Meet the Dietitian: Nadine van Niekerk

Inspirational Dietitians Nadine van Niekerk and Stefanie du Plessis make a huge impact in their area (Bethlehem, Free State) by going above and beyond their job description of Dietitians. They empower, encourage and equip their patients and colleagues and frequently reach the papers for the impact they are having.

We spoke to them both and decided to launch both their ‘Meet the Dietitians’ on the same day! Read on and be inspired.

 

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Why did you become a Registered Dietitian?

I had thought a lot about what career path to choose in school, and after shadowing a lot of different careers I ended up choosing dietetics. I love the science and research behind it and I was fascinated by the physiological effect of food on the human body. And I just love eating!

Where did you study (degree and/ or postgrad)?

I studied at North-West University, Potchefstroom campus and completed my B.Sc. Dietetics degree in 2010.

Where do you work and what does your job entail?

I am a dietitian for the department of health, stationed at Dihlabeng Regional Hospital in Bethlehem in the Free State.

The Hospital is Regional and caters to a large community. It offers all specialised fields of medicine, from intensive care, surgical, orthopaedic, gynaecological, paediatric, obstetric, medical and outpatient services. As the dietitian, I tend all wards rotationally and ensure all nutritional needs are met, especially in critical care, surgical and paediatric wards. I am also responsible for product selection and prescription.

What do you enjoy most about the work you do? What are the most satisfying moments?

What I enjoy most is really feeding the patients that cannot feed themselves. Critical care is my passion and I love ensuring those that cannot speak for themselves are taken care of. Ensuring our ICU discharges survivors, not victims is basically our focus and what we strive for, focusing on early effective nutrition and ensuring better outcomes.

I also love working with the premature unit and being involved in breastmilk banking and striving for a formula free unit. Breastfeeding advocate is an understatement! We make a very big deal of breastfeeding week and always try to go the extra mile when promoting. Debunking all the terrible myths around breastfeeding is a very high priority.

We also organise a big event each year to ensure more people are aware of the benefits of breastfeeding and why we are so obsessed with it. We usually use all proceeds from sales for our own lodger mothers and NICU, as the unit is so close to our hearts. This year we raised over R 5000 in the breastfeeding event, which really focused on the empowering role breastfeeding plays.

We used the proceeds for toiletry packs to improve the personal hygiene in the unit and also just to treat the moms to something nice, as we are expecting so much of them. The toiletry project is ongoing, so we also encourage anyone interested to contact us for more details with regards to donating.

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My most satisfying moments are seeing patients leave the hospital in better condition than they arrived, helping mothers reach breastfeeding goals and making a difference in people’s lives that would otherwise be unable to afford your services.

At this year’s breastfeeding event we also let mothers get the opportunity to take professional portraits of themselves in a professional studio setting by an accomplished photographer. The point was to remind all women of how beautiful they are and just to boost their confidence. The photos came out more beautiful than we ever imagined. Giving opportunities to people that would maybe otherwise not have been able to have them, is I think, by far the most satisfying aspect of my job. Government work is really what I love to do and I am so thankful that I have the opportunity to work for the Department.

What has been your career highlight?

That’s a hard one! I think this year’s breastfeeding event and all that was achieved and all the money raised is something I am very proud of. But also each year offers a new highlight, we have really also made our mark in the Hospital and are at an all-time high when looking at in-hospital referrals and ensuring no patients fall through the cracks.

 

What are the most challenging aspects of your career?

Working in Government you sometimes have to make difficult choices with regards to stock availability and you have to be flexible due to budget restrictions. I also find the Intern doctors very challenging, hahaha 😉. Having to go through the same routine each year to ensure proper referrals is often exhausting.

  • What are the three things that you think people should stop saying when they meet a dietitian?
    Oh my word don’t look at what I am eating!
    Can I quickly ask you something?
    What do you do all day in a hospital?

Meet the Dietitian: Stefanie du Plessis

Inspirational Dietitians Stefanie du Plessis and Nadine van Niekerk make a huge impact in their area (Bethlehem, Free State) by going above and beyond their job description of Dietitians. They empower, encourage and equip their patients and colleagues and frequently reach the papers for the impact they are having.

We spoke to them both and decided to launch both their ‘Meet the Dietitians’ on the same day! Read on and be inspired.

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Why did you become a Registered Dietitian?

I was interested in a career in health and dietetics was brought under my attention and I immediately knew that was what I wanted to do, especially the type of work that a hospital dietitian did.

 

Where did you study?

I studied at the University of the Free State in Bloemfontein and completed my degree in 2008.

 

Where do you work and what does your job entail?

I work at Dihlabeng Regional Hospital in Bethlehem. It’s a level 2 hospital which serves a very large community and offers a variety of services which includes intensive care for adults and neonates, surgery, medical, orthopaedics, paediatrics, obstetrics, renal as well as an outpatient department. We are 2 permanent dieticians at the hospital and we rotate between all the departments on a weekly or monthly basis. We are very fortunate to gain experience in all the different specialised fields that the hospital offers.

I am also responsible for managing the budgets for the Dietetic Department, monitoring stock levels and placing orders to ensure that sufficient stock is always available.

I also attend all management related meetings and I am responsible for all Quality improvement programs involving the Dietetic Department.

 

What do you enjoy most about the work you do? What are the most satisfying moments?

The part that I enjoy the most is definitely feeding the critically ill patients, doing a thorough assessment of their condition, calculating their nutritional requirements and choosing a suitable product. Working in the paediatric ward is also a part of my work that I enjoy a lot, especially tending to the severely malnourished babies and children. With both of these scopes of patients, it’s very gratifying to see the big difference that proper nutrition can make in a short while and see my patients going home in a better condition.

Dihlabeng is a Mother and Baby Friendly hospital so I also have a lot of passion for breastfeeding and everything that goes with it. We really strive towards enabling all mothers to breastfeed successfully before they leave our hospital. We recently had a big event for World Breastfeeding Week where the aim was to empower parents and this then leads to a mother being able to successfully breastfeed her baby and to continue at home.

All the proceeds made on the day was used for our newly established Toiletry Project for the lodger mothers in the Neonatal Intensive Care Unit. The aim of the project is to supply all the mothers with basic necessities for their stay in NICU.

Toiletry packs containing all the goodies for both mother and the baby

These mothers do so much for their tiny babies and sometimes stay there for up to 3 months (sometimes longer). We recognised the need to do something special for the mothers and that’s when the Project was born. We would like this to be an ongoing project, so anyone who is interested in donating or becoming involved in any way is more than welcome to contact us.

Furthermore, I also enjoy and appreciate the fact that we, at Dihlabeng Hospital, are able to work very well together as a multi-disciplinary team. This really makes all our jobs much easier. Especially me and my colleague, Nadine van Niekerk, we really work well together as a team to ensure that the Dietetics Department is run as smoothly and well as possible!
What has been your career highlight?

Wow, there are so many! But one of the highlights is definitely being accredited as a Mother and Baby Friendly Hospital in 2016. All of our staff put in a lot of effort and hard work to achieve this, so this was a very proud moment for us all.

And then, of course, our Breastfeeding Empowerment Day that we held for World Breastfeeding this year. It was a very gratifying experience for us as the dieticians and staff of DRH to be able to do this to show our support and dedication to breastfeeding!

 

What are the most challenging aspects of your career?

It can be challenging to plan and decide which nutritional products to order due to dealing with budget constraints, but this also keeps our work interesting.

 

What are the three things that you think people should stop saying when they meet a dietitian?

  • You’re a dietitian and you are eating that???
  • Can you give me a diet?
  • Asking about detox diets.

Diabetes in the family – It’s All for One, and One for All

 

A diagnosis of diabetes in the family comes as a shock and sets in motion a range of emotional and practical lifestyle changes. How well you come together as a family to master those changes, not only restores peace in the home, but also positively impacts on the ongoing well-being of your loved one with diabetes. Diabetes is a chronic lifelong condition but with good medical care and through education to empower more effective self-management of the condition, the potential complications can be prevented or delayed. According to the World Diabetes Day campaign which is featured on the 14th of November, it is the world’s leading cause of blindness, amputation, heart disease, kidney failure and early death. However, maintaining healthy blood glucose, blood pressure and cholesterol levels can help delay or prevent such diabetes complications.

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ADSA (Association for Dietetics in South Africa) spokesperson, Liana Grobbelaar, who works at the Centre for Diabetes & Endocrinology, points out that knowing what to eat, and how much to eat is one of the most challenging parts of managing the treatment plan of a family member. “Getting the whole family on board makes it easier for the person with diabetes to stay healthy,” she says. “It breaks the isolation that comes with being the sole member whose plate looks different, for one thing. But there’s another positive effect – everyone else can get healthier, too.”

 

The reason for this, Liana points out, is that there is actually no ‘diabetic diet’. Instead, the person living with diabetes and their family, find themselves on a journey of understanding the impact of different foods on blood glucose levels and health. “Healthy eating should be for everyone, with or without diabetes,” says Liana. “It’s actually an ideal opportunity to take positive steps to adopting a healthy family lifestyle. You can transform the negative into positive by educating your whole family to help them understand the importance of making the necessary changes, healthy choices and to be more supportive.”

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Psychologist, Rosemary Flynn also emphasises the importance of family-wide support. “The way each member of the family responds to the necessary changes influences how well the person with diabetes will accept and manage their condition,” she says. “If they feel criticised and devalued because of their condition, they can feel alienated and resentful. If they feel empathy and support from the family, they will have the encouragement to embrace their treatment management in an effective way.”

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Knowledge is power

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Understanding diabetes, its symptoms, treatment and lifestyle impacts is key for the whole family. All people with diabetes should be offered a referral for individualised nutritional education provided by a registered dietitian with experience in diabetes management.
Registered dietitians are uniquely skilled in equipping people living with diabetes with the knowledge to better understand the impact of food choices on blood glucose levels and overall health, which can lead to improvements in quality of life. A registered dietitian will take into account factors like culture, religion, age, other health conditions, medications and your finances, food preferences and family dynamics which will influence the approach that will work best for you and your family.

 

Practical tips for families with a loved one with diabetes include:

  • Choose healthier carbohydrates – All carbohydrates tend to raise blood glucose levels, but some carbohydrate sources provide nutrients important for health. Focus on high fibre carbohydrate sources such as vegetables, fruits, whole grains, unsweetened dairy products and legumes such as chickpeas, beans, peas and lentils instead of refined carbohydrates with added sugar, fat and salt. From a blood glucose perspective, the portion size of these foods is critical.
  • Eat a rainbow of vegetables and fruit – Vegetables, particularly non-starchy vegetables, contain much bulk relative to the amount of energy they provide. They also contain phytonutrients or plant chemicals that play many vital roles in the body including behaving as antioxidants (repairing the body from daily damage) and stimulating a good immune system response. Although fruits also contain these properties, they do contain natural sugars which can affect your blood glucose management, so, don’t eat fruit to excess.
  • Swop out red fatty and processed meat with healthier alternatives – Replace red, fatty and processed meat with protein-rich legumes such as beans and lentils, as well as eggs, fish and poultry.
  • Choose heart healthy fats – Fats are an essential component of one’s daily food intake. But, the type and quality of the fats you consume is vital. Eat foods rich in long chain omega-3 fatty acids or anti-inflammatory fats found in naturally fatty-fleshed fish like mackerel, pilchards, sardines, salmon, trout and herring, at least twice a week. Reduce your intake of saturated fats such as animal fats, coconut and palm kernel oils. Rather choose mono-unsaturated fats like olive or canola oils, avocado, olives and nuts. Remember that fats are a concentrated source of energy and should only be used in small amounts.
  • Treat any new foods as an experiment – test your blood glucose before and after trying out something new to understand the effect of your food choices on blood glucose levels.

Meet the Dietitian: Community service edition

By Marlize Erasmus

Every 4th-year Dietetics student experience feelings of stress, anxiety and excitement when making the decision of where to do their community service year. I googled every hospital on the list, trying to figure out where to go. I got my first choice (believe it or not) – a rural hospital (Connie Vorster Memorial District Hospital) in a small town called Hartswater in the Northern-Cape. This is where driving past cows and chickens on your way to the clinic is a daily norm.

The first time I heard about dietetics was from my grade 9 teacher when I had to do an assignment on what career to follow. I decided to shadow a clinical Dietitian in grade 11 and got intrigued by the profession. It wasn’t until my first year while studying dietetics at the Potchefstroom Campus of the North-West University that I knew I made the right choice. I realised that dietetics is my passion.

I did not really know what to expect when I started. I quickly realised that this was nothing like that perfect picture of dietetics that you have while studying. Especially when you are working in a place with severely limited funding and resources with communities in extreme poverty. This makes both spectrums of under-and-over nutrition (Obesity and Non-Communicable Diseases as well as a high prevalence of Severe Acute Malnutrition) major problems in the communities in the area.

I originally felt estranged to dietetics because working in rural is nothing like the bigger hospitals I was used to when I did my internship. Something important to know is that working in a rural hospital means there is no such thing as parenteral nutrition, fancy surgeries or certain wards like ICU or Renal. You are working with the basics.

I was not enthusiastic about community nutrition at varsity so I felt a bit discouraged when I found out that half of my time this year would entail working in the clinics. I developed a new kind of appreciation and love for working in the community. Community nutrition started to change me. It is especially in rural communities where dietitians are extremely needed. Working in the community can be challenging but the reward is sweet when you can see you’ve made a difference. I came to love going out into the community to fetch a SAM kiddie, to do outreaches and health talks and to work at a hospital alongside people who make the hard days better. I believe it was God’s plan that I got placed in Hartswater. This has shaped me into a better Dietitian and a better version of myself.

No matter at what hospital you are or what type of dietetics work you do, it is always important to realise that at the end of the day your happiness as a human being is a necessity. This is not only a year for practical experience in the dietetic profession but a year of personal growth and new adventures. Be open-minded as you step into the unknown.