Practice Blog

To share practice related stories, create connections and engage readers in the amazing diversity of dietitian experiences.


Jack of all trades, master of none: Musings of a small town dietitian.

Laurel Leconte has been a jack-of-all-trades dietitian on Manitoulin Island for the past 8 ½ years. In her spare time she enjoys running, cooking and wearing disguises to the grocery store. She appreciates the broadened perspective that being a mother of small children brings to her dietetic practice. She would love to network with other dietitians working in similar practice situations. Email her at lleconte@mhc.on.ca.

  
If you work in a large city, I hope you don’t take for granted the anonymity you might have as a dietitian working in an urban center. You certainly don’t have that in a small town!  As a small town dietitian, it’s not unusual to be the inpatient clinician, outpatient diabetes educator, diabetes education program coordinator (for five communities) and foodservices manager (for a two site hospital). Yes, that’s me! As a result, you’re positioned in the interesting role of knowing a little about a lot of food and nutrition issues. You also get to know every person in town. They are all your patients, or friends and relatives of your patients. This means you are reminded of your respective roles and relationships everywhere you go. Here I describe just some of my day to day experiences as the Manitoulin Island dietitian.

At the Grocery store… Brace yourself before going to the grocery store. Pull down your ball cap, put on your glasses and keep your eyes glued to your list so you don't make eye contact with another shopper. Be prepared to make that person (who happens to be the guy you counselled about his cholesterol the day before) feel like he is naked. The look on his face will say it all. The fact that you might see what’s in his cart is making him feel very, very uncomfortable.  
And feel like chips or maybe some ice cream for yourself? You better have them surrounded by veggies and whole grains in your cart because you will get a running commentary from the cashier, who is also most likely one of your patients. 

Patients tattling during their appointments… In a small town everyone is related. Be prepared to have your counselling sessions derailed by patients who simply want to tell you how much worse their cousin/sister/aunt/friend’s eating habits are.  Said people are also your patients. You will be constantly on guard about maintaining patient confidentiality and to neither agree nor deny that so-in-so is also a patient.

Defending the menu… Being the jack-of-all-trades dietitian means that not only do you have to talk to your patients about healthy eating, you also have to try to implement those recommendations in a practical way by planning the hospital menu. The inpatient you had yesterday for clinical assessment is your outpatient for diabetes today.  Be prepared to be challenged by patients about your decisions.  Why did you serve me juice at breakfast when you clearly told me the whole fruit was better than the juice last week? If whole grains are good for my blood sugars, why did I get white crackers with my soup at lunch? You may spend your whole visit with a patient discussing the complexities of the hospital foodservice operation instead of their most recent A1C.

Restaurant experiences… I once went out for breakfast and literally every single patron of the restaurant was a patient I had seen within the last two weeks. I tried not to look at what they had ordered, honestly I tried not to…but I couldn’t help myself! And even though I really, really wanted bacon, I felt I couldn’t because they were also looking at my plate too. Don’t even get me started about what happens when I might want to go out to the one and only bar in town for a drink on a Saturday night!

Sheesh. Small town dietitian problems. But it’s not all “bad”. The great thing about being the small town dietitian is the rapport you develop with patients. They appreciate seeing you at community events and knowing a little about you as a person. It makes the relationships you build with patients more rewarding and potentially more effective. They also get very attached to their dietitians! I remember how many times I heard when I first started: "You’re not going to leave us like the last dietitian, are you?” No, I’m not leaving. I’m here to stay!


Editor's Note: I love this humorous take on the life of a small town dietitian.  If you've had similar experiences, please share below!
  1. I laughed when I read this! I too am a small town dietitian...reading your article reminded me of my first trip to the Legion dance on a saturday night. The 4 ladies in the bathroom were all cardiac patients! Not sure who felt more "busted"!!
  2. Hi Everyone, thanks for the awesome feedback. Seriously heartwarming! I just wanted to clarify...I'm actually not THE Manitoulin Island dietian...just the only one at the hospital. I am lucky to have 5 other full time RD's on my Island. Two work from the family health teams (covering the non-native communities) and 3 work a the Aboriginal health access centre. We network and have RD potlucks as often as we can!
  3. Laurel, this sounds like a bit of home! I'm in northern BC, but am inpatient, outpatient and diabetes dietitian all in one too. I've had people at the grocery store say loudly, "let's see what the dietitian has in her cart!" There are challenges, and "multiple relationships" galore, but overall I think it's great to be able to see patients through the continuity of care and to have a lot of variety in the job. Thanks for the post!
  4. This sounds about right! I am the dietitian for the family health team, diabetes education centre, long term care, inpatient, and food service. It is a quick way to get to know people but it can be difficult sometimes to remember what people said to you at the grocery store and what they said at your appointment that day! Speaking of grocery stores - my first week in town I had two people stop me and ask, "Aren't you the new dietitian?"
    I've only been doing it for 1 year, but I must say that I love it! You can't get this kind of flexibility in a large centre. I can choose what projects to pursue. And you get whatever holidays you want because there is no one else competing for that time off! And on top of an awesome job, you get to live in an area surrounded by some of the best outdoor areas that Canada has to offer, and there is never any traffic (unless a deer decides to stop in the middle of the road).
    I would highly recommend working in a rural, small town. It is such an amazing learning opportunity, a great opportunity to meet amazing people, and you get to introduce yourself as THE dietitian.
  5. Laurel!
    Loved this and can relate to all aspects!! I'd add to the list of having family (and extended family) walk through the door as an added struggle, as well as others checking out what my little ones are (or aren't) eating...all in good fun ;)
  6. Love this article! Totally relate to this as it reminds me of all my cherished memories in small-town Kitimat. What I loved most about working in a small town was the relationships. Instead of 6 degrees of separation, it's more like 2! Everybody knows everybody and you actually feel apart of a community. It's hard to imagine if you haven't been outside the big city bubble yet, but it is honestly overwhelming how caring and supportive people are in small towns.
  7. I can totally relate to the grocery cart :) I can't decide if it's best to have only healthy choices - but does that make me look too good to be true? - or if it's OK to slip in some chocolate bars - for our canoe trip, of course!!

    I also liked your take on Jack of all trades, master of none. When I interviewed for this position with DC as Public Affairs Manager, I used that very same line!! I've worked in every sector of dietitian work over my past 30 years - some jobs were a product of what was available, given my family choice to not be flexible to move; eventually, it all seemed to fall into place - I love my current job!! As a dietitian, practical life experiences from work and volunteering in the community can be a great asset!

    Thanks for a great post - loved it!!
  8. Hi Laurel

    I am doing the same role as you in Chapleau. I love your stories above and they are all so true of life as an RD in a samll town.I have been doing this role for 18 years ! I often hear "you can't eat that, your a dietitian" or "If Robin is eating it, it must be ok for me to eat too. "
  9. I related completely! I work in Inuvik - a town in the Arctic of 3500 people and have many of the same challenges. Great to know I am not alone.
  10. I love it!! I can soo relate. I cover 3 small communities, one of which I graduated high school from, so you also get to counsel past highschool friends and enemies :). The funniest moment is when a client runs up to me and my 4 year old daughter in the grocery store saying can I eat these strawberries -I couldn't remember why I saw him! Humm, are you allergic to strawberries??, high cholesterol??, nope diabetic -yup in a reasonable portion you can have the strawberries! There are joys in being a jack of all trades in a rural towns.

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