Increasing Long Term Care Dietitian Hours: A Proposal

Do you want to increase the Long Term Care Dietitian hours in your facility?

If you are the only Dietitian in your facility, you likely feel like you don’t get enough hours a week to get to all the assessments, consults, initials, MDS, care plans, and weekly family meetings done. I’ve heard this far too many times at LTC Dietitian meetings, and in my own work experience.

I’ve developed a system/presentation for ALL my CEO’s to increase my hours. I eventually worked my way up to FULL TIME in 2 Facilities from 2 days a week! If you want more hours, you need to have a great argument about WHY you NEED more hours.

Long Term Care Dietitian Hours

There is SO much for a Dietitian to do in a LTC facility, or any hospital, outpatient, inpatient, ANY setting. I’ve worked in many facilities over my career and the number 1 thing I feel every time I start is, ‘If I had more hours, I could really turn this place into an amazing facility.’

I know that Dietitians deserve SO MUCH MORE CREDIT! I’ve never met another profession that is so innovative, always trying to improve their area, and has a thirst for knowledge.

Now is a key time for Dietitians to really be bold and take a stand on the importance of our profession. This is the basis for your presentation that you NEED more hours to make a difference in your facility. Here are some do’s and don’ts of how to increase your hours in any facility.

The Do’s and Don’ts of Gaining More Dietitian Hours

  1. Do NOT start by saying you deserve more hours.

    No one in a workplace setting deserves anything, it’s earned. Your hard work will earn you more hours. The first key step is that you need to show how hard you work without complaining.

    I have worked as a Director in Healthcare twice, and trust me when I say, the complainers are not the employees that I look to promote. They are the ones I pass over for promotions.

    Your CEO/Administrator needs to know you before they will consider giving you additional time. Your reputation will also enter their office long before you do.
  2. Do NOT ask for more hours right when you start at a new facility.

    They don’t know you, your work ethic, your attendance record, your personality, how well you work with a team, if you actually know what you’re talking about, they don’t know anything about you except what your resume said.

    You need to prove that you are a diligent, hardworking, intelligent, team player type of worker. It doesn’t take long to prove this. I have found the number one way to speed up this process is to really immerse yourself in the work culture.

    Work with the Nurses, Managers, Care Aides, Educator on everything. Even if it’s small conversations throughout the day, getting feedback on residents, let the Educator know what projects you’re working on or ideas you have.

    The more people are aware of your work ethic the more word will spread on the type of person you are. Like I said, if you commit to this, it won’t take long for people to talk about you, even if you’re there 1-2 days a week to start.
  3. Compile a list of duties in your job description that you feel you cannot dedicate enough time to getting done to a high standard you expect from yourself.

    This could include: Initial nutrition assessments not being completed within 14 days of admission, monthly weight audits not being properly documented or followed up on, not being able to fully participate in a wound care team meeting/keeping up with wounds/pressure injuries, not being able to complete monthly audits, not being able to follow up with residents/family’s that call you, wanting to initiate new projects that will improve care/budget, etc.

    Come up with a list of things that you see as VALUE to your facility. Type this up into a document, with explanations beside each point about the importance.
  4. State Audits/Surveys and Provincial Standard Audits happen much more frequently now than they used to.

    Random pop in Surveyors are starting to come into LTC/NH’s because COVID ravaged us. All facilities NEED to be prepared at any time for a tough review. Have a copy of what the Surveyors/Reviewers will be auditing you on, go through it point by point and see where your section stands. How prepared are you if they came tomorrow? This is KEY.

    You should be doing this almost monthly so your facility can pass with flying colours. Fill in the survey, audit yourself, and write a detailed review on how prepared you are for an audit. Trust me when I say that when you talk about Surveys/Audits your CEO/Adminstrator’s ears will perk up. You’re now speaking their language.

    To them, acing an audit is essentially the whole point of their job. If you can appeal to them that your extra time will be to ensure that your facility is fully prepared for the audit, they will be listening. You need to show your proof of areas that need improvement. Go through the audit critically!

    If you want to be VERY prepared for an audit, click here to read an interview I did with a Surveyor!
  5. Come up with a new project!

    For example: My CEO asked me to review the Nutrition Supplement area because we were over budget for what they had projected for the year. I realized that I had never audited residents on nutrition supplements and whether they still needed to be on them.

    * Light Goes On *.

    I knew that this project would take me at least a full day, if not more to really dig into this.

    Do you have a project or audit that would be beneficial to both you and your CEO/facility? Try to think of one!
  6. Lend your expertise to the Nutrition and Food Services Department.

    Review the Nutrition and Food Services Department and look at ways that you can use your education to improve the area. Trust me, there are always ways that you can improve the area, there is so much awesome research coming out that can help.

Draft Your Proposal

Now that you’ve gone through the list above, work on a document that is very detailed on exactly why you need more time in your facility and ask your CEO/Administrator for a meeting.

Start by asking for just 1 month you’d like to work an extra day a week to work on XYZ. Explain in detail how your projects will be worth the money that they’re putting into your time. I like to have it all in writing too, your CEO/Administrator likely works better with paperwork, not just conversations. Don’t read from your document word for word, but know exactly what’s in your document. Leave them a copy of your document too so they can review it.

Know your stuff before you sit down for the meeting, you need to have confidence when you sit down, in your head feel like you’re going to get a yes. Even if they need to take time to think about it, that’s okay! But be keene, ask them for updates if you haven’t heard back in a week.

Continue the Process

As time goes on, continue this process. Ask them if there are any areas that they would like you to help in. I wouldn’t have know about the nutrition supplement budget if I hadn’t asked. Ask if there’s an area of the budget within Food Services that needs attention, offer to help work on the budget stuff.

You went to school for this, you are the EXPERT!

We as a profession need to take charge and know that we are experts in Clinical Nutrition and Food Services. Don’t be afraid to get involved with other departments, especially food services, the more experience that you can get the better. You may be the Clinical Dietitian, but you know food and nutrition as well.

Drop a comment below or send me an e-mail if you need any more advice or would like me to review your proposal!

Michelle saari dietitian
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Michelle Saari is a Registered Dietitian based in Canada. She has a Master's Degree in Human Nutritional Sciences and is a passionate advocate for spreading easy to understand, reliable, and trustworthy nutrition information. She is currently a full time online entrepreneur with two nutrition focused websites.

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