As a Registered Dietitian, my 26-year amazing career has been filled with incredible experiences in various specialities within the NHS and my private work.
One of the most memorable and rewarding phases was my time as a Haematology Dietitian. Serving as the lead Dietitian for the Regional Haematology Department at City Hospital, this included working alongside the Oncology team also when required. Within my role I had the privilege of caring for patients facing challenging battles with their health. Throughout this role, the focus was on addressing significant weight loss and providing bespoke nutrition support tailored to each individual’s increased needs.
This blog aims to highlight the hurdles and triumphs encountered during my time as a Haematology Dietitian.
The Complexities of Nutrition Support as a Haematology Dietitian
The patients under my care when entering the ward were mostly facing critical health conditions, Leukemia, Myeloma, Lymphoma, all cancers arising from abnormal blood or bone marrow cells. These patients often becoming extremely sick due to their treatments. Many were naturally terrified at what was ahead others were too sick to really care. A sensitive and upsetting time for patients and family members and us as a ward team worked hard to ensure everyone felt safe and supported.
My top priorty from the outset was halting and addressing weight loss, as it played a crucial role in their overall well-being and treatment outcomes. My approach involved not only working out their metabolic requirements but delving deep into each patient’s likes, dislikes, and individual responses to their treatments. Understanding their preferences, optimising the timing of feeling good or not so good, and their specific treatment regimens allowed me to develop bespoke nutrition plans.
Catering to Neutropenic Patients
One of the most challenging aspects was catering to neutropenic patients who were confined to their laminar airflow rooms. These individuals faced significant restrictions and were unable to leave their rooms during treatment. This was lonely for them but essential to reduce infection risk which could kill them. Ensuring they received the correct food choices and supplements was of utmost importance, as it directly impacted their nutrition intake and recovery. This required close coordination with the catering and supplement rounds, and I worked tirelessly to ensure the patients’ nutritional needs and likes were met.
Overcoming Unbearable Side Effects
Haematology patients often experienced severe side effects like diarrhoea and vomiting due to their treatments. These side effects made it difficult for them to consume regular meals and maintain proper nutrition. As a Dietitian, I strived to find innovative solutions and worked closely with the medical team and pharmacists to mitigate these side effects. The goal was to make meals more appealing and tolerable, giving the patients a sense of normalcy and potentially something to look forward to during their challenging treatment journey.
Going Above and Beyond: The Pursuit of Success
I was fully committed to my patients and made sure they received optimal nutritional support. I persistently explored various avenues to enhance their well-being in this aspect.I explored various strategies, including creating mocktails and introducing low-volume, energy-rich choices to boost their nutritional intake. My interactions with pharmacists became frequent and productive as we collaborated to enhance the patients’ well-being through every possible avenue.
I commisioned an audit that was very successful. This was on the importance of NJ feeding and tube insertion Day 0 at the bedside of a patient booked for a BMT (bone marrow transplant). I was fortunate to be invited to various conferences to speak about the positive results including the British Society for Haematology and the Haematology Nurses Ireland conference in Dublin.
The Emotional Impact of working as a Haematology Dietitian
Working in Haematology left a profound emotional impact on me. Understandably and devastatingly not everyone survived and witnessing patients’ struggles and celebrating their victories alongside them created a deep connection and sense of fulfilment. Many individuals successfully navigated their treatments with adequate nourishment, aiding their recoveries significantly. While some patients faced tougher challenges, their resilience and determination to improve their nutrition motivated me to keep exploring innovative solutions.
Looking back on my time as a Haematology Dietitian, I am filled with pride and gratitude for the opportunity to work with these brave patients. Addressing their nutritional needs during critical periods of their lives was both challenging and rewarding. The hurdles and frustrations were met with unwavering determination and a commitment to providing the best possible nutrition support.
As I continue my journey as a Consultant Registered Dietitian, the experiences and lessons from my time in Haematology will forever hold a special place in my heart.
I have come a long way in my private practice since these days but I continue to use the skills that I learnt over these years to assist others in their struggles with mulitple health issues including gaining weight, poor appetite, recovery post-surgery, discordered eating or bouts of severe inflammatory attacks.
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