We are UHB: Nishat Chowdrey, General Medicine and Renal Dietitian

University Hospitals Birmingham NHS Foundation Trust runs the Queen Elizabeth, Heartlands, Good Hope and Solihull hospitals.

I’m Nish, one of the dietitians working at Queen Elizabeth Hospital Birmingham (QEHB). I’ve been working at the Trust for almost a year and I’m really enjoying my experience.

I started my journey in dietetics with an undergraduate degree in Biomedical Materials Science. At the time I was unsure of my career path, but I was certain that I wanted to work in healthcare. I knew I wanted a career in a field that is fulfilling, versatile and will enable me to continuously learn, while truly making a difference to people’s health. That’s when I stumbled across dietetics, and I’m so thankful that I did!

Unfortunately, dietetics isn’t widely promoted as a career path, but it’s multi-faceted as we work in a variety of specialities with endless opportunities to learn - that’s one of my favourite things about my job. I currently work in two different specialities: general medicine, where I cover acute medical wards and elderly care; and I’m also part of the renal team, where I support patients with kidney disease and kidney failure, including both dialysis units and ward-based care. I generally work in general medicine on Mondays, Wednesdays and Fridays, and renal on Tuesdays and Thursdays.

My role, in summary, focuses on nutrition support for those who are malnourished, or at a high risk of malnutrition and I provide dietetic support ranging from a food-first approach to oral nutritional supplementation and enteral feeding (tube feeds). I work with patients to identify their barriers to eating and work with them and others involved in their care to set personal dietetic plans.

Here’s a quick look into what a week in the life of Nish, the dietitian, is like:

Monday mornings are usually busy as we have lots of new referrals which come through over the weekend, so I work with my team to prioritise our caseload for the day. I also cover an outpatient lipid clinic on Monday mornings, which aims to support those with high cholesterol with dietary advice. We have lots of dietetic students shadowing at the QEHB, so I usually have a student either shadowing the clinic or I support or train students in practicing their clinic skills.

I then have a few hours in the afternoon to see my ward patients, including patients I need to review for example, those with feeding tubes. This is where organisational and prioritisation skills are essential, to ensure patients receive their care on time.

By the time Tuesday rolls around, it is time to switch gear, as it’s a renal day. I currently see both inpatients on our wards, and outpatients, which are those who come in to the dialysis unit for their morning or afternoon dialysis session. I spend the day seeing patients for various dietetic input, which can range from nutritional support, or more therapeutic dietary advice such as low potassium, phosphate and fluid-restricted diets.

I usually work a shorter day on a Wednesday, so I have a busy morning seeing ward-based patients on the general medicine wards. As I spend most of my morning on the wards I get to catch the doctors during their ward round to discuss patient plans, which is really important to help progress their care.

As we’ve started to reintroduce visitors to the wards, I get to spend a bit more time with families. This is really beneficial, particularly on elderly care wards, as families support at meal times and are able to provide more information about a patient’s background. I also call nursing homes or care homes to gather information about new patients. I also try to catch up with our lovely dietetic assistants who review our patients that require oral nutritional supplements.

I then usually complete a ‘length of stay’ meeting, which involves reviewing notes of patients who have been in hospital for a longer duration to see if they might require some dietetic support, for example those who have lost a significant amount of weight during their time in hospital.

On a Thursday, it is back to working in renal; so I continue to see both inpatients and dialysis outpatients. I also try to use some time to do some reading or continued professional development (CPD), as I’m new to the speciality and have lots to learn.

Fridays are a full day on the general medicine wards. I try to see as many patients as I can, as well as making sure plans are put in place for patients over the weekend.

I also attend meetings such as ‘best interest meetings’, which involve discussions with patients, their families, and the wider multi-disciplinary team (MDT), such as speech and language therapists, doctors, nurse and psychologists. These meetings often take place on elderly care wards to enable collaborative decision-making for patients’ care or discharge plans.

Some weeks I’ll also try to provide some training for ward-based staff, such as healthcare assistants, to support them in identifying malnourished patients.

I try to wrap things up by Friday afternoon and complete some non-clinical work and administrative duties, such as writing GP letters for supplement prescriptions.

I’d attribute a big part of my job satisfaction to my supportive team; we help each other with our caseloads when it’s needed and we always get to have a laugh over lunch or a cup of tea in the morning! Getting to work with a friendly MDT also makes a huge difference. I’m warmly greeted on the ward by my extended team which can include nurses, housekeepers and healthcare assistants. Although it’s a busy job, it is really rewarding. I always feel fulfilled at the end of the week knowing I was able to support someone in their care and contribute to their recovery.

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