Nutrition Professional of the Month: Annette Rugyendo

Annette works as a catering dietitian for Serco Health, providing dietetic support for five hospitals across East London. We caught up with her to find out more about her role as a dietitian working in the Food Service Industry.

Hi Annette, thanks for joining us. Could you talk us through your career journey to date?

I got into Dietetics after a change in career; Nutrition and Dietetics is my second BSs(Hons) degree, which I obtained from London Met University. During my second year of studying, I realised that I did not want to be a clinical dietitian - I joked with my colleagues that they would never have to compete for an NHS job with me! I didn’t know what I was going to do but I knew the dietetics degree was a great qualification so I was confident I would find something. In my final year, we did our dissertation, which I had been dreading. I was surprised when I found myself enjoying the investigative process, and this experience led me to pursue a career in research.

After qualifying, I went to Imperial College London, where I was part of the Nutrition & Dietetics Research Group. I worked on several projects and learned so much about research and academia. Eventually, changes in my personal life meant I needed to change the way I worked. I saw an advert for a Dietitian to work for a Facilities Management Company. I looked at the job description and I knew I had the dietetic knowledge about clinical conditions, dietary requirements, standards and recommendations. I also realised, the skills I had developed and reinforced in my previous role, skills like critical thinking, project planning, auditing, risk assessment and teaching would be perfectly transferrable to this new role! So I applied and got it and met some amazing people who taught me a great deal about food service provision in hospitals.

When the opportunity to work for Serco came along, I found the prospect of covering five hospitals a bit overwhelming, it was a real ‘feel the fear and do it anyway’ moment! My personal and professional growth whilst in this role has been immense. I have a great team around me and managers and a company that challenge and support me.

What does a typical day of work involve?

For Dietitian’s Week, I produced an infographic about my role, which I shared on Twitter (@Annette_RD) . My days are very varied, and it depends on whether it’s a site based day (where I am very involved in site activities) or an admin day. Typically, I get into work for 8-8.30am. I check my email for urgent actions (usually dietetic queries about allergens or therapeutic diets) and respond to any emails that require a straightforward answer. The rest get added to my very long “To Do” list as per priority.

If it’s a site based day, I will carry out dietetic training for catering or nursing staff or do ward audits for food service or modified texture meals. We may have received food samples to try - the catering teams like being involved in these! I attend any Trust meeting with a nutritional element to it, from the Nutrition Steering Committee to 1-2-1s with Dietitians or Speech and Language Therapists. I tend to work more closely with the leads of clinical teams; they provide input from their wider teams. If it’s an admin day, I will carry out tasks like menu planning, development of new menus, analysis of data, preparation of reports and training materials as well as attending Serco catering and leadership meetings. 

I try to leave at a reasonable hour so I can get home to at least have dinner with my children! I close my day with a final check of my emails when I am parked outside my house to make sure there is nothing that cannot wait until the morning!

How do you apply your clinical dietetic knowledge within your role? (special diets, malnutrition, obesity, ethical/cultural requirements, nutritional analysis, etc.)

I use my dietetic knowledge to review our standard menu to ensure that it meets nutritional guidelines for nutritionally-well and nutritionally-vulnerable patients coming into the hospital. I also ensure there are suitable menus for our paediatric patients. I develop and review therapeutic menus to ensure that they can meet unique requirements and support the treatment of specific conditions. I develop and review menus for those with special dietary requirements (i.e. religious and cultural menus). I am mindful of service provision for malnourished patients and look at what can be done to support their food and beverage intake. During menu review cycles I will carry out qualitative and quantitative nutritional analysis to support the new menu. 

I use my dietetic knowledge when delivering special diet and allergen training, and produce documentation to support ongoing learning. I do not do individual assessments of patients but when I am asked to see a patient regarding supporting their food and beverage choices, I refer to my dietetic knowledge. I also get involved with health promotion events for patients and staff such as Nutrition & Hydration Week or Dietitians Week.

Does your job involve multidisciplinary team working? Could you tell us more?

As a catering dietitian, part of my role is to help bridge the relationship between the clinical staff and the catering staff in a way that I can only describe as being two sides of the same coin. I work with clinical dietitians, speech and language therapists and nursing staff to manage issues at ward level. On the other hand, I work with catering staff and the leadership team on service delivery, including innovation, training and long-term planning. There are times when I must explain to the catering or leadership teams the nutritional and dietetic processes or implications of a course of action. Likewise, I explain the catering process to dietitians, including behind the extensive operational changes required to deliver a small change at ward level and the difficulties in getting a bespoke product (it isn’t like popping to Sainsbury’s!).

How can dietitians get involved with the hospital catering sector? Are there any organisations or membership bodies we can join?

The BDA has a Food Services Specialist Group, which includes dietitians working in different areas including clinical settings, catering and the food industry. The Group supports dietitians by raising our profile and promoting the importance of our role, encouraging good nutritional practice and providing opportunities for collaboration and communication. They recently peer-reviewed the BDA’s Nutrition and Hydration Digest - this is my Bible for best practice! The Digest in a great document, available online in an interactive format, which makes it easier to navigate. Check out The Digest here.

What are your thoughts on celebrity chefs advising the government on hospital food?

Their celebrity profile makes the work that they do very interesting to the public and they do have a contribution to make. There are many examples of great food service provision throughout the NHS, but these are not always publicised as (unfortunately) success stories do not make for headlines. Sadly, it seems that current service provision must be shown in a negative light. I’d question how involved the celebrities are when it comes to reviewing catering contracts or service level agreements for catering provision. Do they work collaboratively with the catering dietitians to take into consideration the therapeutic needs of patients? 

How do you maintain your CPD? Do you have a professional support network?

My CPD is considered important and I am encouraged to keep up with it. I attend courses and external study days. I also spend time with the clinical dietitians to support their CPD sessions. I also get to carry out non-dietetic CPD which I feel greatly supports my role. For example, I recently completed my Level 4 Managing Food Safety in Catering which I was super excited to pass with a Distinction! 

Congratulations! We understand that you are involved with the RD Journal Cub. What does this involve?

While I was at Imperial, myself and a couple of colleagues thought it would be useful to have a Dietetic Journal Club. We decided that having it online would allow maximum participation. More recently we have moved it to a Facebook Group as this allows us to better catalogue the learning. At the start of the year we did a poll amongst members to determine which topics we should cover. We then choose several papers based on the results of the poll.

The Journal Club team review the paper, decide on 5-6 questions which support critical appraisal of the study and application to practice, and develop any infographics that might be needed to explain the statistics. We also identify and approach a subject matter expert to provide the Expert Review. Our aim is to provide an environment where Dietitians can participate in CPD together and develop and/or practice their critical appraisal skills. We currently have over 2000 members and are growing steadily. Get involved here.

What are the most rewarding aspect(s) of your job(s)?

Seeing people smile. Whether I am running events such as Nutrition Hydration Week, speaking to a patient on the ward, running training sessions for catering or nursing staff or chairing a meeting with catering leads, being able to bring a smile to people’s faces is rewarding. We celebrated the NHS 70th Birthday by providing a selection of meals and desserts that represented each decade. I visited the wards to see how the patients were finding the celebrations and I was overwhelmed by the nostalgia our ‘Desserts Through the Decades’ produced. They triggered conversations between patients, their loved ones and catering/clinical staff. Experiences like that are extremely rewarding.

I also enjoy spending time with Dietetic Students (who are on clinical or public health placements) and educating them about the role of a Catering Dietitian. I also deliver a lecture on catering at London Metropolitan University. Feedback from students is often along the lines of ‘I didn’t know that your job was so varied and interesting!’. Catering Dietetics is so diverse and every day is different. I’m happy to shout about that!

And finally, do you have any advice to other dietitians who are interested in a career in hospital catering?

The dietetic qualification is extremely versatile. I feel that we don’t always realise our qualifications can be utilised outside the traditional clinical setting. We have an important role to play bringing our dietetic knowledge and skills to institutions such as hospitals, educational establishments, custodial services such as prisons or young offender institutes, care services such as residential or day care services and even within the armed forces.

There is no single “correct” pathway in dietetics; I have entered this field without having practiced clinically. Think outside the box and apply your dietetic skills to a non-clinical environment, use your own initiative to seek out these opportunities, be prepared to learn non-dietetic skills on the job and in turn, you will develop a strong skill set and a resilient personality.