors and others with some training and experience in dietetics. In a college with a home economics department, the dietitian may be a teacher as well as a food service manager.
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