Emergency Preparedness in Dietetics during a Pandemic: Lessons Learned from an ICU Dietitian during Covid-19

Purpose: The incidence, prevalence, and chaos of the Covid-19 disease sequelae is an adverse event akin to a natural disaster or wartime creating a high degree of uncertainty and vulnerability for health care providers. This is an account of a Registered Dietitian Nutritionist's (RDN) experience on the frontlines during an epidemic providing care to patients with Covid-19. The purpose of the series of discussions was to create a live account of a frontline RDN's experience during the pandemic to develop recommendations for emergency preparedness in dietetics during Covid-19. Methods: Since the Covid-19 pandemic is causing significant hardship, loss of life, and changes in health care provider roles, particularly in the intensive care unit (ICU), we conducted a real-time job analysis of an ICU RDN in New York during the height of the pandemic in that region. Critical Incident Technique (CIT) has been gradually refined and is used for curriculum development, performance evaluation, and for the creation of professional standards in health professions jobs. To gain an in-depth understanding of the job of an ICU RDN on the frontlines during Covid-19, CIT was used an information-gathering strategy in a series of 7, hour-long meetings via Zoom, an online meeting platform. These meetings occurred during the apex of the Covid-19 pandemic in NYC from March 2020 - June 2020. Results: Covid-19 resulted in RDN decision-making that involved circumstances with a high degree of variability and uncertainty. There were several mediators that enabled the RDN to be resilient and adapt to the adversity of Covid-19 in this hospital. Conclusions: The RDN's account of her experience during Covid-19 resulted in several recommendations for ICU emergency preparedness. This account also elucidates the trauma and resilience experienced by a health care provider during Covid-19.