Marisue Payne, a patient at the Smilow Cancer Care Center in North Haven, discussed her eating plan with Courtney McGowan, RD, during a recent visit. YNHH's registered dietitian nutritionists treat patients with a wide variety of conditions.
"Let food be thy medicine and medicine be thy food." This famous quote attributed to Hippocrates, a physician in ancient Greece, remains relevant today, when registered dietitian nutritionists are integral members of patient care teams.
More than 50 registered dietitian nutritionists and dietetic technicians work in Yale New Haven Hospital's inpatient and outpatient areas. They manage the nutritional needs of patients with a variety of conditions, including cancer, heart disease and diabetes, and those preparing for or recovering from weight-loss surgery, organ transplantation and other procedures.
"We see patients with high acuity levels, including many with multiple conditions," said Ann Belforti, RD, director of Clinical Nutrition.
The dietitian's job can be complex because it involves patients' psychological and socioeconomic situations, as well as their medical conditions. Vinny Shamansky, RD, who works with adults on the inpatient general medicine units, has patients with uncontrolled diabetes who are also homeless.
"Under ideal circumstances, these patients could follow an eating plan to help them control their chronic disease," he said. "But it's hard to ask a person who relies on soup kitchens not to eat so many carbs."
Shamansky also works with patients with eating disorders. Depending on their stage of recovery, he might develop IV or feeding tube solutions or help them eat nutrient-dense, solid food. It can take a couple of days to months to get patients medically stable.
"These patients frequently have a lot of history behind their relationship with food that doesn't get presented until they trust you," he said. "Sometimes, I'm coaching them through meals one bite at a time."
Courtney McGowan, RD, is a certified specialist in oncology nutrition who works at the Smilow Cancer Care centers in North Haven and Guilford. She develops nutrition plans based on the type and stage of her patients' cancer, treatment side effects that can affect their ability and/or desire to eat and food preferences.
Still, she said, "every patient is an individual. Two patients might have the same disease and treatment, but they react to them differently."
Education – of patients, family members and caregivers and students in YNHH's Dietetic Internship Program – is a major component of inpatient and outpatient dietitians' work.
"There's great satisfaction when you come up with a suggestion for a patient and they come back the next week and say, 'Hey, that really worked!'" McGowan said.
